Minister of Health, the Hon. Mark Scotland announced that a cancer prevention vaccination, the Human Papillomavirus vaccine (HPV), will be integrated into Cayman’s childhood immunization programme starting in November of this year, following the successful pilot programme in 2009 and 2010.

Minister Scotland confirmed, “It will be a phased programme initially held at the Public Health Clinic at the Cayman Islands Hospital, West Bay and Bodden Town health centres, Faith Hospital in Cayman Brac and all government high schools throughout the Cayman Islands.“

Dr. Sook Yin, Medical Director of the Cayman Islands Cancer Society says, “The Cancer Society is pleased to partner with the Ministry of Health to expand the HPV vaccination programme. I am elated that we can now move forward with the school-based aspect of the HPV immunization, making the programme convenient for both students and parents.”

Minister Scotland commended the ongoing collaboration between the Ministry of Health and the Cancer Society saying, “Our immunization programme continues to be very successful. I encourage young women and their parents or guardians to take advantage of this cervical cancer prevention vaccination.”

HPV causes cancer of the cervix, genital warts and some precancerous lesions of the cervix, vagina and vulva. The vaccine is of greatest benefit if it is administered before the onset of sexual activity; hence the target age group is 11 to 12 year old students. At this age, the antibody response to vaccine is optimal. However, the vaccine will also be available to young women between the ages of 11 and 17 years at the various Health Services Authority facilities.

While some countries started offering the vaccination to boys also, the programme in the Cayman Islands will be limited to girls only in the initial phase. The HPV vaccine is given as a course of three injections administered at set intervals over a 6-month period. The vaccine will be offered on a first come, first serve basis, while supplies last.  Parents or guardians must attend the appointment with their children at the clinics and give written consent for the vaccine to be administered.

Minister of Education, the Hon. Rolston Anglin welcomed the initiative of a school-based HPV vaccination programme at Clifton Hunter and John Gray high schools and assured parents and guardians that “the HPV vaccine is not mandatory. The vaccination is being offered at school for your convenience. No child will be vaccinated without parental consent and you will have the opportunity to be present at the time of vaccination if you choose.”

He also added, “I commend the Public Health staff, Cancer Society, and school principals for making this a reality.” While initially, it is offered to girls in the government high schools, children between the ages of 11 – 17 from private schools can get their HPV vaccination at the listed Health Services Authority facilities. The vaccination schedules along with a detailed process will be announced later.

A public awareness campaign about cervical cancer and the HPV vaccine will be undertaken by the Cayman Islands Cancer Society and the Public Health Department using a variety of outlets including media interviews, advertisements, public education presentations in schools, including Home School Associations and specially organized district awareness sessions. Leaflets will also be available at these sessions as well as the Cayman Islands Cancer Society on Maple Road, all Health Services Authority facilities, doctor’s offices and libraries.

Side bar: Questions & Answers for HPV Vaccine

What is HPV Vaccine? Why get vaccinated?

HPV stands for Human Papillomavirus. There are about 40 types of HPV that can infect men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cancer of the cervix and genital warts.

Cervical cancer is the second leading cause of cancer deaths among women around the world. There are four major types (6, 11, 16, & 18) of HPV. These include two types that cause about 70% of cervical cancer and two types that cause about 90% of genital warts. The vaccine (Gardasil—used in our programme) protects against these four types. Hence HPV vaccine is recommended for protection against cervical cancer and most genital warts.

The FDA (Food and Drug Administration of the USA) has approved the vaccine for use among females aged 9 to 26 years.

What does the vaccine not protect against?

The vaccine does not protect against all types of HPV— so it will not prevent all cases of cervical cancer. About 30% of cervical cancers will not be prevented by the vaccine.

Hence it will be important for women to continue getting screened for cervical cancer (regular Pap tests).

How is HPV transmitted?

HPV is the most common sexually transmitted infection. More than 50% of sexually active people will get HPV at some time in their lives, though most will never even know. It is most common in people in their late teens and early 20s.

How is the HPV vaccine given?

The vaccine is given in three shots over a six month period.

1^st dose –  selected date

2^nd dose – 2 months after first dose

3^rd dose – 6 months after first dose.

It is not yet known how much protection girls/women would get from receiving only one or two doses of the vaccine. For this reason, it is very important that girls/women get all three doses of the vaccine.

Who should get the HPV vaccine?

HPV vaccine is of greatest benefit if it is administered before the onset of sexual activity. For these girls, the vaccine can prevent almost 100% of disease caused by the four types of HPV targeted by the vaccine.

The vaccine is routinely recommended for girls 11-12 years of age although it is approved for females from age 9 to 26 years.

If a girl or woman is already infected with a type of HPV, the vaccine will not prevent disease from that type.

Who should not get the HPV vaccine?

Anyone who has had a severe allergic reaction to yeast or any component of the vaccine or to a previous dose of HPV vaccine should not get the shot.

Pregnant women should not get the vaccine since the effects of the vaccine during pregnancy are still being studied.

People with moderate or severe acute illnesses should also defer their vaccine until after the illness improves.

Will sexually active females benefit from the vaccine?

Ideally, females should get the vaccine before they become sexually active.

Sexually active females who have not been infected with any of these four types of HPV would receive the full benefit of the vaccination.

Females who already have been infected with one or more HPV type would still get protection from the vaccine types they have not acquired. Few young women are infected with all four HPV types in the vaccine.

Should girls/women be screened for cervical cancer before getting vaccinated?

No. Girls/women do not need to get a HPV test or pap test to find out if they should get the vaccine as it is very rare that any one is infected with all four HPV types covered by the vaccine.

Will the girls/women who have been vaccinated still need a regular pap test, also known as cervical cancer screening?

Yes. Regular Pap tests are recommended as the vaccine will not provide protection against all types of HPV that cause cervical cancer.

How long does the vaccine protection last? Will a booster shot be needed?

Protection from HPV vaccine is expected to be long lasting. More research is being done to find out if women will need a booster vaccine.

How safe is the HPV vaccine?

This vaccine has been licensed by the United States Food and Drug Administration (FDA) and approved by the Center for Disease Control (CDC) as safe and effective.

Studies have found no serious side effects. The most common side effect is soreness in the arm (where the shot is given).

There have recently been some reports of fainting in teens after they got the vaccine. For this reason, it is recommended that they wait in the clinic for 15 minutes after getting the vaccine.

Where will the HPV vaccine be available?

The vaccination schedules in schools and clinics along with a detailed process will be announced later.

References: www.cdc.gov