Programme to vaccinate schoolgirls extended

Major effort to prevent cervical cancer as Abu Dhabi offers inoculations in every school in the emirate, subject to consent of both the pupil and her parents.

Nancy Brajtbord, left, administers a shot of Gardasil to a 14-year old patient in Texas to vaccinate against human papillomavirus, or HPV.

ABU DHABI // Building on the success of a pilot programme last year, the Health Authority-Abu Dhabi is offering vaccinations for cervical cancer to girls at all schools in the emirate. Almost 6,000 girls aged 17 were inoculated last year, and a further 4,000 have received the first dose of the Gardasil vaccination this year. The three-dose vaccinations, which were administered by school nurses, required the consent of the girls and their parents or guardians. The scheme was so successful - about 70 per cent of the girls chose to be vaccinated - that the health authority will now extend it to both government and private schools.

The injections are free for Emiratis; expatriates pay a fee of Dh50 (US$14) for the three doses. According to the health authority, cervical cancer strikes 9.9 women in every 100,000. It is the second most common form of cancer in the UAE, behind breast cancer, according to the Ministry of Health. Official figures show that 70 per cent of cases in the emirate are diagnosed in the late stages, when the chance of survival is lower. Overall, women diagnosed with cervical cancer have a one in three chance of surviving.

"With this vaccine, we hope to be able to prevent most cases of cervical cancer altogether," a health authority spokesman said. "The strong uptake of the vaccine clearly shows that parents understand the importance of vaccinating their daughters and protecting their health." More than 99 per cent of cervical cancer cases are caused by the human papillomavirus (HPV), which is also responsible for other cancers affecting both sexes. The Gardasil vaccine, manufactured by Merck and approved by the US Food and Drug Administration in 2006, protects against four types of the virus, two of which can increase the chance of developing cervical cancer. Around 70 per cent of cancers and diseases linked to HPV are caused by these two types of the virus.

Gardasil is believed to be most effective if given to women between nine and 26 years old. Health officials estimate that about 10 per cent of women will get an HPV infection at some point in their lives, but the virus is more common in women under 30. Since some HPV strains are sexually transmitted, questions have arisen in some countries over the morality of administering the vaccine to girls. In the UAE, however, a majority of parents and girls have accepted the vaccine.

Dr Ally Abdel Razek, the executive director of the Gulf International Cancer Centre in Abu Dhabi, said he fully supported a yearly vaccination programme. "This is one of the very few cancers for which there is a vaccination," he said. "I totally agree that vaccinating young women will help save lives." Reducing the number of overall cases, he said, was better than reducing the number of people diagnosed in the late stages.

"I would encourage everyone to have the vaccination," he said. "This is a way to protect children and young mothers from getting this type of cancer. The first part of the programme has been very successful, so it is a very good decision by the authority to keep it going." Some non-serious side effects such as headaches, nausea and fever have been reported, but health officials said the benefits of the vaccine outweighed any risks.

Dr David Sexton, chief medical officer at the Corniche Hospital in Abu Dhabi, compared the vaccine to the introduction of antibiotics. "What we are facing is a major breakthrough in medicines somewhat akin to when penicillin was discovered," he said. "Despite screening programmes in the western world there is still quite a high mortality rate. A lot of our efforts should be focused on prevention, which this is."

Dr Sexton, who has worked in the obstetrics and gynaecology sector for more than 30 years, said he applauded the health authority for making the vaccination programme permanent. "We should be strategising as the rest of the western world is so we are not going to be left behind," he said. "That is vitally important. We want to be up there with the best of them. This is one such strategy move." The health authority is also planning to expand the programme to older women in line with World Health Organisation recommendations.