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Rapid response to:

Research

Risk of miscarriage with bivalent vaccine against human papillomavirus (HPV) types 16 and 18: pooled analysis of two randomised controlled trials

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c712 (Published 02 March 2010) Cite this as: BMJ 2010;340:c712

Rapid Response:

Misleading title?

We are writing to express concern about the title of this research
paper: ‘Risk of miscarriage with bivalent vaccine against human
papillomavirus (HPV) types 16 and 18’. The way the title is phrased could
be interpreted to mean that there is a risk of miscarriage associated with
the vaccine, when in fact the findings are the opposite. We note that the
paper is already in the top ten ‘most shared’ articles on the BMJ website,
and we feel very strongly that in an era where scientific research is so
easily accessible to the public, every attempt should be made to ensure
that the findings are not misinterpreted by people who may not read much
more than the title.

Given the recent history of attitudes to vaccination, particularly
the MMR vaccine, we know that public opinion can easily be swayed by
misinterpretation of research findings. While it is vital that adverse
events associated with vaccination are clearly communicated, it is equally
important that when data are reassuring, these findings are communicated
as clearly as possible. A Google search for ‘HPV vaccination and
miscarriage’ yields over 31,000 results, many of which suggest that the
vaccine may increase miscarriage risk. The search result heading for
Wacholder et al’s paper reads ‘Risk of miscarriage with bivalent vaccine
against human…’ and underneath: ‘In secondary descriptive analyses,
miscarriage rates were 14.7% in the HPV vaccine arm and 9.1% in the
control arm in pregnancies that began within three ...’. On a quick look,
this could easily lead to the belief that miscarriage was more common in
the HPV vaccine group.

Perhaps it is time to reconsider the way in which the titles of BMJ
articles are constructed to ensure that they accurately reflect their
findings.

Competing interests:
We have, in the past, received funding and honoraria from Sanofi Pasteur MSD and GSK, both of whom manufacture HPV vaccines

Competing interests: No competing interests

05 March 2010
Jo Waller
Senior Research Associate
Jane Wardle
Health Behaviour Research Centre, Dept of Epidemiology and Public Health, UCL, London WC1E 6BT