Rush to introduce vaccination throws up worrying questions

Published on Sunday 31 May 2009 22:13

LAST year, I became aware of Cervarix when co-presenting a radio show. Sandwiched between talk segments were 60-second promotional adverts commissioned by the Scottish Government aimed at girls aged 12-17. They were advised to get jabs "critical in helping to protect Scottish women from a disease that can attack them in the prime of their lives".

A listener from America immediately texted in. By the end of last year, more than 23 million doses of rival vaccine Gardasil had been distributed in the US and reports of side-effects were flooding in. Why wasn't this information being conveyed to Scottish schoolgirls?

So the HPV vaccines became one of the case studies for my PhD in public health communication. I started digging. The US listener wasn't the only person with concerns about the safety and efficacy of the vaccines. Campaigners, scientific experts, doctors and parents all over the world were asking questions.

Why were efficacy studies so disappointing? Does vaccination even prevent cervical cancer? Why has the duration of protection not fully been established? Will our daughters need a booster jab at a later stage? What if they are pregnant? Is there proof their unborn children won't be harmed? What is the long-term safety of the drug? And, most important in my opinion, how is all this information being communicated to the public?

A request was sent to the Scottish Government under the Freedom of Information Act. What struck me about the documents was the apparent lack of attention to the science behind the vaccination leading up to the publicity campaign for Cervarix. The focus was on how vaccination would be made appealing to schoolgirls. References to side-effects that might put them off were watered down. All the right "buzz words" were used to sell this revolutionary drug.

It was discussed how a "hero" girl would be used as the "face" of the TV advert. The leaflets would be in "signature pink", after research found this colour "tested well" for the target group.

The same research also concluded that schoolgirls and parents wanted "simple and direct clarification about the effectiveness of the vaccine".

But this wasn't the focus of the publicity campaign, focusing on the "good news" was: "This vaccine helps prevent cervical cancer." Even this has been contested by scientists in Germany, who have investigated the degree to which the vaccine actually lowers the rate of new cervical cancer cases.

GlaxoSmithKline asked me to stress that a large number of UK girls are now partway through their HPV vaccination schedule and it does not want articles relating to the safety of Cervarix to deter them from receiving their final dose. The drug company insists it offers girls "optimal protection against up to 70 per cent of cervical cancer", a disease which kills three women a day.

No-one disputes the sadness of this statistic. And the idea of having a preventative vaccine to stop these deaths would be warmly welcomed by anyone with a heart. But what is being challenged is the extent to which all information – whether positive or negative – is being communicated to the public and how this is being done.

Why didn't the Department of Health's Joint Committee on Vaccination and Immunisation recommend a large-scale, long-term trial in the UK to assess early side-effects? Here was an opportunity to weigh up the benefits of both vaccinations and come up with an honest risk versus reward appraisal. Instead, an immunisation programme was rushed out giving critics a chance to raise genuine objections.

In internal exchanges, health officials referred to "(getting] on top of any potential vaccine scares quickly". It is their job to strengthen and co-ordinate health protection in Scotland, so it can only be assumed their intentions are to protect the public by minimising scaremongering statements with the potential of putting girls off being vaccinated. But surely it is in the public interest to let patients make an informed decision based on all the evidence?

Why not invest time and effort educating patients about the yellow card reporting system – the health regulator's way of monitoring suspected adverse reactions to drugs? And why not openly report and investigate incidents of girls who've been injected and have experienced side-effects they believe to be associated with the vaccine?

Patients do not deserve to be patronised. It is their right to approach these authorities for advice when they fear for their safety or their children's wellbeing. We're not trying to promote a product here. We're trying to save lives.

&#149 Marisa de Andrade is a broadcaster and journalist completing a PhD in public health policy at the University of Strathclyde