to re-open the dialogue about the cervical cancer jab?

[gonetoseeamanaboutadog]

Read threads about this issue on MN before, but somehow I'm no further along. In light of the tragic death of athlete, Sarah Tait, who died of cervical cancer despite having received the HPV vaccine, the time seems right to ask more questions.

In controlled trials of the cervical cancer vaccine, the evidence suggests that the vaccine actually caused cancerous lesions in girls in the 16-18 age group, even those who had no pre-existing HPV infections.

Now, the NHS considers it more or less impossible to have cervical cancer in the absence of an HPV infection. Even if a smear test shows abnormal cell growth, if there is no HPV infection you're considered 'safe' and no further action is taken. So did these girls get cervical cancer?

There is also research to suggest that while cervical cancer is a common killer in developing countries, this is very rarely the case in developed countries. In fact, the deaths from cervical cancer are several times lower than the rate of adverse reactions (including death) connected with the HPV vaccine. And the adverse reactions can be debilitating, life-limiting and life-long.

Meanwhile, it's claimed that the evidence to show the HPV vaccine actually reduces the cancer rate simply isn't there, especially given the high adverse reactions. There is a school of thought claiming that this vaccine is being routinely administered without properly observing the patient's right to make an informed choice; we are trusting the NHS that the risk of adverse reactions is as tiny as it usually is for vaccines, but this may not actually be the case.

This is all I know. One day, although not soon, I'll have to make this decision with my DD. At the moment, I'm decidedly on the fence.

'let's look at this with an open mind' attitude, rather than, 'How can we discredit the research journal?

If you've ever been in a journal review meeting you'd realise that "trying to discredit the research journal" is exactly what scientists do with all journal articles. Every aspect gets pulled apart for potential weaknesses in methodology or bias. If it doesn't stand up to detailed scrutiny it doesn't deserve to be given any consideration.

I think I still have not the foggiest idea of the distinction between cost and cost benefit. Care to enlighten?

purple How do you know I haven't been in a review meeting? Though not in this field, I agree! But still, don't be patronising. I do realise the attack and defend process goes on and that it works, but that's a bit different from trumped up excuses not to take research seriously. It's more prejudice (though I realise that the size of the journal is very important, but at the same time, this journal may be small and perfectly valid). But to denigrate it's name as being cheekily too like the name of a bigger journal, in the context of supposedly analysing some (if it really exists) very important data, is not the sort of rigorous academic scrutiny I would expect, in good faith, from researchers.

I don't think it's reckless to start a conversation like at all. The whole point is that information is out there and nothing is known about how it feeds into the wider debate about the vaccine. We need to draw these strands together and make if possible for more people to make informed decisions. There is a significant minority who feels there is some way still to go in doing this where HPV vaccine is concerned. Where better to have the conversation than mumsnet, where countering views tend to flung around freely.

Afaik its the difference between rolling out the vac to everyone versus the cost of treatment of those who may become infected if nothing is done

I think I still have not the foggiest idea of the distinction between cost and cost benefit. Care to enlighten?

If each vaccine costs a penny, is given to everyone, but only helps one in a million people, it is relatively expensive.
It costs a million pennies to save one person.

A vaccine that costs 10p per person but helps 40% of those vaccinated is better value for money even though it is more expensive.

The reason that the vaccine is given to young people is that, hopefully, they are receiving it before they are infected.
That is the most cost effective way of using it.

For older members of the population there is a much higher chance we are already infected, and they would have to test us all. It would not be cost effective.

My DD will be vaccinated.

Like most I have lost family members to cancer and I have seen the horrors that chemotherapy and radiation treatments bring. If I can do something to drastically reduce my DDs chance of getting this disease, I will. Same goes if I ever have a son.

There is a lot of scaremongering about this vaccine. An anti vacc relative of my DH posted an article on Facebook claiming there were X deaths caused by Gardisil in the US (can't remember the exact figure). 30 seconds on google showed these were deaths around the time of the vaccine and almost all attributable to unrelated causes (eg road traffic accidents).

It not possible to assess the article you have posted as I can only see the abstract. journal quality is important. However, Andrew Wakefield's research was published in a very high prestige journal much to their great embarrassment when the very obvious flaws and dubious research methods were uncovered.

It should also be considered that while deaths from cervical cancer have been reduced by the smear screening programme this is not without other costs.

It has not happened to me fortunately but I imagine being told you have a high risk smear and need to come in for treatment can be a pretty upsetting experience. LLETZ treatment saves lives but is not without risk including for some women increasing risk of premature birth.

There is also research to suggest that while cervical cancer is a common killer in developing countries, this is very rarely the case in developed countries.

You can say the same for diarrhea.

Sark has a car accidents, southern African countries have less skin cancer than Australia despite similar hours of sunlight, etc etc

So you are concerned that people responding to this thread are biased and therefore unable to properly debate your point? And yet you don't see an issue with a researcher who has spoken out vociferously against vaccines and chosen not to vaccinate his kids publishing an article about vaccines? Is there not a slight danger of bias there then?!

I'm all honesty, you can't expect these debates to exist in a vacuum anyway . We all come to them with some bias or pre-conceived ideas. What you try and look for is actual, clear evidence. When I looked into the nasal flu spray for my youngest I definitely felt very sceptical about it. I found loads of blog posts hypothesising about the potential dangers. Some from qualified scientists. No actual firm statistics and clear evidence to show it caused any harm though.

