UK: Revealed: The serious health concerns about the cervical cancer jab

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From Jackie Fletcher @ JABS

http://www.dailymail.co.uk/health/article-1051578/Revealed-The-health-concerns-cervical-cancer-jab.html

Revealed: The serious health concerns about the cervical cancer

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Isla Whitcroft

Last updated at 10:04 AM on 02nd September 2008

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The pink leaflets are ready, the posters are poised to go up and the

advertising slots have been booked both on kids and primetime TV and

radio.

Tomorrow marks the start of a new academic year. It is also the launch

date of a campaign which heralds the introduction of the biggest mass

vaccination programme for more than a decade.

By the end of September, there will hardly be a Year Eight girl (aged

12-13) in the country who doesn't know that, barring an opt-out, she is

shortly to receive three injections of the drug Cervarix, which will

offer her 70 per cent protection against cervical cancer.

Vernon, 50 and her daughter Sophie, 12 think that the cervical

cancer injection is a positive thing

More...

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Later in the year, another 300,000 girls aged 17 and 18 will be

vaccinated before they leave school. By 2012, most girls over the age of

12 should have received the vaccine.

Made by pharmaceutical giant Glaxo-Kline, Cervarix works by creating

an immunity against the two strains of the human papillomavirus (HPV),

numbers 16 and 18, responsible for 70 per cent of all cervical cancers.

For the Government, the programme - reputed to have cost tens of millions

of pounds - has been seen as little short of a community medicine

triumph.

'This vaccine could save the lives of 400 women a year,' pronounced

public health minister Dawn Primarolo earlier this year, shortly after it

was announced that GlaxoKline had won the contract to supply the

drug over its rival Merck, who make the more expensive vaccine, Gardasil.

'It is an exciting opportunity to immunise young girls against the future

risk of cancer, the impact of which will be felt by women and their

families for generations to come,' she said.

And, on the face of it, who could argue? Cervical cancer is a dreadful

disease.

The HPV (said to be carried by one in ten girls under 16) is sexually

transmitted and once it enters the cervix causes cell mutation which, if

undetected, will lead to cancer.

Once the cells are past the pre-cancerous stage, treatment is notoriously

drastic. 'Women who are caught early and end up having just a

hysterectomy are the lucky ones,' says consultant gynaecologist

Ind from the Royal Marsden Hospital and St '.

'It is not uncommon to see a woman in her early 30s who has lost her

bowel, vagina, bladder and colon to the disease.'

Quickly introduced

In that context, perhaps it is laudable that the vaccine programme

has been introduced in the UK so quickly (the drug was approved by the

European Union only in September 2007 and has yet to receive full

approval by the American FDA).

Indeed, there has been some criticism that the Government had not acted

as quickly as European countries such as France, Italy and Germany who

began their programmes a year earlier.

But look more closely and it is not hard to see why many British experts

are uneasy about the rush to vaccinate all our young girls.

Cervical cancer may be a nasty disease, but it is also, thanks to our

world-class screening programme - where all women from 25 to 64 are

eligible for a free cervical screening test every three to five years -

very rare in the UK.

Around 3,000 cases are diagnosed each year and about 940 women die. While

this is 940 too many, it equates to less than three deaths per 100,000 of

population and does not even begin to compare with the carnage caused by

breast or lung cancer.

We have one of the highest rates of teenage sexual activity in the

developed world. We should be experiencing an epidemic of cervical

cancer,' says Ind.

'The fact that we are not is down to our screening programme. I fear that

introducing another preventative method will dilute both money and

attention away from this.'

Indeed, one of the main worries about the mass vaccination is that girls

will then feel 'safe' against cervical cancer and ignore the screening

programme.

That would be nothing short of disastrous, because the jab gives

protection only against HPV 16 and 18 which are implicated in around 70

per cent of cervical cancers.

Smear tests still needed

There is still a 30 per cent chance that another strain could

cause cancer, making it vital that women go for regular smears.

Cervarix is also very new - large-scale trials go back only six years -

and there is no way of knowing just how long protection will last.

