17 February 2018

Kenya: Rollout of Cancer Vaccine Deferred as Demand Grows

Photo: Mworia Muchina/Daily Nation
Pupils promote awareness on cancer during the International Childhood Cancer Day on February 15, 2018.

A national rollout of free cervical cancer vaccine that was to kick off this year has been pushed to 2019, the Sunday Nation has learnt.

The rollout was initially scheduled for this year after two successful pilot projects conducted in Kitui County schools in four years demonstrated acceptability and effectiveness.

Dr Collins Tabu, the head of the National Vaccines and Immunisation Programme, confirmed that the change of the programme was due to high demand from countries across the globe for the Human Papillomavirus (HPV) vaccine and the need for the manufacturer to accommodate more requests from interested countries.


Dr Tabu said that the postponement of the rollout was a decision taken by the Global Alliance for Vaccines and Immunisation (Gavi) that requested for more time to manufacture the vaccine.

"We are very ready for the programme and it is in the final stages of ensuring that everything is in place but at the same time, we have to ensure that we have enough vaccines so that when the rollout is here, we are not interrupted," Dr Tabu said.

"Many countries are now doing national rollout. The demand has gone very high in a short span.

"It is not that the company cannot meet the demand, it is how quickly they can produce as everybody now wants the vaccine," a researcher at the Kenya Medical Research Institute (Kemri) working on the vaccine said.

PILOT PROGRAMMEDr Nelly Mugo, the Head of Sexual Reproductive Adolescent Child Health Research Programme at Kemri and a member of the HPV committee, said that the vaccine will be rolled out in the health facilities and not in schools as earlier planned.

Currently, Gavi helps Kenya procure its vaccines through a co-financing model, where Kenya pays for 10 per cent of its entire vaccine budget, about Sh400 million, while Gavi pays the other 90 per cent, around Sh3.97 billion, every year.

The money is used to purchase pentavalent vaccine for influenza, pneumococcal for pneumonia and rotavirus for diarrhoea and yellow fever.

The free cervical cancer vaccine (HPV vaccine) programme was first piloted among 20,000 school girls in Kitui four years ago and the uptake was 90 per cent.

The acceptance was so high that other areas not covered demanded it hence the second pilot.

"Regardless of the time, I know very well that by next year we will be able to protect 2.4 million of our girls aged 9 to 14 countrywide at no cost," Dr Tabu said.

INFECTIONIn the first year, the programme will concentrate on vaccinating between 11 and 14 years ages, he said.

In the second year, the programme will cover 10-year-old girls and below to ensure that no one is left behind.

Unlike the pilots that were school-based, the vaccine is going to be given only to girls through public health facilities.

The girls will be vaccinated twice, with the second dose administered after six months.

The HPV is spread sexually and women tend to be infected with it at one time or another in their lives, especially during their sexual debut.


Whereas in the majority of women the immune system clears away HPV naturally, for a small percentage, the virus persists in the cervix, leading to cellular changes in the cervical cells that progress over five to 15 years to become cancerous, and eventually manifesting as cervical cancer.

According to Dr Mugo, the virus is the primary cause of cervical cancer at 99.7 per cent worldwide.

The 13 to 15 years' girls that the government is targeting are classified as high-risk population.

SCREENINGCurrently, pap smear and visual inspection are used to screen cervical cancer, but according to Dr Mugo, they are all important but with the vaccine, more girls are going to be protected.

"Improvements in screening can lead to a decrease in the incidence of invasive cervical cancer. We are good to go as a country," Dr Mugo said.

Cervical cancer is preventable and curable if detected early.

However, the World Health Organization says in sub-Saharan Africa, lack of effective screening and treatment policy, contribute to the high cervical cancer cases and deaths.

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