The case of the girl who received a vaccine against the human papillomavirus at the Carmen de Bolívar (Bolívar) in 2014 marked a milestone in the vaccination program that began in 2012 in the country. That year, in the municipality, some minors said they had "fainted" because of the vaccine.
After news related to the tight vaccine with fainting, the program went from 95% coverage in the first dose in 2013, to 6% in 2016, according to figures presented by Diego García, Deputy Minister of Public Health
With this scenario, in 2015 Javier Luna took the position of city health secretary at the Carmen de Bolívar. Audience He spoke with him during the meeting on HPV Prevention and control in Colombia and cancer related to HPV: lessons learned and the way forward ".
When he took over, how did he find the situation of Carmen de Bolivar regarding the vaccine against the human papillomavirus?
A year ago, the first crisis had occurred. That is a very complicated situation. The first thing we did was meet with parent associations to offer them full support and follow-up to EPS so that the attention needed by the girls could be achieved.
How at the meeting?
First, good. Someone was assigned to follow up EPS because of delays in authorization and to use the emergency properly. And we are trying to improve the bad environment that exists between emergency workers and parents. We met even with the direction of the hospital and we reached an agreement so that both parties could slightly lower their vigilance.
So women still have symptoms?
Yes, they continue to have symptoms more or less until 2016. And then they decline. The initial database taken in urgency decreases as if.
What is the situation now?
He is much more calm. We have followed up on the commitments made by the Ministry, the provision of several health posts, the rescue plan for the city ESE which is the first level, the mobile unit needed for maintenance in rural areas. An agreement is also achieved with Super, to permanently prioritize attention or complaints placed against EPS for non-attention and non-delivery authorization. Parents demand that they be given transportation, because Carmen is a difficult access area. This is a rather complicated situation where the Secretariat's position must be neutral.
And how is the belief, from the standpoint of scientific evidence, about the harmlessness of vaccines?
Null Until now we have not been able to advance in that regard, even though there have been some very lukewarm attempts that we have made. The association of parents has a certain strength when it comes to vaccine problems, so it is quite difficult for us to act from the Secretariat. We have "stock" only 10 doses of vaccine this year and we have not had any requests. However, starting in January, we will produce trade for schools and educational institutions, and remind them that vaccines are available for each girl. And start with ads that will be the hardest part of the four years.
But you need to create a strategy to convince people …
Exactly We must see the possibility of producing a little more information through local channels and other ways, finding ways for people to eliminate the stigma from the HPV vaccine. The problem is that it cannot only be a strategy for the city health secretary. This is a problem that belongs to us. It is easier to say Bogotá, saying it is in a province where there is almost no access to any type of communication. I can do an aggressive strategy, but I will accept all these series of anti-vaccine people, that they will have a reason, and I respect their position, but scientifically they have no evidence. That's where we initially collided, after several meetings, and then I remained a little warm in that sense, but without maintaining a clear position that the vaccine must have nothing to do with that problem.
This is the work that I handled very carefully because it was a fear that was established by those who directly underwent their situation with the girls. I always assert that girls don't get sick, even though there are actually some basic pathologies diagnosed. All have a diagnosis and some have left control. But there are several diagnoses related to the application of vaccines. That is the hardest thing and I have lived in my own case … My wife told me that she doubted. Even when I gave him proof, he told me, "Even so, it raises doubts." And I put myself in the family's mother's shoes. They saw that the girls were taken on motorbikes, the crisis at school … a lot of things.
And if you have brought scientific evidence to your wife, now what is the next step to convince him?
Well, the next step is to bring him to Bogotá to help me convince him (laugh). I don't see it easily. But I will think that he must prioritize our girl's future, her health in the future. I always gave the example of a girl from the sidewalk who told me that one day talking to her mother, she had told her that when girls experience a crisis in class, she leaves the room and doesn't see where the girls are. And it works. The girl never repeated the crisis. And he said that he was a healthy girl and if he had the chance to get a third dose, he would wear it.
At the Secretariat we have two people who are permanently available to receive complaints. We don't have family welfare support, because many girls are underage. I cannot solve from the territorial command of a subject that has the competence of this institution.
How many companions did you feel in this crusade?
I really felt very lonely, even though I got support from the Ministry. I even received threats at some point in my life and my daughter … but well, that was my political and social role. I have always been a public person and in Carmen I have worked in the public sector for 18 years.
Does your mayor trust you?
Yes, of course. The Mayor has given me total confidence, the only thing we have not agreed on is the issue of this HPV vaccine, and I respect its criteria and position.
How does it feel to know that he is the Minister of Health of a population that marks an important milestone in state indicators?
They feel a lot of things. Responsibility and job satisfaction are fulfilled. I feel that I have done what is within my reach and that I remain in my clear position, that vaccines must have nothing to do with the pretensions of girls who, I repeat, are sick, but we have done all I work from EPS. I feel that we have to find more ways to make visible problems that don't have the attention needed at some point. I acknowledge the ministry's efforts, but also that more can be done to care for these parents. Carmen de Bolívar is a small Colombian, all problems come together. You should see it as a more national problem. Let's see what God and fate continue to follow.
You have one year and one month left to do human papilloma virus activity, what is that?
Vaccination again at school. Follow the pilot school and bring it more calmly and rest, do it in coordination with the city government, that things are done as is and explain the benefits to parents. This is the original plan. We hope God will accompany us.