In June, Isobel Cockerell wrote about the dangers posed to young women by the movement against HPV vaccination. Now, global uptake of immunizations is being affected by pandemic restrictions and lockdowns.
The coronavirus presents both a monumental challenge and a huge opportunity to advocates for the human papillomavirus vaccine. As scientists race to find a safe and effective method of immunization against Covid-19, vaccine campaigners are hoping to encourage more people to agree to be inoculated against HPV, which causes cervical cancer.
“We’ve never had a focus on vaccines like this before, so in many ways there’s never been a better time to work on increasing vaccine takeup. We could actually see this work really well for increasing acceptability of the HPV vaccination, increasing dialogue and overcoming vaccine hesitancy along with spurious claims made by the anti-vax movement,” said Rose Brade, a representative for Cervical Cancer Action Elimination and an international policy advisor at Cancer Research UK.
But the HPV vaccine and other routine immunizations are also at risk of being sidelined by coronavirus restrictions. In April, the World Health Organization warned that 117 million children could miss out on the measles vaccine as a result of such measures. In July, a study by The Lancet found that it was imperative that African nations keep up with their vaccination schedule. It stated that “The deaths prevented by sustaining routine childhood immunisation in Africa outweigh the excess risk of Covid-19 deaths associated with vaccination clinic visits, especially for the vaccinated children.”
Global access to the HPV vaccine has been significantly affected by the pandemic. In Kenya, where nine women a day die from cervical cancer, its introduction in October 2019 was seen as a major breakthrough.
Benda Kithaka, cofounder of Women 4 Cancer, a health advocacy group committed to reducing rates of cervical cancer in Kenya, had been working up to the launch of the vaccine since 2012. “We were actually just kickstarting the rollout proper,” she said. “Marshalling the resources to be able to reach our targets. And then this monster comes along: Covid-19.”
Since the outbreak of the virus, uptake among girls in Kenya has been hindered. “We’re losing traction with the gains that we had made – both on the vaccine side as well as the cervical cancer screening side,” said Kithaka. “My biggest worry is that because of the fear of Covid-19, we have less women accessing screening; we have less families taking girls to be vaccinated.”
According to a July statement by Patrick Amoth, the country’s health services director-general, less than half the 800,000 girls targeted by the program this year have received their shot.
“The closure of schools for the December holidays, and subsequently due to Covid-19 concerns, reduced the momentum for vaccination,” he told Kenya’s Daily Nation newspaper.
As cases continue to rise in Kenya, the country is facing a shortage of personal protective equipment, which, Kithaka explained, has left families afraid to go to vaccination and screening clinics. “It’s a moral dilemma we face,” she said.
Last week, 194 countries formally agreed on the WHO’s global strategy to eliminate cervical cancer. A key element to this campaign is to ensure that 90% of girls receive the HPV vaccine by 2030. But experts say those targets will only be met if more is done to ensure that immunization programs are possible, even amid national lockdowns.
“People are more concerned with Covid vaccination,” said Brade. “Schools are being disrupted, and they are the primary and most effective method of delivery. Girls aren’t getting their first or second doses. If schools aren’t restarted, how will we address the backlog?”
Illustration by Sofiya Voznaya