It was about ten years ago I first heard of the cervical cancer vaccine. I was a teenager in the backseat of the car, with my mom and dad in front. My mother mentioned to my dad a new vaccination that prevents girls from getting cervical cancer, and she wanted my sisters and me to get it. In his typical gentle manner regarding matters affecting his daughters, my father asked my mum to gather more information. Sadly, at the time, evidence on the side effects and efficacy of HPV vaccines wasn’t readily available. My mom didn’t know any girl or woman who had gotten this so-called miracle shot. None of her friends had, and none of their daughters had either. Ultimately, the lack of information made my parents hesitant, and I didn’t get the vaccine that year.
As the years passed, medical research increasingly confirmed that the HPV vaccine was effective in preventing cervical cancer, the second leading cause of cancer deaths among women in Nigeria. I would always see new information about the vaccine whenever I came online and it intrigued me. Plus, after all those years, my mother expressed her wish again for me to receive the vaccine. One day, she handed me the business card of the Planned Parenthood Federation of Nigeria (PPFN), which she had received during one of their medical outreaches. Her insistence ultimately led me to get the HPV vaccine.
Researching the Price, Types and Availability of the Vaccine
Before contacting PPFN, I decided to call Marie Stopes Nigeria to inquire about the HPV vaccine. They had been my go-to clinic for gynecological matters, and I had a pap smear examination there two years ago. Through the call, I learned that there were three types of HPV vaccines available:
- The Cervarix Vaccine: Cervarix has been developed to protect against infection from HPV types 16 and 18, which together cause approximately 70% of all cervical cancers. At the time, Cervarix cost 20,000 Naira per shot. I needed three shots.
- The Gardasil 4 targets four strains of human papillomavirus (HPV): HPV-6, 11, 16, and 18. The additional strains it protects against, HPV-6 and -11, cause about 90% of genital warts. At the time, this cost 120,000 naira per shot, so I needed three shots.
- The Gardasil 9: Trials show that this vaccine is 100% effective in preventing cervical, vulvar, and vaginal infections and precancers caused by all seven cancer-causing HPV types (16, 18, 31, 33, 45, 52, and 58) that it targets. At the time, it cost 250,000 naira per shot. I needed three shots.
Initially, I had only known about Cervarix, but Gardasil 9 intrigued me—I wanted full protection. I decided to go to PPFN to compare prices and use that opportunity to see how the clinic looked. There I found that Gardasil 9 was similarly priced and only available by pre-order.
Planned Parenthood Federation of Nigeria (PPFN) is a national Non-Governmental Organization that promotes Reproductive Health in Nigeria. The headquarters, located in the discreet environs of 4 Baltic Crescent Off Danube Street, Maitama, Abuja, is a medium-sized building with modest facilities. There, I met Anthonia*, a warm and soft-spoken healthcare provider. She introduced me to a cost-effective alternative to the pap smear test, the Visual Inspection with Acetic Acid (VIA) examination—currently, a pap smear goes for an average of 20,000 naira. In comparison, the VIA exam averages 5,000 naira. VIA involves a naked-eye examination of the uterine cervix with appropriate illumination after the application of 3–5% acetic acid solution.
The interpretation of the test is based on the detection of a well-defined opaque acetowhite area on the transformation zone of the cervix that appears one minute after the application of the acetic acid solution. Importantly, the VIA screening is just as invasive as a pap smear procedure. VIA screening results come out faster than pap smears, however pap smears are scientifically more accurate. Nevertheless, know that you don’t need to get a pap smear before you take the HPV vaccine.
Getting the First Shot
The Cervarix vaccine was slightly more expensive than Marie Stopes’, but I felt that since I was already at the clinic, I should get the first shot. So, I did. Ordinarily, I don’t like injections, but this felt more painful than usual, but only at the moment of inserting the drug through my right arm.
After my shot, I had a few questions for Anthonia, one of which was when my next shot would be. She replied, ‘In six months,’ and mentioned I only needed two shots. However, my prior research showed that three doses are recommended at 0, 1, and 6 months. While Anthonia was the professional, I couldn’t help but let my Google-acquired knowledge shake my confidence in her.
The nail in the coffin for me was when she requested that I send the payment of my first dose into her personal account. With that singular fraudulent act, I sensed a lack of management oversight and immediately knew I wouldn’t return to PPFN for my remaining doses. There’s a lot of anyhowness in Nigeria, but I wouldn’t let that culture near my health. Apart from those two things, the clinic was alright, and getting my first shot was quick and straightforward.
I would later come to find out that Anthonia wasn’t wrong to have recommended 2 doses of the vaccine. In 2022, the World Health Organization (WHO) updated its recommendations for the human papillomavirus (HPV) vaccine, recommending two doses with a 6-month interval for women older than 21 years. Regardless, if I only took 2 shots, I would have still felt my dosage was incomplete.
Side Effects
A month after my first dose, I went to my primary health provider, Nisa Premier Hospital, Jabi, Abuja, to get my second shot. Six months later, I got my 3rd shot at the same hospital. Each shot cost 22,000 naira only. The process was seamless and straightforward: I walked into their pediatric clinic (where they administer the shots) on a Friday, paid for a card and the vaccine, and within minutes, a nurse administered the injection. One thing I noticed after each of my shots was the mild, short-lived fever that came afterwards and an arm pain that lasted up to 3 days. Apart from these, there were no other side effects.
Reflections
I took my first shot of the HPV Vaccine as a 24 year old eager to be administered this preventive drug before the 25 years old age limit. However, in this journey, I came to learn that there is no longer a strict age-limit for the vaccine. Women as old as 45 are recommended to take the drug. This expanded accessibility makes me hopeful—every woman deserves to be two steps away from cruelty of cancer, even if its just one form of the disease. The fact that a relatively accessible option exists to combat this disease is a testament to the wonders of science.
Overall, my experience getting the HPV vaccine was fulfilling. Getting the shot has been on my bucket list for a while. It was 66,000 naira excellently spent and once I can afford it, I’m getting the Gardasil-9 for maximum protection.
