Exclusive | Fresh push for HPV vaccination from top advisory body on immunisation

HPV vaccines in India have been mired in controversy for the last 13 years after eight girls died during clinical trials and activists accused vaccine makers and government agencies of violating research ethics.

Vaccination against Human Papilloma Virus (HPV) for adolescent girls, meant to lower the risk of cervical cancer, has received a fresh push with the top advisory body on immunisation recommending it under the Universal Immunisation Programme (UIP), Moneycontrol has learnt.

The National Technical Advisory Group on Immunisation (NTAGI) at a recent meeting suggested introducing the vaccine for girls aged 9-14 years at the earliest but also acknowledged that the final decision may depend on the Supreme Court, which has been hearing a petition related to the vaccines’ clinical trials in India.

The Indian Academy of Paediatrics Committee on Immunisation recommends that HPV vaccines should be given as a two-dose regimen six months apart for girls below the age of 14 years while for those above 15 years, the shots can be given in a three-dose regimen.

The introduction of HPV vaccination has been embroiled in controversy since the vaccine’s clinical trial days in 2009 when the deaths of some trial participants came to light.

PATH, a non-profit from the US, in partnership with the Andhra Pradesh and Gujarat governments had recruited nearly 24,000 pre-adolescent girls who were administered MSD and GSK vaccines in the trials, overseen by the Indian Council of Medical Research (ICMR) and the Drug Controller General of India (DGCI).

However, eight of the girls died and public health activists had accused PATH and other agencies involved of violating research ethics by enrolling the girls without their guardians’ informed consent.

The incident had led to a 2012 activists filing a writ petition in the apex demanding action against the DCGI, ICMR, PATH, MSD, GSK and the two state governments. Ten years later, the case is still ongoing.

“We are aware that pending the judgment, this vaccine can’t be launched in India but in the wake of fresh evidence supporting the efficacy of the vaccines in contrast to the disease burden, it is imperative that the jabs be incorporated in the UIP,” said an NTAGI member.

Cervical cancer burden in India and the hurdles in introducing vaccines against it

Cervical cancer is the most prevalent form of cancer among women in India after the cancer of the breast and every year over a fourth of this disease burden reported globally is from the country.

A recent study from the UK, on the other hand, had shown that the existing vaccines reduced the risk of developing cervical cancer by 62 per cent in women between the ages of 14 and 16.

The introduction of the vaccines in India, however face many hurdles and several groups, including Rashtriya Swayamsevak Sangh (RSS) affiliate Swadeshi Jagran Manch, have been opposing them.

Some health experts have also been pointing out the issue of rare side effects from the vaccines as since the introduction of HPV vaccines worldwide, Japan and Denmark have reported few cases of autoimmune illnesses in vaccine recipients.But no large study, so far, has conclusively established a link between the vaccines and these illnesses, and several health bodies such as the World Health Organisation, the US Centre for Disease Control and Global Advisory Committee on Vaccine Safety recommend administering the vaccines to prevent cervical cancer.

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