HPV Vaccine Against Cervical Cancer
Although not drastically, the number of teenagers who have received a HPV vaccine has still increased, indicate the statistical data of the Kumanovo Public Healthcare Center. In the first half of the year, approximately 400 girls have protected themselves with vaccine against cervical cancer. A slight rise in the number of vaccines against the Human Papillomavirus has been registered nationwide, too. The overall increase throughout Macedonia amounts to 53.3%, but it needs to be stressed that in some bigger towns, such as Bitola and part of the Skopje municipalities, this percentage is 6 or 9, while in the smaller towns like Kratovo, Delchevo, Vinica, and Probishtip, it is 100%. The percentage in Kumanovo is 60. Doctors explain that the prophylactic HPV vaccine is most useful in medical terms if administered to the young population before contracting this virus, that is, boosting their immune system before they become sexually active. The mandatory HPV vaccination was introduced in Macedonia back in 2009.
The Human Papillomavirus, HPV, is the most frequent sexually transmitted virus that attacks the skin and the mucous membranes on various parts of the body. It affects both men and women equally. It most often affects young people who are sexually active. Many people infected with HPV may show no signs or symptoms, but this virus is transmitted through sexual intercourse. So far, more than 130 different strands of HPV virus have been detected. The high-risk genotypes 16 and 18 are responsible for more than 70% of cervical cancers and pre-cancerogenic lesions – CIN 2 and 3, as well as anogenital cancers. The low-risk genotypes most often cause genital condyloma in the external genitals and in the anal region. In 90% of the cases, these changes are related to the HPV types 6 and 11.
Cervical cancer is the second most frequent malignant disease among women worldwide, given that there are 500,000 new cases every year. Over 80% of the cases of cervical cancer and death from this disease have been registered in the developing countries. In Europe, around 65,000 people still develop cancer, while about 32,000 die annually from this disease. In Macedonia, the rate of the newly-registered cases of cervical cancer is higher than 22.5 to 100,000 residents.
The vaccine is recommended for girls aged 9-26. It has been introduced as a compulsory vaccine in Macedonia for girls older than 12 and it is administered in the vaccination services of the healthcare centers. The vaccination takes places in schools or the vaccination services in compliance with the prepared vaccination plans.
“There is lower interest in vaccination in the central Kumanovo schools, while in the rural areas and the suburbs it is nearly 100%. You yourself know that this is due to the strong anti-vaccination campaign that has been going on for a decade, not only against the HPV vaccine, but against vaccination in general. The first dosage that is administered in schools among 12-year-old girls covers 64.7%, while the second dosage, which is administered after six months, covers 59.8%”, the Public Healthcare Center epidemiologist, Dr. Jadranka Stamenkovska, says.
Healthcare Center officials say that, at the beginning, there was almost no interest in this vaccine, despite the doctors’ and the relevant institutions’ appeals.
“Sometimes, the girls refuse to receive the vaccine at school, but their parents then change their minds and vaccinate them. In Kumanovo, the vaccination is taking place at the ‘Tode Mendol’ outpatient infirmary. Some people, those who go work in Germany, have already been informed that this vaccine is not free-of-charge in the Western European countries, so they have decided to vaccinate their children with this vaccine, which is compulsory in our country”, Stamenkovska says.
As for the safety concerns, the doctors explain that, according to the World Health Organization reports, more than 50 million doses of this vaccine have been administered and there have been no side effects during the tests and the vaccinations. Studies show that it is efficient for 5 or 5.5 years and up to 10 years when it comes to immunogenicity. It has been recommended by the medical and doctors association in more than 120 countries. The Kumanovo doctors call on the girls to be vaccinated on time, adding that screening tests of the cervix (regular gynecological controls and PAP tests) need to be done, too, as secondary prevention.