Immunisation is regarded as one of the safest and most cost-effective of all health care interventions. It is also one of the most effective ways a parent can protect the health of their child.
Worldwide cervical cancer is the fourth most common cancer in women and HPV immunisation is an important part of our childhood immunisation programmes which protects women from developing cancer later in their lives. Ninety nine percent of cervical cancer is caused by persistent infection of certain high risk types of the Human Papillomavirus, which is acquired during sexual contact.
HPV is the most common infection transmitted by intimate or sexual contact in the world. Approximately 50 to 80% of people who are sexually active contract some form of HPV at least once in their lifetime. There are over 100 types of HPV. Around 40 types of HPV can infect the genital tract. Some of these are low-risk types which cause genital warts, while others are high-risk types that are associated with the development of various cancers such as cancer of the cervix, vulva, vagina, anus, penis and throat.
Cervical cancer impacts the lives of a large number of women in Ireland every year. It is the second most common cause of death due to cancer in women aged 25 to 39 years. In 2018 more than 90 Irish women will die from cervical cancer. A further 280 women will need intensive treatment, such as surgery, radiotherapy or chemotherapy, to help them overcome invasive cervical cancer. Unfortunately, 4 in 10 of these women will die within 5 years. A further 6,500 women will need hospital treatment to remove precancerous changes in the cervix.
We are all aware of the old saying that prevention is better than cure, and this is especially true of cervical cancer. In September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools. In 2011 a catch up programme commenced for all girls in second level school and was completed in 2014. Uptake rates for the HPV vaccine peaked at 87% in 2014/15 and have fallen since then.
There are 2 licensed HPV vaccines available in Ireland - Gardasil and Cervarix. Gardasil is the vaccine used by the HSE in the Schools Immunisation Programme. It provides protection against two high-risk HPV types that cause 70% of cervical cancers and pre-cancers, and two HPV types that cause 90% of genital warts. It has been licensed worldwide since 2006 and is used in over 25 European countries, the US, Canada, Australia and New Zealand.
The introduction of HPV immunisation has had a significant impact in many parts of the world. Countries with high vaccine uptake rates have seen the highest impact: In Scotland where 90% of girls have been vaccinated since 2008 there has been a 90% fall in HPV infections in vaccinated girls. Precancerous growths of the cervix have been reduced by more than 50% in countries such as Australia, Sweden and Scotland. Finland recently published the evidence that HPV immunisation protects against invasive HPV-associated cancer.
One of the most important things we can do is to provide accurate and credible information to enable parents to make a fully informed decision concerning HPV vaccination. The HSE National Immunisation Office has developed a comprehensive range of materials for parents, schools and medical practitioners as part of the immunisation programme. The HPV website has been endorsed by the WHO. The HPV Vaccine Information Campaign helps parents access trusted sources of information. This campaign will be supported through social and digital media activity and local and national radio advertisements.
The initial evidence suggests that this campaign is having a positive effect. Provisional figures show uptake rates have increased by 11% this year to 62%. While this increase is very welcome, we must continue to work to get back to we were before. As recently as the 2014/15 academic year the uptake rate for HPV was 87%.
This Government fully supports the HPV immunisation programme and recognises its benefits. We must continue to focus on increasing uptake rates as the best way of reducing cervical cancer, and I would encourage the parents of all eligible girls to ensure that their daughters receive this important vaccine.