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'Denial of HPV vaccines will cost more lives'

By Kim Boodram

THE introduction of Human Papillomavirus (HPV) vaccines in schools is a progressive step for reproductive health in Trinidad and Tobago but withholding it would be regressive, World Health Organisation (WHO) consultant, Dr Everold Hosein has said.

Hosein, a Trinidad-born international consultant on women's reproductive and sexual health, said in a telephone interview that while all stakeholders must be consulted properly before the vaccine is introduced in schools, denying it will cost more lives in the future.

The administration of the vaccine has been stopped in primary and secondary schools following an outcry by the Denominational Board.

Some members of the Board, including the Hindu School Board and the Catholic School Board, did not attend sensitisation seminars on the vaccine prior to the Ministry of Education's approval of implementation.

The Roman Catholic Church said on Monday it was opposed to the vaccine, which is viewed worldwide as one of medicine's best weapons against cervical cancer in women, in schools within its archdiocese.

The Church has questioned the safety of the HPV vaccines for pre-teen girls.

The Catholic Education Board of Management (CEBM), supported by Archbishop Joseph Harris, said it "strongly recommends that parents of children attending Roman Catholic schools should desist from allowing their children to be vaccinated with Gardasil, pending further advice from CEBM".

The Ministry of Health has given the green light for the vaccine to be available through vaccination programmes and community centres, saying it is safe.

Hosein said yesterday the vaccine could become a human rights issue in Trinidad and Tobago if it being denied to young men and women who stand to benefit health-wise in the future.

He added that the denominational board must clarify its position.

"The notion that the vaccine will cause a sudden release of sexual energy in young men and women is as ridiculous as the notion that handing out condoms causes people to go out and have sex," said Hosein, who is also an adjunct professor of Health Communications and New York University.

"It shows a poor understanding of what causes people to have sex. Any attempt to pull back the vaccine at this stage would be highly regressive," he added.

Hosein said the fact is that boys and girl will, at some point in their lives, engage in sex and this has nothing to do with the vaccine.

The Family Planning Association of Trinidad and Tobago (FPATT), in a media statement yesterday, supported the availability of the vaccine and said it is an intervention that could save lives.

According to the FPA, statistics from the Ministry of Health show that about 123 females are diagnosed and 93 females die annually in T&T, due to cancer of the cervix.

"This situation need not happen and can be reversed with effective immunisation interventions. Research worldwide has provided evidence that HPV is the cause of 90 per cent of cervical cancer cases globally," the FPA stated.

The main transmission route for HPV is through sexual activity and it is one of the most common sexually transmitted infections. It is estimated that 80 per cent of females will contract HPV in their lifetime.

"It stands to reason therefore that this is a very important initiative in primary health care and an important component of the Ministry of Health's national policy and strategy for prevention, diagnosis and treatment of cervical cancer," the FPA said.

The association said the initiative must be preceded by "a very robust information and education campaign that would provide important information on the benefits of the vaccine and at the same time allay the fears of the man in the street".

HPV has several strains and the vaccine, as a preventative method is intended to address more specifically strains 16, 18, 6 and 11.

HPV types 16 and 18 cause about 70 per cent of cervical cancers, the FPA said.

HPV types 6 and 11 cause about 90 per cent of anogenital warts.

The HPV vaccine protects against future infection and is aimed at ensuring girls are immunised against HPV before they become sexually active.

It is not effective in those who are already infected therefore the vaccine would not completely eradicate cervical cancer within the future female population but would significantly reduce the risk of cervical cancer.

"FPATT is calling on all parents to educate themselves about the HPV Vaccine and the benefits it can have for the women of Trinidad and Tobago and to take the right course of action to have their children immunised.

"All boys and girls 10-12 should be immunised before they become sexually active. We also wish to encourage all women to continue to do regular pap smears," the media release stated.

Genital Human Papillomavirus

Genital Human Papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it. HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems. Most people with HPV do not develop symptoms or health problems from it. In 90 per cent of cases, the body's immune system clears HPV naturally within two years. But, sometimes, HPV infections are not cleared and can cause genital warts. Rarely, warts in the throat — a condition called recurrent respiratory papillomatosis, or RRP. When this occurs in children it is called juvenile-onset RRP (JORRP). Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils) can also occur. The types of HPV that can cause genital warts are not the same as the types that can cause cancers. There is no way to know which people who get HPV will go on to develop cancer or other health problems. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Health care providers can diagnose warts by looking at the genital area during an office visit. Warts can appear within weeks or months after sexual contact with an infected partner — even if the infected partner has no signs of genital warts. If left untreated, genital warts might go away, remain unchanged, or increase in size or number. They will not turn into cancer.

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