«What justification is there to pay the price of a serious adverse reaction, in girls with their whole lives ahead of them, to prevent a hypothetical cancer after 30 years?» asks Alicia Capilla, the president of the Association of People Affected by Papilloma vaccine (AAVP).
The Spanish organization publicly linked this week the treatment against the virus associated with cervical cancer – the human papilloma virus (HPV) – with the death of three girls in the country.
However, the position of the highest health authority is clear. «The WHO recommends that countries consider HPV vaccination when the incidence of the disease is high and when the vaccine is profitable and its application affordable and sustainable,» the organization remarked to BBC Mundo.
His position has been firm since 2009, when he made his position public through a statement. The only thing that has changed since then is the suggested dosage.
«Following the recommendations of the Strategic Group of Experts on immunization of April 2014, on reducing the doses inoculated to adolescents between 9 and 13 years from three to two, the WHO will publish a document in October 2014,» the organization reported. in that sense.
Despite the clear position of the WHO, adverse reports do not stop being made public. Reactions that detractors associate with the aluminum that the vaccine contains.
According to the August 1, 2014 report of the Vaccine Adverse Event Reporting System, of the 2,566 forms received reporting injuries from such treatments in the United States, and which were analyzed by the Compensation Program, 151 correspond to HPV vaccine cases. Of these, 71 were compensated, according to the US Department of Health.
The European Medicines Agency has also received such reports.
«Why then is it not thoroughly investigated, with medical rigor, whether there is causality between the application of the vaccine and the adverse reactions?» the president of the AAVP asks again.
It is one of the hands of the association, so that the cases stop being «suspicions». Since, for the moment, no body or court has said otherwise, despite the fact that in some cases legal actions have been initiated.
Capilla founded the association in Valencia, Spain, when her 14-year-old daughter had to be admitted after receiving the vaccine. It is received by between 150,000 and 160,000 adolescents a year in the country, according to the guarantee of BBC Mundo, the Ministry of Health.
«She was very serious. She began to convulse, they moved her to the Intensive Care Unit, where she spent 41 days, and then she was admitted to the hospital for four months,» she told BBC Mundo by telephone.
«They told us that hers and other Valencian girls were the only cases of adverse reaction to the vaccine in Spain, in Europe, even in the world.» She soon saw that this was not the case, when other affected parents began to contact her and began to learn about her.
recognition of consequences
Since then, he has been trying for five years to get the Spanish government to recognize the existence of side effects in the treatment; «the basic problem, the one that leads to not investigating».
There are countries that do. Like the United Kingdom, whose National Health System (NHS, for its acronym in English) mentions on its website the consequences «common», «rare», «very rare», «frequency», unknown «allergic reactions» and » chronic fatigue».
They are the same as indicated in the package insert for Gardasil, one of the brands of the vaccine, which is marketed by the American company Merck & Co. The other trademark, Cervarix, from GlaxoSmithKline, mentions fewer negative effects.
In the category of rare reactions, the British system includes Guillain-Barré syndrome, a disorder that causes the immune system to attack the peripheral nervous system, but none of the neurological diseases associated with AAVP, let alone death. .
When asked about this specific issue, the WHO told BBC Mundo: «As every vaccine said, the HPV vaccine can have possible adverse effects.» According to the organization, the most frequent are localized reactions in the injection area, such as pain, redness and swelling. And also headache, nausea and fever.
«Death is not on the list of possible consequences of the HPV vaccine,» he said emphatically.
He added that the Global Advisory Committee on Vaccine Safety (GACVS) has regularly reviewed the safety of the treatment and that to date more than 175 million doses of the vaccine have been given worldwide.
Questioned efficacy and alternatives
Beyond the claim about the recognition of side effects, there is questioning of the efficacy and, subsequently, inoculating adolescents between 9 and 13 years of age to prevent sexually transmitted disease.
«The vaccine prevents two to four serotypes (infectious microorganisms) of the 16 that exist (related to cervical cancer). That is, it does not prevent it at all,» Capilla insisted. «In addition, it is not yet possible to know if it is effective, because the disease develops in 20 or 30 years,» and the vaccine is recent.
Diane Harper, a vaccine researcher, was already critical of the decision for intensive vaccination because of its «experimental» nature.
But the strongest objection is the manifesto signed by more than 10,000 health professionals in Spain, entitled «Reasons for a moratorium on the application of the HPV vaccine in Spain.» It was made public in the fall of 2007, when the Ministry of Health decided to include the treatment in the national immunization programme.
The manifesto questions the cost and opportunity of the measure. He also points out that there is already a method of prevention, cytology, an examination that consists of taking a sample of tissue from the cervix to be analyzed in the laboratory, in order to detect the presence of abnormal or cancerous cells.
He stresses that the test is «highly effective and inexpensive», so it is recommended to continue practicing it «even in the vaccinated population.» Something that he also insists on in the Spanish organization for those affected.
In this sense, it is worth noting the second part of the WHO position, the nuance that it makes of the recommendation to vaccinate. He suggests its use «when the incidence of the disease is high and when the vaccine is cost-effective and its application is affordable and sustainable.» And also «as part of a comprehensive approach to the prevention and control of cervical cancer.»
A comprehensive approach that should therefore include cytology and, above all, sexual education. Something that all the parties mentioned in the article agree with.