The St. Vin­cent and the Grenadines gov­ern­ment says it hopes ‘per­sua­sion’ will be ef­fec­tive as it seeks to vac­ci­nate 90 per cent of the girls aged 15 and un­der against the hu­man pa­pil­lo­mavirus (HPV) by 2030.

Health, Well­ness and the En­vi­ron­ment Min­is­ter, Jim­my Prince, said the vac­cine has been proven ef­fec­tive against HPV, which caus­es cer­vi­cal can­cer.

How­ev­er, he told leg­is­la­tors that many par­ents are push­ing back against the vac­cine, say­ing that it en­cour­ages young girls to en­gage in sex­u­al ac­tiv­i­ty, even though he said there is no ev­i­dence to sup­port such an ar­gu­ment.

Op­po­si­tion leg­is­la­tor, Shev­ern John, not­ing that HPV is a well-es­tab­lished cause of cer­vi­cal can­cer world­wide, had asked the health min­is­ter to state the preva­lence of HPV in the coun­try, the age group that was tar­get­ed for HPV vac­ci­na­tion and why.

She al­so sought an up­date on the progress of the vac­ci­na­tion over the last two years.

Prince said that 17 women had been di­ag­nosed with cer­vi­cal can­cer last year, an 88.9 per cent in­crease over cas­es di­ag­nosed in 2023, when nine cas­es were record­ed.

He said in each of the years 2020 and 2021, eight women were di­ag­nosed with cer­vi­cal can­cer and 11 cas­es were record­ed in 2022.

The Health Min­is­ter said 44 women died of cer­vi­cal can­cer be­tween 2020 and 2024.

“The five-year preva­lence of cer­vi­cal can­cer in St. Vin­cent and the Grenadines from 2020 to 2024 is 14.7 per 10,000 Vin­cent­ian women,” Prince said, not­ing the deaths as­so­ci­at­ed with the can­cer.

“So, this is a very im­por­tant dis­ease in all the cir­cum­stances,” he said.

He added that his min­istry is com­mit­ted to em­pow­er­ing all women in the coun­try and their fam­i­lies “to live as free as pos­si­ble of this scourge of cer­vi­cal can­cer through strong, pre­ven­ta­tive, ear­ly de­tec­tion and cu­ra­tive pal­lia­tive ini­tia­tives.”

“Through the im­ple­men­ta­tion of our cer­vi­cal can­cer elim­i­na­tion pro­gramme … we in­tend to en­sure that by 2030, 90 per cent of girls are im­mu­nised against HPV in­fec­tion by age 15,” Prince said.

The health min­is­ter told the SVG Par­lia­ment that years and years of re­search and re­al-world ev­i­dence sup­port the ef­fec­tive­ness of im­mu­nis­ing girls and boys at a very ear­ly age against HPV in­fec­tion.

“The rec­om­mend­ed age is be­tween nine years and 13 years, ear­ly enough so that it is be­fore any ex­po­sure through close con­tact, in­clud­ing sex­u­al con­tact, so as to re­duce the like­li­hood of be­ing in­fect­ed by the HPV virus.”

Min­is­ter Prince said that in 2015, the Min­istry of Health joined with the Pan Amer­i­can Health Or­ga­ni­za­tion (PA­HO) to con­duct an HPV preva­lence of high-risk types in women 30 years of age and old­er, here and in St. Kitts and Nevis.

“Their study re­vealed that 30 per cent of the par­tic­i­pants were de­ter­mined to have high-risk HPV and there­fore at greater risk for cer­vi­cal can­cer be­tween 30 and 65 years old, which is ex­treme­ly high for our pop­u­la­tion,” Min­is­ter Prince said.

He said the min­istry re­spond­ed to this study by in­tro­duc­ing the HPV vac­cine and pro­mot­ing pap smears in post­na­tal clin­ics.

“Un­for­tu­nate­ly, the HPV vac­cine was met with sig­nif­i­cant neg­a­tive forces, which se­vere­ly re­duced its up­take. In ad­di­tion to that, we have a vac­cine hes­i­tan­cy prob­lem in St. Vin­cent and the Grenadines,” he not­ed, “ex­ac­er­bat­ed since the pan­dem­ic.”

