Doctors on the HPV vaccine

Annually, government administer a Human Papilloma Virus (HPV) vaccine to young girls, and often this announcement attracts sceptics on social media.

Despite encouragement from health practitioners like Joburg’s MMC for Health and Social Development, Dr Mpho Phalatse and Dr Gary Reubenson who is a paediatrician specialising in infectious diseases at Rahima Moosa Mother and Child Hospital, some parents are still wary of the vaccine.

They fear dire side effects such as autism and others that ‘far outweigh the advantages’.

The City of Johannesburg’s healthcare workers will administer the first dose from 7 February to 16 March and the second dose will continue on 7 August until 14 September.

Only girls in public schools will receive the vaccination from government. And here, at least according to Reubenson, the reception is mostly positive.

Currently, government gives the HPV vaccine to people most at risk and least able to afford the vaccine.

Reubenson is, however, aware of families who decline vaccinations and he said that these are mostly, although not exclusively, more privileged families.

He explained that the vaccination’s main goal is to prevent cancer of the cervix, which according to the World Health Organisation (WHO), globally affects nearly 500 000 women every year.

Yet some parents still refuse the vaccine to be administered to their daughters. The fear of a serious adverse affect is far too great, they argue.

He explained that the vaccination’s main goal is to prevent cancer of the cervix, which according to the World Health Organisation (WHO), affects nearly 500 000 women every year.

Yet some parents still refuse the vaccine to be administered to their daughters. The fear of a serious adverse effect is far too great, they argue.

But Reubenson said there are no medical interventions, including vaccinations, that are completely free of danger. He said vaccines are carefully evaluated before widespread use and the closely monitored once widely available. HPV vaccines have already been given to hundreds of millions of girls around the world.

“As far as I am aware, despite all those millions of doses, there is no convincing evidence at this stage that the vaccine is associated with anything more serious than a bit of discomfort.” Fainting and symptoms related to anxiety have been reported, he said, but these are short lived and not harmful.

“You will find parents who claim damage because of the vaccine, but from a scientific point of view, that is not adequate to prove a link between that patient and the vaccine. But it also cannot prove an absence of a link and that is why it is important for healthcare workers to report suspected adverse effects related to vaccinations.”

Still, he remains convinced that at this stage there seems to be no reason for any concern.

“Some people refuse the vaccine because since it protects against a sexually transmitted infection, parents believe their daughters will not engage in risky sexual activity and believe that there is no need for them to be protected. But I don’t find that a particularly compelling argument.

Certainly, there is benefit to being protected even if a child is at lower that average risk.”

In fact, Reubenson explained that most people will get an infection by one or more of the HPV strains within a few years of becoming sexually active. Most people clear it by themselves, but those who don’t are at risk for being diagnosed with cervical cancer many years later.

Delaying HPV vaccinations is also not recommended because if someone is infected with a high risk strain of HPV before vaccination it is too late, Reubenson said. This is because vaccinations at that time will not be able to prevent serious effects of such infection.

“That is why it is important to give the vaccination to girls before they become sexually active,” he said.

Reubenson said he believes that, unfortunately, stories told by parents to each other are often believed more than a well-informed evidence-based medical information campaign.

“Simply presenting the numbers convinces healthcare workers and scientists but a single parent telling a group of other parents that they think their child was affected by the vaccine may carry more weight in many peoples’ minds.”

But even if there are any serious adverse effects, which Reubenson said there is no reason to believe that there are, the benefits still dramatically outweigh any risks.

The World Health Organisation said cervical cancer is by far the most common HPV-related disease. Nearly all cases of cervical cancer can be attributable to HPV infection. It still recommends vaccination for girls aged between 9 and 13 years since this is the most cost effective public health measure against cervical cancer.

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