Cervical cancer vaccination: Up to parents

Star: KUALA LUMPUR: Parents will be given a choice to allow their daughters to be given anti-cervical cancer vaccination that will begin next year for secondary schools girls aged 13.
Those who agree need to sign a letter of consent, said Education director-general Tan Sri Alimuddin Mohd Dom when contacted regarding the Human Papilloma Virus (HPV) vaccination programme that was announced by Health Minister Datuk Seri Liow Tiong Lai recently.
Datuk Dr Hasan Abdul Rahman, director of the disease control division at the Health Ministry, comfirmed that vaccination will only be given after getting the consent of parents.
The move is to contain cervical cancer that is the second most common cancer among women in Malaysia, after breast cancer, with 1,500 new cases each year.
“The ministry is still waiting for further directives from the Health Ministry regarding the vaccinations. We are ready to cooperate with the Health Ministry in implementation,” Alimuddin said.
Alimuddin said the ministry had not received any complaint or objection from any quarter regarding the Health Ministry’s suggestion.
“From feedback we have received many Parent-Teacher Associations and parents agree with the vaccination, and we believe the Health Ministry will study the best medicine available before implementation,” he said. Honorary advisor to the National Cancer Society Malaysia (NCSM) Datuk Zuraidah Atan supports the programme as a preventive measure.
“However, the decision by the schools to implement the vaccination programme depends on the parents. If they are aware of the importance of the vaccination as protection for their children, they should continue with it,” she said.
“For NCSM, we support fully the Health Ministry’s action to have the vaccination programme at 13 years of age. I’m sure the ministry had thought of the process before intending to implement it and the programme is really good, especially for rural students, who mostly cannot afford it,” she said.
Dr Hasan said that the decision to introduce the HPV Vaccination Programme for girls as young as 13 years old was made as that age group produced better immune response compared with those in older age groups.
At that age the girls are considered to be still naive to the HPV infection and are free from the disease, he said.
He said the Health Ministry has also had “a secondary prevention programme” since 1969, the PAP Smear Screening Programme, to help detect cancer, but the response has not been satisfactory.
“The acceptance rate is however not very encouraging as shown by the National Health Morbidity Survey III (2006) which indicates that only 43.3% of women aged 18 and above ever had a PAP Smear.
“The Penang Cancer Registry Report 2004 has also reported that 75% of cervical cancer cases are detected at late stages,” he said.
He said based on research done by Prof S. AlJunid of Universiti Kebangsaan Malaysia, results showed that prevention of cervical cancer by vaccination was cost effective.
It was estimated that the cost of three vaccination doses was RM400 compared with RM235,000 for a lifetime of treatment for cervical cancer.
“Thus it would cost approximately RM360mil to treat 1,500 newly diagnosed cervical cancer cases every year,” said Dr Hasan.
Dr Hasan said many factors contributed to the onset of cervical cancer, usually closely related to HPV infection, and the risk of getting infected got higher with increased sexual activity.
He said the impact from HPV vaccination can only be seen in the long run, between 15 and 20 years, as benefits from the vaccination will reduce any side effects as well as prevent premature deaths among women who were in their productive years.
The World Health Organisation (WHO) estimated the 13 types of HPV could trigger cervical cancer with HPV types 16 and 18 causing 70% of cases.
Dr Hasan said the estimate was consistent with the situation in Malaysia where 74% of cases were caused by those two types of HPV.
On the death of a teenaged girl in Britain after being vaccinated, Dr Hasan said: “There is no increase in the rate of the documented adverse events reported due to HPV vaccine.
“There was also no convincing evidence between HPV vaccination and the deaths reported,” he said.