Re: Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study
I am grateful to Timothy Palmer . In line with Castanon and Sasieni  I was careful not to argue that incidence of cervical cancer had gone up in 20-24 year-olds in England , only that it had not apparently gone down. He notes "that it has occurred in a cohort of largely unvaccinated women", but vaccination began for 18 year-old women in 2008, so by 2014-15 they would surely be "largely" vaccinated.
Regarding problems with safety I provided a short bibliography to Julia Brotherton in an earlier letter  and there are some further references here . The many issues represented by these publications should not be swept aside.
 Timothy J Palmer, 'Re: Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study', 7 April 2019, https://www.bmj.com/content/365/bmj.l1161/rr-3
 Alejandra Castanon, Peter Sasieni, 'Is the recent increase in cervical cancer in women aged 20–24 years in England a cause for concern?', Preventive Medicine Volume 107, February 2018, Pages 21-28, https://www.sciencedirect.com/science/article/pii/S0091743517304802
 John Stone, 'Cervical Disease Vs Cervical Cancer' 6 April 2019, https://www.bmj.com/content/365/bmj.l1161/rr-2
 John Stone, 'Re: The remarkable impact of bivalent HPV vaccine in Scotland', 4 April 2019, https://www.bmj.com/content/365/bmj.l1375/rr
 John Stone 'Primum non nocere', 11 December 2018, https://www.bmj.com/content/363/bmj.k4602/rr
Competing interests: No competing interests