Every teenage girl in the UK should be given the HPV vaccine
This year the NHS launches its vaccination programme against the Human Papilloma Virus (HPV). The vaccine will be given to girls aged 12 and 13, and then to all girls between 12 and 18 as part of an initial catch-up programme. Certain strains of HPV are responsible for 99% of cervical cancer cases and the disease kills around 1000 women each year. But the vaccine has caused controversy. Is this vaccination the best way for the NHS to spend its funds?
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HPV is an extremely common virus
80% of women will be infected with some form of the HPV virus in their lifetime. You clearly don’t have to be particularly promiscuous to be at risk, especially as it rarely causes any immediate symptoms so neither partner will know they have it. Most people will fight it off naturally, but others infected with one of the 15 cancer causing strains may go on to develop a cervical tumour fifteen or twenty years down the line. Statistics suggest that around 25% of women have come into contact with the virus by the time they reach university, so it is important to vaccinate at a young age, before girls become sexually active
HPV may be common, but for most people it is also perfectly harmless. Additionally, the new vaccine will only protect girls against 2 out of the 15 cancer causing strains. These strains, HPV 16 and 18, only account for 70% of cervical cancers.
Cervical cancer kills; this vaccine will save lives
The lifetime risk of developing cervical cancer for a UK woman is 1/116. In 2006 831 women died of the disease, about a third of all cases diagnosed. It mainly affects women in their thirties and forties, but sufferers have been as young as 22. Experts estimate that the HPV vaccine could save around 400 lives a year. That’s four hundred families who would be saved the grief of losing a daughter, a mother, a sister or a wife. If a simple vaccination can stop women from dying needlessly, it must be worth it.
Yes. It will save lives. But…not that many. For every 1000 girls vaccinated, only 80% will actually come into contact with HPV. That’s 200 vaccines essentially wasted.
We can also rule out all those who do not come into contact with a cancer causing strain, those who would fight the virus naturally anyway, and those who would be exposed to one of the cancer-causing strains not protected against by the vaccine.
This leaves around 3 people out of that 1000 who would actually be prevented from developing cervical cancer. Of those, 2 would be cured through treatment. So for every 1000 vaccines, we save A SINGLE LIFE. The idea that ‘every life is sacred’ is all very well…but not when you have a cash-strapped national health service trying to maximise the good it can do with limited resources.
Prevention is better than cure
Treatment options for cervical cancer have improved and the survival rates for cancers caught at an early enough stage are quite good. However, for late stage cancers it falls to around 15%. Nobody wants to go through the trauma of discovering they have cancer or the pain and hassle of radiotherapy, chemotherapy and surgery. Furthermore, the surgical procedures used to treat this kind of cancer often involve removing large portions of the reproductive system. Not only is this painful and debilitating, but it robs women of an essential part of their female identity, and young women of their chance to have children. Even non-fatal incidences of cancer are worth preventing.
The survival rate for early stage cervical cancer ranges from 90-96%. With treatment that effective, it really isn’t worth all the expense and effort of a vaccination to prevent the disease.
The vaccine might not be safe
As the recent MMR controversy proves, we can’t really know that any vaccination is 100% safe. It may take years to realise the connection between the vaccine and a potentially devastating side effect. Furthermore, the ‘extensive testing’ of the vaccine was for the most part not carried out on the age group for which the jab was intended. Because the process involved a series of cervical smears, the testers were mostly 15-16 rather than 11-12. Who knows whether these less developed girls will react the same way as the older testers, when their immune systems are potentially weaker? There have also been a handful of deaths in the U.S. which occurred shortly after receiving a Gardasil vaccination. While no link has been proven, and this may be a coincidence, it is still cause for concern. While contagious diseases such as measles or meningitis are so potentially harmful that the risk of immunisation may be considered ‘worth it’, is this also true for the far smaller threat posed by HPV?
The vaccination bought by the NHS has been in testing for around 6 years and trialled on thousands of girls without any serious side effects being reported. A different version of the vaccine, Gardasil, has also been in use in the U.S. for the past couple of years. The vaccine can thus potentially do a great deal of good, protecting women from cancer, but will certainly not do any harm. The course of three injections has also proved to have long term efficacy in protecting against HPV, although the possibility of a follow-up booster has not been ruled out.
Also, the MMR 'controvesy' was more or less fake - only a tiny number of children were tested, and the theory has now been rejected.
