As the COVID-19 pandemic and its vaccines take centre stage, concerns of the rising number of children who are missing routine vaccinations from last year have been observed.
This is because so many mothers and children are confined to their homes.
Despite the COVID -19 mortality rate being low in children and adolescents, the routine children’s immunisations is a source of concern because diseases such as measles, chickenpox and malnutrition still remain a threat to a child’s health.
In Zambia, the routine Child Health Week for vaccines and growth monitoring for children also included cervical cancer vaccines for girls between the ages of 13 and 18.
Cervical cancer is a major public health problem globally, and it is the second most common cancer in women worldwide.
Every year, more than 270,000 women die from cervical cancer.
More than 85 per cent of these deaths are in Low and Middle Income Countries (LMICs).
The 2018 Global Health Report of the Lancet says Zambia had the third highest incidence of cervical cancer in the world with 664 new cases per 100,000 women.
This is despite the country establishing the Cervical Cancer Prevention Programme.
The World Health Organisation (WHO) recommended that the vaccination against Human Papillomavirus (HPV) in girls aged nine to 13 years old, combined with regular screening in women over age 30 for precancerous lesions, followed by adequate treatment, is key in preventing the 530,000 new cervical cancer cases diagnosed every year.
Cervical cancer is caused by a sexually acquired infection with HPV, which may lead to cervical cancer if not cleared when one is infected.
However, it is important to note that receiving the vaccine will not prevent the disease from that particular type, but the vaccine will protect against infection from the other HPV strains included in the shot.
Earlier this month, Child Health Week conducted its routine campaign and outreach events that provided nutrition and health services to under-five children.
Muchinga Province Health Director Nero Chilembo said Child Health Week is a mechanism that is used to provide preventive services that are extended to outreach and preschool children that have already finished their immunization schedule.
He said the programme is an opportunity to those children that might have missed their doses of different vaccines to cover up.
Dr Chilembo said routine services are still given in health facilities and the campaign is also extended to provision of other services such as malaria control and checking on child common illnesses.
The Human Papilloma vaccine introduced in the immunisation programme exercise in Zambia has also included cervical cancer screening for young girls.
Dr Chilembo said because of integration, the programme is meant to make maximum benefits of the resources used.
Arising from this, other programmes, such as the HPV vaccine, are included.
He said the HPV vaccine is still an on-going programme and girls are being vaccinated against cervical cancer.
He said the vaccines are readily available in health centers.
“In terms of sensitization, we depend on our community volunteers who play a key role in social mobilization and also support the services during Child Health Week as we go round to do the exercise,” he said.
Dr Chilembo said the Child Health Week exercise in Muchinga was a success, though the HPV presented with some challenges because most of the target population are school going girls who were had been forced to stay at home due to the school closure that was necessitated by the
COVID-19.
“For HPV 1, which is the initial injection, we only had 36 per cent coverage, while with HPV 2, which is a follow-up vaccine, we recorded a 44 per cent in the province. The young girls are encouraged to get their vaccine in the clinics, though certain times when schools are open, outreach services are done in various schools,” he said.
Additionally the vaccine is administered to the young girls after consent from their parents is given through forms that parents are asked to sign.
Dr Chilembo said the response from the parents has been positive though health workers encountered a challenge when the vaccine was introduced as the initials – HPV – for the vaccine was mistaken for HIV and this had to take a lot of sensitisation in the community by health staff and volunteers.
The other challenge about the HPV vaccine roll out encountered by the health staff in the community has been the myth referring to the vaccine as a permanent family planning method that would prevent the girls from bearing children.
The vaccine contains a simulation of the virus, not a live virus, and cannot cause cancer or HPV infection.
The vaccine stimulates the body to produce antibodies against HPV so that when one is exposed to the real virus, these antibodies can protect the body.
Some head teachers in Ndola also confirmed that young girls in schools where encouraged to take the HPV vaccine.
The teachers, who spoke on condition of anonymity, said officials from the Health Department visit schools to identify girls who qualified for the vaccine.
“We are encouraged to talk to the girls about the vaccine which can protect them from cervical cancer before they get exposed to the virus or engage in sexual activities later in their adult life.
Similarly, the officials from the Ministry of Health leave copies of the girls to take home so that parents consent to the vaccine that will be administered,” one teacher said.
The teacher said it remains for the parents to go to any health centre with their child so that they can receive the vaccine.
The teacher also said before the schools were closed, a good number of girls received the second shot of the vaccine by health officials from the district.
The children are given forms for their parents to give consent before the vaccine is given.
However, health workers have had some challenges of some parents expressing concern over vaccinating their children who are not yet sexually active.
This has taken more awareness for the parents to enable more girls to receive the shot.
A nurse in Luanshya, who participated in the last Child Health Week exercise, said the vaccine is administered in clinics to preteens from 13 years old with another shot after one year.
She said the vaccine has no major side effects, but only having the common problem of minor soreness at the injection site which is similar to one receiving other vaccines or injections.
Further, studies show that the HPV vaccine is routinely recommended for girls from 13 years to 18 years, although it can be given as early as the age of nine years.
Additionally, the full benefit of the HPV vaccine occurs only if one receives it before one is infected with any of the HPV strains included in the vaccine.
This is why the health experts recommend vaccinating girls between ages of 11 and 13 years.
With cervical cancer still being a health challenge among women in Zambia, it is important that health experts continue to scale up opportunities and promote more awareness in the community which is key for promoting public health.
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