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Covid-19 Hampers Vaccination against Cervical Cancer

By Aramata Jatta

The vaccination against the Human Papilloma Virus(HPV) which is to prevent cervical cancer in girls in grade 3 and out of school girls aged 9-14 has massively declined from 83% to 17% due to the stroke of Covid-19 pandemic and the misinformation surrounding the Covid-19 vaccine.
Cervical cancer, is the abnormal growth of cell in the cervix (opening of the womb)it is the most common cancer among women in the Gambia. Globally cancer kills 260,000 women annually. Almost all cases of cervical cancer(99%)are the Human Papilloma Virus(HPV) which can also cause genital warts in both men and women and other cancers of the anus,vagina,penis,vulva and throat.
Upon introduction of the Covid-19 vaccine in the Gambia, rumours and misinformations have emerged from all social media handle regarding vaccine this has left the ministry of health with little or no choice but to put a stop on the PHV immunisation routine in schools.
Aja Kande, Communication Officer Expanded Programme on Immunization under the Ministry of Health. said they are given the HVP vaccine to girls aged 9-14 as studies indicates that is most effective at that time not after 14 as some of the girls might gone into premature sexual activities or even sexually active, as she might already be exposed to the virus.
She emphasis that, the vaccine is no way related or associated to Covid-19 vaccine. She said they are different as this vaccine has been introduced in the country well before the Covid-19
She said “In 2019 we had a demonstration of the vaccine, the HPV vaccines are very safe and effective, but we were demonstrating,To see which of the strategies, outreach or route , we are going to take. For example we have so many interventions strategies, we were using the normal clinic schedule known as nurse for campaign. Sometimes we go from house to house, but this ones we want to reach out to shools”, Aja explained
Aja said that was a demo they were doing, to see whether the school approach was going to work out for them or not. As they used a small scale which was done in West coast region, in 2014,2015,2016,2017, where they had two rounds. Every girl is expected two doses for maximum protection.
“We did that and it was successul we had about 93% that was the demo within, we found out that, the school enrollment was very high therefore we adopted the school tragedy reaching out to schools. so that all girls that are in schools are vaccinated, we had the outreach strategies going out to communities to find girls who are not lucky to be in school being it conventional, or an arabic school with that we had 93%”, Aja Recalls
She said in 2019, they introduced a nationwide vaccination for those who were part in the first demonstration. “As they were in grade 3,our approach was in grade 3 because, when we did the study, we found out that girls age between 9 and 14 are mostly found in grade 3 that was why we went in for grade the 3,”she said
Aja said they went into grade 3,in the first year in 2014, and 2015 the girls were promoted to grade 4. “So we were given it to grade 3 & 4 and the next year. Grade 5 and 6 and now those girls are in grade 8. So you could see in other regions when we did the national introduction, we took it from grade 3 to 8, so that we capture and reach the gap between demo areas and non demo areas, so that no girl is left behind from 2014 to 2019”,
She revealed that they had a multiple cohorts from, grade 3 to 8 this includes all the girls in the country and had a coverage of 83% in 2019 which was just for first dose while the second dose was to be given after six months then came the Covid-19
“We were expecting to give the second dose in june and covid stroke in march, and we couldn’t give it as schools were closed for a long time. We couldn’t reach them because we cannot have teams to go to very household,”
She further explains that they, were waiting for the schools to resume and when the schools resumed they worked with the Ministry of basic and secondary education, who advised they should wait a bit for schools to re-stabilise which they did.
“Therefore second dose when on delaying, we know between the doses there is a minimum of 6months but there is no maximum time to say what time it should be given but we capitalise to say before the covid vaccine came, we went into the communities to seek for girls to come for their second doses”, Aja said.
Explaining the challenges they encountered during the implementation, Aja said “when we go to schools, some of our staffs were been attacked by parents, sometimes even teachers or the girls will refuse this was the case. We hold on and the second dose stood at 17% , the first dose for the next cohort which is grade 3 stood at 18% which was very bad, so you see the gap between 83% who received their first dose already we could not get all those people we got only 17% . And it went on for a long period. Almost for six months we were battling with that one,”
She said in other to mitigate this challenges, they had series of activities on tvs, radios, community sensitisation, to make sure that people understand their agenda but it was just unfortunate that Gambians this time around disappointed the ministry of health.
Aja also told this medium that the HPV, is one of the cancers that is killing women, in the country and according research 12% of women are leaving with cancer. She said that only include the reported cases in health facilities,as many are under reported.
However, the numbers could be understimated, as there are people who do not go to health facilities to report cases of cervical cancer.
According to the studies around manufacturing of the vaccine, it is most effective when a girl is not sexually active and not yet exposed to sexual activities, this Aja said is the reason why they are giving it to girls knowing that cervical cancer affects only women but it may affect men in the other part of their body or the genital parts.
The cervix is only found in women , which is the opening of the uterus and this is where the baby comes out during birth, if that is affected there will be a decline in production and this is one of the attributes that people are saying that HPV is only targeting girls only and why not boys .
“The reason behind it, it is because the cervix is only present in women, we can only give it to girls but then the same, virus can affect men in their different forms, men are vehicles or the transmitter, they can transmit it to others but the environment where the virus can be disruptive is in women and this is why we are focusing on women than men,” Aja Kandeh explained.
She said ,If all the girls are protected there is no way that a boy or a man can transmit the virus as when ever the man has the virus and transmits it to another person, if that person is protected there is no way that, the individual will be infected.
“The ministry of health is overwhelmed with activities, we know when we stop the HPV vaccination in schools there is still the healthy facilities. anybody who wants to get the vaccinated can go to and receive it in the any facility as it is in cooperated in the routine activity schedule”, she highlighted.
She further stated that ” is part of the routine and any girl who wish to be vaccinated can walk into any public health facilities and get vaccinated, we have scheduled periods and the interval is six months that being the case we don’t want to interrupt their classes”,