The worst case scenario is that the Government could be paying a fortune

for a vaccination that may protect young girls for only the next six or

so years. So just as they hit the peak years for sexual activity they are

totally unprotected.

Furthermore, with the possibility that women will stop going for smears

because they think they're protected, the vaccination programme could end

up being counter-productive and costing more lives than it saves.

But according to Dr Elliman, a consultant community paediatrician

who works for Haringey NHS Trust and Great Ormond Street Hospital and

sits on the cervical cancer screening board, this is an unlikely

scenario.

'The girls receiving the jab are many years away from the age of

screening,' he explains. 'In addition, in all the literature it is made

extremely clear that the vaccination is not a substitute.

'For all its merits, our screening process doesn't prevent cancer, it

simply picks it up at an early stage. The vaccination is the only thing

that actually prevents HPV 16 and 18 from causing cancer.'

However, some people feel the programme is a case of taking a

sledgehammer to crack a nut. 'Six million women carry the HPV virus at

any one time,' says Woollams, founder of the charity CancerActive

and a former biochemist.

Protection

'In the majority of cases the immune system renders it harmless.

Only 3,000 women get cervical cancer each year and less than 1,000

actually die.

'Looking at those figures, you have to ask whether the most sensible

response is to put a drug that has little long-term safety and efficacy

data behind it into the immune system of all our young girls and women?

'The best protection against contracting HPV and therefore cervical

cancer is to use a condom. It gives you 100 per cent protection. For a

fraction of the money you could run a very effective sex education

campaign.'

The Government refuses to release the cost of the vaccination programme,

claiming commercial confidentiality. But given that, privately, Gardasil

costs around £160 per injection, it will not be cheap.

In July, the British Medical Journal calculated that by using Cervarix -

cheaper than Gardasil because it protects only against strains 16 and 18

and not 6 and 11, the strains responsible for genital warts - the

Government will save up to £18million in the first year alone.

Either way, huge sums are involved and there has been criticism that drug

companies funded charities and doctors to lobby the Government in the

battle to ensure the programme went ahead.

In America, where the vaccination programme using Gardasil has been in

place since June 2006, some experts are now expressing unease about the

scheme.

Twenty seemingly healthy girls died within a few days of being injected

with the vaccine which has a similar generic make-up to Cervarix.

These deaths have been dismissed as coincidence by Merck who make the

American jab, although both Cervarix and Gardasil list fainting, dizzying

and sore arms as side-effects.

Here in the UK, the awareness group JABS is reporting an upsurge in calls

from parents who are worried about possible side-effects.

Last month, an article in the New England Journal Of Medicine claimed

that serious questions regarding the overall effectiveness of the vaccine

remained unanswered.

It pointed out that studies into the vaccine were carried out on girls

aged 15 to 24 so there is no way of knowing how the drug will affect

pre-pubescent girls, how long it will last and whether there was the

potential for interference with the body's natural defence against other

HPV strains.

So parents are being faced with an agonising decision. Do they say no to

the vaccine and risk their child contracting a dreadful disease.

Or do they put their trust in a drug for which evidence of safety and

efficacy is probably insufficient and at worst may do harm?

YES

Vernon, 50, is an office manager from Northampton.

She has three children , 26, , 23, and Sophie, 12, who will

be having the jab.

She says... I WAS diagnosed with pre-cancerous

cells at 33, after a routine smear.

I had always been very careful to keep up with my smear tests and there

had never been a problem before. So when the doctor told me I needed

investigating it was quite a shock.

I knew people who had had breast cancer but I was the only person I knew

who had been in this situation, so I felt very alone.

Between 1990 and 1995, I had four operations to have abnormal cells

lasered away, but they kept returning. My children were very young and it

was a worrying time.

But I was relatively lucky because although the abnormal cells kept

coming back they were only graded as a low risk.

Even so, the laser treatment had unpleasant side-effects - painful, heavy

periods and abnormal bleeding for several months afterwards which badly

affected my quality of life.

The last treatment was done under local anaesthetic and was extremely

painful.

