Give your daughters HPV vaccine urges doc

As confusion and controversy continues surrounding the Human Papilloma Virus (HPV) vaccine, MARIA ROLSTON talks to Cork-based consultant Dr Matt Hewitt who has hit out at the ‘scaremongering’ and ‘misinformation’ about vaccine, which he says can prevent cervical cancer and save lives
Give your daughters HPV vaccine urges doc
Uptake in the HPV vaccine has fallen to around 50%, from 87%.

A CUMH-based gynaecology consultant has called on parents of young girls to disregard non-science based individual “opinions” and vaccinate their daughters against the cervical cancer-causing human papilloma virus (HPV).

Dr Matt Hewitt, a consultant gynaecologist and obstetrician at CUMH, who specialises in gynaecological oncology and is a senior medical lecturer at UCC, has echoed Health Minister, Simon Harris’s recent comments lambasting “scaremongering and misinformation” around the HPV vaccine, stating that it is both “safe and effective”.

He said that of the 300 women in Ireland diagnosed with cervical cancer each year, around 40 to 50 are here in Cork, and that slightly less than half of all of these women will ultimately die of their disease.

Matt Hewitt CUMH based gynaecology consultant
Matt Hewitt CUMH based gynaecology consultant

Dr Hewitt praised the national cervical screening programme introduced in 2008, saying it has been responsible for preventing cancers that could otherwise have gone undetected until late stage development.

However, he said that “no screening programme can ever be perfect” and that the HPV vaccination programme had been “designed to prevent women from getting the HPV virus (which causes the vast majority of cervical cancers) and developing pre-cancerous cells”.

The now controversial HPV vaccine has been offered for free by the HSE to all girls in their first year of secondary school since 2010, to protect them from cervical cancer in adulthood. The vaccine is recommended by the World Health Organisation, the International Federation of Obstetricians and Gynaecologists and the National Immunisation Advisory Committee and is offered to girls in this age group because the response to the vaccine is considered best at this age before first sexual contact.

Uptake of the vaccine had reached 87% nationally but newly elected president of the Irish Medical Organisation, Dr Ann Hogan, last week said that vaccination rates, which have now dropped to around 50%, had “declined to a worrying extent due to fake news stories about non-existent risks from vaccinations”. She said that “as a result, we are putting the future health of young women at risk of cervical cancer and other ailments.”

The Health Minister, Simon Harris, later echoed Dr Hogan’s concerns, calling on doctors to “take on the scaremongers” who he said were misinforming people about the HPV vaccine.

Fears surrounding the vaccine’s alleged side-effects have been circulated primarily by a group of parents who claim that some of their children developed severe adverse symptoms including extreme fatigue and nerve-related pain after receiving the vaccine.

The group’s concerns, which have been spread in some media and on social media websites, prompted members of the Teachers’ Union of Ireland to vote on and pass a motion at their annual conference earlier this month, asking for a review of the HPV vaccine programmes in schools.

However, both the Health Minister and IMO have said there is no scientific evidence to support the group’s claims that the vaccine has risks.

This week, Dr Hewitt, who on a daily basis “sees, diagnoses and operates on women who have had cervical cancer,” said that while it was “very sad and unfortunate” that some young people who received the vaccine have been experiencing health problems, their ailments are most likely due to coincidence and not because of the vaccine.

“In any scientific framework you can’t look at individuals, you have to look at populations,” Dr Hewitt said. “Numerous independent sources and countries have carried out research to show scientific evidence that there is no actual harm from the vaccine. One very good study was carried out in Scotland, where all childhood disease is monitored very closely. It looked at illnesses among young people before the vaccine was introduced and afterwards and found that there was no difference.

A picture of the human papillomaviruses, on a colorful background.
A picture of the human papillomaviruses, on a colorful background.

“The campaign against the vaccine is based on the opinions of individual people who have had problems with their children but there is no scientific evidence to support the idea that their ailments are because of the vaccine. The Scottish study looked at the purported side effects of the vaccine after individual complaints. It found that prior to the vaccine, teenage girls and boys were getting these illnesses because all populations will get these illnesses irrelevant of the vaccine being introduced. However, I would like to say that it’s very sad that these teenagers are experiencing problems, but it’s not because of the vaccine.”

After speaking last month in Dublin at a screening of Someone You Love: The HPV Epidemic, a new documentary aimed at raising awareness of the HPV virus, Dr Hewitt said he is concerned by the drop in vaccination rates and is eager to promote the importance of the HPV vaccine. He said it is important for young girls to get the vaccine “because it’s safe, effective and free.”

“The vast majority (99%) of cervical cancers are caused by the human papilloma virus and about 5% of all cancers are HPV related. So if you can give a population a vaccine to prevent HPV cancers, you’d probably be preventing a lot of those cancers.”

However, Dr Hewitt said that the vaccine doesn’t prevent all cervical cancers and added that it is still important to have regular cervical smear tests regardless of receiving the HPV vaccine.

“The vaccine potentially prevents 70% of cervical cancers, so people will still need to be screened after having had it, but as vaccination rates increase, the number of people with abnormal smears would decrease and ultimately the number of people with cervical cancer would decrease. And if we get enough people vaccinated, herd immunity will evolve over time and we’ll have a situation whereby the virus is no longer prevalent.”

Jade Goody and Jeff Brazier. Jade died from HPV caused cervical cancer.
Jade Goody and Jeff Brazier. Jade died from HPV caused cervical cancer.

Dr Hewitt added that currently, even if people are screened but not vaccinated, they can still get genital warts, cervical cancer and other cancers that can’t be screened for.

“The virus is usually spread by sexual contact and it can also cause oropharyngeal cancers, anal cancers and penile cancers. Around 80% of the population will at some point get genital HPV but most people will build up an immune response and therefore won’t get cervical cancer. However women at risk of cervical cancer can’t be identified so it’s better to get vaccinated to prevent getting the virus in the first place.

“Cervical screening is also very important. It takes a long time for cervical cancer to develop, which is why is we aim to pick up the precancerous stage through screening and the screening rate in Ireland is still about 80% which is not too bad at all.

“Unfortunately, one of the problems is that the people that tend not to turn up for their smear tests are the ones that that end up getting cervical cancer. We can cure the majority of cases but that could involve major surgery and or chemotherapy or radiotherapy, but we can’t cure them all due to the stage at which they’re diagnosed and, unfortunately, women still die from cervical cancers which could be prevented through vaccination,” he said.

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