Vaccinating boys with HPV vaccine is critical step forward

Dear Editor,

In 2010, as Minister of Health, I announced the HPV Vaccine Initiative. In 2011, we launched the HPV vaccine Initiative for girls 9 to 11 years old. The Initiative’s implementation was launched with a simple ceremony at the Grove (East Bank Demerara) Health Centre. I spoke at the launching. Among the persons present was the Regional Health Officer, who at the time was Dr. Karen Cummings, now the Minister in the Ministry of Public Health. Amusingly, this HPV Initiative has been launched, at least, three more times since May 2015. This week, the Minister of Public Health, Ms. Volda Lawrence announced that the HPV Vaccine Initiative will be extended to boys. This is a necessary move and I commend the Ministry of Public Health. In commending them, I urge that this announcement is not merely more talk, since the rollout of the Initiative to include boys is now, at least, three years late.    

At the time, the PPP Government invested in the HPV Vaccine Initiative because global research had shown HPV was, and is, a common virus that infects both men and women. Studies show that HPV is so common that 8 out of 10 people will get an HPV infection at some point in their lifetime. HPV infections can cause cervical cancers in women, cancers of the back of the throat, known as oropharyngeal cancer, cancer in the anus, in both women and men, and penis in men. Cancers of the back of the throat have now surpassed cervical cancer as the most common type of cancer caused by HPV. Unlike cervical cancer in women, there are no recommended screening tests for the other types of cancers that HPV causes, so they may not be found until they cause health problems. The HPV Vaccine Initiative, therefore, was more than an Initiative to stop cervical cancer. While best known as a critical strategy in the fight against cervical cancer, HPV vaccines are now seen as a potent tool in the fight against several cancers. This is why, we must spare no effort to ensure universal access to HPV vaccines for our children and other vulnerable groups.

The Minister of Public Health’s announcement that the HPV Vaccine Programme will be extended to boys is correcting a grave mis-step since this progressive move is already more than three years late from the timeline established in 2010, when I was Minister of Health. At the time, we promised HPV vaccine would become part of the immunization programme by 2011, starting with vaccination of girls age 9 to 11 years. Parents of girls 12 to 15 years old were encouraged to bring in their daughters for vaccination also. At the time, we established 2015 as the start date for extending HPV vaccination to boys between 9 and 11 years old. The announcement by the Minister that the programme will now include boys is a case of “better late than never”. 

When we outlined the details for the rollout of the HPV vaccination initiative at the Initiative’s launching at the Grove Health Centre, beginning with girls 9 to 11 years old in 2011 and including the vaccination of boys by 2015, we also announced by 2020, we would begin providing HPV vaccines for women 20 to 40 years old who did not have the HPV vaccines, which would be the vast majority of Guyanese women of that age group. Interestingly, the US started the adult women HPV vaccine programme in 2018. When we launched the HPV Vaccine Initiative in 2011 with its rollout details, the initiative was one of the most ambitious HPV Initiatives in the World.

Vaccinating boys with the HPV vaccine is a critical step forward and even though Guyana missed the original timeline of 2015, Guyana still is in the forefront of developing countries when it comes to HPV vaccines. This was an important strategic move by the Ministry of Health in its fight against cervical cancer, but since then, it is a critical initiative in the overall anti-cancer fight. Once we have universal access to HPV vaccines in Guyana, we have a good chance of reducing the incidence of cervical cancer by greater than 70% by 2030 and also to have a prevention success in the fight against other cancers.

In making the announcement, the Minister did not update the citizens of our country with the status of HPV vaccination for girls 9 to 11 years old. If the programme has been effective, the vast majority of girls between 11 and 18 years old at this time should be HPV immunized. The Ministry of Public Health needs to update the country on the HPV-status of girls between the age of 11 and 18 at this time. Does the Ministry have any data? We need to know. Guyana cannot simply be launching the programme every year without updating citizens about progress made in immunizing our children, both boys and girls, with the HPV vaccine. It is like spinning our wheels, and not going anywhere.

Yours faithfully,

Dr. Leslie Ramsammy

Former Minister of Health

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