Indigenous HPV vaccine can be game-changer, say experts

Cervical cancer is second to breast cancer in prevalence among Indian women

hpv vaccine Representational image

With the Union government adding Human Papilloma Virus (HPV) vaccine in the Universal Immunisation Programme, girls aged between 9 and 14 years across the country will now be vaccinated against cervical cancer. CERVAVAC, India's first indigenously developed vaccine for the prevention of cervical cancer, is expected to be rolled out by mid 2023.

The Drugs Controller General of India (DCGI) gave market authorisation to Serum Institute of India (SII) in July this year to manufacture CERVAVAC.

Cervical cancer is second to breast cancer in prevalence among Indian women, say doctors THE WEEK spoke to. A Lancet study also identifies India as a 'high disease burden country' for cervical cancer, accounting for 21 per cent of global cases and 23 per cent global deaths. Around 60,000 deaths due to cervical cancer are recorded every year in India, say reports.

And, as per health experts, 85 per cent of cervical cancer cases are due to HPVs.

How can cervical cancer be prevented?

Cervical cancer is mostly caused by various strains of HPV and is sexually transmitted. One can reduce the risk of developing cervical cancer by vaccinating at an early age, and regular screening during adulthood. Unlike other genetically influenced cancers, cervical cancer does not run in families.

For a cancer caused by a virus, this vaccine would be a game-changer in reducing the number of cervical cancer cases, say experts.

"Vaccines that are currently available in the country are unaffordable for the common man. The Serum Institute's vaccine would be accessible and affordable to all. This decision taken by the government to prevent a cancer that is caused by a virus, unlike breast and ovarian cancers which have been found to be genetically linked, is a momentous step in India's healthcare journey,” said Dr Sareena Gilvas, gynaecologist and president of Kerala Federation of Obstetrics and Gynaecology.

Dr Arun Warrier, senior consultant medical oncologist, Aster Medcity, dismissed concerns about the vaccine. “It (efficacy of the vaccine) is proven and there is no need to worry. It has no major side-effects as well. However, the vaccine does not offer protection against all HPVs. There are different variants of this virus, and the vaccine protects only against the major cancer-causing ones. Therefore, even after taking the jab, we advise screening after 30 years of age.”

There are different variants of HPVs, of which HPV16 and HPV18 have been identified as highly responsible for causing cancer.

Said oncologist Dr C.N. Mohanan Nair, “Cervical cancer is preventable, like polio. In most European countries, cervical cancer vaccines are already in use.” Those taking immuno-suppressive drugs, undergoing chemotherapy or other medications, should consult their doctors before taking the vaccination, he said.

Centre issues letter to states

The letter issued jointly by Sanjay Kumar, Secretary, School Education and Literacy Ministry of Education, and Rajesh Bhushan, Secretary, Ministry of Health and Family Welfare, said that "The National Technical Advisory Group of Immunisation (NTAGI) has recommended introduction of HPV vaccine in the Universal Immunisation Programme with a one-time catch up for 9-14 year old adolescent girls followed by routine introduction at 9 years."

“Cervical cancer is a preventable and curable disease, as long as it is detected early and managed effectively. Most cervical cancers are associated with Human Papilloma Virus (HPV) and the HPV vaccine can prevent most cases of cervical cancer if the vaccine is given before girls or women are exposed to the virus," it said.

Awareness is the key

Creating public awareness about the disease and its vaccine is a major challenge. The Union government is planning to administer the vaccines primarily through schools. States have been asked to make necessary preparations to spread awareness among the parents through parents-teachers meetings and outreach programmes, since addressing parent's concerns about a new vaccine may be a difficult task. Stigma against STDs, too, may lead to reluctance from large sections of society.

"Generate awareness through school teachers to all parents during Special Parents-Teachers' Meeting (PTAs). Support the health team to plan vaccination campaigns in the state, excluding months of examination and holiday," the letter read.

According to the health ministry, the vaccination will be made available through government health facilities as well. "For registration, recording and reporting of vaccination numbers, the U-WIN App would be used," it said. The Centre has requested states to direct education officers in each district to support the district immunisation officers and be part of efforts of the district task force on immunisation under district magistrates.

The Union government has asked states and Union Territories to start collecting data of those eligible for the vaccination.