Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Problems with HPV vaccination
- Zekria Ibrahimi (22 December 2008)
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Re: Problems with HPV vaccination
- Dr Viera Scheibner PhD (23 December 2008)
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Re: Re: Problems with HPV vaccination
- ZEKRIA IBRAHIMI (23 January 2009)
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Zekria Ibrahimi, psychiatric patient Coombs Library UB1 3EU
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There is a tentative vaccine, if not a total cure, for HPV- Human papillomavirus- which is culpable for genital warts. The Government's present much vaunted approach to HPV is against all epidemiological common sense. In effect, only schoolgirls are being vaccinated, not mature women, and not boys or men. Avoiding male vaccination is not going to ensure a rapid deacceleration of HPV. The policy is discriminatory at the expense of gay adolescents and gay men, who will not be receiving the vaccine, but for whom genital warts can be nasty and disfiguring. Strangely, this Government, blinkered by its Scrooge- like miserliness, has not yet managed to perceive that 'herd immunity' will be of no benefit to gay men if vaccination is restricted narrowly to girls. The Department of Health has absolutely no genius for being inclusive towards the homosexual community. The seemingly sophisticated 'mathematical modelling'(1)of the Government factored in QALYs, but did not include compassion for gays. The Governemnt is concerned about cost, not health, and thus is blind to the suffering of gay men under HPV. The menace of HPV is 'not inconsequential'(2). It is associated with cancers and with extreme sexual dysfunction. There may be some sort of cruel sub- conscious assumption that people with HPV or indeed any STD have brought the condition on themselves, and do not merit sympathy- or a vaccine. One fears also the faulty misconception that the condom seems the 'magic bullet' for HPV. But skin infections such as HPV can spread across the vulva and the scrotum, can elude cover by a condom, and can subsequently be transmitted. And the tragic fact remains that people often omit to use a condom, although they may be in an extreme risk situation, such as discordance for Herpes (another common viral STD) or HIV. The problem for the Government may have been expense. The Government reprimanded the BMJ in a public letter thus: 'We took full account of the burden of genital warts and the benefits that might come from vaccinating males. Perhaps Hammond might have asked himself how much he was prepared to pay to prevent genital warts.' (3). The Government is being dangerously mean over HPV, and STDs in general. As the next letter, by Colm O'Mahoney, a STD consultant from Chester, implies, the Government's balance sheet on HPV and the (limited) vaccine may not be overwhelmingly correct. The Government 'model' underestimates the price of treatment of warts at £134 per patient, while the actual cost in the real world may be £423. The bill for the vaccine-Cervarix or Gardasil- is £240 (4). We are victims of bad epidemiology being applied to all STDs. There is not going to be an immediate cure for HIV, there is probably not going to be a vaccine, and to rely on condoms alone is a bankrupt strategy. Condoms 'per se' are not just about to stop HIV. Without consistent and compassionate epidemiology, we will not defuse the explosion of AIDS. Current screening is inadequate, and up to a third of those with HIV do not know they are positive (5). What the Government attitude to HPV involves is misinformed and foolish penny- pinching, which indeed has been the curse in the global attitude to HIV too. It is gay men who are being left behind and left out in the Government's heartless calculations. References: (1) Kim. J.J Human papilloma virus in the UK. BMJ 2008;337;a842 (9 August.) (2)Genuis S.J. Are condoms the answer to rising rates of non- HIV sexually transmitted infection? No. Head to Head.BMJ 2008;26 January, pg. 185. (3) Salisbury D. Government fully considered HPV vaccine. BMJ 2008;337;a2552. (22 November.) (4) O'Mahony C. "Annoyance" of genital warts. BMJ 2008;337;@2553. (22 November) (5) Mashta O.HIV testing should rise in areas of high prevalence. BMJ 2008;337;@2748 (29 November.) Competing interests: None declared |
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Dr Viera Scheibner PhD, Scientist/Author Retired Blackheath NSW Australia
