Cancer
HPV vaccination discourses and the construction of “at-risk” girls
SYNOPSIS
Peer-reviewed critique of Merck’s reckless and immoral marketing strategy for Gardasil.
CITATION
Geneviève Rail, Luisa Molino, Caroline Fusco, Moss Edward Norman, LeAnne Petherick, Jessica Polzer, Fiona Moola, Mary Bryson. June 2018; Canadian Journal of Public Health (2018) 109:622–632 https://doi.org/10.17269/s41997-018-0108-8.
The objective of this study was to investigate the deployment of HPV vaccination (HPVV) discourses and their impact on Canadian girls, parents, nurses and physicians.
Comments in response to: “Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study.”
SYNOPSIS
Researchers assert that bivalent HPV vaccination in Scotland has been “highly effective” in reducing pre-malignant cervical disease, but have failed to discuss serious adverse events following HPV vaccination or other secular trends that could provide an explanation for the declines.
CITATION
Comments by Exley C, Gervas J, Selley P, Stone J, Thomas N, Vasquez A, Miller NZ, in response to: Palmer T, Wallace L, Pollock KG, et al. Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study. BMJ. 2019;365:l1161.
SUMMARY
This collection of published comments responds to the assertion by Scottish researchers (Palmer et al., 2019) that bivalent HPV vaccination in Scotland has been “highly effective” in lowering the prevalence of pre-malignant cervical disease. The seven commenters make the following points:
- Exley critiques the authors’ “serious omission” in failing to discuss serious adverse events following HPV vaccination; those with “privileged access to human data” should use it “to cover all aspects of both efficacy AND safety of this vaccine.”
- Gervas estimates that 4,300 women would need to receive the HPV vaccine to prevent one case of severe cervical dysplasia (the “number needed to treat”).
- Selley describes secular trends in teen sexual behavior over the study period and asks whether the falling prevalence of pre-malignant cervical disease attributed to the HPV vaccine could be related to changes in sexual behavior.
- Stone calls attention to an article (Castanon and Sasieni, 2018) that reported a “dramatic increase” in England of cervical cancers in the first generation to be targeted for HPV vaccination.
- Thomas contests the lead author’s assertion that “In Scotland, as elsewhere, no serious adverse effects have been demonstrably linked to the [HPV] vaccine,” pointing to reports of several hundred thousand adverse events assembled by the World Health Organization (including 400 deaths) and almost 13,000 reported reactions in the UK, and observes that valid informed consent is not possible without communicating information about these risks.
- Vasquez points to Scotland’s public health campaign to address endemic vitamin D deficiency implemented in “close chronologic proximity” to its launch of HPV vaccination. “Crediting the reduction in HPV-related disease solely to vaccination…is potentially invalid and misleading, especially when the authors make no account whatsoever of the national program for vitamin D supplementation which started in the same timeframe.”
- Miller points out that the Palmer et al. study only included 12- and 13-year-old girls and “did not include older teens and women who are sexually active, have been exposed to HPV prior to HPV-vaccination, and are likely to have significantly worse outcomes than unvaccinated females.”
Feline vaccine-associated sarcomagenesis: is there an inflammation-independent role for aluminium?
SYNOPSIS
Aluminum adjuvants in vaccines can initiate and promote feline cancers.
Citation
AbdelMageed MA, Foltopoulou P, McNeil EA. Feline vaccine-associated sarcomagenesis: is there an inflammation-independent role for aluminium? Veterinary and Comparative Oncology. 2018;16(1):E130-E143.
Summary
This study, which examined whether aluminum adjuvants in vaccines can cause tumors in cats, found that the aluminum hydroxide adjuvant causes DNA damage and mutation. The study followed up on the observation that up to 10 of every 10,000 vaccinated cats develop an aggressive and invasive feline cancer at the site of vaccine administration within one to three years post-vaccination. The study confirmed that aluminum is highly persistent, continues to damage cells “for significant periods of time after initial exposure” and may “directly facilitate carcinogenesis” through the initiation and promotion of tumors.
HPV vaccines—A review of the first decade
SYNOPSIS
HPV-vaccinated women, in some settings, are less likely to get routine cervical cancer screening, which is necessary to reduce population incidence of cervical cancer.
CITATION
Harper DM, DeMars LR. HPV vaccines—A review of the first decade. Gynecologic Oncology 2017;146(1):196-204.
SUMMARY
This mostly uncritical review of a decade of HPV vaccination draws attention to an underdiscussed aspect, which is that “[p]revention of cervical cancer must still rely on participation in ongoing screening programs.” The authors show that in many settings, HPV-vaccinated women are significantly less likely to get routine cervical cancer screening than unvaccinated women. Of concern, “the uptake of screening after the HPV vaccine introduction…has been lower than necessary to reduce population incidence of cervical cancer.” The authors comment that administering repeat doses of HPV vaccine to already vaccinated women “causes harm with no evidence of any improved prevention of HPV infections.”