CORRESPONDENCE

HPV vaccine: Why the rush?

To the Editor: It was disconcerting, not to say frightening, to see that at the time of writing, only weeks after the launch of the national campaign of human papillomavirus (HPV) vaccination of grade 4 girls in South African (SA) public schools, a number of countries had put a moratorium on HPV vaccines. The Japanese government has done so more recently.^[1] Austria has rejected the inclusion of HPV in its vaccination schedule. The Green Party MPs at the European Parliament are preparing to call for a moratorium in France.^[1]

The reasons are many. Evidence of effectiveness has not yet been provided. Clinical trials were carried out without proof of safety, since there was no placebo arm. Adverse reactions as serious as permanent disability or even death (139 deaths so far)^[2] are likely to result from the aluminium adjuvant that accumulates in the central nervous system.^[3] The goal - the prevention of cervical cancer - remains to be proven. Finally, the two existing vaccines 'protect' only against two out of ten or more high-risk HPV types.^[3-7]

Ever since gaining Food and Drug Administration approval in 2006, Merck has been heavily criticised in the USA for their overly aggressive lobbying campaigns and marketing strategies.^[4] Further, the vast majority of publications on the topic have been authored by Merck or GlaxoSmithKline (GSK) employees, or researchers employed by or funded by these companies.^[8] To declare one's conflict of interest in a scientific paper does not per se make one unbiased.^[8,9] Of note is the fact that even publications by independent researchers rely on data funded by the vaccine manufacturers, which makes their opinion questionable.^[4] On the other hand, the reader may point out that the expressed cautionary views reflect only a limited number of independent authors. This may be attributable to powerful lobbying by the industry.^[4]

SA media such as SAfm advertise the campaign and mention GSK's sponsorship, an overt use by GSK of public media for personal gain. This use is of concern in view of the billions of US dollars GSK had to pay for bribery in the USA, and is currently under investigation in China, the UK and Poland for the same reason.^[10] On air, the argument used to entice parents to have their daughters vaccinated is to prevent 3 000 women from dying of cervical cancer annually. This is misleading, since it will take at least another 20 years to find out if this will materialise.^[9] Meanwhile, screening and follow-up remain necessary even for vaccinated women, who may well forget about them in view of the claimed benefits of vaccination.

These are the author's views and not those of the National Health Laboratory Service or the University of Limpopo. The author declares no financial link or interest with GSK and Merck.

Louis-Jacques van Bogaert

National Health Laboratory Service and University of Limpopo, Polokwane, South Africa. louis.vanbogaert@nhls.ac.za

1. Frompovich CJ. International symposium about HPV vaccine problems in Japan. http://www.activistpost.com/2014/international-symposium-about-hpv.html (accessed 7 April 2014).         [ Links ]

2. SANE VAX Inc. New death post-Gardasil updated VAERS figures & report that HPV vaccines adverse reactions are 50% higher than other age-related recommended vaccines. http://sanevax.org/new-death-post-gardasil-updated-vaers-figures-report (accessed 12 May 2014).         [ Links ]

3. Tomljenovic L, Spinosa JP, Shaw CA. Human papillomavirus (HPV) vaccines as an option for preventing cervical malignancies: (How) effective and safe? Curr Pharm Des 2013;19(8):1466-1487. [http://dx.doi.org/10.2174/1381612811319080014]        [ Links ]

4. Tomljenovic L, Shaw CA. Who profits from uncritical acceptance of biased estimates of vaccine efficacy and safety? Am J Public Health 2012;102(9):e13-e14. [http://dx.doi.org/10.2105/AJPH.2012.300837]        [ Links ]

5. Tomljenovic L, Shaw CA. Too fast or not too fast: The FDA's approval of Merck's HPV vaccine Gardasil J Law Med Ethics 2012;Fall:673-681. [http://dx.doi.org/10.1111/j.1748-720X.2012.00698.x]        [ Links ]

6. Tomljenovic L, Shaw CA. Human papillomavirus (HPV) vaccine policy and evidence-based medicine: Are they at odds? Ann Med 2013;45(2):182-193. [http://dx.doi.org/10.3109/07853890.2011.645353]        [ Links ]

7. Gupta S, Kerkar RA, Dikshit R, Badwe R. Is human papillomavirus vaccination likely to be a useful strategy in India? South Asian Journal of Cancer 2013;2(4):193-197. [http://dx.doi.org/10.4103/2278-330X.119887]        [ Links ]

8. Van Bogaert LJ. Are the currently existing anti-HPV vaccines appropriate for the developing world? Ann Med Health Sci Res 2013;3(3):306-312. [http://dx.doi.org/10.4103/2141-9248.117924]        [ Links ]

9. Yank V, Rennie D. Financial ties and concordance between results and conclusions in meta-analyses: Retrospective cohort study. BMJ 2007;335:1202. [http://dx.doi.org/10.1136/bmj.39376.447211.BE]        [ Links ]

10. BBC World News. Current Affairs, 26 April 2014.         [ Links ]