More than 2 million adolescents still cannot access the vaccine against human papillomavirus (HPV) due to the delay of the Ministry of Health (Minsa) in regulating Law No. 31883, which established the extension of this dose up to 18 years of age on September 30 of last year. Due to the lack of this regulation and despite the public health problem that the country is experiencing due to the increase in cases of cervical cancer, said antigen has not been included in the 2024 National Vaccination Plan.
With 5,746 confirmed cases between 2021 and 2023, cervical cancer, after breast cancer (4,623), is the pathology most frequently treated in hospitals and, at the same time, the first cause of death in women —50% of them die—, according to Minsa statistics between the years 2021 and 2023 (see infographic).
“Cervical cancer is what is affecting the population the most. That surprises us, because we have molecular detection of HPV, visual inspection with acetic acid and pap smear. It really catches our attention why we have this pathology so frequently,” Víctor Palacios, head of the Minsa’s Cancer Prevention and Control Directorate, told Perú21.
Of 100 women who undergo screening in one of the 19 specialized centers, 15% test positive for HPV, so they must enter a medical monitoring system; The remaining 85% take the test again within the next five years, the official stressed.
THERE IS NO REGULATION
With the aim of preventing this growing deadly disease, last year the Minsa included vaccination against HPV in boys and girls from 9 to 13 years old, achieving coverage of 96.1%.
However, the sector led by César Vásquez has not yet approved the regulations of the law that could protect the health of thousands of adolescents between 14 and 18 years old before they begin their active sexual life.
“This plan contradicts what is established in Law No. 31883, which expanded HPV vaccination coverage up to 18 years of age, which was approved with the favorable opinion of the Ministry of Health, thus leaving more than two million young people without the possibility of being immunized against HPV. The law clearly specified that the target group would include girls, boys and adolescents from 9 to 18 years of age, establishing a legal basis that has been overlooked in the formulation of the National Vaccination Plan against HPV,” said Pilar Collantes, president of the Citizen Voices Association.
HPV is responsible for approximately 99% of cervical cancer cases, one of the main causes of morbidity and mortality in women, he added.
Dr. Palacios said that his department is not opposed to expanding vaccination to more age groups, and even to it being applied freely. “In the United States, this vaccine is administered up to age 26. We, as the Cancer Directorate, are not opposed; “We support that this vaccine can be administered freely,” he stated, although he specified that, according to WHO recommendations, to eradicate cervical cancer, vaccinating girls before the age of 15 should be prioritized.
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EXPERTS SAY NO
In turn, Magdalena Quepuy, executive director of the Immunization Directorate of the Minsa, explained to Perú21 that the National Institute of Health (INS) has given the green light to this public health policy, but the sector’s Committee of Experts has not found studies that endorse the effectiveness in adolescents from 14 to 18 years old.
“The National Institute of Health (INS) has given approval, it has given approval, but we also have a Committee of Experts from the Minsa that issues an opinion. Last week we had a meeting and (the Committee) issued an opinion: the point is how effective the vaccine is in those who have had sexual contact. And they have not found studies that support this. First, giving a 16-year-old girl the vaccine does not guarantee that she has not developed the disease; Second, that in that person who has already had sexual contact, a dose will not be required, but a higher dose. Therefore, we would have to program greater resources to be able to make the additional purchase of vaccines… that is why we require the studies, that is why we are delaying,” he argued.
Asked about the age at which adolescents, men and women, begin their sexual life, Quepuy said that “we do not have that information,” although she later argued: “It will depend on cultural patterns: while in areas urban or mountain is later; in the jungle it is more premature: the range is 12 to 13 years. Therefore, this age range was taken to define the objective population.”
However, he indicated that the Minsa should already have a response on the effectiveness of vaccination against HPV in adolescents up to 18 years of age by May or June of this year. To implement this vaccination, the sector would adapt this vaccine to the national plan, making several regulatory modifications.
Keep in mind
Cervical cancer is caused by 13 types of HPV and can be acquired by anyone who has started their sexual life.
The Minsa recommends the use of condoms during sexual relations, maintaining only one sexual partner and undergoing periodic preventive check-ups.
Until February 29, the Minsa is developing a national campaign to close gaps in regular vaccines.
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