English Article

Fighting cancer: On cervical cancer vaccine for girls

Along with vaccination, screening must be done to detect early signs of HPV

India has taken up the fight against cervical cancer in earnest with the Central government announcing that it will roll out vaccination for girls aged between 9 and 14 years through schools. The decision comes at a critical juncture with a study in The Lancet published this month showing that India accounts for the highest number of cervical cancer cases in Asia, followed by China.

 

World Statistics

More than 58% of all cases of cervical cancer and deaths globally were estimated in Asia with India accounting for 21% of cases and 23% of deaths, followed by China (18% and 17%).

Cervical cancer is a preventable and treatable cancer. It is caused by infection with the human papillomavirus (HPV) and there are vaccines which protect against carcinogenic HPV. With more than 6,00,000 women diagnosed with cervical cancer worldwide in 2020, the World Health Organization laid down several guidelines that countries need to follow to eliminate it as a public health problem.

According to the International Agency for Research on Cancer, the WHO has specified that countries must reach and maintain an incidence rate of fewer than 4 new cases of cervical cancer per 1,00,000 women a year. To achieve that goal, it is necessary that 90% of girls will have to be fully vaccinated with the HPV vaccine by the age of 15.

 

HPV Vaccine Included in UIP

To that end, the government’s intent to introduce the HPV vaccine in the Universal Immunisation Programme (UIP) is a welcome move. India’s immunisation network, as was evident during COVID-19, has worked well, and diseases such as polio and maternal and neonatal tetanus have been eliminated.

The UIP is one of the largest public health programmes targeting over 2 crore newborns and 2 crore pregnant women annually, and offers free vaccines for at least 12 diseases.

 

Indigenous vaccine 'Sarvavac'

To battle cervical cancer, India is expected to roll out the indigenously developed Cervavac vaccine by mid-2023. It has received the Drugs Controller General of India’s approval and has been cleared by the National Technical Advisory Group for Immunisation for use in the UIP programme. The vaccination will be provided primarily through schools, but importantly the government has clarified that girls who do not go to school will be reached through community outreach and mobile teams.

 

Now what next?

This is a vital step because studies show that there is a link between cervical cancer incidence and human development index values, with progressively lower rates observed as HDI rises. Together with vaccination, screening programmes must be conducted to detect early signs of the disease to allow time for treatment.

 

About immunization

Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines are substances that stimulate the body’s own immune system to protect the person against subsequent infection or disease.

 

Universal Immunisation Programme

• Immunization Programme in India was introduced in 1978 as ‘Expanded Programme of Immunization’ (EPI) by the Ministry of Health and Family Welfare, Government of India. In 1985, the programme was modified as ‘Universal Immunization Programme’ (UIP) to be implemented in phased manner to cover all districts in the country by 1989-90 with the one of largest health programme in the world.
• Ministry of Health and Family Welfare, Government of India provides several vaccines to infants, children and pregnant women through the Universal Immunisation Programme.

 

Mission Indradhanush

• To strengthen and re-energize the programme and achieve full immunization coverage for all children and pregnant women at a rapid pace, the Government of India launched “Mission Indradhanush” in December 2014. The ultimate goal of Mission Indradhanush is to ensure full immunization with all available vaccines for children up to two years of age and pregnant women
• It represents 7 vaccines against 7 diseases included in the Universal Immunization Programme. These include Tuberculosis, Poliomyelitis, Hepatitis B, Diphtheria, Pertussis, Tetanus and Measles. Apart from this, after the inclusion of vaccines against Measles Rubella, Rotavirus (Rb otavirus), Haemophilus Influenza Type-B and Polio, the number of these vaccines has gone up to 12.
• However, vaccination programs against Japanese Encephalitis and Haemophilus Influenza Type B are being carried out in selected districts of the country.

 

Intensified Mission Indradhanush (IMI)

To further intensify the immunization programme, Prime Minister Shri Narendra Modi launched the Intensified Mission Indradhanush (IMI) on October 8, 2017. Through this programme, Government of India aims to reach each and every child up to two years of age and all those pregnant women who have been left uncovered under the routine immunisation programme/UIP. The focus of special drive was to improve immunisation coverage in select districts and cities to ensure full immunisation to more than 90% by December 2018.

 

Intensified Mission Indradhanush (IMI) 2.0

• To boost the routine immunization coverage in the country, Government of India has introduced Intensified Mission Indradhanush 2.0 to ensure reaching the unreached with all available vaccines and accelerate the coverage of children and pregnant women in the identified districts and blocks from December 2019-March 2020.
• The IMI 2.0 aims to achieve targets of full immunization coverage in 272 districts in 27 States and at block level (652 blocks) in Uttar Pradesh and Bihar among hard-to-reach and tribal populations.
• With the launch of Intensified Mission Indradhanush 2.0, India has the opportunity to achieve further reductions in deaths among children under five years of age, and achieve the Sustainable Development Goal of ending preventable child deaths by 2030.

 

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