One voice needed on HPV vaccine

Dear Editor,
I wanted to write in support of Dr Ruairi Hanley’s recent article on the HPV vaccine (‘Exposing the elephant in the room’, October 28, 2016). As he noted, uptake is down last year and 5,000 eligible girls did not get the vaccine. This exposes them to HPV infection.

HPV infections cause more than 80 per cent of cervical cancer, 60-80 per cent other genital cancers and more than 70 per cent of head and neck cancers. Ireland has one of the highest rates of cervical cancer in Western Europe. Every year, 90 women die, 280 women get invasive cancer and 6,500 need treatment for precancerous form.

The vaccine used in Ireland is Gardasil, and more than 220,000 girls have been vaccinated since the vaccination programme started in 2010. The question most parents have is around safety and effectiveness.

All international regulatory and expert bodies continually report that HPV vaccine is safe with no long-term side-effects. These bodies include the World Health Organization, the European Medicine Agency, Centers for Disease Control and Prevention, International Federation of Obstetricians and Gynaecologists and the American Society for Clinical Oncology.

In Ireland, all adverse reports post-vaccine are sent to the Health Products Regulatory Authority (HPRA). To date, since the introduction of the vaccine, the HPRA has received 1,072 reports of suspected adverse reactions/events post-vaccine. Most of these reports are consistent with the expected pattern of self-limited adverse events post-vaccine. This number includes fewer than 30 reports of any immune or chronic fatigue-like conditions. This number is much less than the estimated prevalence of chronic fatigue syndrome-like conditions occurring by chance among a population of 220,000 Irish girls.

Does the vaccine work? Pre-cancers are reduced by up to 75 per cent in countries with high vaccine uptake rates such as Australia and Scotland. The numbers of new cases of cervical cancer have halved in Australia, which introduced the vaccine programme in 2007.

Fair play to Dr Hanley for highlighting the scientifically based ‘Fact check’ article in The Journal.

Readers may like to seek further information at www.hpv.ie. It is important that all healthcare professionals are acting as advocates for this cancer-preventing vaccine with one voice.

Dr Anna Clarke,
Consultant in Public Health Medicine,
National Immunisation Office.