KUALA LUMPUR, Jan 12 — The Malaysian chapter of global health care company MSD has donated 300,000 human papillomavirus (HPV) vaccines worth approximately RM500,000 to vaccinate girls across all 222 parliamentary constituencies.
The HPV vaccines, which help prevent cervical cancer, will be distributed through a collaborative effort by the Ministry of Health (MOH), the Health Parliamentary Special Select Committee (PSSC) and the National Cancer Society of Malaysia (NCSM) in a multi-sectoral HPV vaccination drive.
The programme, titled “Leaving No One Behind: Eliminating Cervical Cancer in Malaysia”, is designed to complement the existing National Immunisation Programme (NIP). It will involve the active participation of Members of Parliament, state assemblymen, the Social Welfare Department, and about 70 other non-government organisations (NGOs).
NCSM managing director Dr Murallitharan Munisamy, winner of the Global Best Cancer CEO award, highlighted the importance of engaging MPs, district health offices, and NGOs to identify and create a list of targeted communities, including school dropouts, single mothers, orang asli communities, and female sex workers.
This information will guide the development and implementation of a vaccination plan.
“To ensure that we have and will be able to give this programme to the group that needs it, we will approach each parliamentary location and ensure that, firstly, we will get input from MPs’ offices.
“Parliamentarians are officers or representatives that are ready to understand and know their constituents and also understand those who are poor, asnaf (zakat aid recipients) and so on. Indeed, your honourables’ offices have been helping every week.
“Secondly, is the district health office which will have a list of chronic patients, people with disabilities (PWD), and so on.
“Thirdly, are the NGOs and community associations that are carrying out activities aiding your honourables,” Dr Murallitharan said during the “Leaving No One Behind: Eliminating Cervical Cancer in Malaysia” launch held in the Parliament building last November 23.
A vaccination plan will then be developed and implemented in three phases: communication, vaccination, and observation.
Dr Murallitharan said the communication phase is vital to address potential vaccine hesitancy, as Covid vaccinations have resulted in the public becoming vaccine wary.
The programme will have a multilingual campaign and a tele-call centre that will employ a 1-800 free-to-call number that the public can call if they have any queries about the HPV vaccine.
“This call centre will provide psychosocial services. There will be a counsellor, psychologist, and so on, to tackle mental health queries that might arise among any of the circles that are hesitant to take the vaccine,” Dr Murallitharan added.
Dr Murallitharan said the NCSM will then target girls and women between the ages of nine and 20, utilising available data, for HPV vaccination. Women below 45 can also request to be vaccinated.
“We will conduct the vaccination programme via two methods. For constituents or those who are in your honourables’ parliament constituencies that are maybe from the PWD group or [who] are [living] in the interiors, we will conduct house-to-house vaccinations.
“That is the first method. The second is through the pop-up mobile method, where we will have halls or — centres which became very popular during Covid – PPVs (vaccination centres), small PPVs, public halls, community centres and also your honourables’ offices, if need be.”
When it comes to vaccinating boys and young men for HPV, Dr Murallitharan stated that the programme is prioritising the female population first and only if there is an access of vaccines will males be vaccinated.
“Currently, we are running, ‘Let’s do the girls first’, because of our [vaccine] numbers. We work out that we have to power the girls first. Once we’re done with that, if we have excess, for sure [we will vaccinate boys]. Like I was saying, my job is to make sure that in one and a half years I will have no more vaccines. So, our first layer is the girls, and then once they’re done, by all means.
“For example, in an orang asli village, and I’m very happy to share this example, if I’m going to vaccinate the girls, I’m going to vaccinate the boys as well. Because there is no way in a thousand years is there anyone who is going to come back and do those programmes,” said Dr Murallitharan.
The American Centers for Disease Control and Prevention (CDC) states that HPV can cause penile cancer, anal cancer, oropharyngeal cancer, warts, unusual growths, lumps, or sores in men. Although there are no screening methods for HPV in men, the CDC recommends that boys and men also get vaccinated against HPV.
Post-vaccination, the NCSM team will observe vaccinees for 72 hours through phone calls to ensure that there are no side effects.
To prevent double vaccination, the programme avoids schools and utilises snowball sampling, a non-probability sampling method where currently enrolled participants help recruit future subjects, to reach target groups.
“This programme, we will do with the education and empowerment to community volunteers, and most importantly, is done in a bottom-up way. We will take the labour and a great burden to ensure that we will reach every girl and woman who needs it in all your parliamentary constituencies.”
Dr Murallitharan appealed to MPs to collaborate with NCSM, so that HPV vaccinations can begin in their constituencies.
The pilot test for the programme, according to Dr Murallitharan, began last December with phase one set to kick off in East Malaysia with Sabah and Sarawak before moving on to the peninsular. He also said that NCSM is expected to complete the first round of vaccinations in six months.
Current Health Minister Dzulkefly Ahmad, who was then-Health PSSC chairman, said that the involvement of the health PSSC in the programme was an unprecedented one and expressed his thanks to NCSM for approaching him with the proposal and to former Health Minister Dr Zaliha Mustafa for trusting the PSSC with this task.
“We hope in six months, we can roll out this programme, and here we hope that all your honourables in your respective areas [can help] to identify how we can roll out this programme and moralise [so that] we will be able to give out all 1,500 doses at each parliamentary constituency,” said Dzulkefly during the event.
Dr Zaliha, who is now Federal Territories Minister, commended NCSM on the complementary programme.
“This will be a complementary programme to the efforts of the Health Ministry which plans to eliminate cervical cancer in Malaysia by the year 2030.
“This noble effort by NCSM not only helps protect individuals from the risk of cancer, but also contributes to overall health prevention and recovery efforts,” said Dr Zaliha in her speech at the event.
In 2022, the World Health Organization’s (WHO) Immunisation Data portal reported zero coverage for the last dose of the HPV vaccine among females aged 15 and above in Malaysia.
The country’s vaccination coverage for the HPV vaccine significantly declined to 39 per cent for the first dose among girls aged 15 and older during the Covid-19 pandemic.
In 2021, Malaysia recorded 14 per cent and 13 per cent coverage for the first and last dose of the HPV vaccine respectively that helps prevent cervical cancer.
As of June 2023, more than 300,000 girls who missed their HPV vaccination in the years 2020 to 2022 were still awaiting their doses.
In late August 2022, NCSM and other advocates raised concerns about the fact that over half a million girls have missed their HPV jabs due to school closures during the pandemic.
NCSM revealed that, based on previous HPV vaccination rates, approximately 176,944 and 186,593 13-year-old girls would have missed their HPV shots in the disruptions of the National Immunisation Programme (NIP) in 2020 and 2021, respectively.
An additional 200,000 girls in this cohort are estimated to have missed their vaccinations in the current year, resulting in at least 560,000 teenagers in Malaysian secondary schools missing out on their HPV vaccinations, crucial for preventing cervical cancer.