|LETTER TO EDITOR
|Year : 2015 | Volume
| Issue : 4 | Page : 301
Barriers to uptake of human papilloma virus vaccine in Nigeria: A population in need
Brandon Brown1, Morenike Folayan2
1 Center for Healthy Communities, Division of Clinical Sciences, School of Medicine, University of California, Riverside, California, USA
2 Institute of Public Health and Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
|Date of Web Publication||17-Nov-2015|
Center for Healthy Communities Division of Clinical Sciences, UCR School of Medicine 900 University Ave., Riverside, CA 92521
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Brown B, Folayan M. Barriers to uptake of human papilloma virus vaccine in Nigeria: A population in need
. Niger Med J 2015;56:301
Authors of Knowledge and perception of human papilloma virus vaccine among the antenatal women in a Nigerian tertiary hospital presented data on the knowledge of cervical cancer, awareness of HPV and HPV vaccines, and potential acceptability of the HPV vaccine among Nigerian mothers for their daughters. Agida et al., highlight that knowledge of cervical cancer and awareness of HPV infection and HPV vaccines was very low in a community where the prevalence of cervical cancer is extremely high. These data are a positive first step towards understanding vaccine uptake, and pertinent to future vaccination campaigns in the country.
While knowledge and awareness of HPV and HPV vaccine were low (both under 10%), over 60% of the participants reported being willing to recommend the vaccine for their female children. This begs the question whether details of the HPV vaccine were provided prior to asking mothers about their recommendation, as few would accept a vaccine they have not heard of, particularly in a country with a history of logical distrust in pharmaceutical companies.
In addition, the low number of respondents who were aware of cervical cancer (40%) implies that women who make multiple visits to health facilities for antenatal care may not have been screened as part of their comprehensive sexual and reproductive health service. The national policy on primary health care proposes that all hospital clients should have access to comprehensive sexual and reproductive health care. Unfortunately, that package does not include access to cervical cancer screening. Failure to screen women who attend antenatal clinics, and refer for management of cervical cancer when a diagnosis is made is a missed opportunity for their health and screening options should be explored.
Another data point missing from this article is if any of the mothers received HPV vaccine. With a mean age of 26.9 years, most mothers would have been eligible for the vaccine in the past year. There may be an ethical imperative to make this vaccine available and at low cost. We must consider that even in places where the HPV vaccine is covered by health insurance, uptake is low compared to other vaccines. For example, 33% of girls and 8% of boys completed the HPV vaccine series in the United States in 2012, and this is with the vaccine as part of the routine vaccination program.  HPV vaccine is not included in the national routine immunisation program in Nigeria, so we would assume uptake might be lower with availability limited to private healthcare settings.  A dose of HPV vaccine in Nigeria is about $ 103 dollars, a cost higher than the minimum monthly wage of Nigerians. The high price and low health insurance coverage limit access to this essential potentially life-saving vaccine.  For a country that contributes 10% of the global cervical cancer burden,  the government has an ethical obligation to ensure access of all young girls to HPV vaccine and cervical cancer screening. Funding from the Global Access to Vaccines Initiative may make this possible.
| References|| |
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