By SEAN DOUGLAS Friday, June 22 2012

PRE-TEEN girls will be offered a vaccine against the cancer-causing Human Papiloma Virus (HPV) from November, said Health Minister Dr Fuad Khan, at yesterday’s post-Cabinet news conference at the Office of the Prime Minister (OPM), St Clair.

The measure could protect them later in life from cervical, anal and oral cancers, he said, and has long been lobbied for by local gynaecologists.

Two local gynaecologists polled by Newsday were yesterday unanimous in their praise of Khan’s proposal.

Khan said from November, his Ministry would start a programme to offer doses of HPV vaccine to young girls on a voluntary basis. Khan said 66,000 vials of vaccine would be brought over 2012 at a cost of US$14.60 each, for a total cost of about TT$6 million, which is a reduced cost obtained by acquisition through the Pan American Health Organisation (PAHO).

He said the vaccine was a “novel idea” to combat cervical cancer which is a very debilitating disease that can lead to kidney failure and uterine damage. “Hopefully in the next 10 or 15 years we will see a decrease in cancer of the cervix in Trinidad and Tobago,” he said.

Such vaccination has been requested by local gynaecologists and certain members of the public, and has been discussed at length by Cabinet and the Ministry of Gender Affairs, he said. “Cancer is a very real problem,” he warned, “abnormal growth in a normal organ”.

Khan, in reply to queries, said World Health Organisation (WHO) data showed that globally cervical, oral and anal cancer together made up 18 percent of all cancers.

“The incidence is high but what has happened over the years is that the stage three cancers have been decreasing but stage one and two are high, the early detection cancers.” He said TT is affected by HPV strains 11, 16 and 18, which will be remedied by the use of the HPV vaccine known as Gardasil.Khan vowed to very soon launch an educational campaign on the HPV vaccine, pending the required Cabinet note. “There is going to be a very strong media campaign for all the cancers...Cervical cancer will be the foremost cancer, however oral cancer, urino-genital cancers and urino-genital warts we will be speaking about that in the campaign also.” He did not have data on the gender breakdown of anal and oral cancers in TT.

“We will not be forcing anybody to do it. We are going to educate the population. We are going to deal with informed consent and it’s going to be a volunteer programme, by the parents on their daughters. However, may I seek this opportunity to say that (for) pre-pubescent girls there is a higher efficiency of prevention, as compared to those who have become sexually active....”

He said that while recent studies have shown the vaccine can be given to older girls who are sexually active, its efficacy drops. Asked the ideal target age to give the vaccine, he said, “Just the SEA (Secondary Entrance Assessment) time. The SEA level.” That is, age 12 years.

He confirmed the Ministry, PAHO and WHO had all properly assessed the issue of vaccine side- effects. Pressed, Khan said the vaccine would only be offered if both parents and child agree, saying, “We seek informed consent from the parents. From the minor, they must be aware of what the vaccine is, and be educated on the vaccine and you can opt not to do.” He said there is documented evidence of the vaccine’s efficacy and side-effects, the latter which he said were not life-threatening. Khan confirmed that HPV vaccine recipients would be monitored.

Gynaecologist, Dr Spencer Perkins, told Newsday the move was “an excellent idea”. He said the inoculation targets persons vulnerable to the HPV viral strains. While the vaccine is costly, he said its use is excellent.

“It is done to try to reduce the incidence of cancer,” he said, noting that apart from cervical cancer in females, the HPV can also cause anal and oral cancers. Asked if it should also be given to boys, as now mulled in developed nations, he replied, “I expect it eventually will.”

Another gynaecologist, who did not wish to be named, said the HPV inoculation was a good idea, to combat cancers that harm women. “It is not a licence to have sex, but a measure for the prevention of a tumour,” the source said. “It is a good idea, especially in a country where there is so much promiscuity and where girls are having sex at a younger age.”

The gynaecologist said that for the past several years, some doctors in private practice have already been offering their patients the HPV vaccine.