Journalism of Courage
An affordable and indigenously developed HPV (human papillomavirus) vaccine to prevent cervical cancer is now ready and will likely be included by the Union government in its universal immunisation programme.
The vaccine, Cervavac, was developed by Serum Institute of India with the support of the Department of Biotechnology and will likely be priced between Rs 200 and Rs 400 per dose.
Serum Institute of India CEO Adar Poonawalla, on the sidelines of an event to celebrate the “scientific completion” of the vaccine, said: “The government of India will induct it in a few months in the national programme. It will be affordable.”
HPV is a common sexually transmitted infection. Cervical cancer, caused by persistence of certain high-risk strains of the HPV virus, continues to be the only type of cancer preventable by vaccines. Two vaccine doses are supposed to be administered to teenage girls before they are sexually active.
Two officials, requesting anonymity, confirmed to The Indian Express that the government was working on rolling out an HPV vaccination drive, which would be part of the universal immunisation programme, for girls between the ages of nine and 14.
The National Technical Advisory Group on Immunisation had said in a June 28 meeting (the minutes were released on July 17): “The indigenously developed qHPV vaccine may be considered for introduction in the UIP as a two-dose regimen… once the HPV WG satisfactorily reviews the requested data.”
India accounts for about a fifth of the global burden of cervical cancer, seeing 1.25 lakh cases and 75,000 deaths a year. The SII vaccine is quadrivalent, meaning it protects against the four most common strains of the virus known to cause cancers — HPV 16, 18, 6, and 11. Around 83 per cent of invasive cervical cancers are attributed to HPV 16 or 18 in India.
The country’s drug regulator approved the vaccine in July after examining data of its immunogenicity trials conducted across thirteen centres. At the trials, the response of the SII vaccine was compared to Merck’s Gardasil quadrivalent vaccine.
Poonawalla said that the vaccine is likely to be priced between Rs 200 and Rs 400 per dose, but added that discussions for finalising the prices are on with the government.
To compare, the vaccines available in the market are priced between Rs 2,500 and Rs 3,300 per dose. The SII vaccine will be provided to the government first, followed by the market, and then globally, with the company aiming to manufacture 200 million doses over the next two years.
Cost had been a major hurdle in rolling out universal immunisation for HPV.
Dr Rajesh Gokhale, Secretary, Department of Biotechnology, told The Indian Express that antibodies developed after the two doses can last between six and seven years and, unlike Covid-19 vaccines, boosters may not be required for the cervical cancer vaccine.
“This indicates India’s tremendous capacity to develop vaccines,” said Dr Gokhale, adding that the vaccine will be launched this year . “This is a much-needed low-cost, affordable quadrivalent HPV vaccine that will help prevent cervical cancer deaths in India and globally.”
Union Science Minister Dr Jitendra Singh, a medical doctor himself, said at Thursday’s event that this was a big step in preventive healthcare in the country. He said not only has the Covid-19 pandemic awakened India to the importance of preventive healthcare, the Modi government’s policies such as Ayushman Bharat have put the country in a position to enjoy what was thought to be the luxury of preventive healthcare.
The vaccines can prevent an infection, but cannot clear it once it happens. For older individuals, three doses are recommended. Worldwide cervical cancer is the second most common type of cancer according to the WHO’s International Agency for Research on Cancer.
“Instead of looking at cancer incidence among the vaccinated, we can just look at whether it prevents persistent infection as that has been well linked with cervical cancer. For this vaccine, we have looked at the immune response generated and compared to already existing vaccines in the market,” said Dr Neerja Bhatla, one of the investigators of the trial and the head of the department of obstetrics and gynaecology at the All India Institute of Medical Sciences.
According to Dr Smita Joshi, who was Principal Investigator for SII’s HPV vaccine study, there is a huge need for stepping up awareness about the disease and the vaccine in the community. “Unlike Covid-19 and the vaccination programme, there is very little awareness about cervical cancer. Overall awareness and screening is very low in the community and that is a concern. This is a preventable disease and hence a huge awareness programme is required,” Dr Joshi said.
WITH INPUTS FROM ANURADHA MASCARENHAS IN PUNE
