October 2017 Statement from the Paediatric Association of Jamaica (PAJ) on the HPV Vaccine

The Paediatric Association of Jamaica (PAJ), as the medical professional organization responsible for the care of children and adolescents in Jamaica, feels obliged at this time to assist in bringing some clarity to the issue of HPV vaccination for Jamaican youth.

The Human Papilloma Virus (HPV) is the most common viral infection of the reproductive tract, with cancer of the cervix (neck of the womb) accounting for over 80% of all HPV-related cancers. Cervical cancer is the second most common cancer in Jamaican women. 5-10% of persons infected with HPV will have a persistent HPV infection which may lead to a pre-cancerous lesion and later to cancer.

As of 31 March 2017, 71 countries globally have introduced the HPV vaccine in their national immunization programme for girls in an effort to reduce the incidence of cervical and other HPV-related cancer, including the USA (2006), Australia (2006), the United Kingdom (2008), Canada (2007-2009), Trinidad and Tobago (2013), and Barbados (2015). Countries such as Australia who have been administering the HPV vaccine for over a decade, have reported a decreased amount of pre-cancer of the cervix in women.

Vaccine Safety

None of the HPV vaccines contain live biological products and so are non-infectious; they do not contain antibiotics or preservative agents. The World Health Organization Global Advisory Committee for Vaccine Safety (GACVS) regularly reviews the evidence on the safety of HPV vaccines and other vaccines globally. After reviewing surveillance data from countries worldwide over the last decade of HPV vaccine use, the WHO has concluded that the available evidence does not suggest any safety concern regarding the use of this vaccines. Large international clinical trials have shown HPV vaccines to be safe and well tolerated. Well conducted population studies show no association with venous thromboembolism (blood clots) and stroke, autoimmune conditions (Multiple Sclerosis and Guillain-Barre) and cerebral
vasculitis, complex regional pain and / or other conditions of chronic pain syndrome and postural orthostatic tachycardia syndrome.

Side effects of vaccine
HPV vaccination is typically not associated with any serious side effects. Similar to other vaccines, common side effects include pain, redness, or swelling in the arm where the shot was given. Dizziness, nausea, and headache may be alleviated by sitting or lying down for 15 minutes after administration. These symptoms are generally mild and self- limiting, with the benefits of the vaccine far outweighing these mild temporary side effects.

The HPV vaccine being administered by the Ministry of Health provides high protection against HPV-16 and HPV-18, the HPV types which are associated with 71% of cervical cancer cases globally. The HPV vaccine is being introduced to school girls in the Grade 7 cohort with two doses given 6 months apart, which is in keeping with global standards of care.

As we do for all other vaccines, the PAJ encourages parents and guardians’ to ensure their adequate knowledge and understanding of the HPV vaccine, so they can make an informed decision. We therefore recommend that parents carefully read the fact sheet and information letter that has been sent home with their daughter/ ward from the Ministry of Health and that parents contact their paediatrician, family doctor or nearest health centre for further information if they need further clarification.

The PAJ acknowledges the prior significant accomplishments of the Ministry of Health in Jamaica through its National Immunization Programme which has seen the eradication of many serious infectious diseases through its effective vaccination programmes, including polio, measles and rubella.

The Paediatric Association of Jamaica supports the Ministry of Health in this national HPV vaccination initiative, while we help to inform parents and recipients of the vaccine.

Dr. Abigail Harrison
Paediatric Association of Jamaica