HPV vaccine for boys – right thing to do, even if it is 3 years late

Dear Editor,
In 2010, as Health Minister, I announced the HPV vaccine initiative. In 2011, we launched the HPV vaccine initiative for girls – nine to 11 years old. The initiative’s implementation was launched with a simple ceremony at the Grove, East Bank Demerara Health Centre.
I spoke at the launching. Among the persons present was the Regional Health Officer, who at the time was Dr Karen Cummings, now the Minister within the Public Health Ministry. Amusingly, this HPV initiative has been launched, at least, three more times since May 2015. This week, Public Health Minister Volda Lawrence announced that the HPV vaccine initiative will be extended to boys. This is a necessary move and I commend the Public Health Ministry. In commending them, I urge that this announcement is not merely more talk, since the roll out of the initiative to include boys is now, at least, three years late.
At the time, the People’s Progressive Party Government invested in the HPV vaccine initiative because global research had shown HPV was, and is, a common virus that infects both men and women. Studies show that HPV is so common that eight out of 10 people will get an HPV infection at some point in their lifetime. HPV infections can cause cervical cancers in women; cancers of the back of the throat, known as oropharyngeal cancer; cancer in the anus, in both women and men; and of the penis. Cancers of the back of the throat have now surpassed cervical cancer as the most common type of cancer caused by HPV. Unlike cervical cancer in women, there are no recommended screening tests for the other types of cancers that HPV causes, so they may not be found until they cause health problems. The HPV vaccine initiative, therefore, was more than an initiative to stop cervical cancer. While best known as a critical strategy in the fight against cervical cancer, HPV vaccines are now seen as a potent tool in the fight against several cancers. This is why, we must spare no effort to ensure universal access to HPV vaccines for our children and other vulnerable groups.
The Public Health Minister’s announcement that the HPV vaccine programme will be extended to boys is correcting a grave mis-step since this progressive move is already more than three years late from the timeline established in 2010, when I was Health Minister. At the time, we promised HPV vaccine would become part of the immunisation programme by 2011, starting with vaccination of girls age nine to 11 years. Parents of girls 12 to 15 years old were encouraged to bring in their daughters for vaccination also. At the time, we established 2015 as the start date for extending HPV vaccination to boys between nine and 11 years old. The announcement by the Minister that the programme will now include boys is a case of “better late than never”.
When we outlined the details for the roll out of the HPV vaccination initiative at the initiative’s launching at the Grove Health Centre, beginning with girls nine to 11 years old in 2011, and including the vaccination of boys by 2015, we also announced by 2020, we would begin providing HPV vaccines for women 20 to 40 years old who did not have the HPV vaccines, which would be the vast majority of Guyanese women of that age group. Interestingly, the US started the adult women HPV vaccine programme in 2018. When we launched the HPV vaccine initiative in 2011 with its rollout details, the initiative was one of the most ambitious HPV initiatives in the world.
Vaccinating boys with the HPV vaccine is a critical step forward and even though Guyana missed the original timeline of 2015, Guyana still is in the forefront of developing countries when it comes to HPV vaccines. This was an important strategic move by the Health Ministry in its fight against cervical cancer, but since then, it is a critical initiative in the overall anti-cancer fight. Once we have universal access to HPV vaccines in Guyana, we have a good chance of reducing the incidence of cervical cancer by greater than 70 per cent by 2030 and also to have a prevention success in the fight against other cancers. It is therefore encouraging that Guyana is implementing the programme, as originally envisaged, even if it is disappointing that the timelines have shifted. I encourage the Public Health Ministry to hasten forward with the timelines.
In making the announcement, the Minister did not update the citizens of our country with the status of HPV vaccination for girls nine to 11 years old. If the programme has been effective, the vast majority of girls between 11 and 18 years old at this time should be HPV immunised. The Public Health Ministry needs to update the country on the HPV-status of girls between the age of 11 and 18 at this time. Does the Ministry have any data? We need to know. Guyana cannot simply be launching the programme every year without updating citizens about progress made in immunising our children, both boys and girls, with the HPV vaccine. It is like spinning our wheels, and not going anywhere.

Sincerely,
Dr Leslie Ramsammy