Background

Cervical cancer is the second most frequent type of cancer in Cameroon [1]. More than 7.1 million Cameroonian women aged 15 and above are at risk of this disease [2]. In the past ten years, various pilot projects have demonstrated the efficacy and acceptability of Gardasil TM, the vaccine against Human Papillomavirus (HPV) [3,4]. Based on these successful demonstration phases, with the support of the Global Alliance for Vaccines and Immunization (GAVI), the HPV vaccine is finally being implemented countrywide by the Ministry of Public Health. The main objective of the vaccine roll-out will be to immunize at least 80% of 9-year-old girls, and thus reduce the morbidity and mortality due to cervical cancer and other HPV-related infections in Cameroon.

Controversy: social media campaign against HPV

In Cameroon, as in other countries, social media has become a powerful instrument for public communication, allowing users to initiate, modify, share and discuss personal experiences, information, opinions, images, video clips and just about everything online [5]. Although this novel communication channel can be an invaluable tool for networking and visibility on the global arena, it also carries the great potential of heavily negative influence on health campaigns. Studies have shown that false and unverified information is propagated on popular social media platforms such as Facebook, WhatsApp, Twitter, Instagram, Snapchat, with far-reaching and long-lasting deleterious impact on the health of our communities [6].

The launching of the HPV vaccine in Cameroon on 29 October 2014 did not raise as much controversy as the recent announcement by the Minister of Public Health on the decision to finally implement the use of the vaccine to the general population in the coming months. The recent fiery debate emanates from various anti-HPV vaccine campaigns carried out mainly on WhatsApp and Facebook that highlight adverse effects such as sterility that allegedly occurred in Japan and other countries [7].

Although Cameroonian parents are generally more inclined towards vaccinating their children [8], contrary social media campaigns are likely to negatively affect the government’s efforts to implement the use of this HPV vaccine for young girls. Studies have shown that parents and teenagers who have been exposed to anti-HPV vaccine messages on social media are more likely to remember the harmful effects than the health benefits reported [9]. More so, parents who listen to the negative stories are more likely to delay or even refuse the vaccination of their children [9]. Many Cameroonians have experienced the destructive effect of public scrutiny through social media in the face of national events and tragedies. In these instances, the narratives received by the public were almost completely controlled by social media, making it nearly impossible for the government to control the situations and protect its citizens. In the case of the HPV vaccine, social media videos, images and text messages are feeding the community with unsubstantiated myths and misinformation. This anti-campaign undermines the government’s efforts, in concertation with international health communities, to diligently work towards curbing the progress of cervical cancer in the country. On 13 September 2019, a press conference was held by experts from the Ministry of Public Health and the Association of Science Journalists and Communicators for Health Promotion in Cameroon in order to dispel the ambiguities around the controversies on the large-scale implementation of the HPV vaccine in the country.

Cultural and religious beliefs

Culture is known to weigh heavily on health behavior. It affects the perception of health, illness, beliefs about the causes of illness, approaches to health promotion, vaccination, experiences and expressions of disease, places where and people to whom patients go for help, and the type of care that patients prefer [10]. The videos widely spread through social media may promote cultural prejudices that suggest that vaccination is intended to sterilize children [8]. One of these videos cited some studies conducted in Japan and in other countries, alleging that sterility was among the adverse events highlighted in Japan [7]. It is thus not surprising that the planned implementation of HPV vaccination for young girls in Cameroon runs the risk of being rejected if effective community sensitization on the necessity of the vaccine is not carried out.

Conclusion and Recommendation

Vaccination against the Human Papillomavirus is an effective approach for the primary prevention and reduction of the burden of cervical cancer among young girls. The Cameroonian scientific community thus has the impetus to counteract the greatly negative influence of social media on the subject by setting the records straight through presenting empirical and scientific evidence that will leave no grounds for these myths and misinformation.

References

1. Cameroon Human Papillomavirus and Related Cancers, Fact Sheet 2018 (2019) https://hpvcentre.net/statistics/reports/CMR_FS.pdf. Accessed on 03 October 2019.
2. HPV Information Centre – HPVIC (2019) Cameroon Human Papillomavirus and Other Related Diseases Report.
3. Ministère de la Santé Publique (2013) Yaoundé Cancer Registry.
4. Ogembo JG, Manga S, Nulah K, Foglabenchi LH, Perlman S, et al. (2014) Achieving high uptake of human papillomavirus vaccine in Cameroon: Lessons learned in overcoming challenges. Vaccine 32: 4399–403. [crossref]
5. Hao J, Gao B (2017) Advantages and Disadvantages for Nurses of Using Social Media. Journal of Primary Health Care and General Practice 1: 001.
6. Katherine J, Igoe (2019) Establishing the Truth: Vaccines, Social Media, and the Spread of Misinformation. Harvard School of Public Health. https://www.hsph.harvard.edu/ecpe/vaccines-social-media-spread-misinformation/. Accessed on 02 October 2019.
7. Okuhara (2019) Newspaper coverage before and after the HPV vaccination crisis began in Japan: a text mining analysis. BMC Public Health 19: 770.
8. Kwedi Nolna S, Bonono CR, Nsangou Moncher M, Bindé T, Nolna D, et al. (2018) Factors influencing the performance of routine immunization in urban areas: A comparative case study of two cities in Cameroon: Douala and Yaoundé. Vaccine 36: 7549–7555. [crossref]
9. Margolis MA, Brewer NT, Shah PD, Calo WA, Gilkey MB (2019) Stories about HPV vaccine in social media, traditional media, and conversations. Prev Med 118: 251–256. [crossref]
10. White, Peter (2015) The concept of diseases and health care in African traditional religion in Ghana. HTS Theological Studies 71: 01–07.