Tuesday, 29 September 2009
How Many Deaths Will Be Too Many...?
The HPV vaccine is being administered to schoolgirls in England right now.
Quite apart from the moral issues involved (though I feel strongly about these too) I think that the vaccination programme has been rushed through.
In the US, the vaccine, called Gardasil, has been associated with some adverse reactions - the Center for Disease Control & Prevention reports a rate of approximately 0.06%.
93% of these adverse reactions were what the CDC terms "non-serious" - that is, anything other than hospitalization, death, permanent disability, and life-threatening illness. Most of the adverse reactions were fainting, pain and swelling at the injection site (the arm), headache, nausea and fever.
There have been 43 reports of death among women receiving Gardasil. This was the official figure in the US up to June 2009. The authorities say that there is no evidence to suggest that these deaths were actually due to the vaccine...
There is no evidence to say that they were not due to the vaccine, either.
And now there has been a death of a schoolgirl in England following her vaccination with Cervarix, the vaccine chosen for use in the UK, though the post-mortem has yet to be carried out, so there isn't any evidence to prove that the vaccine was responsible.
Cervarix isn't licensed for use in the US. I haven't found out why. Speculation as to why the UK chose Cervarix over Gardasil suggests that it was due to financial considerations.
The figures quoted by the BBC (4,657 reported adverse reactions out of 1.4 million doses) suggest that the rate of adverse reactions for Cervarix is higher than that for Gardasil: 0.3%.
How much warped thinking is going on here, and why hasn't more been made of this in the media? They were quick enough to start screaming about swine flu.
Now, I am a scientist. I know that there is no such thing as a treatment without side effects. One has to weigh up the risks against the benefits. But this vaccine is being given because it reduces the risk of cervical cancer: it doesn't eliminate the chance of getting cervical cancer. Gardasil protects against 2 strains of the Human Papilloma Virus which cause around 70% of cervical cancers. The use of the cervical smear screening programme at 3 year intervals, on the other hand, helps to pick up 84% of changes which would, if untreated, lead to cervical cancer.
In addition, giving the vaccine in school is, I think, a big mistake. The girls at my school were been given their injection and sent straight back to class. None of the teachers were given any advice on what sort of adverse reactions to expect: and several girls reported headaches, nausea, soreness in their arms and dizzy spells - more so than would be expected compared to the BCG vaccinations, for example.
No doubt the post-mortem on the schoolgirl in Coventry will show that she had some underlying medical problem which predisposed her to an adverse reaction. I'm sure that is how it will be explained. But no-one in school has been advised of any medical problems which would constitute contra-indications for the vaccine. I'd be very surprised to hear that parents were told of specific risk factors.
In the meantime, I fear that there will be more deaths before anyone takes action.