HYDERABAD: Widespread immunisation with HPV vaccines can reduce or even eliminate the impact of cervical and other cancers
What is HPV vaccine?
“Human Papilloma Virus (HPV) is the virus that is responsible for around 99% cases of cervical cancer. HPV vaccinations are given as prevention against four major types of HPV infections. The HPV vaccines are licensed for girls and women in the age bracket of 9 years to 45 years of age, administered in 3 shots. However, the ideal age for HPV vaccination is adolescence as it gives best immune system response. HPV vaccinations are ideally safe and keeps one away from the risk of developing cancer causing infections or pre-cancers which may develop into a possible cancer (especially in the cervix). HPV, being a sexually transmitted infection that gradually affects the cervix of a woman can also lead to vaginal, vulvar cancer. Widespread immunisation with HPV vaccines can reduce or even eliminate the impact of such cancers,” says Dr Sameer Kaul, senior consultant, surgical oncology and robotics and president at bcpbf-The Cancer Foundation.
Is it only for women?
“The vaccination is not only restricted to girls and women, but boys should also be administered until the age of 21 years which may prevent transmission of the virus among women. There are various types of HPV which are linked to other cancers such as throat, mouth and oral cancers.HPV vaccination is likely to provide protection and helps in prevention of these cancers too,” adds Dr Sameer.
What are the types of HPV vaccine available in India?
“Two vaccines licensed globally are available in India — a quadrivalent vaccine (Gardasil™ marketed by Merck) and a bivalent vaccine (Cervarix™ marketed by Glaxo Smith Kline). Vaccination is the best form of prevention currently,” says Dr Jyoti Kankanala, senior consultant obstetrician and gynecologist at Continental Hospitals.
Dosage and age:
“The vaccine dose is 0.5 mL given intramuscularly, either in the deltoid muscle or in the antero-lateral thigh. The recommended age for initiation of vaccination is 9-12 years. A total of three doses at zero, two and six months are recommended with Gardasil™ or zero, one and six months with Cervarix™. There should be minimum interval of four weeks between the first and the second dose, 12 weeks between the second and third dose and 24 weeks between the first and third dose. HPV vaccines can be given simultaneously with other vaccines such as Hepatitis B and Tdap. If the HPV vaccine schedule is interrupted, the vaccine series need not to be restarted. If the series is interrupted after the first dose, the second dose should be administered as soon as possible, with an interval of at least 12 weeks between the second and third doses. If only the third dose is delayed, it should be administered as soon as possible,” adds Dr Jyoti.
Cost: HPV vaccine is easily available in Hyderabad. The cost of each dose ranges from `2,500 to 3,500.
Are there any side-effects?
The most common adverse reactions are local reactions like pain (mild to moderate) in 83%, swelling with erythema in 25% and systemic adverse effects such as fever in 4% of the vaccines. Rare serious vaccine-related adverse events have been reported. The vaccine is not recommended for use in pregnant women Lactating women and immune suppressed female patients can receive the vaccine. The efficacy and the degree of immune response could be poor in the latter group.
Burden of cervical cancer in India
According to the recent data provided by Globocan 2018 India Factsheet, cervical cancer is the second most common type of cancer accounting for around 22.86% cases of all cancers among women. It is also estimated that one woman dies of cervical cancer every eight minute in India. As per the records, over 96,000 new cases of cervical cancer have been registered last year with around 60,000 casualties. Though the average survival rate without treatment is less than 50% for 5 years, timely vaccinations and regular screening can produce better outcomes and improve the quality and survival of life.
(As told by Dr Sameer Kaul from bcpbf-The Cancer Foundation)
— Kakoli Mukherjee