It is possible to vaccinate against some types of cancer, but not enough Israelis do so.
A new national program, which is supposed to save the lives of hundreds of Israelis from cancer and prevent diseases in thousands of Israelis, was presented about a week ago to senior officials of the Ministry of Health.
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This is an unprecedented plan in the field of public health in Israel, and it includes a recommendation for a series of long-term measures, which will lead to the elimination and eradication of all diseases caused by the papilloma virus (HPV).
It is one of the most common viruses in the world, which causes a series of serious and deadly cancers, including cervical cancer, oral and pharyngeal cancer, and genital cancer.
According to the data of the health system, when the national plan is fully and successfully implemented, every year it will be possible to prevent most of the hundreds of cases of women suffering from cervical cancer and men with other cancers such as those of the genitals, anus and pharynx.
Also, it will be possible to prevent about 20,000 cases of the sexually transmitted disease condyloma, which causes benign wart-like growths or lesions in the genital area, and sometimes can even be a preliminary sign of carriers of the strains of the virus that can be cancerous and cause severe morbidity and even death.
Cancer (illustration), photo: none
The new national plan, which is revealed here for the first time, is part of a global move by the World Health Organization, which began back in 2018, in which almost 200 countries participate.
Australia, the United Kingdom and especially Scotland, Canada and Denmark were ahead of Israel, and have already managed to significantly reduce the morbidity and mortality from these cancers.
A series of explanatory, budgetary and national measures are proposed that will lead to the vaccination of 90% of the eligible population against the virus.
So far, only about 50% of the population in Israel have been vaccinated against the virus, a low and frustrating figure on a global level, especially in light of the fact that this is the only vaccine that has been proven to prevent deadly cancers that cause suffering, serious illness and the death of hundreds of Israelis every year.
Prof. Galia Rahav: "There is a maximum possibility of eradicating cervical cancer. This is an opportunity that we in Israel must not miss"
The GARDASIL vaccine injection (GARDASIL) from the pharmaceutical company MSD has been included in the public vaccination basket for middle schoolers funded by the Ministry of Health for a decade.
However, the response to the administration of the vaccine among a part of the population, for example in the ultra-orthodox sector, is very low.
The new national plan is shared by the four health insurance funds, the patient associations and the heads of the doctors' unions in the Medical Association, including the Israeli Society for the Research and Prevention of Sexually Transmitted Diseases, the Israeli Association for Diseases, the Israeli Association for Pediatrics, the Medical Society for LGBT Medicine and more.
A very effective vaccine.
According to the program, in Israel as in many other Western countries, "the possibility has arisen to bring about the elimination of the development of cancer tumors caused by strains of the human papilloma virus (HPV). The combination of an effective and safe vaccine, advanced scanning methods and available treatment allows us, precisely now, to act to that in the near future the development of cancer due to HPV in men and women will be extremely rare in Israel."
90% vaccination by 2030
The program was written by experts and those interested in the prevention and treatment of cancer and other diseases caused by HPV.
The authors belong to a variety of scientific societies and organizations dealing with the subject.
This is a multidisciplinary and interprofessional initiative, and thus its strength.
The disclosure constitutes a public appeal to the policy makers to act now, following the World Health Organization's policy for the elimination of cervical cancer.
This, with the aim of bringing about in Israel the elimination of cancer tumors and other diseases caused by HPV, as in the past humanity led to the eradication of polio and smallpox, and with the awareness that in Israel the response to vaccination against strains of the HPV virus, which contributes significantly to the elimination of the development of cancer tumors, is still far from the goal recommended by World Health Organization.
Papilloma vaccine (illustration), photo: none
The current manifesto recommends evidence-based goals suitable for Israel, and offers a strategy in the following areas: vaccination, screening, treatment and public awareness, by using existing infrastructure and realistic investment.
The national plan includes a long list of recommendations and requirements.
The most important thing is to act and reach the point where by the year 2030 the vaccination rate with two doses will be at least 90% of all girls and boys up to the age of 15. All this when "already now the vaccination rate in state schools is about 80%, while in schools in the ultra-orthodox sector it is only About 7%. The goal is to reach equality between the different demographic groups."
