BY DR ABIA NZELU, Secretary, Committee Encouraging Corporate Philanthropy (CECP- Nigeria)
(Presented @ coolwazobiainfo on Friday 7th of June, 2013)
What are cancer vaccines?
Cancer vaccines are designed to boost the body’s natural ability to protect itself, through the immune system, from dangers posed by damaged or abnormal cells such as cancer cells.
There are two broad types of cancer vaccines:
1. Preventive (or prophylactic) vaccines, which are intended to prevent cancer from developing in healthy people; and
2. Treatment (or therapeutic) vaccines, which are intended to treat an existing cancer by strengthening the body’s natural defenses against the cancer.
Two types of vaccines have been approved to prevent cancer: vaccines against the hepatitis B virus, which can cause liver cancer, and vaccines against human papillomavirus (HPV); and one cancer treatment vaccine has recently become available in the United States.
Implementing widespread infant and childhood immunization programs targeting — Human Papilloma Virus (HPV), and Hepatitis B — could lead to a total eradication of cancers related to these viruses in 20 to 40 years,
What is HPV?
HPV is Human Papillomavirus, the most common Sexually Transmitted Infection (STI) in the world. There are over 100 types of HPV but the 4 that cause most of the diseases are Types 6, 11, 16 and 18.
What Cancers are caused by HPV?
HPV is linked with cancers in both men and women:
- Cervix- Nearly all cervical cancers are caused by HPV
- Anus- 8 out of 10 of cancer of the anus are linked to HPV
- Vulva (the outer private part of women)- Half of vulval cancers are related to HPV
- Vagina – 7 out of 10 cancer of the vaginal cancers are HPV-related
- Penis – 1 out of 3 cancers of the penis are linked to HPV
- Conjunctiva (Covering of Eye)
- Nail bed
Please visit http://www.cecpng.org/?p=182 for further details on HPV and cancer.
HUMAN PAPILLOMAVIRUS VACCINE
Is there vaccine to help prevent HPV?
What are the types of HPV vaccines available?
At this time there are 2 vaccines available to help prevent certain types of HPV and some of the cancers linked to those types: the bivalent vaccine and the quadrivalent vaccine.
What are the differences between these HPV vaccines?
1. The bivalent vaccine prevents only 2 types of HPV (HPV-16 and HPV-18) that cause most cervical cancers, while the quadrivalent vaccine prevents the 4 most important types of the virus (HPV-16 and HPV-18 as well as 6 and 11 responsible for genital warts).
2. Although, both vaccines prevent the 2 types of HPV that cause most cervical cancers (HPV types 16 and 18), the quadrivalent vaccine also prevents cancer of the anus, vulva (female outer private part), and vagina as well as genital warts and recurrent respiratory papillomatosis (RRP)- an asthma-like condition. In fact, in Australia there was a 93 percent drop in genital warts in young women when only 85 percent of males and females were vaccinated. This suggests that the herd immunity that is protecting men is, in turn, also protecting unvaccinated women.
3. The bivalent vaccine is approved for only females while the quadrivalent vaccine is approved for both males and females
Can the 2 types of vaccine be used interchangeably?
No, if you have started one you cannot take the other.
ACCESSING THE CANCER VACCINE
Are the HPV vaccines available in Nigeria? If so, how much do the HPV vaccines cost?
Yes. Both are available in Nigeria. The drug company price for either vaccine in the United States is about $130 per dose. This cost does not include the cost of giving the shots or the doctor’s charge. In Nigeria, the bivalent one is about $50 and is more widely available while the quadrivalent one is about $100.
The good news– The drug companies have reduced the price of both vaccines to about $5. This is already being implemented in 8 countries namely: Kenya, Ghana, Lao People’s Democratic Republic, Madagascar, Malawi, Niger, Sierra Leone and Tanzania.
The bad news– Nigeria is not a beneficiary of the price reduction
The urgent appeal: We need to put our house in order! The Federal, State and Local governments of Nigeria should do more to ensure that Nigerians benefits from this price reduction.
Who gets HPV vaccine and when?
To be effective, the vaccine should be given before a person becomes exposed to HPV – usually through sexual activity. The vaccines are recommended for widespread use for girls between ages 9 to 26 years old.
The quadrivalent vaccine is also licensed for males between ages 9 through 26 years. Both are given as shots in a series of 3 doses within 6 months.
What about those older than 26? Should they get one of the vaccines?
Although routine vaccination is not recommended in those above 26 years, in those between 27 and 45, it was found that the quadrivalent vaccine is also protective.
Are the HPV vaccines safe?
Yes. They have been taken by millions of people and have been found to be safe.
How long will the vaccines prevent HPV infection?
Current research shows no sign that the protection decreases with time. Research will continue to find out how long protection against HPV lasts, and if booster vaccines will be needed.
Can a pregnant woman or breastfeeding mother take the vaccines?
Pregnant women should not get either vaccine at this time. Even though they appear to be safe for both mother and the unborn baby, this is still being studied. If a woman who is pregnant does get an HPV vaccine, this is not a reason to consider ending the pregnancy. Women who are breastfeeding may safely get either vaccine.
Do you need to be tested for HPV before getting the vaccine?
No. Testing is not needed and it’s not recommended.
Do women and girls who have been vaccinated still need cervical screening?
Yes. Females who get vaccinated will still need cervical screening.
If girls who are vaccinated will still need cervical screening, why should they get vaccinated?
Because the vaccines do not prevent all types of HPV that can cause cervical cancer (the vaccines can prevent about 70% of cervical cancers). But there are still other types of HPV that can cause changes in the cells (building blocks) of the cervix. Even though cervical screening does not keep the cells in the cervix from changing – it is needed because it can find the changes before they become cervical cancer. This means that if a woman has an abnormal cervical cancer screening result, she will have other tests done and then treatment to keep the changed cells from becoming cancer.
Can cervical cancer be prevented without a vaccine?
In most cases, yes, cervical cancer can be prevented even without a vaccine. Yearly cervical cancer screening can find changes in the cells of the cervix early, before they become cervical cancer. These changed cervix cells can then be treated to keep them from becoming cancer. Indeed, thanks to cervical cancer screening, fatal cervical cancers were almost unknown today in rich countries even before the introduction of vaccines. But the disease kills an estimated 275,000 women a year in poor countries where cervical screening are impractical and the vaccine is unaffordable.
For maximal protection against HPV- related cancers, the following measures are complementary: optimal genital hygiene, sexual discipline, quitting smoking, vaccination, regular screening, and prompt treatment if screening result is abnormal.
1. Since the quadrivalent vaccine has a wider coverage for both sexes and both vaccines cannot be used interchangeably, it is preferable to use the quadrivalent vaccine.
2. The Federal Govt should take advantage of the price reduction of the quadrivalent vaccine by the drug company to incorporate it into the NPI schedule
3. Women should undergo yearly cervical cancer screening whether they have had the vaccines or not
4. Every woman should ensure they carryout regular cervical cancer screening in addition to observing proper genital hygiene, sexual discipline and abstinence from smoking
5. Vaccination does not treat cervical cancer changes; therefore, any woman that has abnormal screening result should go for evaluation and treatment.
6. Support the CECP- Nigeria to ensure that cancer screening and treatment reaches every Nigerian irrespective of their location.
ACT! (Attack Cancer Together!)
© 2013 Committee Encouraging Corporate Philanthropy (CECP- Nigeria)