Cervarix Vaccine death is tragic but let’s not panic

Dr Christian Jessen
30.09.09

The cervical cancer vaccine Cervarix was hailed by scientists as an important breakthrough in the fight against women's cancers. But not since MMR, and certainly because of it, has a simple injection caused so much controversy.

Parents objected to girls as young as 12 being immunised against HPV (human papillomavirus), the “sex virus”, believing that it would encourage promiscuity and vice. Now a schoolgirl has died after being given Cervarix and panic will inevitably follow.

The vaccination programme of young secondary-school girls began in September last year and since then there have been 1,340 reports of adverse reactions. Most were minor complaints such as rashes, nausea, swelling on the injection site, pain or allergic reactions. But some cases caused more serious concern: four girls had convulsions, one had a seizure and one an epileptic fit. There were also several cases of paralysis, including Bell's palsy, which paralyses the face, and one case of Guillain-Barré syndrome, which paralyses the legs.

But the truth is that all these reactions occur with other vaccines and are a recognised complication of stimulating an immune response in this way. This number of reported cases of side effects is to be expected within the population and is in keeping with other, less obviously controversial vaccine programmes.

Interestingly, the UK is the only country to use Cervarix. Other nations opted for its more expensive competitor Gardasil, which has shown similar side effects. Aside from the cost, Cervarix does seem to offer longer-lasting protection than Gardasil. It also has more cross-protection against other strains of HPV.

But do we need this vaccine when we have an effective and established screening programme? Smear tests can detect abnormal cells before they become cancerous seemingly negating the need for a vaccine.

The answer is that we need both.

I believe that a screening programme is actually as effective as a vaccination programme but screening means up to 300,000 women a year have to go through invasive procedures to see if a suspicious smear test result is due to a cancer or not. The HPV vaccine will help to reduce this worrying experience.

So I am not overly concerned with side effects but worried about complacency. Women receiving the vaccine may well decide that they no longer need to go through the embarrassment of smear tests.

The vaccine has been reported to be 99 per cent effective at preventing cancers but remember there are more than 100 strains of HPV and at least 15 of those cause cancer. A 99 per cent efficacy actually means 99 per cent success against only two strains, not all the others.

We must be vigilant that this vaccine is not going to damage our young people. But we must also bear in mind that it is a useful weapon in our fight against sexual infections and cancers.