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Nov 3, 2016

HPV Vaccine to be Given to Schoolgirls in Cancer Fight

Over four thousand girls are expected to receive the HPV vaccine to help prevent cervical cancer. While Belize has one of the highest cervical cancer mortality rates in Central America, it is one of the last to introduce this vaccine as part of its national vaccine schedule.  Today, the Ministry of Health and its partners in the fight against cervical cancer and other HPV-related infections briefed the media on how this vaccine will work. They say it is not mandatory, but they are encouraging parents to give the consent for their girls in Standard Four class to receive the vaccine. While this is only for small group, the Ministry would like to see it expanded if the funding becomes available. News Five’s Andrea Polanco was at today’s press briefing:

 

Andrea Polanco, Reporting

The Ministry of Health wants to administer HPV Vaccines to four thousand four hundred school girls. While the plan is to include the vaccine in the yearly national vaccine schedule, this vaccine isn’t mandatory. Parents will have to provide written consent for their child or children to receive the vaccine.

 

Dr. Marvin Manzanero, Director of Health Services 

“The WHO suggest that we should be vaccinating girls nine to thirteen years that is before they start to have sexual life. But we had to establish a cohort as we are introducing this and based on the attendance rate that we have from schools, which is where most of the girls of this age group are, the standard four classrooms are the ones being selected to be part of this first initial phase; that is an estimated four thousand four hundred girls across Belize.”

 

Natalia Largaespada Beer

Dr. Natalia Largaespada Beer, Maternal & Child Health Adviser, MOH

“The way how we are envisioning the administration of the vaccine is that first we meet with the parents. We provide them with the information and invite them to sign the consent form. We want them to receive the information and make the decision and as Doctor Manzanero mentioned earlier, we need to document the yes or the no for the child to receive the vaccine.”

 

So, what is the HPV and what is this vaccine? The HPV is the Human Papilloma Virus, one of the most commonly sexually transmitted infections. In 2006 a vaccine was introduced to prevent some of the HPV health effects. The HPV is known to be one of the causes of cervical cancer. In Belize, people are still dying from this treatable and preventable disease.

 

Marvin Manzanero

Dr. Marvin Manzanero

“There is lots of data suggesting that we have higher rates of cervical cancer. Unfortunately, cervical cancer we are identifying in very late stages of the disease. It is not that people are coming in in the early stage. Data from last year, for example, that we have managed to capture in the BHIS,  suggest that there were twenty one cases and thirteen patients died as a result of cervical cancer last year. These are all preventable diseases. HPV is one such preventative measure that we can implement to try to curtail the number of cervical cancer cases. This is about females and even though we won’t be addressing the male situation. HPV has also been linked to some oral cancers in male, anal cancers and penile cancers; they are not that frequent, but I also think that we need to be aware of.”

 

Almost two hundred and fifty thousand dollars, funded by the Social Security Board, was used to procure around seventeen thousand vaccines.They willbe administered in two doses at the schools by medical practitioners who have been trained specially administer them. The Ministry of Health says that there will be minor side effects.

 

Dr. Marvin Manzanero

“It is two doses that will be given; one initial dose and the patient has to come back six months later to get a second dose. It is an intra-muscular injection, just like the tetanus shot. There will be an effort also to get to the out of school girls who are not in the high school setting. The average cost when that was procured it was about ten US dollars per dose. So, in getting two doses it will be twenty US dollars. That doesn’t include the internal logistics, the human resources, the needles and the cotton swabs and all those other things used to give an injection. So, on average the full two doses will cost forty Belize dollars, plus all the other costs as they come along.”

 

Dr. Natalia Largaespada Beer

“Similar like other vaccines, pain, redness, and swelling in the injection side. Some rare effects are listed, it is a huge list. They are not specific to directly link to the HPV. There are some very rare side effects with 0.05% that can also present with other conditions, not only administering HPV vaccines. But we have a surveillance system in place and parents are encouraged to report any side effect other than the most common and then an investigation is conducted to try to establish if there is any link.”

 

Alba Mendez Sosa

Dr. Alba Mendez Sosa, Gynecologist Obstetrician/Oncologist

“At this moment, our experience in the private sector, basically the side effects is minimal and it is localized in the area of the injection.”

 

Dr. Marvin Manzanero

“As I said, this is an investment.You want to see, it is almost a quarter of a million dollars. If you want to do the math with that, that is equivalent to treating six persons at the end stage of cervical cancer and that doesn’t factor in the quality adjusted life areas and all those other factors, economic factors of having lost somebody who may be at a very productive age. So, those are a lot of factors that are not in here.”

 

But just how effective will this vaccine be?  Since 2007, Countries like Australia and the US have recorded dramatic decrease in infections and genital warts within three years.  And the Ministry of Healthbelieves that Belize will see similar success. But, as it relates to cervical cancer, the effectiveness will not be evident until some fifteen or more years.

 

Dr. Natalia Largaespada Beer

“The vaccine is pretty much effective.Cervical cancer is known to be caused by HPV. We have more than one hundred and fifty different types of HPV; thirteen of them are related to cancer. Sixteen and Eighteen are what contain in the vaccine currently that we will be using, confer protection against seventy percent of the causes of cervical cancer.  We won’t see numbers falling when it comes to cervical cancer  because that is a process that takes fifteen year, ten years and if a person has an immune compromise because of conditions that they have this may shorten to five or ten years. So, it is a bit difficult to project,so we won’t see the actual reduction in cervical cancer cases until probably ten years from now. But what we will see immediately, is a reduction in the HPV infections. That will lead to cervical cancer and that is what we are looking for.”

 

But to see that reduction in HPV related infections, parents and other agencies must be onboard. A number of consultations and meetings have been held since 2015 and there will be even more sensitization meetings with parents. Ministry of Education and the faith-based schools say they support this initiative.

 

Laura Longsworth

Laura Longsworth, President, Belize Cancer Society

“It is important that parents understand that this is a cancer prevention strategy. It is not treating them for anything. It is not encouraging the children to do anything; it is part of the vaccine schedule and as such it is a public health issue.”

 

Carol Babb

Dr. Carol Babb, Chief Education Officer

“We intend to educate all girls. I mean girls and boys; everyone. We intend to do that through our Health and Family Life Education program. So, we are also going to be meeting with our curriculum unit and Doctor Beer and Miss Laura will meet with them and we will ensure that this is included; that this vaccine is included that all studentsare aware of the importance of this vaccine.”

 

Howell Longsworth

Pastor Howell Longsworth

“We are very concerned about the situation since the churches at the faith-based organizations have to deal with the reactive care of cancer. We are the ones beside the doctors and the nurses who have access to these patients. After they are sent home and there is no hope, we have to provide spiritual mentoring and help not only to the patient but the families who are waiting to see their loved ones die. So, when this came aboard it was for us of concern that we would approve such a program to be preventative; not as reactive but to be proactive in dealing with some of the circumstances.”

 

Reporting for News Five, I’m Andrea Polanco.

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