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Researchers Insist On Multiple HPV Vaccine Dose

In the guidelines issued last month, WHO recommends that dose schedules should be updated to have one or two-dose schedules for the primary target of girls aged 9-14, one or two-dose schedules for young women aged 15-20 and two doses with a 6-month interval for women older than 21.
One of the poster presentations at the International Conference on HIV treatment, Pathogenesis and Prevention Research in Resource Limited Settings

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Researchers in Africa are insisting on girls taking two jabs of the Human Papilloma Virus-HPV despite a World Health Organization (WHO) guideline issued to countries that a single dose of HPV vaccine is sufficient enough to offer protection.

African researchers who were attending the closure of a four-day International Conference on HIV treatment, pathogenesis and prevention research in resource-limited settings on Friday said whether or not to reduce is still controversial for the continent that still has a very high burden of cervical cancer.

Dr Hennie Botha, a Gyn – Oncologist and lecturer at the University of Stellenbosch in South Africa told scientists who gathered in Kampala that he still sees a high number of especially HIV positive women unnecessarily succumbing to cancer of the cervix in his clinics.

He revealed that HIV positive women are at a very high risk of developing cancer but many don’t seek care when they see suspicious signs such as warts. Those that are diagnosed with precancerous lesions sometimes don’t complete their treatment regimens, he says.

With such circumstances, Pediatric HIV researcher Dr Sabrina Kitaka says it’s not feasible to change the dose especially since the impact of whether it works or not will be seen after a long period of up to 20 years.  This is so because when a person gets infected with the HPV virus, it can take them up to 20 years to start experiencing symptoms.

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In the guidelines issued last month, WHO recommends that dose schedules should be updated to have one or two-dose schedules for the primary target of girls aged 9-14, one or two-dose schedules for young women aged 15-20 and two doses with a 6-month interval for women older than 21.

WHO noted that immuno-compromised individuals including those living with HIV, should continue taking their three-dose jab or if not available at least opt for two as they didn’t find conclusive evidence regarding the efficacy of a single dose in this group.

But even before these new guidelines and the fact that Uganda started immunizing girls as early as 2015, uptake of the second dose has been low prompting researchers like Kitaka to come up with innovations such as sending SMS reminders to parents and adolescents about when they are due for the second dose.

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She says such innovations can be replicated elsewhere to ensure that girls can complete their shots. Apart from the messages, the team at Mulago National Referral hospital-based adolescent clinic has developed the HPV comic handbook to give information and all the awareness needed on the vaccine.  

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Meanwhile, the cervical cancer burden and mortality rates are still very high. According to data from the Uganda Cancer Registry, 3915 women were newly diagnosed with cancer of the cervix in 2020. Also, 2160 succumbed to the disease the same year.

Researchers said effective vaccination of girls can cut these future deaths considerably.