I had also become aware of just how awful cervical cancer can be if it

becomes aggressive and how the treatment can involve extensive surgery.

Each time I went back for my test results I was in a panic about what the

doctor would say.

I am delighted that Sophie has the opportunity to have the jab. She is

aware of my medical history, so, naturally, she is keen to be protected.

I just wish it had been available for my older daughter, , because

I wouldn't want either of my daughters to go through what I did.

Cervical cancer tends to affect young women with young families and if

just one life can be saved by the vaccine it will have been worthwhile.

I definitely don't subscribe to the argument that the vaccination will

give young girls the green light to behave in a sexually irresponsible

way. Girls who act like that are going to do it anyway, irrespective of

an injection.

NO

lin , 55, a shop assistant from Harrow, Middlesex, has

two children , 15, and Gaby, 11. Gaby is due for the jab in

September 2009 but will opt out.

She says: Since Gaby suffered a bad reaction to a

tetanus jab as a baby I have become much more questioning about the idea

of vaccination.

I am not against it, but if I am going to agree to something being

injected into my daughter I want to make sure it is safe, effective and

has no side-effects.

Cervarix answers none of my questions satisfactorily. So until there is

more long-term data I feel there are better ways of protecting my

daughter against cervical cancer.

lin , 55, is determined not to expose her daughter Gaby, 11, to

the cervical cancer vaccine

We already have a good open relationship and I will be rigorous in

educating her about the perils of unsafe sex - not just in regard to

cervical cancer but also about genital warts, other sexually transmitted

diseases and, of course, unwanted pregnancy.

Using a condom gives 100 per cent protection against cervical cancer, the

vaccination can only offer 70 per cent at best.

I am not particularly impressed by the fact that this vaccine will be

given at school by an anonymous medical team.

It should be a matter between the parent, the child and their GP, who

knows the child and is aware of her medical history and can watch and

record any adverse side-effects.

I am fully expecting that both Gaby and I will be put under considerable

pressure for her to have the jab and I know in America those who opted

out have been made to feel as if they were bad parents, which is

outrageous.

I don't think the vaccine will encourage promiscuity, there will always

be girls who sleep around, but I do think it will make girls more blase

about their sexual health, less likely to use a condom and less likely to

go for screening.

But my main concern is that we have no idea of the long-term effects of

this vaccine - whether it works, for how long and whether it

can harm the immune system.

I am not going to expose my daughter to that level of risk and she

doesn't want it either.

What you need to

know

What causes cervical cancer?

Most cervical cancer is caused by the human papillomavirus (HPV).

HPVs are sexually transmitted and invade the cervix, although 90per cent

of infections are cleared by the immune system within two years.

If it remains, the virus begins to cause cell mutation which will lead,

if untreated, to cancerous lesions and eventually cancer. Most cases

occur in women aged 25 to 34.

How does the vaccination work?

Both Gardasil and Cervarix work by mimicking the structure of the

live HPV strains 16 and 18 and stimulating an immune reaction in the body

which will enable it to fight the real infection at a later date.

The vaccine does not contain live strains of HPV and tests so far show it

cannot cause the disease. There is no significant data on how long the

vaccination will be effective.

Who will receive the vaccination?

This year, all girls aged 12 to 13 will be offered the injection

at school. Any 17 to 18-year-olds will receive the injection as a

'catch-up' before they leave school.

Why are we vaccinating so early?

For the vaccination to work, it has to be administered before the

girl has been infected by HPV. Given that around one in ten girls under

the age of 16 already have the virus, it was thought best to vaccinate

girls before they were likely to have had sexual activity.

Can my daughter opt out?

Every parent will be asked to sign a consent form before the jab

is given. If your daughter wishes to have the jab and you don't, the

final decision is legally yours for a Year Eight girl, but not for a girl

over 16.

• HELPLINES:

www.nhs.uk/hpv or

0;

www.jabs.org.uk

--------------------------------------------------------

Sheri Nakken, former R.N., MA, Hahnemannian

Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales

UK

Vaccines -

http://www.wellwithin1.com/vaccine.htm

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