When the national program is fully and successfully implemented, every year it will be possible to prevent most of the hundreds of cases of women suffering from cervical cancer and men with other cancers such as those of the genitals, anus, and pharynx
This year, a request was submitted to the Medicines Basket Committee to include giving the vaccine to adults as well without a time limit.
As part of the national plan, it is also proposed to start giving vaccines at age 9, and to allow vaccination in high schools throughout the year.
It is also suggested to inform clerics and opinion leaders in the ultra-orthodox population that infection with the HPV virus may harm fertility and indirectly cause premature births, if a pre-malignant condition develops in the cervix (CIN), therefore it is advisable to vaccinate before marriage and also allow the nursing staff (and if possible in the future - also pharmacists) ), recommend the administration of the vaccine, and even vaccinate, similar to the vaccine that is given for the flu, without the need for a prescription by the doctor.
Papilloma vaccine, given to female students in the 8th grade, photo: none
It is also proposed to run vaccination programs for women and men who are at high risk, including men who have sex with men, immigrants and sex workers, HIV carriers, PREP patients, immunocompromised and patients with autoimmune diseases.
Ping-pong paste
Gynecologist Prof. Yaakov Bornstein, chairman of the Israeli Society for the Research and Prevention of Sexually Transmitted Diseases and the former director of the Department of Women and Maternity at the Galilee Government Medical Center in Nahariya, is one of the initiators of the national program and its prominent authors. According to him: "The common myth in the public is that the HPV virus only causes cervical cancer He is wrong.
The virus also causes other types of cancer, such as vulva, vagina and anus cancer, and oral and pharyngeal cancer in men.
Prof. Jacob Bornstein: "Even vaccination at older ages can reduce the risk of infection",
"In the USA, the incidence of oral and pharyngeal cancer in men is already higher than that of cervical cancer in women.
In Israel, an average of 100 new cases of oral and pharyngeal cancer are discovered each year in men and women.
According to Bornstein, one of the most difficult problems in Israel is that "the low compliance in Israel is significant at school age compared to childhood vaccinations and compared to countries like Australia or Portugal. Compliance did not increase during 10 years when the vaccine was given in the education system as part of the regular vaccinations. The reasons for this are a lack of awareness of the importance and safety The vaccine, logistical difficulty in administering the vaccine in different regions of the country and reluctance to receive the vaccine, which is linked to marital relations, among ultra-Orthodox religious populations."
Prof. Jacob Bornstein: "Even vaccination at older ages can reduce the risk of infection. A person may be infected many times with the same strain"
"Recently, the vaccination committee discussed the possibility of starting to vaccinate as early as the fourth grade. The time interval from infection with the virus to the development of cancer is about 20 years on average. Therefore, even vaccination at older ages can reduce the risk of infection with the virus. A person may be infected many times with the same strain of the virus. Widespread It is the constant, alternating infection, 'ping-pong' between spouses. Only a vaccine prevents repeated infections, by creating memory cells in the immune system."
MRI examination (illustration), photo: GettyImages
"It is also important to know that although it is recommended to vaccinate before contracting the virus, that is, before starting sexual intercourse, it has been proven that the vaccine is effective even after infection with the virus, even after the development of a precancerous disease or condylomas. Thus, quite a few women and men who were not vaccinated at school age will find that the vaccine is effective And it is important that they ask to receive it even after the age of 18."
"An opportunity we must not miss"
Prof. Galia Rahav, chairman of the Israeli Association for Infectious Diseases and president of the Infectious Diseases Unit at the Sheba Government Medical Center in Tel Hashomer: "There is no doubt that the world of medicine continues to move towards many goals that were never thought of in the past.
Although there are not many vaccines in the world that can prevent cancer, today there is an effective and proven vaccine to prevent infection with the papilloma virus, HPV, which can cause, among other things, many types of cancer, in both women and men, which was unknown in the past, but awareness of this is still low.
The existence of the vaccine is extremely significant these days, because in combination with other significant actions, there is a maximum possibility of completely eradicating cervical cancer as well as the development of the virus.
Prof. Galia Rahav: "There is a maximum possibility of eradicating cervical cancer", photo: Efrat Eshel
"This is an opportunity that we in Israel must not miss. There are many countries that have succeeded in this course of significant elimination."
The Ministry of Health stated in response: "The Ministry is working on a program on the subject, which includes various strategies regarding vaccination and treatment. The report will also be examined within this framework."
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