In 2010, Malaysia’s HPV school-based immunization program is considered compulsory to a female child aged 13 years old. Starting from 2019, the Ministry of Health Malaysia has initiated the policy of free HPV vaccine to be extended to women born between the year 1992 to 1996. Other eligibility criteria include:
- Single/not yet married.
- Malaysian or Permanent Resident of Malaysia.
- Not pregnant.
- Have not suffered from severe allergies that required treatment at a hospital.
If interested, various clinics or even hospitals provide HPV vaccination in Kuala Lumpur and the whole of Malaysia.
The Human Papilloma Virus or HPV
HPV is one of the causative organisms in sexually transmitted diseases, specifically the HPV genotype 16 and 18. The HPV infection can cause health problems such as genital warts, cervical cancer and of the oropharynx. It takes years of transformation at the cellular level before symptomatic changes of cervical cancer occur. This transformation phase known as Cervical Intraepithelial Neoplasia is detected via a Pap Smear screening test. Globally, cervical cancer is the fourth most frequent cancer in developing countries whereas, in Malaysia, cervical cancer is the second most frequently occurring cancer (after breast cancer) amongst women aged 15–44 years.
The HPV Vaccination Program
Various strategies for prevention of HPV infection are available including vaccination, cervical cytology (Pap testing), and HPV DNA based screening, for early detection and effective treatment at no charges. Unfortunately, due to poorer health literacy, the uptake rates for Pap testing were only 26{d1fd1324cb7aedcd00148b10ed9fd85e3fe67e92b90615b6977b2411f2f691a9} in 1996 and 43.7{d1fd1324cb7aedcd00148b10ed9fd85e3fe67e92b90615b6977b2411f2f691a9} in 2006. To overcome the issue, inter-agency and multi-sectoral collaborations were drawn up for Malaysia’s HPV school-based immunization program for a female child aged 13 years old.
The HPV vaccine
The HPV vaccine is administered via intramuscular injection. Each recipient is required to take 3 doses of the vaccine at 0, 2 and 6 months interval.
Like any medication, there are also side effects for the recipient of HPV vaccine injection, most commonly:
- Pain, redness, or swelling in the arm where the shot was given
- Fever
- Headache or feeling tired
- Nausea
- Muscle or joint pain
These mild symptoms are only temporary and can be overcome with adequate rest.
On very rare occasions, individuals can experience side effects of severe (anaphylactic) allergic reactions that may occur after vaccination. People with severe allergies to any component of the vaccine are not recommended to receive that vaccine.
Incidence rate of HPV infection after vaccination program
It may be too early to expect a drastic change in the HPV infection incidence rate of Malaysia. Nonetheless, an observable change in the statistics is seen after the implementation of the National HPV Vaccination Program in Australia starting from the year 2007. Women aged 18–24 years attending clinics for Pap testing reported that the prevalence declined from 28.7{d1fd1324cb7aedcd00148b10ed9fd85e3fe67e92b90615b6977b2411f2f691a9} before the vaccination program (from 2005 to 2007) to 2.3{d1fd1324cb7aedcd00148b10ed9fd85e3fe67e92b90615b6977b2411f2f691a9} in vaccinated women (from 2010 to 2012). The statistics further analyze any difference in using quadrivalent versus the nonavalent type of HPV vaccines.
Warning signs of Cervical Cancer
For HPV infection to develop into cervical cancer, it will take a few years. Cervical cancer is prevalent among women ages between 40 and 50 years old. Patients are required to consult with a doctor immediately if found to experience symptoms of :
- Bleeding between periods.
- Vaginal bleeding after sexual intercourse.
- Vaginal discharge of unusual amount, colour, consistency, or smell.
- Back, leg or pelvic pain
- Tired
- Sudden, unexplainable weight loss
- Loss of appetite
- A single swollen leg
Apart from the clinical presentation, a cervical cancer diagnosis is highly suspected if patients also have risk factors such as:
- Multiple sexual partners
- Young age at first coitus (<17 years old)
- Sexual partner with multiple sexual partners
- Young age at first pregnancy
- High parity
- Lower socioeconomic status
- Smoking
