by Tania Hassan | Staff Writer

HPV (human papilloma virus) infection remains one of the most widespread sexually transmitted infections. In actuality, it is estimated that almost all nonvaccinated sexually active individuals will catch the virus at some point in their lives. While many of these infections are asymptomatic, prolonged infection with HPV is the main cause of cervical cancer. Like all cancers, cervical cancer includes the unregulated growth of cells, leading to damage to the surrounding tissue. This growth, if left untreated, can spread to different parts of the body and eventually cause death.

A common saying in medicine is that prevention is better than the cure; this definitely applies to cervical cancer and HPV. Vaccines have been available for almost a decade, but controversy still exists over whether their benefits outweigh their risks.

The most common reason for not administering the HPV vaccines are concerns over adverse effects. Nevertheless, about 92.4% of the adverse events are not serious; there are no common patterns that would suggest that the vaccine caused any deaths. While some concerning reports showed that the HPV vaccine could trigger certain severe symptoms, the overwhelming evidence favors administration of the vaccine to prevent HPV symptoms, in addition to preventing cervical cancer.

This, however, does not mean that cancer screening should stop. Considering that HPV vaccines, like all other vaccines, may not protect all vaccinated individuals, regular screening programs should be maintained irrespective of whether a person receives HPV vaccination.

The relatively minor side effects of the vaccine seem to be worth the almost 100% effectiveness in preventing precancerous lesions caused by HPV. Several studies have demonstrated the long-term durability for protection against infections caused by the vaccine. Moreover, a US survey documented a 50% decrease in viral prevalence from the pre-vaccine years to the post-vaccine era, and a consequent drop in cervical cancer cases.

In developing countries, however, the burden of HPV infection is increasing. Lebanon, for example, has always been a conservative country, where sex before marriage was not permitted. This has led to a lack of sexual health education, including education about HPV and cervical cancer, leaving many women at risk of getting cervical cancer. Therefore, in parallel to the breaking down of taboos related to sex, we should build public awarness to prevent unsafe sex practices, sexually transmitted diseases, and cervical cancer.

References:

Abou El-Ola, M. J., Rajab, M. A., Abdallah, D. I., Fawaz, I. A., Awad, L. S., Tamim, H. M., Ibrahim, A. O., Mugharbil, A. M., & Moghnieh, R. A. (2018). Low rate of human papillomavirus vaccination among schoolgirls in Lebanon: barriers to vaccination with a focus on mothers’ knowledge about available vaccines. Therapeutics and clinical risk management, 14, 617–626. https://doi.org/10.2147/TCRM.S152737

Dany, M., Chidiac, A., & Nassar, A. H. (2015). Human papillomavirus vaccination: assessing knowledge, attitudes, and intentions of college female students in Lebanon, a developing country. Vaccine, 33(8), 1001–1007. https://doi.org/10.1016/j.vaccine.2015.01.009

Intlekofer, K. A., Cunningham, M. J., & Caplan, A. L. (2012, January 1). The HPV vaccine controversy. Journal of Ethics | American Medical Association. Retrieved November 12, 2021, from https://journalofethics.ama-assn.org/article/hpv-vaccine-controversy/2012-01 .

Nicol, A. F., Andrade, C. V., Russomano, F. B., Rodrigues, L. L., Oliveira, N. S., & Provance, D. W., Jr (2016). HPV vaccines: a controversial issue?. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 49(5), e5060. https://doi.org/10.1590/1414-431X20155060

White M. D. (2014). Pros, cons, and ethics of HPV vaccine in teens-Why such controversy?. Translational andrology and urology, 3(4), 429–434. https://doi.org/10.3978/j.issn.2223-4683.2014.11.02