A drive to prevent cervical cancer in young girls at public schools could be extended to independent schools although costs of the vaccine pose a major challenge.
The Independent Schools Association of Southern Africa (Isasa) confirmed that it was in negotiations with the Department of Basic Education (DBE) with regard to rolling out the human papillomavirus (HPV) immunisation programme to willing member schools.
Isasa executive director Lebogang Montjane said: "Independent schools could run similar initiatives for their learners, but the vaccinations would then be at cost – either paid for by parents or by medical aid.
"Given that many independent schools are themselves low-fee and have limited resources, Isasa has been in communication with DBE to see how this and other integrated health programmes could also be rolled out to willing independent Isasa member schools," said Montjane.
The HPV vaccination programme was introduced in South Africa in 2014, targeting 9-year-old school pupils.
It is administered in two doses of vaccine, with the second dose given six months after the first.
The Western Cape Department of Health said there was still a high demand for the HPV vaccine and that it had been well received by parents and caregivers of pupils.
Spokesperson Byron La Hoe said the successful roll-out was also due to the support received from the school governing bodies, teaching staff, school leadership and community health-care workers.
La Hoe said since the programme's inception in 2014 to 2020, the department had maintained an 85 to 91% first dose cover of eligible girls and annually an average of 1 100 schools were covered.
However, the second dose was deferred in 2021 due to schools being closed and general high absenteeism as a result of Covid-19.
The department also experienced a drop of first-dose vaccinations during this period.
"An additional impact is the myths on social media platforms, and vaccine hesitancy related to Covid-19 vaccines that is increasing vaccine non-acceptance towards other vaccines, such as the HPV," said La Hoe.
Head of the Department of Obstetrics and Gynaecology at UCT and global cervical researcher Professor Lynette Denny said data supported by testing and evaluation by the World Health Organization (WHO) showed that HPV vaccination was safe, well tolerated by girls and boys and highly effective against HPV infection over time.
"Recently, two very large follow-up studies have shown that both the bivalent and the quadrivalent vaccine significantly reduce HPV infection rates and the incidence of precancerous and cancerous lesions in vaccinated girls and boys and HIV-positive individuals – this is after 10 to 12 years of follow-up,“ said Denny.
Initially, vaccines were prescribed in three doses: the first (ab initio), a second is administered one to two months later and then the third, six months later.
However, Denny said it had now been shown to be effective if only two doses were given, ab initio and again six months later.
"Booster doses do not appear to be necessary and all available evidence suggests that two doses will give lifelong immunity or protection against HPV infection and its consequences,” she said.
A study conducted by Lancet in the UK, where the HPV programme was introduced in 2008, showed that HPV vaccinations resulted in an 87% drop in cervical risk among women vaccinated at the ages of 12 and 13 years old, 34% in the 16- to 18-year-old group, and 62% between the 14- to 16-year-olds.
"The study observed a substantial reduction in cervical cancer in young women after the introduction of HPV immunisation programme. It has successfully almost eliminated cervical cancer in women born since September 1995," it noted.
La Hoe said in South Africa the cost was the reason behind the limited target in the country.
But he said the target would be reached if the vaccine became more affordable.
Parents of girls who had reported negative reactions to the vaccine were reluctant to speak to the media.
"My daughter is now fine and doing very well at school," said one.