The Communication Officer concluded that, this vaccine has been here prior to covid,and the targets are different. She said covid vaccine is targeting 18years above and is not targeting only females but everybody while the HPV is only targeting females.
” am urging every parent or guardians to please go in for the vaccine, it is safe and effective., it 95% effective am not sure if we will have a better vaccine than this one, it safes about four different conditions,” Aja urged.
She reassured the general public to be Be rest assured that the ministry of health will never bring any vaccine that are unsafe, as we are Gambians and they wouldn’t want it to affect our children or grand children.
Tabu Njie Sarr, Women’s right Manager Action Aid who also doubles as President of the CSO Gender platform the Gambia, said Covid has impacted the lifes of women and girls and the misinformations surrounding the Covid vaccine has created a lot problems vaccination for this girls
She said the ministry of health has suffered as a result of the miscommunication of the covid vaccine, describing health as a fundamental human rights, saying this is a preventive measure that is geard towards ensuring that girls are prevented from cervical cancer. Which destroys the reproductive organs of girls.
“It is rather sad that it has come to a time that, when even those that have been vaccinated with the first dose did not complete the second due to covid. Civl society organisations have been on programmes, promoting and talking to mothers to allow their girls complete the vaccination. but its difficult simply because there is no data to outline how many girls were vaccinated but also and how many are yet to be vaccinated,”
The Women’s right activist said, it is incumbent upon all and sundry,government, CSOs and private sector to ensure that this is well communicated to communities especially to women and mothers to ensure that girls are protected against cervical cancer.
“The ministry of health actually reached out to women’s right organisations such as the gender plaform and there were posters that communicated this disease to the population but more needs to be done , we have seen maternity mortality going up , especially when we were confronted with covid, due to some lapses here and there,”
Talking from a gender perspective, Tabu said key stakeholders needs to be engaged.” The government need to invest more in health and in protective mechanisms such as this and include everyone by using all the mediums to reach out to women,who are the mothers and also engaged the girls to explain to them the dangers of not taken the vaccine,”
She said women need to be enlightened on the difference between covid and the cervical cancer vaccine. ” the People need to be educated about it especially women and girls, and more budgetary allocation needs to be done”,
“I’m a mother, I have a girl. I want mothers to understand that the preventive cervical cancer vaccine different from the covid vaccine, even the covid vaccine is a preventive mechanism that we should all try and take to ensure that we have a healthy population”,Tabu reitrated.
She said Preventing this girls from cervical cancer will help in a long way, not only to ensure that they do not suffer from cervical cancer but it will ensure that they will have a reproductive healthy lifestyle.
“Am urging all mothers, to take the vaccine, it is not a death sentence to the girls but rather it prevents them from the dangers of cervical cancer, as it is yet to be treated but can be prevented. Am a mother and my girl has been vaccinated and I would want to see all girls vaccinated and free from cervical cancer,”
“many of the my students, refuse to take their dose as they are been told by their parents not to take any vaccines in school. am just a teacher, the only thing I can do is to tell this girls to take the vaccine but I cannot force them”, Said Lamin Jobe a teacher at Tallinding School
Mr. Jobe believes that more efforts needs to done, in educating the woman and girls regarding reproductive health and vaccine preventable disease. He said prevention is better than cure.
“My two girls took their first doses, but my husband called me all the way from England to warn me not to allow my children to be vaccinated with sickness and he even sent me a video, which contains images of school girls being vaccinated with the covid-19 vaccine and the teachers are telling us it is a vaccine against cancer”, Said Mademu Sillah a mother of two.
The Human Papillomavirus and Related Cancers, Fact Sheet 2021 shows that Gambia has a population of 670,131 women ages 15 years and older who are at risk of de- veloping cervical cancer. Cur- rent estimates indicate that ev- ery year 286 women are diag- nosed with cervical cancer and 199 die from the disease. Cer- vical cancer ranks as the 1st most frequent cancer among women in Gambia and the 1st most frequent cancer among women between 15 and 44 years of age. Data is not yet available on the HPV burden in the general population of Gambia. However, in Western Africa, the region Gambia belongs to, about 4.3% of women in the general population are estimated to harbour cervical HPV- 16/18 infection at a given time, and 55.6% of invasive cervical cancers are attributed to HPVs 16 or 18.
This story was produced with support from Journalists for Human Rights (JHR), through its Mobilizing Media in the Fight Against COVID-19 in partnership with Mai-Media and The Daily News.

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