HPV Vaccinations Expanding in India

As the Indian government is considering offering the HPV vaccine to all female children, public health officials have ongoing concerns.

“There is a culture of silence when it comes to cervical cancer in India. What can we do now to prevent cervical cancer deaths is improve access to screening and awareness/education programmes," says Anant Bhan, researcher, Global Health and Bioethics.

"The HPV vaccine is only part of the solution and one should not fall into the trap that if we use the vaccine, our burden will be ameliorated. Any vaccine will cover only [a] specific number of streaks of [the] virus and it can be caused by other factors as well as other streaks,” said Bhan.

HPV Vaccines are not new to India, as they have been available since 2006.

Ravi Mehrotra, Director of the National Institute of Cancer Prevention and Research, believes that the efficacy of the vaccine is proven by the fact that more than 65 countries have adopted it as part of their health programmes.

Cervical cancer, mainly caused by Human Papillomavirus infection, is one of the leading cancers in Indian women. Cervical cancer kills roughly 67,477 Indian women annually.

The two HPV vaccines currently available in India are bivalent (Cervarix) and quadrivalent (Gardasil). The Nonavalent vaccine, Gardasil 9 which is considered to be the most effective in the West, is currently not available in India.

Human papillomavirus (HPV) is a group of viruses that are extremely common worldwide. There are more than 100 types of HPV, of which at least 13 are cancer-causing.

HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. Cervical cancer is caused by sexually acquired infection with certain types of HPV.

Suneeta Krishnan, Director, Research Triangle Institute Global India, says “that there is no evidence that improving sanitation and hygiene will reduce cervical cancer incidence.”

“Even in countries such as the US, UK and Australia, where population has access to sanitation and hygienic conditions, cervical cancer is controlled through HPV vaccination and regular screening," said Krishnan.

Shankar Prinja, Associate Professor, Post Graduate Institute of Medical Education and Research (PGIMER), Punjab, who has been commissioned to do a cost effectiveness study of the vaccine for Punjab, points out that out that for every 280 girls immunised, one case of cervical cancer can be saved.