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The HPV vaccine and its efficacy

Nov 18, 2014, 10:27 AM

The Gambia government has taken a major step towards protecting women by launching a vaccination campaign against the Human Papoilloma Virus (HPV), a virus that causes cervical cancer, the second leading cause of cancer deaths among women in the country.

The vaccination campaign targets all Grade 3 girls and their peers outside school in the West Coast each of whom will receive two doses of injections of the HPV vaccine at six months interval.

This initiative is not only commendable, but also timely.It is commendable because it is geared towards protecting the lives of our caregivers, our mothers, our wives and sisters but above all the larger segment of our population.

And timely because it is introduced at a time when cervical cancer is becoming a problem in the country, as recent study revealed that about 100 women are diagnosed with the disease and 57 die every year from cervical cancer.This is worrying.

But the situation is not only alarming in The Gambia as global statistics indicate that HPV is the fourth most common cause of cancer in the world with approximately 500,000 new cases and about 25,000 deaths annually.

But there is hope in the horizon as the HPV vaccination is said to able to protect against the two HPV types that cause about 70% of cervical cancers worldwide.

However, we know that like other vaccines, the HPV vaccine is not 100% effective; it is not 100% safe.As with any drug, there are risks and side effects with the HPV vaccine, although serious side effects are rare.

Our key concern is aroused by the information we found in the US National Library of Medicine which states that after a systematic review of HPV vaccine trials to assess the evidence of their effectiveness and safety, the vaccine’s clinical trials design and data interpretation of both efficacy and safety outcomes were “largely inadequate”.

The authors of the report in the US National Library argued that the widespread optimism regarding HPV vaccines’ long-term benefits appears to rest on a number of unproven assumptions and significant misinterpretation of available data.

For example, the claim that HPV vaccination will result in approximately 70% reduction of cervical cancers is made despite the fact that the clinical trials data have not demonstrated to date that the vaccines have actually prevented a single case of cervical cancer (let alone cervical cancer death), nor that the current overly optimistic surrogate marker-based extrapolations are justified.

The authors even further maintained that the notion that HPV vaccines have an impressive safety profile is only supported by “highly flawed design of safety trials” and is contrary to accumulating evidence from vaccine safety surveillance databases and case reports which continue to link HPV vaccination to “serious adverse outcomes”.

Based on this, for us, the fight against cervical cancer might be best won by optimizing cervical screening, which has very little or no risk at all, rather than by the reliance on a vaccine with questionable efficacy and safety profiles.

We are not against vaccination because we know vaccines are responsible for many global public health successes such as the eradication of smallpox and significant reductions in other serious infections like polio and measles, but we are mindful of introduction of vaccines on which concerns have been raised; hence we are ambivalent about the HPV vaccine.

“It’s clear that prevention will never be sufficient. That’s why we need a vaccine that will be safe.”

Luc Montagnier