Restart The HPV Vaccination Programme

KUALA LUMPUR, 29 August 2022 – About 56,000 teenage girls in Malaysia were not provided human papillomavirus (HPV) vaccinations in schools, and are at a much higher risk of cervical cancer than those who were.

A survey from the National Cancer Society of Malaysia (NCSM) shows that the Malaysian HPV Immunisation Programme – implemented since 2010 – has been halted from year 2020. This has resulted in at least 360,000 13-year old teenage girls missing their HPV vaccinations in year 2020 and 2021. Based on previous statistics, NCSM estimates that 200,000 individuals from this cohort would have missed the HPV vaccinations in year 2022.

“Human papillomavirus infections are the main cause of cervical cancer – the third most common cancer among women in Malaysia,” says Dato’ Dr Saunthari Somasundaram, President of NCSM. “Individuals infected with HPV are at risk of developing a pre-cancerous lesion called Cervical Intraepithelial Neoplasia, which subsequently develops into cervical cancer.

“HPV vaccines. by protecting individuals from 90 percent of HPV-related cancers are the main preventive measure worldwide against cervical cancer.”

Since 2010, the Malaysian government has implemented a national school-based HPV immunisation programme, in which two doses are given six months apart. This is carried out according to the global recommended dosage, in which two doses are required for individuals vaccinated before age 15, and three doses for individuals vaccinated after age 15.

In this programme, HPV vaccines have been provided to 13-year old teenage girls in Malaysian secondary schools. Based on reports by the Ministry of Health, about 250,000 individuals – 85.8 percent of this cohort – were vaccinated each year.

Upon receiving enquiries from concerned parents and organisations, NCSM carried out a survey across secondary schools in Malaysia. After identifying all districts in Malaysia, one secondary school was randomly selected from each and contacted. Teachers in charge of the vaccination programme were asked if the school had successfully carried out the HPV immunisation programme in year 2020, 2021, and 2022.

The results showed that overall, most states did not report having carried out a comprehensive HPV immunisation programme in these years. The districts surveyed in:

• Perlis, Putrajaya, and Labuan did not report conducting any HPV vaccination programmes;
• Melaka reported having conducted the programme in 2020, but not in 2021 and 2022;
• Kedah, Perak, Penang, Johor, Selangor, Negeri Sembilan, Pahang, Terengganu, Kelantan, Sabah, Sarawak, and Kuala Lumpur did not report conducting full HPV vaccination programmes from 2020 to 2022.

“This situation is not exclusive to Malaysia – the Covid-19 pandemic had shifted the world’s focus to acute communicable diseases,” says Dr Murallitharan M, Chairman of the Malaysian Medical Association Public Health Society. “The halting of HPV vaccinations for our teenage girls is one of it, and the impact can be devastating.

“For example, a study in the U.S. estimated that the disruption of HPV vaccination programme would lead to 132,000 more cases of cervical intraepithelial neoplasia over the next 50 years, and up to 6,487 more cases of cervical cancer over the next century.”

Malaysian Council For Child Welfare president Datuk Dr Raj Karim adds that a similar situation is expected of Malaysia: “We must act on this now. We urgently request the Government to restart the HPV vaccinations for 13-year old teenage girls in Malaysian secondary schools, and implement a catch-up programme for those who have missed out from 2020 to 2022.”

Apart from saving lives, restarting the HPV vaccination programme is also cost-effective, as three doses – rather than two – will be required for individuals over age 15. Protecting individuals against cervical cancer also leads to leas healthcare resources spent on treating and managing cervical cancer in the future.

“Catch-up programmes for HPV vaccination have been carried out before, in which the MyHPV programme vaccinated single or unmarried women born between 1992 and 1996 for free in 2019,” says Roslizawati Md Ali, President of Malaysian Women’s Action on Tobacco Control and Health.

“The cost for the HPV vaccination programme should be allocated as a part of the Covid-19 recovery efforts under the 2023 Budget.”