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Dear Editor, The, no doubt well-meaning, concern of Zekria Ibrahim has one little, but important, flaw: HPV vaccines of any kind, just as any other vaccines, do not prevent HPV infection and symptoms, whether given to young girls, adult women or boys and men (including gay men). This is based on orthodox immunological research (old and new) which demonstrated that all that any vaccines do is to sensitise, meaning to increase susceptibility to HPV and other viruses and bacteria. This has been known for two hundred years; if we discount the first 100 years, the orthodox immunological research in the second 100 years (all of the twentieth century) has been demonstrating that what any vaccines actually do is causing anaphylaxis. A simple perusal of Medical Dictionary (mine is dated 1983) reveals that sensitisation equals anaphylaxis (as opposed to prophylaxis). The biggest epidemics of smallpox occurred in the areas with the highest vaccination compliance and in the vaccinated. The example of citizens of Leicester is a well-known historical document: they refused vaccination and thus stopped smallpox epidemics in their city. Regular 2-3 year outbreaks of measles continued in the well- vaccinated non-Amish communities in the USA for 18 years (1970-end of 1987), during which time the unvaccinated Amish had not reported a single case of measles (Sutter et al. 1991. Measles among the Amish: a comparative study of measles severity in primary and secondary cases and households, J Infect Dis; 163: 12-16) All over the world, including the US, large outbreaks of paralysis occurred within days of mass polio vaccination drives, with both injectable and oral vaccines (The Cutter incident: Nathanson and Langmuir 1963a,b,c; Am J Hygiene; 78: 16-81) right ab initio to this day. Here I only mention in some detail a comment by Biellik et al. (1994. Poliomyelitis in Namibia. Lancet; 344: 1776) to van Niekerk et al.'s (1994. Outbreak of paralytic poliomyelis in Namibia. Lancet; 344: 661- 664) to the original description of the 1993-1994 outbreak of paralytic poliomyelitis in Namibia, and which is very revealing: "Although OPV3 coverage was fairly low in northern compared with southern Namibia, a higher proportion of northern children might have been protected, at least to type 1, by natural immunity, thus suppressing epidemics. In 1993 OPV3 coverage among infants aged less than 1 year was higher in the south than in the north. However, evidence suggests that a substantial pool of susceptibles, especially among [northern] children aged 1-3, was created when coverage [with vaccine] was low, and the apparent interruption of wild poliovirus circulation [by vaccination] limited the acquisition of natural immunity". In other words, the poliomyelitis outbreak was limited to the south health region in which 80% of infants have received four doses of oral poliovaccine (OPV) by the age of 1 year, while there was no mass vaccination in the north health region. No vaccination enabled the northern children to develop natural immunity to polio without developing paralysis. Taking things like this into consideration, the usually dispassionate health departments anywhere are doing boys, men and the gays a good service by not starting their mass vaccination with HPV vaccines. Competing interests: None declared |
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ZEKRIA IBRAHIMI, PSYCHIATRIC PATIENT COOMBS LIBRARY UB1 3EU
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Medicine cannot progress without forthright scepticism. Never to question any modern medical paradigm would be to betray patients. So we would be wrong to casually reject the contribution of Dr. Viera Scheibner and doubts about all vaccination in general (1). But we would be equally wrong not to reexamine the facts and history. According to the Coombs Library Steadman's medical dictionary, smallpox had tormented humanity for thousands of years. Without the invention of vaccination by Edward Jenner in 1796, smallpox could not have been confined and conquered (2). This Government, deprived of any generosity or insight, does not want to emulate Jenner's example with respect to another scourge-HPV (Human Papillomavirus). Perhaps the grey ghost of Jenner is unhappy as it confronts the narrowness of the Department of Health. The policy on HPV vaccination is necessarily excluding gay men, because of the restriction to (a very limited range of) girls only. We are yet again being hindered by grubby secret deals between the Government and this or that drug company (3). Refrences: (1) Re: Problems with HPV vaccination. Dr. Viera Scheibner. Rapid Responses. 23 December 2008. (2) Stedman's medical dictionary. Marjory Spraycar. Williams and Wilkins. 1995. (3) (Not) warts and all. Personal View. Phil Hammond. BMJ2008;337;a2186. Competing interests: None declared |
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