(TRINIDAD GUARDIAN) — The Gardasil vaccine, one of the two vaccines used in the prevention of the Human Papilloma Virus (HPV), which is the primary cause of cervical cancer, is only utilised by five to six per cent of T&T’s female population at public health centres and hospitals.
This was worrying according to T&T’s lead gynaecological oncologist Dr Anthony Pottinger, particularly because cervical cancer is the second leading cause of death among women in T&T.
He said T&T had a very high incident rate of cervical cancer and this was being “downplayed.”
He even dismissed the official statistics from the Cancer Registry, which currently indicates a rate of 29 per 100, 000 cases, claiming he knows for a fact, this figure has doubled.
“With the number of cases I deal with on a daily to weekly basis, in my practice alone, I know this figure has to be inaccurate and needs to be updated,” he said.
Asked what he thought might be the reason for women still not accessing the vaccine, Pottinger said, the way in which the vaccine was introduced to the public nearly nine years ago, might be the cause. He said prior to the introduction of the vaccine there were no education or awareness drives to sensitise the public.
“Before the vaccine was rolled out, there should have been a massive nationwide education drive, at least for two years in advance to raise awareness and to sensitise the population. There should have been visits to schools, hospitals, clinics, and communities, but this was not done. So I believe it is very little, people know about the vaccine,” he reckoned.
Pottinger was speaking to Guardian Media on the occasion of Cervical Cancer Prevention Week, which will be observed from January 21-27. The entire of January is also noted globally by the United States Congress as Cervical Health Awareness Month.
Additionally, Pottinger who has done thousands of life saving surgeries in his practice, also argued the Ministry of Health needed to switch fully from the Gardasil vaccine, the primary one publicly available, to the Cervarix vaccine, which he says is the better one, as it guards against the two more dangerous HPV strains—HPV 16 and 18, which cause around 70 per cent of cervical cancer cases.
There are two vaccines that protect against the various HPV strains- Cervarix, used in the UK, blocks HPV 16 and 18; whereas Gardasil protects against strains 6, 11, 16 and 18. The strains 6 and 11, are which cause most cases of genital warts, which are not life-threatening, but can pose various health challenges.
Pottinger explained since its discovery, there have been known to be at least 200 types of the HPV virus existing. One hundred of these different types he said, infect animals and 100 infect humans. Out of the 100 that infect humans, 30 can cause infections in the genital and anal region. And out of these 30, 15 are oncogenic–cancerous. Of these that cause cancer, Pottinger reiterated roughly 70 per cent of cervical cancer world-wide is due to infections of HPV 16 and HPV 18.
HPV 45 and 31 make up another 10 per cent while HPV 33, 35, 52 and 58 make up a following ten per cent.
“Again, of all the types mentioned, HPV 16 and HPV 18 call for more concern if one is diagnosed with either of the two,” he warned.
It is with this fact, he insisted, the Ministry of Health needed to work fast on making the Cervarix vaccine available at public healthcare institutions. Pottinger said oppose to Cervarix, the Gardasil vaccine does not produce as many antibodies, not even one third as much of the antibodies in Cervarix, which are far superior.
He revealed, for all the people who were vaccinated with Gardasil, within five years of the shot, for as much as 35 per cent of them, the antibody levels would fall below the level that does not protect against the HPV strains that cause cervical cancer. And after eight years it falls at even lower levels in 15 per cent of those people vaccinated, whereas with Cervarix there is a lifetime assurance.
Pottinger was also quick to dismiss the fallacy that the HPV vaccine was only for women, he said men should also be vaccinated as they can transmit HPV through sexual intercourse.
He also addressed another mistaken belief that the vaccines could only be taken before a particular age. Pottinger said there was no specific age that disqualifies a woman from getting the vaccine as has been rumoured. (According to the Centre for Disease Control and Prevention (CDC), all children who are 11 or 12 years-old should get two shots of HPV vaccine six to 12 months apart. Adolescents who receive their two shots less than five months apart will require a third dose of HPV vaccine.)
“All women with the Gardasil can go as far as 45-year-old. The people between 30 and 40 who get vaccinated, the zero conversion rate is like 100 per cent, meaning that everybody will produce antibodies,” he explained.
He claimed even today, doctors as well the public health centres continue to irresponsibly inform women that if they pass the age of 25, they cannot be vaccinated.
“I want everyone to know this is not true, as studies have shown that with Gardasil women can go up to 45 -years- old and 55 with Cervarix.”