Parliament: Free opt-in cervical cancer vaccine for Sec 1 girls from this year

SINGAPORE - All Secondary 1 girls in national schools, including madrasahs, will be offered free vaccination from next month to protect them against cervical cancer.

About 200 women get the cancer each year and 70 die from it, said Senior Minister of State for Health Dr Amy Khor on Wednesday (March 6).

She said: "This cancer, which is caused by infection with the Human Papilloma Virus (HPV), can be prevented with vaccination and screening."

The vaccine protects women against common HPV strains which primarily causes cervical cancer, but can also cause vulva, vaginal and anal cancers.

As a one time catch-up, the offer will be progressively extended to all girls currently studying in Secondary school.

Those of similar age studying in private education institutes will also be offered the free vaccination, if they are Singapore residents.

The government has put aside $10 million for this year, and $2.5 million annually from next year.

This is an opt-in scheme.

Singapore has picked the oldest of three HPV vaccines on the market, Cervarix, which protects against HPV strains 16 and 18, which account for 70 per cent of cervical cancers.

The MOH told The Straits Times that Cervarix was selected based on factors such as efficacy, price and stock availability.

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Its spokesman added: "MOH is evaluating Gardasil 9 to compare it to the other two HPV vaccines. If found to be cost-effective in the local setting compared to Cervarix or Gardasil, MOH will consider offering Gardasil 9 under the school-based programme in the future."

Gardasil 9, the only HPV vaccine used in the United States, protects against nine strains that account for 90 per cent of cervical cancers.

HPV is generally transmitted during sex, and the vaccine is recommended before women become sexually active.

Girls who are 14 years and younger need two doses of the vaccine while those who are 15 years and older require three doses.

The first dose will be given in Secondary 1 and the second dose the following year. A third dose will be given to older students. The vaccination will be done in school.

Depending on the vaccine used and the age of the person, cost ranges from about $300 to more than $700 for the full course of two or three doses.

Up to $400 from Medisave can be used for two of the HPV vaccines, for females between the ages of nine and 26 years.

More than 70 countries, including Brunei and Malaysia have included the HPV vaccine in their national immunisation programme.

Women who have had the vaccine will still need to go for regular Pap smear tests to check for cervical cancers, since the vaccine does not protect against all strains.

The ministry also announced that it will be adopting a more accurate cervical cancer test which will allow women to test every five years, instead of every three years.

"The better test will cost more, but the Government will provide more subsidies, so the cost to women will be the same in the long run," said Dr Khor.

This is part of the MOH's move to increase disease prevention so as to reduce the strain on healthcare services down the line.

Another change in this direction is to introduce non-fasting blood tests for diabetes and cholesterol. From May, these tests will be available at the more than 1,000 Community Health Assist Scheme (Chas) GP clinics.

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This way, the doctors would be able to recommend, and immediately carry out, such tests instead of getting the person to come back another day with his stomach empty.

Under Screen for Life, such tests are free for the Pioneer Generation, and cost $2 for Chas cardholders. From Nov 1, the Merdeka Generation will also pay $2. All other Singaporeans pay $5.

Dr Khor said women who had gestational diabetes, and are therefore at higher risk of getting diabetes, will be automatically eligible for subsidised screening without needing to take the risk assessment test.

To cut the risk of cardiovascular diseases, the MOH plans to ban partially hydrogenated oils (PHOs), which is a key source of artificial trans fat.

This is a step further than the 2 per cent limit of trans fat in fats and oils introduced in 2013. That has reduced daily trans fat intake from 2.1g in 2010 to 1g last year.

The ban will also apply to all pre-packaged food, like noodles and cookies.

Mr Amrin Amin, Senior Parliamentary Secretary for Health, said the ban "should not have an adverse effect on Singaporeans' food options and cost".

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This article was first published in The Straits Times. Permission required for reproduction.