Dr. Naznin Akter’s journey in safeguarding special girl children against human papillomavirus (HPV)

"My mother used to have excessive bleeding and pain during menstrual periods. Later due to the pain becoming unbearable, she had to have her uterus removed through surgery in order to prevent cervical cancer as she was in high risk of contracting the disease since she was not vaccinated against Human Papillomavirus (HPV)," said Dr. Naznin Akter, a general practitioner and ultrasonologist at Surjer Hashi Clinic. A mother of two children, Dr. Naznin Akter also works as a master trainer for the Expanded Program on Immunization (EPI), providing training to vaccinators assigned by Dhaka City Corporation.

In the face of the daunting reality of cervical cancer in Bangladesh, which claims the lives of nearly 5,000 women each year, an effective solution emerged through the HPV vaccine. The Government of Bangladesh in collaboration with UNICEF, the Vaccine Alliance (Gavi), and World Health Organization (WHO), initiated an HPV vaccination campaign in Dhaka division, which started from October 2023. To be implemented in three phases throughout the entire country covering all the other divisions gradually, the HPV campaign is targeting over 10 million girls in grades V to IX as well as those who are out of educational institutions aged between 10 to 14 years, providing them the vaccine free of cost.

Battle against cervical cancer

When Dr. Naznin Akter learned about the HPV vaccination campaign during a training session at the EPI headquarters, her personal connection to the impact of cervical cancer fueled her determination to spearhead a session at Proyash Institute of Special Education where her son is enrolled. Proyash is a specialized institution which provides services for the holistic development of children with special educational needs.

"As a mother of a child with special needs, I am aware of the extra care they need, especially girls. Being a doctor and recalling my mother’s prolonged sufferings, I saw it as both my responsibility and an opportunity to ensure that the girls studying in Proyash who are eligible to take this vaccine are protected against the deadly disease caused by HPV. Besides ensuring the vaccination of my own daughter at her school, my aim was to extend this opportunity to the girls studying at my boy’s school," said Dr. Naznin Akter.

Overcoming HPV myths and spreading awareness

However, organizing the session at Proyash presented its own challenges. Deep-rooted myths and societal taboos surrounding HPV vaccine, such as the misconception that it's ineffective past age 12 and the unfounded belief in side effects like infertility, cast a shadow, making parents hesitant to vaccinate their children. Adding to the reluctance was the apprehension stemming from the recent launch of the vaccine, with parents fearing potential adverse reaction on their children.

Undeterred, Dr. Naznin Akter arranged multiple counseling sessions with teachers and school administration members. Her persistence paid off when the school principal gave her the word to counsel parents together with the teachers and distribute booklets explaining the vital importance of HPV vaccination along with information about the safety and efficacy of the vaccine. This comprehensive approach not only provided valuable information but also helped quell concerns and debunk common myths. However, Dr. Naznin Akter believes that direct counseling from doctors could have significantly increased registration among parents.

During the one-day vaccination session at Proyash, 25 girls received the HPV vaccine. The initial phase in Dhaka division encompassing all 13 districts, spanning four months, thus far saw 1,489,193 eligible girls receiving the vaccine after registering through the "Vaxepi" app or website.

“I took my daughter to her school today so she could receive the HPV vaccination. Cervical cancer has always worried me since I have a girl child and not getting her vaccinated against HPV will put her in danger as she grows older. I read all the available information on this vaccination. I can confirm that it is very safe. In order to provide children a healthier and more prosperous future, I would strongly advise all parents to register their daughter for this vaccine,” said Ms. Farhana Azad, a parent at Proyash.

A safer tomorrow for girls in Bangladesh

In Bangladesh, millions of women die from cervical cancer, a disease which can be prevented by a single dose of vaccine to girls at an early age. Despite cervical cancer being the second most common cancer among women in Bangladesh and causing the highest number of cancer-related deaths, many people are not aware about the dangers of HPV and the importance of getting vaccinated. To raise awareness and encourage more people to get vaccinated against HPV, Dr. Naznin Akter believes it is critical to organize counselling and awareness sessions for the general public. "The collaborative efforts of UNICEF and healthcare workers played a pivotal role in organizing the vaccination session at Proyash. Many parents registered their children on the spot after hearing fellow parents share positive vaccination experiences. By combining our efforts, we can eliminate cervical cancer from the nation,” said Dr. Naznin Akter.

Beyond the initial session, Dr. Naznin Akter’s advocacy continued, with parents who missed registering their daughters, seeking guidance and expressing interest in registering them. The post-session influx of parental inquiries underscores the growing awareness and trust in the HPV vaccine, echoing the broader significance of the nationwide campaign. Community engagement and awareness sessions at schools with active participation of teachers, parents, and Board members, are crucial for the successful introduction of new vaccines such as the HPV vaccine.