Why the Ministry of Health must vaccinate Jamaican Boys and Girls against the Human papilloma virus

Who knew vaccinating schoolchildren could stir up so much problems in Jamaica.

I am of course referring to mass vaccinations of grade seven for HPV (human papillomavirus vaccine) by the Ministry of Health as reported in the article “Ministry To Roll Out HPV Vaccine Amid Backlash”, published Saturday September 30, 2017 by Jodi-Ann Gilpin, The Jamaica Gleaner.

Health Minister Dr Christopher Tufton as assured everyone that the girls are safe and they are not guinea pigs to test the vaccine before rolling out nationwide to girls in all grades, quote: “The ministry is not going to embark on anything that will put the population at risk - certainly not our young girls. This is not a trial-and-error programme and we are not using our people as guinea pigs. We are not trying to prove anything to the world, population or any pharmaceutical company or big-money interest. It is a tried and proven approach and a science that is intended to make our population healthy as it relates to the risk of cervical cancer”.

There are about 22,338 girls in Grade 7 based on 2016 entry data from the Ministry of Education.  So what really happened.

Ministry of Health and HPV Vaccinations – Ministry of Education call for halt of program

The Ministry of Health had begun vaccinating girls more than 20,000 grade seven girls islandwide on Friday 29th October 2017 as reported in the article “More Could Have Been Done, Tufton Says Of Controversial HPV Exercise”, published Tuesday October 3, 2017, The Jamaica Gleaner.

So far only four high schools volunteered their Grade 7 as guinea pigs:

1.      Oberlin in west rural St Andrew

2.      Papine in eastern St Andrew

3.      Titchfield in Portland

4.      Happy Grove in Portland

Ministry of Health Dr Christopher Tufton reported only 309 females received the vaccine, while 21 said hell no. On Tuesday October 3, 2017 Grade 7 girls at the following schools were on the schedule to receive the HPV Vaccine:

1.      Westwood High School in Trelawny

2.      Muschett High in St James

3.      The Queen's School in St Andrew

So that's a lot of guinea pigs to keep track of, making this a mass experiment if it really was.

So concerned expressed by the Administration of several schools were voiced to the Minister of Education Minister Ruel Reid, as noted in the article “HPV Vaccine Programme Leaves Some School Admins Disgruntled”, published Tuesday October 3, 2017 by Jody Ann Gilpin, The Jamaica Gleaner.

This as many school administrators called for a halt to the program and for more knowledge to be decimated to school administrations about the logistics of the programme, the benefits and reasons behind the initiative.

So if this HPV Vaccine offers protection against Cervical cancer, why all the noise about mass vaccinations intended to protect Grade 7 girls from contracting the disease?

HPV and Cervical cancer - Boys should also be vaccinated it causes Penile and prostate cancer

Cervical cancer is the second leading cause of cancer-related deaths in women. It is caused by a virus, the HPV (human papillomavirus) and curiously, is a multi-vector disease.

This as it is transmitted as follows:

1.      Sexually transmitted

2.      Skin-to-skin contact

Basically, you can get the virus via contact with sex or body fluids, a lot like the common cold. Infection occurs at age 25, with 80% of sexually active individuals contracting the disease. Three variants of HPV exist:

1.      Type 16 and 18 account for 70% of cases of cervical cancer,

2.      Type 45 and 31 the next most

3.      Type 6 and 11 cause genital warts

For young men thinking that this is a female disease, think again. HPV also causes penile cancer.

Which is why there is now a push for boys to also as noted in the article “Broaden HPV Vaccination To Schoolboys”, published Friday October 6, 2017 by Paul Jennings, The Jamaica Gleaner.

This as the disease is not really gender specific, as it can be spread by boys to girls and it can cause prostate cancer in males as noted in the article “HPV and Men - Fact Sheet”. Truly troubling though, is the fact that in both men and women, HPV has no signs or symptoms, and some persons never develop HPV problems.

Of the 80% of sexually active individuals that contracting the disease, only 20% develope precancerous cervical lesions, which, if left undetected, become cancerous. Again all to like the common cold; many contract it but few may show signs if they have a strong immune system.

In Jamaica, HPV results in 30 cases for every 100,000 persons, second only to Breast Cancer but higher than the infection rate in Cuba, which has fewer than 10 for every 100,000 persons.

So is this disease preventable?

Pap Smear and HPV Vaccination - After sensitization campaign both Boys and Girls need to be vaccinated

The answer is yes; The Pap Smear along with the HPV Vaccine is the key to prevention.

HPV is indeed preventable but early detection is necessary via having women do a Pap Smear test.  Pap Smear detects the changes in cervical cells caused by HPV. This simple, yet necessary procedure detects changes in the cervical cells before they get to a precancerous stage.

For women it is usually done between the ages of 21 and 65 years and should be done every one to two years. Even after vaccination, it still has to be done to see the vaccine has boosted the immune system enough to prevent cervical cells reaching the precancerous stage.

Vaccinations are given in three doses over a six-month period.  It prevents the developement of HPV into cancer in 90% of those who are infected by the HPV virus. The Pap Smear occurs later in life, the vaccine is best done before the girls become sexually active, which is at age 10, around the same age as the 22,338 girls in Grade 7 based on 2016 entry data from the Ministry of Education.

However, it can still be given after being sexually active, and after having HPV. It works by giving the immune system a weakened version of the HPV to defeat, thus allowing it to learn how to deal with the active HPV and thus prevent it from invading the body's cells to do damage.

This is where the issues comes in for parents, as the current policy stance by the Ministry of Health stigmatizes Grade 7 girls, possibly making them feel embarrassed if it is not fully explained why they are being singled out. Still, the effects of the HPV vaccine are expected to be very mild according to Acting Director of Family Health Services at the Ministry of Health, Dr Melody Ennis, quote: “Adverse effects are very mild. You are going to get a little redness, you are gonna get some swelling, you are going to get fever, possibly, but no severe reactions have been identified”.

Despite fears, one fear has already been alleviated; no long lines albeit the vaccine might make you dizzy as pointed out by Dr Melody Ennis, who addressed a media forum held at the Pan American Health Organization offices in St Andrew on Saturday September 30th 2017, quote: “It's not a case where students are going to be in long lines and persons just stick them, we have made special provisions. They must be seated, they must be observed for at least 15 minutes, and efforts must be made to ensure that they don't fall”.

It is not yet mandatory as noted by Health Minister Dr Christopher Tufton in the article “Ministry Not Ready For HPV Vaccine To Be Mandatory”, published Monday October 2, 2017 Jodi-Ann Gilpin, The Jamaica Gleaner.

But if it becomes mandatory, after a proper sensitization campaign as requested by the PNP (People’s National Party) as noted in the article “Opposition Calls For Public Education Campaign On HPV Vaccines”, published Monday October 2, 2017, The Jamaica Gleaner, it should also apply to both Grade 7 boys and girls islandwide.