OPEN LETTER TO THE JCVI

28th August 2017
jcvi-consultation@phe.gov.uk

Dear JCVI members

We write in response to the consultation concerning the deployment of the HPV vaccination to teenage boys as part of the NHS schedule.

Whilst we appreciate that the vaccination may have been given to millions of girls without adverse reactions and that it may well be of health benefit to them in the future, we write as parents of girls who have developed severe, life-limiting illness within close proximity of having the HPV vaccination.

Our daughters have been ill for a long time, in some cases for 8+ years – they have had their education compromised and those older are not employable. The Government has not yet recognised the link between the vaccination and their illness, but we should point out that legal action is taking place in France, Spain, Germany, Japan, Columbia and large awards have been made by the US Vaccine Court. We believe it is only a matter of time before the Government will have to recognise that for some girls there is a serious problem with having the HPV vaccination.

We strongly feel that we were not provided with sufficient information about the vaccination prior to it being given to our daughters and, in some cases, girls were scared into having the vaccination by advertisements and stories in the press (for example Jade Goody, Michael Douglas). However, it was not communicated to them or us that more than 95% of HPV infections will clear from the body naturally with no intervention; that for most women smear tests are an effective way of avoiding cervical cancer and that there are many factors associated with lifestyle that can increase the risk of developing cervical cancer (for example: smoking, high parity, poor nutrition; long-term use of the contraceptive pill).

Outstanding issues in respect to girls are as follows, and we believe that there should be no extension to the HPV vaccination programme until these are resolved:

– The number of reported suspected adverse reactions is very high in comparison to other vaccinations, but the vaccine is only given to girls. 30% of the reported events are categorised as serious. We don’t believe there is sufficient follow up and investigation of these reports.

– The MHRA say there are no safety concerns, but taken in the context of problems found with Pandemrix (swine flu vaccine) and Narcolepsy; problems with Primodos and Sodium Valporate; and the emerging scandal of the vaginal mesh tape injuries – we do not have confidence that the safety concerns have been sufficiently investigated by the MHRA or the EMA.

– There is an outstanding complaint of maladministration against the EMA with the EU Ombudsman concerning the investigation into POTS/CRPS as suspected side effects of the HPV vaccination in 2015. Some very serious points were raised about why the EMA investigation was not thorough or transparent.

– There are questions around whether the targeting of strains 16 & 18 of the HPV virus will lead to other strains becoming stronger and more virulent and possibly causing more cases of cervical cancer in the future.

– There are questions around the efficacy of the vaccination. PHE are recruiting for a trial to look at the current antibody titres of those having had the vaccination at the start of the programme. Dr Diane Harper has recently published a paper stating that the antibody titres for HPV18 following vaccination with Gardasil are considerably lower than for Cervarix, meaning that for Gardasil protection against HPV18 may have dropped after only two years and after 5 years 35% of those in the study had no detectable HPV18 antibodies.

We strongly feel that the HPV vaccination is not required for the majority of boys, although it should be an option for those who are high risk, and it should not be part of the NHS vaccination schedule. Our reasons for this opinion are as follows (data from the Cancer Research website):

– Head and neck cancer incidence is strongly related to age, with the highest incidence rates being in older males and females. In the UK in 2012-2014, on average each year half (50%) of the cases were diagnosed in people aged 65 and over.

– 91% (93% in males and 85% in females) of oral cancer cases each year in the UK are linked to major lifestyle and other risk factors.

– 93% of laryngeal cancer cases each year in the UK are linked to major lifestyle and other risk factors.

– Smoking is the main avoidable risk factor for head and neck cancer, linked to an estimated 65% of oral cancer cases, and an estimated 79% of laryngeal cancer cases in the UK.

– An estimated 91% of oral cancers in the UK are linked to lifestyle factors including smoking, alcohol (30%), and infections (13%).

– An estimated 93% of laryngeal cancers in the UK are linked to lifestyle factors including smoking, and alcohol (25%).

– Betel nut, smokeless tobacco, ionising radiation and certain occupational exposures can cause oral cancer.

– Certain occupational exposures cause laryngeal cancer.

– A diet high in fruit and vegetables may protect against head and neck cancer – insufficient fruit and vegetables intake is linked to an estimated 56% of oral cancer cases, and an estimated 45% of laryngeal cancer cases in the UK.

Additional research found these statistics:

– More than 4 in 10 (43%) penile cancer cases in the UK each year are diagnosed in males aged 70 and over (2012-2014).

– More than half (52%) of anal cancer cases in the UK each year are diagnosed in people aged 65 and over (2012-2014).

– Incidence rates for anal cancer in the UK are highest in people aged 85-89 (2012-2014).

– Incidence rates for penile cancer in the UK are highest in males aged 90+ (2012-2014).

– Penile cancer and anal cancer in England is more common in males living in the most deprived areas.

– The risk of penile cancer among men who smoked at diagnosis was 2.8 times that of men who never smoked. Among men who smoked at diagnosis, lifetime smoking of more than 45 pack-years of cigarettes elevated risk to 3.2 times that of men who never smoked.

– The penile cancer risk among men who consumed two or more alcoholic drinks on average 35 days or more per year was 1.5 times that of men whose yearly average was 34 days or less.

– The risk of penile cancer among men with five to 29 sexual partners was only 1.3 times that of men with one to four partners.

– Men with HPV-positive tumours were more likely to report a greater lifetime number of sexual partners and a history of gonorrhoea. Although a higher percentage of men with HPV-positive tumours were found to have HSV-2 antibodies and reported smoking at diagnosis.

– Poor personal hygiene is also a risk factor for penile cancer.

We think that most parents presented with such statistics would decline the vaccination for their teenage sons.

We have also looked at the statistics obtained from the annual report on sexual health clinics and found out that the majority of men taking the HPV vaccination between 2012 and 2016 did not complete the course:

1st dose: 6,217
2nd dose: 1,588
3rd dose: 308

Therefore only 5% of men completed the 3 dose schedule. Perhaps before further deployment, PHE should look at the reasons for the non-completion of the course of this expensive vaccine?

We would therefore suggest that the vaccine is made available for high risk men, but that PHE should focus on educating teenage boys on the benefits of a healthy lifestyle and reduction of risk factors rather than subjecting every teenage boy to vaccination.

Yours sincerely

TIME FOR ACTION
UK Families Affected by the HPV Vaccination

www.timeforaction.org.uk

Email: info@timeforaction.org.uk
Tel: 07885 422690