I went to bed, hence did not go further into cost-benefit. Luckily RitavonTeese explained it much better than I would have done

So far ds has had one of the injections, out of 2 over six months. Total cost will be £300. He was mildly ill four days afterwards with a fever and had 2 days off school, which may or may not have been a reaction to the vaccine. Fine since.

Dumbelle, post of 23.36 yesterday, yes absolutely the child/teen consents if competent. Each of our 3 DS were asked and chose to have Gardasil.

It's worth pointing out BTW, that it's not pointless for sexually active adults to have this vaccine (although you'd have to pay).
It's true that if you already have an HPV infected area of tissue which the immune system hasn't cleared, then the vaccine isn't going to change the course of that infection you already have (usually infections are cleared, sometimes they remain in an area of tissue that can then develop into cancer).
However, you can get repeated infections of HPV viruses and and the vaccine can protect you against these.

Dr DH (ever the romantic!), says that if ever either of us were "back in the dating game" for some reason, it would be sensible to have this jab first. He says older adults are another risk group...

Very interesting.

Actual clear evidence could presumably come from any quarter, whether researcher in question has vaccinated his children or not (I presume you would not rule out research from all those who had chosen to vaccinate?). We can't afford to dismiss any information. History is full of examples of people thinking they know something and interpreting evidence to the contrary in light of it. Drawing battle lines is one thing, looking for reasons to disparage researchers that aren't connected to the specific research in question is just prejudice.

Cost effectiveness is interesting, thanks. I can't see the relevance of the original comment to this debate though.

I'd still like to see this research, if it exists. Also to know how we can be sure that adverse reactions are being properly documented.

How dreadful it is to die of cancer is not relevant. We all know it is dreadful. I have lost very close family members to cancer. It doesn't justify giving out a vaccine if there are genuine reasons not to, and I haven't heard objective discussion of the reasons that 'notorious anti-vaccers' (who after all are highly qualified professional scientists) have put forward. Being an anti vaccer should not in itself disqualify a professional opinion.

I wonder how much of Merck's $9.5 billion marketing budget is spent paying people to troll parenting websites?

Are you suggesting I'm a troll? My word, you really can't take disagreement, can you.

You can be a highly qualified professional scientist and still be rubbish at science though. Not every PhD is of the same quality and neither is every research group. These scientists for examples have chosen to publish an article analyzing statistics when they aren't good at statistics. Neither apparently are the peer reviewers of the journal who published the article.

Have you read any of the links others have posted? You don't seem to be coming up with any actual facts about why the links disparaging your linked to research are wrong. You have hypotheses sure - people are biased and dismissive etc but have you got any actual factual evidence to prove that the research you found is safe? You don't seem to really want a proper debate or dialogue here, you just want to dismiss those with a differing viewpoint for being 'prejudiced'.

OP, it is not reckless to start a conversation about public health policy, but what you have done is link to an abstract of an article by a discredited author, in a less-than reputable journal, and backed that up with a series of unsubstantiated claims about a vaccine that will save the health and lives of hundreds of thousands of people. You feign incomprehension of basic concepts and ignore the mass of evidence that opposes your viewpoint, both statistical and anecdotal.

I refer you to my earlier remark about anybody with an internet connection.

If it's so easy to discredit this research and you feel strongly that there is a moral imperative for this thread to be accurate, then you should be explaining exactly why this data is wrong, here on this thread. Not why the research journal has a silly name, not why the researcher in question can't be listened to because his position in this issue is known (as if yours isn't!) Not vague comments that he 'isn't very good' at stats.

Evidence, here please.

Or you could just read the links.

I'm out of here.

"Almost every sexually active adult will contract HPV in their life, but with vaccination, they will not go on to develop cancerous cells. "

You can still develop cervical cancer even if you have had the vaccine. The vaccine isn't 100% effective and there are other strains of HPV that cause cancer that are not covered by the vaccine.

That's true, and I didn't mean to imply that it was. It's probably about 70% effective. But as with most vaccines, I'll take that over the alternative.

Sarah Tait is the same age as me and like me, would have been amongst the oldest (by age) women who qualified for free Gardasil jabs in Australia. They did a retrospective vaccination campaign in 2007 offering Gardasil up to and including 25 year old women.

It's a moot point as to whether there was any point to it given that most women have had at least one sexual partner by 25.

Unless research has moved on - I thought the point of Gardasil was to stop you contracting HPV. If you have HPV and are vaccinated afterwards, it won't stop you potentially developing cancer.

You may find this Australian study interesting.

"Four years after the introduction of a routine and catch-up vaccination programme against human papillomavirus (HPV), we estimated that the quadrivalent vaccine provided 46% protection against histologically confirmed high grade cervical abnormalities and 34% protection against other cervical abnormalities in women who had not started screening before vaccination"

"These findings are in accord with recent studies indicating that approximately 52% of high grade cervical abnormalities are due to HPV 16 and HPV 18.18 This attributable fraction is the theoretical upper limit of vaccine efficacy, unless cross protection against other HPV types provides additional protection. Vaccine effectiveness in the population setting would therefore be expected to be lower than this ideal, owing to imperfect implementation, previous exposure, and other factors."

"The quadrivalent HPV vaccine was 46% effective against high grade cervical abnormalities and 34% effective against any other cervical abnormality in young women attending their first cervical screening after they were fully vaccinated at school or up to 27 years of age"

It's almost 100% effective againt HPV 16 and 18, which are thought to be responsible for about 70% of cervical cancers.