Vaccinations attack cervical cancer

Almost 40% fewer pupils receive vaccine at private schools than at government schools.

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DUBAI // Expatriate schoolgirls are to be targeted by health officials aiming to increase the number of pupils who receive vaccinations for cervical cancer.

Although uptake has been high among Emirati girls, officials say far fewer students from abroad have opted to take the treatment.

Now in its fourth year, the school-based programme run by the Health Authority-Abu Dhabi (Haad) is aimed at all female students between 16 and 17 in Grade 11 at public and private schools.

"The uptake for the past four years is successful and comparable to other excellent models like Australia," said Dr Jalaa Asaad Taher, the section head of cancer control and prevention at Haad.

"I would like to highlight that the uptake among nationals is much better than non-nationals, but we are working on strategies to improve the overall rate and uptake among non-national girls."

Overall, 59 per cent of students received the Gardasil vaccination in 2010-11. In government-run schools, 74 per cent of girls received the vaccine, which requires the consent of their parents, compared to 35 per cent of girls at private schools, where there are a higher proportion of expatriates.

The vaccine attacks the sexually transmitted human papillomavirus (HPV), which causes cervical cancer, the second most common form of cancer in the UAE. It is offered free to nationals, while a fee of Dh50 for the three-dose course is payable by non-nationals.

"We want it to be equal for both nationals and non-nationals, because in the end this will be a burden on our health system, so we are pushing for it to be implemented for all," said Dr Taher.

The programme, which was first introduced in 2007, has now moved into its second phase. "The first phase was to vaccinate girls between the ages of 16 and 17. It has been successful and is ongoing," said Dr Karim Elmasry, a consultant gynaecological oncologist at Tawam Hospital and the chair of cervical cancer at Haad's prevention task force.

"Now we are at Phase 2, which is the catch-up cohort. That means vaccinating those girls that have missed out and are between the ages of 18 and 26."

Haad is extending vaccinations to women up to the age of 45 who have not been married, and who are considered never to have been sexually active, said Dr Elmasry

"For women who have not been married we are extending it up to the age of 45 because the theory behind it is that these women would not have been exposed to the virus and would benefit from the vaccination," said Dr Elmasry.

Dr Taher hopes the vaccine will also be offered to young Emirati men, to curb incidences of HPV-related diseases.

"There is still debate about whether to include men in the programme, but I think it is justified and our efforts will be successful in pushing for it," she said.

The benefits would be two-fold, said Dr Elmasry. "The first benefit is that it would protect them from genital warts. The second is it protects their wives from HPV-related diseases, cervical abnormalities and genital warts," he said.

He stressed the importance of political will in giving impetus to the programmes. Abu Dhabi is the first Arab country to introduce HPV vaccinations for schoolgirls.

"The fantastic thing about Abu Dhabi is that there is the political will and that cannot be emphasised enough," said Dr Elmasry.

In Phase 3, Haad will introduce a cervical screening programme for women aged 25 and above.

Approximately 60 per cent of women diagnosed with cervical cancer in the UAE are at an advanced stage of the disease. "This is unfortunate, as early stages of the disease can be cured," said Dr Elmasry. "The issue is that not only are women getting cervical cancer, but they are getting advanced stage cervical cancer which is a double whammy."