The vaccine is extremely expensive
The three dose course of the vaccine will cost the NHS around £240 per person. If it saves one life for every 1,000 people vaccinated, then that is £240, 000 for that on life. People might argue that you cannot put a price on survival, but in terms of NHS spending several lives could be saved and many more significantly improved through an alternative application of those funds. For instance, 44,000 women a year are diagnosed with breast cancer (compared to 3,000 for cervical cancer), around 12,000 of whom will die of the disease. When you think that some of these women are being denied the latest drugs and treatments because of funding constraints, it seems absurd to be spending such a large amount on a jab that will have so little impact on public health.
We cannot condemn 1000 women a year to an early death because of budget concerns. Other cancers and conditions may be more widespread, but there is no easy means to prevent them aside from better education about keeping healthy. In the HPV vaccine we have a proven, simple means to cut rates of cancer in women and this is an opportunity we should seize. The savings made on treatment for cervical cancer will help offset the costs of this prevention programme.
It is unclear exactly what drugs are being denied to sufferers of other diseases. It also unstated what it would cost to save the lives of breast cancer (and other) patients. If it were demonstrable that the £240 per person could save more lives, the argument against would be much more compelling.
The NHS’ screening programme is sufficient to prevent cervical cancer
The NHS already has an extremely effective screening programme in place which can detect pre-cancerous cells that may one day develop into full-blown cervical cancer. Smear tests are offered from the age of 21, more than early enough to catch most incidences at a very early stage. If girls are vaccinated against HPV, they may be less likely to take up their free cervical smears as they already consider themselves protected, especially considering the slightly unpleasant nature of this procedure. This could then lead to a rise in cases of cancer caused by the strains which the vaccine does not protect against.
Screening does not 'prevent' cancer it merely detects it! Young women already tend to ignore the importance of cervical smears as they find the procedure uncomfortable and embarrassing. Cervical cancer is not publicised in the same way as, say, breast cancer, so they are unaware of the risks. If anything, the vaccination will raise their consciousness of the threat of cervical cancer at a young age and make them more likely to participate in screening in their twenties.
The vaccination programme will encourage promiscuity among young girls
In order to explain the reasons behind the HPV vaccination, parents and teachers will be forced to discuss sex and sexually transmitted diseases with their daughters at a very young age. This will undoubtedly encourage their curiosity about sex and may encourage them to experiment more than they might have done. By giving the jab to 12 year-old-girls, the government is almost advocating under-age sex. It seems to accept that by 14 or 15 it will be too late to give the vaccine as most girls will already be sexually active. Furthermore, the vaccine will give young girls a sense that they are now protected against sexually transmitted disease and can thus go out and have sex with multiple partners without having to worry. This will lead to a rise in promiscuity, incidences of other STDs and teenage pregnancy.
Vaccinating against HPV does not send the message that young girls are now free to be promiscuous. The idea that a 12 or 13 year old girl would never have been told about sex before is ridiculous; most primary schools have some form of basic sex education for 10-11 year olds. Neither will an increased awareness encourage children to have sex; the HPV vaccine combined with a decent programme of sex education will warn children about the dangers that come with sexual activity and inform them that while they are protected from some HPV they are still at risk from other strains and other STDs. It is this attitude, trying to wrap young girls in cotton wool, which leaves them unable to make informed choices about sex and safeguard their own sexual health. Vaccinating at 12 is not condoning underage sex any more than allowing doctors to give contraceptives to under-16s is encouraging them to be promiscuous. It is simply realistic. The role of the NHS is to protect young women from disease, not to judge them.
There is simply no evidence that vaccination, or education for that matter (or availability of condoms etc) leads to promiscuity. No study has shown this affect.
The claim that the government is "almost advocating under-age sex" is so outlandish as to be absurd. It's as if to say the government, by requireing tetanus vaccination, is advocating poking yourself with a rusty nail.
There is no reason to believe that anyone will consider protection against disease A to equate to protection against all diseases B through Z.
The point seems to suggest that promiscuous and alive is a worse outcome that chaste and dead. So what if keeping people alive *might* encourage a handful of girls at the margins to have sex. The enforcement of chastity via fear of disease is a fairly tyrannical notion, anyway.
A % of girls will unfortunately die of it still as with other vaccinations for various deseases. There is no proof whatsoever it will reduce the amount of deaths,so leave alone,and leave our kids alone,
What do you think?