Protect our teenage girls

AFP Relaxnews

WITH cervical cancer being the most preventable cancer worldwide, there is no reason to deprive teenage girls of a means of protection. About 560,000 girls in Malaysia were not provided with the human papillomavirus (HPV) vaccination in schools, and are at a much higher risk of cervical cancer than those who were.

Upon receiving enquiries from concerned parents and organisations, the National Cancer Society Malaysia (NCSM) carried out a survey across secondary schools in Malaysia. After identifying all districts in Malaysia, one secondary school was randomly selected from each and contacted. Teachers in charge of the vaccination programme were asked if the school had successfully carried out the HPV immunisation programme in 2020, 2021 and 2022.

Our survey shows that the Malaysian HPV Immunisation Programme – implemented since 2010 – has been halted since 2020. This has resulted in at least 360,000 13-year-old girls missing their HPV vaccinations in 2020 and 2021.

Human papillomavirus infections are the main cause of cervical cancer – the third most common cancer among women in Malaysia. Individuals infected with HPV are at risk of developing a pre-cancerous lesion called cervical intraepithelial neoplasia, which subsequently develops into cervical cancer.

HPV vaccines, by protecting individuals from 90% of HPV-related cancers, are the main preventative measure worldwide against cervical cancer.

Since 2010, the Malaysian government has implemented a national school-based HPV immunisation programme, in which two doses are given six months apart. This is in accordance with the global recommended dosage, in which two doses are required for individuals vaccinated before age 15, and three doses for individuals vaccinated after age 15.

Through this programme, HPV vaccines have been provided to 13-year-old girls in Malaysian secondary schools. Based on Health Ministry reports, about 250,000 individuals – 85.8% of this cohort – are vaccinated each year. Based on these statistics, NCSM estimates that 200,000 individuals from this cohort would have missed their HPV vaccination in 2022.

Our results show that, overall, most states did not report having carried out a comprehensive HPV immunisation programme in these years.

The districts surveyed in Labuan, Perlis and Putrajaya did not report conducting any HPV vaccination programmes; Melaka reported having conducted the programme in 2020 but not in 2021 and 2022; Kedah, Perak, Penang, Johor, Selangor, Negri Sembilan, Pahang, Terengganu, Kelantan, Sabah, Sarawak and Kuala Lumpur did not report conducting full HPV vaccination programmes from 2020 to 2022.

This situation is not exclusive to Malaysia – the Covid-19 pandemic has shifted the world’s focus to acute communicable diseases. A study in the United States estimated that the disruption to the HPV vaccination programme there would lead to 132,000 more cases of cervical intraepithelial neoplasia over the next 50 years, and up to 6,487 more cases of cervical cancer over the next century.

We must act on this now. We urgently request that the government restarts HPV vaccinations for 13-year-old girls in Malaysian secondary schools, and implement a catch-up programme for those who missed out from 2020 to 2022.

Apart from saving lives, restarting the vaccination programme is also cost-effective, as three doses – rather than two – will be required for individuals over the age of 15. Protecting individuals against cervical cancer also leads to fewer healthcare resources spent on treating and managing cervical cancer in the future.

Catch-up programmes for HPV vaccination have been carried out before, in which the MyHPV programme vaccinated single or unmarried women born between 1992 and 1996 for free in 2019.

The cost for the HPV vaccination programme should be allocated as part of Covid-19 recovery efforts under the 2023 Budget.

NATIONAL CANCER SOCIETY MALAYSIA (NCSM)