He said the health min­istry, how­ev­er, re­mains com­mit­ted and has re­dou­bled ef­forts to in­crease aware­ness about cer­vi­cal can­cer and the pre­ven­ta­tive role of the read­i­ly avail­able HPV vac­cine to pro­vide screen­ing ser­vices, in­clud­ing HPV test­ing to com­mence by Oc­to­ber 2025 and to in­crease treat­ment op­tions, both lo­cal­ly and in CARI­COM neigh­bours.

Min­is­ter Prince said that HPV is trans­mit­ted through sex­u­al con­tact and, there­fore, the vac­cine is most ef­fec­tive when ad­min­is­tered be­fore in­di­vid­u­als are ex­posed to the virus, typ­i­cal­ly be­fore the on­set of sex­u­al ac­tiv­i­ty.

“PA­HO af­firms, ‘HPV Vac­cines are most ef­fec­tive when ad­min­is­tered be­fore in­di­vid­u­als be­come sex­u­al­ly ac­tive and are ex­posed to the virus. The rec­om­mend­ed tar­get group for rou­tine vac­ci­na­tion is girls aged 9 to 14 years, that’s pri­or to the sex­u­al de­but, chil­dren aged 9 to 13 mount a stronger im­mune re­sponse to the vac­cine, of­fer­ing longer-last­ing pro­tec­tion.’

Min­is­ter Prince said the rec­om­mend­ed age for vac­ci­na­tion was part of the prob­lem that his min­istry faces, in­clud­ing “get­ting the push­back from par­ents and from oth­er mem­bers of the so­ci­ety.”

He said the World Health Or­ga­ni­za­tion (WHO) and PA­HO rec­om­mend a two-dose reg­i­men for the age group, which has been proven high­ly ef­fec­tive, hence the in­clu­sion of the HPV vac­cine as a rou­tine vac­cine on the min­istry’s sched­ule.

“De­spite our ef­forts in ed­u­ca­tion and aware­ness, parental con­cerns re­main at an all-time high,” he said. “A per­sis­tent bar­ri­er to vac­cine up­take is the con­cern among some par­ents that vac­ci­nat­ing girls, in par­tic­u­lar at an ear­ly age may be per­ceived as en­cour­ag­ing sex­u­al ac­tiv­i­ty or in­di­cat­ing that a child is al­ready sex­u­al­ly ac­tive. How­ev­er, sci­en­tif­ic ev­i­dence strong­ly re­futes this claim.”

The health min­is­ter quot­ed from guid­ance from PA­HO:

“‘There is no ev­i­dence that HPV vac­ci­na­tion is as­so­ci­at­ed with in­creased sex­u­al ac­tiv­i­ty or ear­ly ini­ti­a­tion of sex­u­al be­hav­iour. The vac­cine is a pre­ven­ta­tive mea­sure, not a sig­nal of readi­ness for sex­u­al ac­tiv­i­ty.’”

He said that de­lay­ing the vac­cine un­til af­ter sex­u­al ini­ti­a­tion great­ly re­duces the ef­fec­tive­ness, as HPV is of­ten ac­quired soon af­ter sex­u­al de­but.

“Vac­ci­na­tion at the rec­om­mend­ed age pro­tects chil­dren be­fore they are at risk,” Min­is­ter Prince said.

He not­ed that as of 2024, at least eight per cent of males and fe­males aged nine to 14 were vac­ci­nat­ed against HPV, adding that the vac­cine is avail­able in the pub­lic health sys­tem and giv­en on de­mand.

“As I re­fer back to what I said about vac­cine hes­i­tan­cy in St. Vin­cent and the Grenadines and the sen­si­tiv­i­ty sur­round­ing this whole thing … And I em­pha­sise that be­cause we do not go around the coun­try forc­ing peo­ple to take this vac­cine,” he as­sured.

The health min­is­ter re­port­ed that more re­cent­ly, health­care teams have been en­gag­ing par­ents, teach­ers, chil­dren, and the church­es to re­mind “and then we en­gage on the im­por­tance of the HPV vac­cine.”

“We have seen a sig­nif­i­cant in­crease in the up­take of the HPV vac­cine,” he said, “and will con­tin­ue to work with in­di­vid­u­als to pro­tect our pop­u­la­tion.” —KINGSTOWN, St. Vin­cent (CMC)