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Canadian paper retreats after vaccine story sparks furor

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h890 (Published 18 February 2015) Cite this as: BMJ 2015;350:h890

Re: Canadian paper retreats after vaccine story sparks furor

Dr Anand, Thank you for your response.

Vaccines are not perfect, can cause side effects and not all of them have been highly effective including the annual Flu Vaccine and Tuberculosis vaccine(1).

But at a population level, Vaccines have immensely benefitted the humans. For instance, Vaccines are responsible for eradication of the deadly small pox, significant elimination of crippling Polio and worldwide reduction in Diphtheria, Pertussis and Tetanus cases. It is a shame that the recent MMR scandal has led to a spike in the incidence of measles.

Now Vaccines are also being used to fight cancer. BCG vaccine is a widely used as an alternative to bladder removal in treatment of superficial bladder cancer (2). Unlike UK, Cervical cancer is one of the commonest cancer in India with more than 100, 000 cases per year(3). In UK, the cervical cancer deaths fell dramatically following the introduction of cervical smear testing and treatment of cervical precancerous lesions but this comes with a price tag of 36000 pounds per life saved (4).

Cervical cancer is caused by HPV infection and the infection is prevalent in vast majority of sexually active women. Hence , the HPV vaccine , offers a cheaper and hugely promising approach to control the high incidence of cervical cancers in many third world countries (NB: HPV spreads predominately by normal sexual intercourse but not exclusively by anal intercourse)(5).

Vaccines have so far provided more benefits than they are given credit for and Vaccines certainly need a image makeover to overcome this unfair negative image.

References
1. Roy A, Eisenhut M, Harris R J, Rodrigues L C, Sridhar S, Habermann S et al. Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis. BMJ 2014; 349 :g4643.

2. Sharma N, Prescott S. BCG vaccine in superficial bladder cancer BMJ 1994; 308 :801

3. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on 26 Feb 2015

4. Peto J, Gilham C, Fletcher O, Matthews FE. The cervical cancer epidemic that screening has prevented in the UK.. Lancet. 2004 Jul 17-23;364(9430):249-56.

5. Chawla S, Singh I, Jain R, Mehta B, Kumari S, Sahoo SS.Human papillomavirus vaccine: A boon or curse.Hum Vaccin Immunother. 2014;10(12):3509-12. doi: 10.4161/21645515.2014.980689.

Competing interests: No competing interests

26 February 2015
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospital NHS Trust
Nottingham