Why is the human papilloma virus (HPV) vaccine for young girls causing so much controversy in Ireland? Scaremongering by vaccine deniers – a term coined by the World Health Organization (WHO) – has led to such a dramatic fall in the uptake of the HPV vaccine that more than 30 organisations formed the HPV Vaccination Alliance. In recent weeks the Minister for Health, Simon Harris, and HSE Director General, Tony O’Brien, have vociferously defended the safety and effectiveness of the vaccine, telling vaccine deniers to “butt out” and stop using “emotional terrorism”. Other politicians, a Catholic bishop, anti-HPV vaccine groups such as Regret and Human Life International Ireland (HLI), have equally vociferously argued that the HPV vaccine is unsafe and ineffective.
Both the bishop and HLI Ireland believe that HPV vaccines encourage “promiscuity” and want school “chastity” programmes instead. The sex connection is what upsets the vaccine deniers because HPV is a sexually transmitted infection (STI). It is one thing to have vaccines for the flu and measles which no one can “help” contracting, it is quite another to provide a vaccine for what the bishop called a “lifestyle” choice. HPV vaccine deniers would prefer if women and girls suffered the consequences of engaging in pre- and extramarital sexual activity; a modern-day Magdalene laundry. As if having husbands protects women from contracting STIs.
HPV infects the skin and mucous membranes of the anus, genitals and respiratory tracts, causing genital warts and multiple cancers, of which cervical cancer is the most significant. HPV is also associated with cancers of the vulva, vagina, anus, and penis, and oral cancers in men and women. Transmission occurs most frequently during sexual intercourse but can occur following non-penetrative sexual activity.
HPV types 16 and 18 are responsible for over 70 per cent of cervical cancers. In Ireland, nearly 300 cases of cervical cancer are diagnosed each year and 79 women died of the disease in 2016. In addition, over 6,500 in situ (CIN 1, 2 and 3) cervical cancers are diagnosed annually. All HPV vaccines are highly effective at preventing infection.
The evidence that vaccinations, including the HPV vaccine, are good for public health is overwhelming. Despite this there have been vaccine deniers since the 19th century when the first anti-vaccination leagues opposed compulsory smallpox inoculation. The WHO is so concerned about growing public resistance to vaccines that it wants to deconstruct the five techniques used by vaccine deniers to make their false claims sound plausible.
First, they create impossible expectations, for example, wanting 100 per cent certainty about the safety and effectiveness of vaccines. No medical treatment is 100 per cent safe and effective. Secondly, vaccine deniers use false logic arguing that natural things are good and unnatural things are bad. In their world vaccines interfere with the natural order of things. Third, they pretend to have technical expertise. Fourth, they claim that governments promote vaccination because of undue influence from the pharmaceutical industry.
Lastly, they are selective about scientific research, ignoring any that says HPV vaccines are safe and effective.
A dangerous and misleading argument on the Regret website is that HPV vaccines have not saved one life. HPV vaccines were only licensed between 11 and nine years ago. Girls who received the vaccine between 2006 and 2008 will now be aged between 17 and 23, much too young to have died from cervical cancer. Cervical cancer does not develop for many years after HPV infection – the average age is about 45 – so the number of women’s lives saved will not be known for some time. What is known now is that HPV vaccines prevent genital warts which cause cancer.
Vaccine deniers forget, or do not care, how many children and adults died from infectious diseases before vaccines became widely available. In 1916 for example, 6,471 people died of tuberculosis, only 16 died in 2016; 525 people, mainly children, died of whooping cough in 1916, one died in 2016; and 218 people, mainly children, died of measles in 1916, nobody died in 2016. In fact, in the past 60 years vaccinations have saved more children’s lives than any other medical intervention.
Check out the facts about HPV vaccine on hpv.ie. This has links to no fewer than 79 research papers written from 2006 to 2017 on the safety and effectiveness of the HPV vaccine. To paraphrase the present HSE campaign get your daughters the vaccine, protect their future. And the HSE must deal much more vigorously with vaccine deniers and parents must learn to recognise nonsense when they hear or read it.