Intended for healthcare professionals

Rapid response to:

Practice 10 Minute Consultation

Discussing human papilloma virus vaccination

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2730 (Published 22 June 2017) Cite this as: BMJ 2017;357:j2730

Rapid Response:

Re: Discussing human papilloma virus vaccination

1. Nowhere do the authors mention that the longer YOU, the GIRL CHILD delay sexual intercourse - regardless of the route - the lower the chances of your contracting the infection.

2. Nor do the authors mention that the sexual experiences of your male partner will have a bearing on your contracting the virus.

3. Nowhere is to be seen a recognition that in SOME societies the risks of Cervial cancers are lower.
Please see CytoJournal, 2015, 12:13 ! Cervical intraepithelial lesions in females attending Women's Health Clinics in Alexandria, Egypt. The authors, Abdel-Hadi et al cite The Middle East Cancer Consortium as reporting a 0.027% prevalence rste for cervical cancer in EGYPTIAN women. The highestage-standardised rate for cervical cancer was observed in Israeli Jews (5.3) followed by Cypriots, Egyptians, Jordanians and the lowest in Israeli Arabs (2.5).
Let us note the Cypriot situation. Perhaps sexual mores?

4. The 10 minute consultation is from Singapur. Surely even in that cosmopolitan country sex at the age of nine years is frowned upon?

5. Coming back to our own country ENGLAND, does PUBLIC HEALTH ENGLAND require those charged by it for carrying out HPV vaccination, to discuss with the parent and child, the desirability of postponing sexual adventures a few years beyond the age of nine? Or, is too embarrassing.? Or, too time consuming? More than the ten minutes?

6. In England we do have populations originating from cultures in which unmarried girls are discouraged from premarital sex. Eg, Cyprus, Afghanistan, Iran, Iraq, Syria, Turkey. Does our government (Public Health England) take this in to account when formulating guidance or directives in this matter? If not, why not?

Competing interests: No competing interests

28 June 2017
JK Anand
Retired doctor
Free spirit
Peterborough