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Claim: Some social media users claimed the human papillomavirus (HPV) vaccine, usually recommended for girls aged 9 to 14 years, could cause infertility and death in the recipients.
Verdict: False! Several studies and experts have confirmed that no scientific evidence supports the belief. Instead, the vaccine helps protect against HPV infection, including cervical cancer.
Full Text
In Oct 2023, the Nigerian government introduced the human papillomavirus (HPV) vaccine into its routine immunisation drive to reach about seven million girls. The vaccination exercise is mainly targeted at girls aged 9 to 14 years.
In Nigeria, the human papillomavirus, according to the UN, is the cause of at least 70% of cases of cervical cancer, the third most common cancer and the second most frequent cause of cancer death in women aged 15 to 44.
Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, noted that “HPV mostly causes cervical cancer, and parents can avoid physical and financial pain by protecting their children with a single dose of the vaccine.”
He also disclosed that his four daughters had been vaccinated and urged other parents to do the same for their children.
The government said a five-day mass vaccination campaign in schools and communities would occur during the inaugural roll-out in 16 states and the Federal Capital Territory (FCT).
It added that the vaccine would be incorporated into routine immunisation schedules within health facilities. The second vaccination phase is billed to start in May 2024 in 21 states.
What is Human papillomavirus?
The World Health Organization described the human papillomavirus (HPV) as a common sexually transmitted infection that can affect the skin, genital area, and throat.
The organization explained that almost all sexually active people would be infected at some point in their lives, though asymptomatic, and the immune system clears HPV from the body.
However, persistent infection with high-risk HPV can cause abnormal cells to develop, leading to cancer.
”Persistent HPV infection of the cervix (the lower part of the uterus or womb, which opens into the vagina – also called the birth canal), if left untreated, causes 95% of cervical cancers,” the health organization explained.
On its part, Cleveland Clinic explained that there are over 100 types of HPV. It, however, said out of these, about 30 HPV strains can affect the genitals, including the vulva, vagina, cervix, penis and scrotum, as well as the rectum and anus.
It also noted that while the majority of genital HPV strains are harmless, certain strains of HPV – most often types 16 and 18 – can cause changes in the cells of the cervix (cervical dysplasia) and, if left untreated, can result in cervical cancer.
“…HPV poses the greatest risk to women and people assigned female at birth (AFAB) because high-risk HPV can progress to cervical cancer if it’s not treated. Pap smears and HPV tests can detect precancerous cell changes early to prevent cancer in your cervix. Harmless forms of HPV can also cause genital warts in women and people AFAB,” the clinic explained.
While cervical cancer is the most common type of HPV-related cancer, other types of cancer, though rare, that could result from HPV include anal cancer (cancer of the anus); penile cancer (cancer of the penis); throat cancer, vaginal cancer, and vulvar cancer.
On the mode of transmission, Medical News Today explained that the human papillomavirus can be transmitted through sexual contact. More worrisome is that transmission can occur regardless of whether symptoms are present.
While it is not all HPV infections that can lead to cancer, the risk of cancer increases if the person has other sexually transmitted diseases, such as chlamydia; delivered their first baby at a young age; has given birth to many children; smokes tobacco products and has a weakened immune system.
The Centers for Disease Control advised that boys and girls between the ages of 11 and 12 years or as early as nine years should get vaccinated to reduce the risk of getting HPV.
Despite government efforts and sensitization around the vaccine, DUBAWA observed growing misinformation around the initiative, discouraging parents and guardians from giving consent.
On a private Facebook group, Once A Mum Always A Mum Initiative (OMAM), a user sought other users’ opinions on the effectiveness of the HPV vaccine.
A screenshot of the post on Facebook
Within a few hours, some other members of the group replied to her, advising that she should ignore it as it may cause infertility for the daughter in the future or even cause death, as seen in the screenshot below.
Another user claimed the vaccine was to reduce the population of the country as it could make young girls sterile. DUBAWA observed that the responses were due to popular misconceptions formed offline, not necessarily what people read on social media.
School administrator shares experience with DUBAWA
DUBAWA observed that, as a result, several schools struggle to get their female pupils to enrol for the vaccination.
In one of the school groups this researcher belongs to, a school administrator posted a circular from the Lagos State Primary Health Care Board titled, “Notification of the introduction of the human papillomavirus vaccine into routine immunization (RI) schedule in Nigeria.”
The circular sensitizes parents and guardians of girls between 9 and 14 to make their wards available for the vaccine.
But the school administrator, who does not want her name mentioned for safety reasons, told DUBAWA that the response from the pupils’ parents was poor.
“We’ve been hearing that the government wants to start immunisation, and parents have already reached out to us that it is ‘lethal injection’, that we shouldn’t allow their kids to take it. I tried to educate one of them, who insisted it was to kill, and she kept comparing it to the COVID-19 vaccine. I told her this was to prevent cancer, that if I have the opportunity, I’d take the vaccine myself, and if my daughter were to be up to the age, I’d have registered her for it,” she lamented.
