Nakuru: The Human Papillomavirus (HPV) vaccination outreach exercise is underway in Nakuru to ensure that no girl contracts HPV - a virus that has been linked to cervical cancer. The County Reproductive Health Coordinator, Ms Nancy Chelule, emphasised the importance of increasing the uptake of the vaccine, as it was safe and had been tested and approved by the World Health Organisation. According to Kenya News Agency, Ms Chelule said they were targeting to vaccinate girls aged 10-14 years in all the 11 Sub-Counties but noted that health workers were grappling with the issue of consent since the target beneficiaries are underage. Speaking at the County headquarters, the coordinator indicated that since the outreach kicked off, 100 pupils had been vaccinated at Karai Primary School, 25 at Sirikwa Primary School, and 22 at Moricho Primary School while 41 had received the jab at Wayside Primary School. She added that parents should know that the vaccine is available for free in all public health facilities. Pri vate hospitals, however, charge up to Sh20,000 a dose. 'We must redouble our efforts to increase the uptake of the HPV vaccine. Protecting our children from preventable diseases is paramount and we have the power to make a difference. The coverage should go beyond 80 per cent, as it is a life-saving vaccine against the preventable cervical cancer,' she said. HPV is a sexually transmitted virus that causes cervical cancer in women, which is a leading cause of cancer-related deaths and the second most common cancer among women. Ms Chelule said besides vaccination, the county was training and equipping health workers to effectively screen for cervical cancer and offer pre-cancer treatment. 'It is now possible for women to get screened and treated at Sub-County hospitals. Further tests can be referred to the Nakuru Teaching and Referral Hospital, where there is a histology lab,' the County Reproductive Health Coordinator explained. According to the World Health Organisation (WHO), cervical cancer is the fourth most common cancer among women globally. The global strategy to accelerate the elimination of cervical cancer requires every country to have 90 per cent of girls vaccinated with the HPV vaccine by age 15 and 70 per cent of women screened by age 35 and again by 45 years. Ms Chelule explained that the HPV vaccine is the only effective way of preventing cervical cancer. 'The HPV vaccine allows the body to create antibodies which fight against the HPV virus that causes cervical cancer,' she stated. HPV vaccination was rolled out by the State in 2019, following a successful pilot programme in Kitui between 2013 and 2015. Under the programme, the Ministry of Health targeted 3.2 million girls across the country who would have received at least one dose by June 2023. Due to past low completion rates (only 31% completed two doses in 2021) and vaccine hesitancy, the Ministry of Health is focusing on community-based outreach, involving teachers, and engaging community health promoters. Ms Chelule pointed out that the HPV vaccine, which comprises two injections taken six months apart, should ideally be administered to girls and women before they become sexually active and exposed to HPV. A three-dose schedule is offered to persons above 15 years. She said the biggest challenge with prevention of HPV infection is lack of information. 'We call upon every parent with a preteen child to partner with us to protect our children against HPV infection and in so doing protect them from a number of cancers caused by HPV,' she added. WHO recommends that comprehensive cervical cancer control should include primary prevention (Vaccination against HPV), secondary prevention (screening and treatment of precancerous lesions), and tertiary prevention (diagnosis and treatment of invasive cervical cancer and palliative care). Despite the low national uptake of the HPV jab, it is higher in some counties but remains low in others. For example, Kirinyaga has 80 per cent of target girls vaccinated, whereas Kwale is among counties with low vacci nation rates at only 12 per cent. The coordinator noted that HPV causes about 99 per cent of cervical cancer, reported at the tender age of 25 years. 'My conversation with parents and guardians is that it is irresponsible to fail to take our girls for the vaccine. Cervical cancer is not a disease to wish for anybody. It bleeds and kills, and it needs not to happen,' she observed. To boost the uptake of the jab, Ms Chelule said the county government is fighting misinformation associated with the vaccine through sensitisation at the community level. 'Vaccination of our girls with the HPV vaccine is the only sure way of fighting cervical cancer. We have to protect the future generation by vaccinating our girls. It is worrying that the disease is killing people left, right and centre, yet we are not utilising the solution with us,' added the official. There are three different types of HPV strains, with over 100 serotypes (different viruses), of which 14 are divided into high-risk, intermediate and low-risk. Th e high-risk strain is mostly associated with cervical cancer. Pre-teens and pre-adolescents are the main targets in HPV vaccination because they have the lowest sexual activity, unlike adults, who are most likely to have been exposed to any one of the HPV subtypes. Ms Chelule affirmed that if vaccination is initiated early, the morbidity and the burden that come with cervical cancer significantly reduce. The expert further encouraged women to undertake regular screening for earlier detection of cervical cancer. But due to low uptake of screening and late diagnosis, most patients present with a locally advanced stage. Cancer has a protracted period, which takes about 10 years to present symptoms. 'Screening is essential because it will help detect cancer at an earlier stage. But the majority present at stages 3 and 4, when they have abnormal bleeding, are cases attributed to delayed presentation from patients and delayed clinical presentation,' Ms Chelule said. There are three methods of screening for cervic al cancer, namely the use of visual inspection, pap smear and HPV DNA testing. Visual inspection is applied in remote areas like Isiolo and Wajir, where visual inspection is done to examine the cervix, to identify abnormality, by use of Lugol's iodine or acetic acid. The HPV DNA test is a blood test that examines if a patient has any of the subtypes associated with cervical cancer. Women are encouraged to undertake cervical cancer screening regularly, up to the age of 69 years. As per the National Cancer Institute of Kenya, at least 8 in 10 women in Kenya have heard of cervical cancer, but only 2 of the 8 go for early screening.