Parents wary of cervical cancer jab

Cold-shoulder for cancer jab in UAE as parents resist vaccinating daughters

Parents in the UAE remain wary of vaccinating their daughters against cervical cancer, with uptake of the jab still low after more than three years in the market, experts have said.

GlaxoSmithKline, the maker of one of two vaccines licensed in the UAE, said the number of females taking the jab is significantly lower than that seen in the UK, US and Australia, where it is included in vaccine schedules.

"The take-up is low, of course it's lower than in countries like the US and UK," said Dr Aly Ziwar, medical director, GSK Gulf and Near East. "We need to make it easier for patients to access the product, and that means working with health insurers and the health authorities. Ideally, we would like to see it on school vaccination schedules."

An estimated 80 percent uptake rate would be needed for community immunity. The vaccine, which protects against the human papilloma virus (HPV), is indicated in the UAE for females between the ages of 10 and 55.

Cost may also play a role in poor uptake rates, said Dr Ziwar. In some emirates, the jab is offered free to 17-year-old Emirati girls. Expatriate women, however, must pay up to AED1,000 for the course of three injections.

A woman dies of cervical cancer every hour in the Middle East. Each year, half a million new cases are diagnosed globally; the vast majority of which are in developing countries.

The incidence could be cut by more than 80 percent with widespread vaccination and active screening programmes, said Dr Swee Chong Quek.

"The vaccines are more than 90 percent effective against HPV types 16 and 18, which cause 70 percent of all cervical cancers," said Dr Quek, head of gynaecological oncology, Women's & Children's Hospital, Singapore. "The pre-cancer stage can last 10 to 20 years, so can be detected by screening. Treatment for pre-cancer is almost 100 percent effective."

Dr Quek has been touring the Gulf region to urge healthcare professionals to work on improving uptake rates.

The launch of the cervical cancer jab sparked controversy as it vaccinates girls against strains of HPV, a sexually transmitted disease. Critics suggested inoculating schoolgirls against HPV could encourage promiscuity.

These concerns may be partly to blame for the UAE's low uptake rates, said Dr Helena Taylor, a gynecologist at Dubai's Dr Sulaiman Abdulaziz Medical Centre.

"I don't think it's the right attitude to take. Yes, HPV is related to sexual activity, but you can't bury your head in the sand and say girls will not be sexually active," she said.

Dr Taylor also rejected claims of mass medicalisation.

"If you know there is a medication that can prevent cancer, it would be utter nonsense not to take it from a medical point of view."

An estimated 80 percent of women will be exposed to HPV at some point in their lives. In many cases, the virus resolves itself, but in 10 to 15 percent of women it will persist. Prior infection does not lead to immunity.

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