On efforts she made to make some parent register their children, she said:
“What we did was to send out a letter, and those who consented were like three (two girls from the same family and one other). We had to call the parents to be sure they were the ones that ticked. Eventually, only four girls took the vaccine. The other girls said their parents didn’t consent because they were scared. I met some personally, and they said I wouldn’t understand, so I just left them.”
The school administrator explained that of all the girls over 20 years of age in her school, only four girls were administered the vaccine. She said while three were administered the vaccine in the school, her mother took the fourth girl to the health centre to get the vaccine.
Disturbed by the experience, she called on the government to keep educating parents in different indigenous languages on the importance of the vaccine via the media.
What studies say about the HPV vaccine
A research article published in Oct 2022 on HPV prevention by vaccination explained that while the vaccine cannot treat the infection caused by a virus, it can prevent the infection in an individual. The study confirmed various myths and misconceptions about the vaccine in people’s minds and called for effective communication about the effectiveness of vaccines and cancer prevention. According to the study, this will motivate parents to vaccinate their children.
The submission of the study is in tandem with a similar research report carried out in Gambella town, Southwest Ethiopia, which emphasised the importance of promoting community health education about HPV infection and vaccines and providing behaviour change education.
Another article published on PubMed x-rayed the long-term effects of the HPV vaccination in clinical trials and real-world data. Findings from the study showed that the preventive development of HPV vaccines against anogenital and oropharyngeal cancers has been proven in both clinical trials and real-world data. It, however, suggested that while most girls and boys are inoculated with the HPV vaccine by the time puberty begins, it is crucial to monitor the vaccine effect at least until the sexually active period in their 20s and 30s.
Experts’ opinion
To further dispel the misinformation around HPV vaccination, DUBAWA engaged two obstetricians/gynaecologists on the fears expressed by parents and the importance of the vaccine.
Dr Nathaniel Adewole, associate professor of obstetrics and gynaecology and chief consultant gynaecologist at the University of Abuja Teaching Hospital, told DUBAWA that there is no correlation between the vaccine and death or infertility as claimed.
Adewole said the HPV vaccine is administered to reduce incidences of cervical cancer the same way the polio vaccine is to reduce the incidence of polio. He added that cervical cancer is the second most common cause of cancer death among women in Nigeria.
“HPV vaccine has nothing to do with infertility. It has nothing to do with death. If people had died from it, there would have been a public outcry. The earlier they allow the kids to take it, the better. Cervical cancer can bring a multi-millionaire to zero. It shouldn’t be taken as a joke; anyone with this opportunity by the government should not let it slide. At least, after a long time, we are seeing the Nigerian government complementing the international organisations in being futuristic about our health and the health of our children,” he said.
The obstetrician and gynaecologist explained that girls in the targeted age category (9 to 14) must get vaccinated before they become sexually active to prevent them from having cervical cancer and other related infections. He also called on parents to embrace the initiative.
“This is a huge investment by the government. It is a good initiative. The vaccine is costly for the government to say it’s now free, and people are saying something else. Remember, it is the same people that developed vaccines to reduce polio, measles, whooping cough, and many other things,” he said.
Also speaking, Dr Qudus Lawal, a consultant obstetrician and gynaecologist at the Irrua Specialist Teaching Hospital in Edo State, said the HPV vaccine “is safe, and there are lots of studies to back up this claim.”
He said there was no cause for alarm as the program had been on since 2006 in developed countries with over 270 million doses of the vaccine administered without any recorded incidence of infertility or death resulting from the vaccine.
Dr Lawal attributed the misinformation around the vaccine in Nigeria to “the uniqueness of the vaccination programme, the fact that it targets only females and children outside the normal age you vaccinate, and the fact that the infection has a relationship with sexual intercourse which we often see as a taboo.”
He also explained that Nigeria’s extant vaccination campaign is targeted at only girls due to limited resources. “In countries like Australia, the UK, and some parts of the world, they vaccinate both male and female, but in resource-limited countries, we vaccinate only the girl child for now,” he said.
Dr Lawal said the alleged deaths linked to HPV vaccinations were “unfounded”, adding that “in scientific engagement, we have a way of detecting if something is a cause of something.”
“For instance, if a person takes coke now and two minutes later, he goes out and has a road traffic accident and dies in the process, you can’t say it is the coke that resulted in his death. So, most of these people try to link up two unrelated events and say it is a vaccine that caused a certain thing. There is no scientific evidence to support that HPV vaccine is associated with all of these,” he said.
Conclusion
The claim that the HPV vaccine can cause infertility and death in human beings is false. There is no scientific evidence to support it.
