After over half a year of shortage, the HPV Gardasil 9 vaccine is now available in Hong Kong. This shortage was following Merck’s announcement of a temporary shut down in the production due to a cyber attack. For Hong Kong, this manufacturing glitch has forced patients to wait until just now (if not longer) to have access to the vaccine. According to obstetrician gynecologist Dr. Michelle Tsui 徐行悅醫生, “due to the temporary halt in production, clinics in Hong Kong have had to turn away new patients and keep their vaccine stock for patients who needed a second or third dose.”
In some instances, this shortage has caused concern amongst users who are behind on their vaccination schedule. Not to even mention the vaccination tourism Hong Kong is receiving from mainland China since the newest HPV vaccine has not yet been approved there.
HPV vaccination providers in Hong Kong
Private sector: previously out of stock, the HPV vaccine is now available (but you may be waitlisted!)
In the past few months, a temporary halt in production entailed that most clinics turned away new patients or waitlisted them until they receive new stock. But since December 2017, the newest HPV vaccine is normally available at most family and women’s clinics. Although stock is limited and some women may still be on the waiting list.
The total fee for getting vaccinated varies per clinic and doctor. Patients are generally charged for: the vaccine itself (prices can vary between HK$1,200 and HK$1,700 per dose and you will need three of them) + a possible consultation fee of HK$800+, especially if it is your first visit and/or a possible jabbing fee of HK$100. As private sector fees are not regulated/standardised in Hong Kong, it is always best to ask medical providers in advance for an estimate.
Public sector: free cervical cancer vaccination pilot for low-income teenage girls
The free Hong Kong childhood immunisation program does not include the HPV vaccine. However, in October 2016 the Hong Kong Government started a free cervical cancer vaccination pilot for teenage girls from eligible, low-income families. In collaboration with the Family Planning Association of Hong Kong, girls eligible for the vaccine must be aged 9 to 18 and receive comprehensive Social Security Assistance or aged over 9 and receive the full grant under the School Textbook Assistance Scheme to receive the 9-valent HPV vaccine.
Charity sector: Karen Leung Foundation
The Karen Leung Foundation (KLF) is a charity that aims to educate women and girls in Hong Kong about the necessity and merits of the HPV vaccine. KLF also helps women and girls to gain access to the vaccine. One of KLF’s programs aims to increase HPV immunization amongst age-appropriate girls and young women. The program is designed to collaborate with schools in Hong Kong to provide free vaccinations for girls aged 9 – 15 of low income backgrounds.
Since program inception, KLF has vaccinated 1,625 girls in Hong Kong, and will continue to provide vaccination for approximately another 1,500 girls in the 2017-2018 school year. The vaccine used within the program is the Cervarix bi-valent vaccine which has no shortage in Hong Kong and covers two of the most high-risk HPV virus strains.
HPV is sexually transmitted and can cause cancer
The Human papillomavirus (HPV) is the most commonly sexually transmitted infection and it has been estimated to infect 75% of all sexually active individuals at least once in their lives (important note to couples: unlike most other sexually transmitted infections, HPV can be transmitted between monogamous couples). Almost all cervical cancer cases are caused by HPV, which has driven some countries to include the preventative HPV vaccine in their immunization programs. In Hong Kong the HPV vaccine is not included in the childhood immunisation program and women and girls mostly get vaccinated in the private sector.
HPV vaccine can prevent up to 90% of cervical cancers
In 2006 the first HPV vaccine, Cervarix, was approved by the FDA to be used as a preventative measure against two HPV strains (16, 18) that are known to cause around 70% of cervical cancer cases in the world and two strains that commonly cause genital warts. Since the first HPV vaccine, the 9-valent Gardasil vaccine has been developed and approved by the FDA, which protects against more HPV strains that can cause cancer and genital warts. The newest vaccine has been estimated to protect against 90% approximately of all cervical cancer cases and can be administered to both boys and girls over the age of 9. In Hong Kong, parents can decide when is a good time to consider vaccination based on their child’s situation.
As explained by Dr. Michelle Tsui, “although vaccinating young girls is the most cost effective policy, it is also important to note that women who have started to have sexual relations or had kids will still benefit from the vaccine. The vaccine will protect against the included strains of HPV as long as you have not already contracted it. Women who have had abnormal pap smears in the past are also recommended to consider the vaccine to prevent reinfection or getting infected with other HPV strains.”
HPV vaccine can protect up to 10 years, if not longer
The timing of the vaccination depends on the age. Most commonly three doses are given and recommended to be given 1 to 2 months and 6 months after the initial injection. According to the latest results published by the WHO, the HPV vaccination offers protection for 5 to 10 years, provided that all three doses have been administered. Furthermore, the WHO reported that there is no evidence that the protection against the two HPV strains that cause approximately 70% of all cervical cancers wanes over time.