Why Is The Cervical Cancer Vaccine (HPV) So Important For India? How Much Does It Cost?

The Cervical Cancer Vaccine (HPV Vaccine) has been a matter of great speculation since the time of its subsidized introduction in India was put on hold.

Cervical Cancer is one of the leading causes of Cancer-related deaths in developing countries such as India. It is also the third most common Cancer in women around the world. It is estimated that one woman in India dies every eight minutes from Cervical Cancer.^[1]

Cervical Cancer is most commonly seen in areas where regular screening and vaccination programs have not been implemented.

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Cervical Cancer Vaccine – Who Needs It?

The HPV vaccine is recommended for people between 9 to 26 years of age.

• For those aged 9 to 14 years, the HPV vaccine is given in 2 shots over a period of 6 to 12 months.
• For those aged 15 to 26 years, the HPV vaccine is given in 3 shots over a period of 6 months. This vaccine is most effective for women if taken before the first sexual intercourse. People with weakened immune systems can also get 3 shots of HPV vaccine.

HPV vaccine prevents cervical cancer, vulvar cancer, vaginal cancer, penile cancer, anal cancer, genital warts, oropharyngeal cancers, head and neck cancers caused by HPV, and the spread of HPV infection to partners.)

What are the risk factors for Cervical Cancer?

The risk factors that can increase/reduce someone’s chances of developing Cervical Cancer, are as follows:

1. Persistent HPV infection: HPV infection is detected in 99% of Cervical Cancer cases. Cervical Cancer usually develops after 10 to 20 years of persistent HPV infection.
2. The risk factors which are associated with HPV infection, are: Early age of sexual intercourse (less than 21Years), a history of multiple sexual partners, having a male sexual partner with history of multiple sexual partners, having a large number of pregnancies, and a history of sexually transmitted diseases such Chlamydia, HIV infection, etc.
3. Chemical, Hormonal and other Carcinogens are also found to be risk factors for Cervical Cancer.
4. Smoking may increase the risk of Cervical Cancer.
5. A prior HIV infection is associated with upto five-fold increased risk of Cervical Cancer, due to the persistence of HPV infection in such patients.

What’s the right time to get the HPV vaccine?

HPV vaccine works best if taken before sexual intercourse or before being affected with HPV. If you have already been infected with HPV, this vaccine cannot help you get rid of it but can help to prevent other HPV strains infections.

The best age to get the HPV vaccine is 11 or 12 years, but vaccination can start at 9 years and can be taken up to 26 years. It is not prescribed after 26 years. Only in a few cases, people can take it with clinician approval even up to 40 years. 

It was proven that the HPV vaccine (Gardasil 9) can be given to both boys and girls of age groups 9 to 26. Vaccination of boys can help protect girls against virus transmission. HPV vaccine (Gardasil 9) is recommended for boys and men in the USA, but it is not yet recommended in India.

We suggest you consult a gynecologist if you would like to receive the HPV vaccine.

Who shouldn’t take the HPV vaccine?

HPV vaccine is not recommended for;

• Pregnant women
• People who are severely or moderately ill
• Allergic to yeast or latex or any components of the vaccine 
• If experienced severe allergic reactions after taking the first dose of HPV vaccine, the remaining doses may not be given

Are HPV vaccines safe?

HPV vaccines are proven to be safe and effective both in clinical trials and in real-world use. Gardasil was approved in 2006 and Gardasil 9 was approved in 2014 by USFDA for use in both males and females. However, a few side effects were reported such as fever after taking vaccination, itching at the site of injection, arm pain, headache, fainting, nausea, etc. 

What are the most common Signs & Symptoms of Cervical Cancer?

Women should consider getting screened for Cervical Cancer if any of the following symptoms are persistent.

1. The most common symptom of Cervical Cancer is Abnormal Vaginal Bleeding.
2. The most specific symptom of Cervical Cancer is post-coital bleeding (bleeding after sexual intercourse).
3. In countries where screening is routinely implemented, the most common finding/indicator is an Abnormal Pap Smear.
4. Other symptoms of Cervical Cancer include Vaginal discharge which is foul smelling and blood stained, accompanied by pain in the Suprapubic region, etc.
5. In patients with Bladder and Rectal involvement, Urinary frequency, Incontinency, Urgency, Blood in urine, Altered bowel habits such as Constipation and Rectal bleeding are noted.
6. Patients may also complaint of easy fatigue, unexplained weight loss and loss of appetite.
7. Patients whose Cervical Cancer may have spread to other organs, are known to complain of abdominal pain and a feeling of fullness (stomach), nausea and vomiting, pain in the bones, nagging cough, difficulty in breathing, etc.

Cervical Cancer Vaccine – Why has the Indian Government still not introduced HPV Vaccinations?

 

The NTAGI (National Technical Advisory Group on Immunization) had initially recommended the HPV Vaccination in India, to prevent Cervical Cancer.

However, in a letter that was later written by Swadeshi Jagaran Manch co-convener Ashwani Mahajan to Prime Minister Narendra Modi in December last year^[2], allegations were made about alternate motives to sell the vaccine.

The letter from SJM to Shri Narendra Modi said:

“Swadeshi Jagran Manch requests you to stop this move to introduce the HPV vaccine in India and we recommend the strongest action against groups that pervert science, which brings ignominy to the scientific community in the country and sells the country to vested interests. It is our concern that this programme will divert scarce resources from more worthwhile health initiatives diverting it to this vaccine of doubtful utility and that its adverse effects will erode confidence in the national immunization programme and thereby expose children unnecessarily to the risk of more serious vaccine-preventable disease.”

The Indian Express Today reported^[3] that the government’s decision to not introduce the vaccine came as a result of this RSS objection.

“We are not going ahead with it now,” was the source-hidden quote that the Indian Express had obtained. According to their report, highly placed sources in the ministry sahave said that the vaccine will not become a part of the country’s Immunization Programme anytime soon, no matter what the NTAGI decides.

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How to get the Cervical Cancer Vaccine in India?

 

Even if the government does not subsidize it, it is possible for educated and aware women in this country to obtain the HPV Vaccine. 

Two vaccines that are licensed globally are available in India,

Gardasil marketed by MSD PHARMACEUTICALS PVT LTD  and

Cervarix marketed by GlaxoSmithKline PHARMACEUTICALS LTD

How much does a single dose of the Cervical Cancer Vaccine (HPV Vaccine) cost? 

0.5ml of Gardasil Vaccine costs around Rs. 10,000 per single dose vial

0.5ml of Cervarix vaccine costs around Rs. 4500 per single dose vial

1. ‘One woman dies of cervical cancer every 8 minutes in India’ (Published on The Hindustan Times, 06 April, 2013) ↩︎
2. ‘The Health Ministry Decides to Shelve Cervical Cancer Vaccine After RSS Affiliate Writes Letter to PM’ (Published on Outlook India) ↩︎
3. ‘Cervical cancer vaccine that RSS wing wanted out faces a wait’ (Published on The Indian Express) ↩︎