By Associate Professor Anne Goh
Beginning April, all Secondary 1 female students in Singapore national schools and all 13-year-old female Singaporeans and permanent residents are eligible for free HPV vaccination. Girls who are currently in Secondary 2 to 5 are also offered the vaccination as a one-time “catch-up” measure. The programme requires parents to opt-in to the programme by providing consent for their daughters to be vaccinated.
As a parent, here are some things that you need to know about the HPV vaccine and the programme to help protect your daughter against cervical cancer.
What is the HPV Vaccination Programme about and why is it being rolled out now?
HPV stands for human papillomavirus, which is the most common cause of cervical cancer. The virus is commonly spread by intimate skin to skin contact such as sexual activity.
In Singapore, cervical cancer is the 10th most common cancer and 8th most common cause of cancer deaths among Singaporean women. Cervical cancer is one of the most preventable cancers. Yet, every year, approximately 200 new cases are diagnosed and 70 deaths from cervical cancer are registered in Singapore.
The HPV vaccine provides protection against the HPV infection, therefore the prevention of cervical cancer is best achieved though the immunisation of girls, prior to sexual intimacy.
There is no history of cervical cancer in my family. Does my daughter still need to be vaccinated?
Cervical cancer can occur even in those without a family history of cancer, as it is not a hereditary trait that is passed down but is caused by persistent infection by the HPV. In some women, the body fights and clears the infection on its own. In others, the virus persists and develops into cervical cancer. As such, the HPV vaccine helps build the antibodies needed to fight off and clear the HPV infection before it develops into cervical cancer.
Does the HPV vaccine really prevent cervical cancer?
Getting the HPV vaccination can reduce the risk of cervical cancer by 70 to 80 per cent, by clearing persistent infection by HPV and reducing the risk of precancerous changes.
The HPV vaccine is being given on a national basis in over 90 countries around the world, including Australia, Taiwan, Thailand and Malaysia. In countries such as England and Spain, data shows that the national vaccination programme has helped prevent over 80 per cent of high-risk HPV infections. Meanwhile, in Finland data ten years post-vaccination shows no new cases of cervical cancer.
However, the vaccination does not completely eliminate the need for screening later in life, and all women should go for screening regardless of whether they have had the vaccination.
Why is the vaccine being given at such a young age?
In Singapore, the HPV vaccination is recommended for females aged 9 to 26 years old. The vaccine is given at a young age because between the ages of 9 and 14, children can develop good immune responses to the vaccine with higher antibody levels compared to when given to older adolescents and adults. Because of this, girls up to the age of 14 need two doses of the vaccine, while those aged 15 and above are required to complete three doses.
Is the HPV vaccine safe?
According to the World Health Organization, all licensed HPV vaccines in the market have comparable safety and efficacy profiles. The HPV vaccine is made from one protein from the HPV virus and is not infectious. Thus, it cannot cause HPV infection or cervical cancer.
Just like any other vaccine, the HPV vaccine can cause side effects. Most side effects are mild and resolve on their own. Your daughter may experience pain, redness and swelling at the injection site, fever, headache, nausea, vomiting, or muscle and joint pain. Anxiety reactions such as fainting spells and, on rare occasions, severe allergic reactions to the vaccine can occur. These normally happen immediately after the vaccination, which is why your daughter will be monitored closely for a period of time right after she receives the vaccine.
Most individuals tolerate the vaccine well without problems. However, you should seek medical advice if your daughter continues to feel unwell after the vaccination.
As of 26 April, more than 2,700 Secondary 1 girls from 25 secondary schools have been vaccinated.
Associate Professor Anne Goh is the President of Singapore Paediatric Society. The views expressed in the article are her own.