HPV immunisation - the media is at it again
When you've worked with the media for as long as I have, you get pretty good at shrugging off scare stories. So much of what we read in the newspapers isn't groundbreaking news, but more selective reporting that wouldn't sound nearly so impressive if it were put into context.
But I do feel strongly about the value of immunisations. As a medical student, I spent three months working in a hospital in the slums in India, where children died regularly (and horribly) from infectious diseases like diphtheria and measles. In my 30 years as a doctor, I have mercifully never seen a case of deadly diphtheria, which kills up to one in 10 children affected by it, in the UK. Uptake of childhood immunisation with DTaP/IPV(polio)/Hib, which protects against tetanus, whooping cough,polio and Haemophilus influenzae type B as well as diphtheria, has seen it all but eradicated in countries with an effective programme of immunisation.
But I have seen measles, and its complications. As a medical student, I didn't expect to see it in the UK - immunisation against MMR, introduced in 1968, had seen the number of cases drop from half a million to the low hundreds a year in England and Wales. Then one man touched a public nerve with his flawed research and suddenly measles was a very real threat.
But Andrew Wakefield could not have has such an impact alone. The media sensed a scare story - the lifeblood of newspaper circulation - and decided not to let the facts get in the way of a good headline. The MMR scare ran for years in the media, which reported time and again on Andrew Wakefield's flawed study involving 12 children while ignoring high-quality trials of up to 1.8 million children, which showed no link between MMR and autism. Parents took what they read or heard at face value, having been told almost nothing of the risks of NOT immunising, and were terrified of immunising their child. My trump card in helping them to understand that I had the utmost faith in the evidence of overwhelming benefit was to be able to assure them that I put my money where my mouth was - I had immunised both my children against MMR without a moment's hesitation.
Now, terrifyingly, another newspaper is trying to sell papers by scaring parents with heavily biased, inaccurate reporting - this time on the HPV vaccine. The HPV vaccine was introduced in 2008 for girls aged 12-13, to protect against the two types of the HPV virus that cause about 70% of cases of cervical cancer in Europe. With about 3,000 women a year diagnosed with cervical cancer in the UK, Cancer Research UK points out that it's estimated 400 lives a year could be saved by the vaccine
Last week The Independent on Sunday ran an article with the headline 'Thousands of teenage girls enduring debilitating illnesses after routine school cancer vaccination'. The whole article centres on one girl, 'supported' by evidence of adverse events from the MHRA (Medicines and Healthcare Products Regulatory Authority). They buried deep in the article a single sentence from the MHRA, pointing out that over the period it received reports of 2,500 possible serious side effects, ' "many millions" of the vaccinations were administered…without any problems reported'. The Independent on Sunday also failed to point out that the job of the MHRA is not to work out whether there is actually a causal link between a medicine or vaccine and a condition, but rather to flag up possible associations.
This may sound like semantics but it's actually of the most fundamental importance to science. People get sick whether they've taken a medicine/vaccine or not. The whole point about the extensive safety trials new vaccines have to go through is to prove whether the medical problem happened as a direct result of the vaccine or by coincidence. To do this, you cannot possibly rely on a single case - or even a handful. Scientists design major trials, either following up large numbers of people who have and have not had the vaccine, or 'placebo controlled' trials, where people do not know if they are given the active treatment or the sham (placebo). These studies weed out fact from fiction - whether people taking a treatment are actually getting any medical problem more often than anyone else. It's called concrete proof.
The HPV vaccine, like every other, had to pass stringent tests before it was introduced, and over 175 million doses have now been given. The Independent on Sunday didn't even mention the 2013 Swedish and Danish data base study, looking at almost 300,000 girls who had, between them, 700,000 doses of HPV. This study concluded that there was no evidence of a link to 'any autoimmune, neurological, and venous thromboembolic adverse events'.
At best, articles such as this are selective reporting dressed up as public information in an attempt to boost the newspaper's profits. From where I'm sitting, they're plain irresponsible - and thousands of doctors who actually know all the facts agree with me. And in case you're wondering, did I have my daughter immunised? Yes, and without a moment's hesitation - I was in possession of all the facts.