Accept the life of the vaccine – save in the Arab world – Articles

Strict religious commitment is common in Arab societies and has relatively conservative sexual behavior compared to other cultures.² Historically, the prevalence of sexually transmitted infections (including HPV) has been low in this geographical region compared to the rest of the world. .³ But with the rapid changes in lifestyle that have come with globalization, patterns of sexual behavior – especially among the younger generation – have become more liberal. This phenomenon is expected to increase the prevalence of sexually transmitted diseases and associated cancers, such as cancer of the cervix, in the Arab region.²

Despite the efforts made over the past two decades, screening tests for cervical cancer in the Middle East and North Africa (MENA) region are relatively low. The World Health Organization (WHO) and other health bodies and experts are trying to defend the HPV vaccine as a method of effective intervention to overcome barriers to access to health services and to eliminate most related cancers to HPVs that can be prevented. However, religious and conservative traditions throughout the MENA region have prevented the inclusion of the HPV vaccine in national vaccination programs by health policy makers in anticipation of popular reaction.

Estimate behaviors in research

To explore this, a recently published systematic review in EMHJ, the WHO's Official Regional Office for the Eastern Mediterranean, investigated the awareness of HPV infection and accepted the vaccine among several subgroups in the Arab countries. ⁴ The results revealed a high-to-medium acceptance of the HPV vaccine – despite the low to moderate knowledge of HPV infection – and the openness between the general public and health professionals, to find out more about the virus and its prevention.

Another recent study was conducted in Tunisia, involving 452 women and 55 gynecologists⁵ And he studied the acceptance of the HPV vaccine. The aim of this work was to conclude the estimated success rate of the potential national HPV vaccination program in Tunisia based on the responses of women and health professionals involved in the Cervical Cancer Prevention Program (a role played by gynecologists in Tunisia).

The results revealed very high levels of acceptance of the HPV vaccine and a clear interest in learning more about the methods of cervical cancer prevention among Tunisian women. More than 80% of the women surveyed said they were willing to receive the HPV vaccine if recommended by their doctors. They also expressed willingness to pay for the future vaccination of their daughters against HPV, even if the cost is relatively high. More than 90% of the women interviewed supported the introduction of the HPV vaccine in the national immunization program to make it available to all Tunisian girls.

Significantly high rates of HPV vaccine acceptance were found despite limited knowledge of women involved in HPV and cervical cancer. Only 38.7% of women understood the causal link between HPV infection and cervical cancer and only 38.9% were aware of the recommended frequency of Pap test.

These findings confirm general public support for the HPV vaccine and that the cultural causes commonly cited by health authorities as a major obstacle to the vaccination program against HPV are not evidence-based. This trend is not limited to Tunisia alone. Other studies have indicated the same medium-high tolerance for the HPV vaccine among women in other countries in the Middle East and North Africa^{4 ,6} .

Educating health professionals

Interestingly, the study found less evidence of acceptance of the HPV vaccine among interviewed gynecologists. Most survey obstetricians / gynecologists reported extensive knowledge of cervical cancer and Pap smears, while their knowledge of the HPV vaccine was relatively lower. The doctors stressed the high cost of vaccination as a determining factor for the delivery of the HPV vaccine extensively. For example, the current price of a dose of bivalent vaccine in the Tunisian pharmacy is around 45.7 USD⁷ While the wholesale price can reach US $ 9.50 per dose when the vaccine is included in a vaccination program⁸ .

Other factors cited included the cultural barrier associated with the introduction of a vaccine against sexually transmitted infections in Arab societies that do not allow extramarital sexual relations, low awareness of HPV among women, the relatively limited knowledge of 39, immunization, their efficacy and possible side effects.

There is growing evidence that there is an urgent need for rapid cooperation between countries in the MENA region to develop continuing education for HPV vaccination among health professionals involved in cervical cancer prevention. This will ensure that healthcare professionals are experienced in vaccination and how they encourage their patients to adopt it. The intervention strategies in the field of education and awareness raising, addressed to health workers or Arab women in general, will undoubtedly improve the knowledge of HPV and its complications and the potential success of national vaccination programs. HPV in the MENA countries.