HPV vaccine: is it for dirty people only?

Back in the late 90s I attended a medical conference in a medical college in Lahore when the speaker, a professor of dermatology, declared HIV/AIDS patients as sinners. It was more than a decade after HIV discovery, but the stigma surrounding HIV was still at its peak. He called it God's punishment on those people who are homosexuals. The whole auditorium applauded this "Islamic touch", and the speaker's face was gleaming with joy and pride once he concluded his speech.

It was not a very new disease then and at least this professor should have known that HIV is not exclusively spread by homosexuals, but there are other routes of transmission too. When he asked questions from the audience, I raised my hand. He was so happy with the audience response that he allowed me to ask the question.

I said, "Sir, are the newborns who get HIV from their mothers also being punished? If yes, for what sins?"

There was a pin-drop silence in the auditorium, and many attendees hated my question and provided the speaker with an escape route by praising him profusely and asking other questions. He had no answer and so-called experts like him just play with people's emotions without facts. Either they are too lazy to research the subject before they speak, or they intentionally hide facts to align with their political or religious beliefs. In this era of social media now people also propagate what can bring them more clicks and more money.

HPV infection is responsible for 95-100% of cervical cancer. Most people will not know if they have been infected by HPV or not. There are no symptoms in most cases except that a few will get warts. According to some conservative estimates, more than 8 million women may have HPV infection in Pakistan. Not all HPV infections turn into cancer, but some do. Pakistan reports around 4,000 women dying of cervical cancer every year, which probably is an under-reported number. In Pakistan when women with cervical cancer come for treatment, it is already too late. That is why Pakistan has one of the highest mortality rates in cervical cancer.

A safe vaccine is available which is being used in around 150 countries. This vaccine provides you around 90% protection against the disease and thus cervical cancer. This should be a no-brainer, but it has provided a fertile ground in social media to generate fears and mistrust of people on government and international organisations. This in return generates some income and audiences. Unfortunately, some popular health professionals with big online presence are also not honest, when they are sowing seeds of suspicion while talking about HPV sexual transmission and vaccine and mixing up two issues "innocently".

How many cancers have vaccines? Actually, there are only two. One is HPV vaccine and the other is vaccine for Hepatitis B. Both will only be effective if you have already not been exposed to specific viruses. That is why young girls are being offered HPV vaccine even though in some countries, women up to the age of 45 years could have this vaccination. This infection is not only for women, men are also prone to it; but it is second or third largest cause of cancer in Pakistani women and that is why it is being offered to girls.

If a safe vaccine which is being used for 10-20 years in most of the world with no major side effects could save your daughter's life from a deadly cancer, then why should anyone hesitate? Multiple large studies have clearly shown that there is no association with infertility or any immunological disorder.

A few years back, I was in Sindh where we had the world's biggest HIV outbreak in children. More than 1,000 young kids were infected, and it was heartbreaking when I was visiting their houses and looking at their innocent faces. They were so young to comprehend the gravity of the situation and according to media reports hundreds of those kids are now gone forever. They were certainly no sinners and it's not a doctor's job to call a disease dirty or clean. Our job is to provide the best treatment and advice to the patient and not judge the person. We are medical doctors and not moral cops.