HPV vaccine: Better safe than sorry, say parents

By Linette Heng

SINGAPORE — When IT manager Elain Tan’s 14-year-old daughter Yuki Ng asked last month (April) if she should be vaccinated against the human papillomavirus (HPV) in school, Tan didn’t think twice before consenting.

Tan is not alone. Senior Minister of State for Health Dr Amy Khor told Parliament earlier this month that as of 26 April, 93 per cent of the students in the 25 schools offered the vaccination had so far opted in.

The HPV vaccination programme began in April and covers all national schools and madrasahs. Citizens and permanent residents aged 13 and studying at private schools can also get the vaccine free at the Health Promotion Board (HPB) and HPB-approved clinics.

The HPV vaccine reduces the risk of cervical cancer, one of the top 10 cancers in Singapore. About 200 new cases of cervical cancer are diagnosed in Singapore each year and around 70 women die from it. HPV is commonly spread by sexual contact.

“To me, it was a layer of protection at a low price,” said Tan, who is also vaccinated against HPV and has vaccinated Yuki against viruses like influenza.

For Yuki, it was important to be vaccinated. “My circle of friends believe that being vaccinated, whether it is for measles, cervical cancer or flu, not only protects us but also other people.”

Yuki will get the vaccine when a one-time “catch-up” programme for current cohorts of female students in Secondary 2 to 5 is rolled out. In its first phase, which began on 1 April, the free vaccine is being given to all female Secondary 1 students. More than 2,700 girls have since been vaccinated.

Anjali Ramchand, whose 13-year-old daughter is covered by the catch-up programme, has also told her 23-year-old undergraduate graduate to get vaccinated.

“It is better to be safe than sorry, and the vaccine has been around for some time, so any major side effects should be known and addressed by now,” said the 52-year-old, who added that any protection against cancer is better than none at all.

Dr Khor had said that follow ups with the parents of the 7 per cent who did not opt in found that less than 1 per cent based their decision on concerns about the vaccine’s safety or efficacy. The remainder had either already had their daughters vaccinated, or planned to do it privately.

Lawyer Navin Kripalani, 45, a father of four including two teenage girls aged 13 and 15, was among those who did not opt in. His reason was to do the shots in a more comfortable environment, and it also meant he could choose the vaccine he wanted.

“We wanted to be able to give them the fullest possible protection,” he said.

Three vaccines, Gardasil 4, Gardasil 9 and Cervarix are approved for use in Singapore. Cervarix, which is used in the schools programme, protects against two subtypes of HPV. Up to $500 a year from Medisave can be used to pay for Cervarix or Gardasil 4, but not Gardasil 9, which is more expensive but protects against more strains.

HPV vaccination is recommended by the World Health Organisation (WHO) and is administered as part of a national vaccination programme in over 90 countries.

The vaccine, which can reduce the risk of cervical cancer by 70 to 80 percent, is best given before young women become sexually active. An especially good immune response has been observed in those between the age of nine and 14, said Associate Professor Anne Goh, President, Singapore Paediatric Society.

In response to those with concerns that having the vaccine might lead to promiscuity or earlier sexual activity, mother of two Zhang Wei Wei, 43, says the link is “not rational”.

“I don’t understand why people might think that their daughters will think that way. Sex education is very important,” she said. Both her 12- and 14-year old will be vaccinated.

Pushpa Lee Sethi, 42, whose 12-year-old daughter was vaccinated last week, agreed, “Preventing cancer is the main focus. I think my children’s sexual choices will have more to do with their upbringing and moral compass.”

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