Numbers of Irish students opting for the HPV Vaccine drops considerably

Caoimhe Gordon explores the reasoning behind falling rates of vaccination and why a general distrust of vaccinations continues to be prevalent in Ireland

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“The three of the most Googled searches for the vaccine in Ireland all involve phrases such as ‘controversy’, ‘side effect’ and ‘is it safe?’” 

A Trinity professor has criticised the lasting impact that fearmongering online has had on the Irish public after recent revelations that the number of female students opting to receive the HPV vaccine in Irish schools has dropped by 10% in the past year. Prof. Kingston Mills of the Experimental Immunology department recently illuminated the crucial role social media has played in leading to this decrease and is holding a public lecture to address gaping holes in the beliefs of many Irish people about vaccinations.

The HPV vaccination scheme began in Irish schools in 2010. The purpose of the vaccine is to protect girls from developing cervical cancer when they are older, by helping them to develop an immunity to human papillomavirus (HPV) that cause most cervical cancers, as well as some cancers of the anus. According to a fact-check by TheJournal.ie, “repeated studies and clinical trials” all contend that the vaccination is completely safe. All studies conclude that allergic reactions, as well as possible side effects, are shown to be extremely rare. The vaccine used by the HSE, Gardasil, is at least 99% effective against the four strongest subtypes of the virus in young women. However, this appears to made little change to reservations held by the Irish public, as the three of the most Googled searches for the vaccine in Ireland all involve phrases such as controversy, side effect and “is it safe?”

Prof. Mills has urged parents to focus on the scientific evidence and not “hearsay” that can be found online, after it was disclosed in October that the rate of immunisation in Ireland has tumbled substantially to 70%. The HSE, acting as advocates of the vaccine, had opted for a target uptake of 80%. Previously, the number of those choosing to receive the vaccine in schools soared above this figure, with some parts of the country recording highs of 90% of pupils choosing to be vaccinated. This is echoed in the overwhelmingly high figures recorded by the Health Protection Surveillance Centre which show that between the academic years 2010/2011 to 2014/2015, 201,410 girls chose to take the full set of vaccine doses. However, this figure is set to fall considerably due to the recent spate of first year pupils in the school-based programme choosing not to receive the vaccination.

“That is a huge concern to us, but also to cancer specialists who really are very, very fearful that we won’t see the impact of the vaccine programme and women will be left at risk.”

Dr. Brenda Corcoran of the National Immunisation Office describes an uneasy atmosphere in the HSE created by this situation as the previous “universal acceptance of the vaccine” appears to be waning: “That is a huge concern to us, but also to cancer specialists who really are very, very fearful that we won’t see the impact of the vaccine programme and women will be left at risk.”

The main reason being attributed to these falling rates are the anti-vaccination campaigns currently being orchestrated by concerned parents. One of such groups is REGRET (Reactions and Effects of Gardasil Resulting in Trauma), a joint force of parents of teenage girls who developed serious health issues after entering secondary school, issues they believe were caused by the vaccine. On the group’s website, the parents explain that they “are certain that the HPV vaccine (Gardasil) is the cause of their daughters’ otherwise unexplained illness.” There are believed to be over 800 cases of adverse reaction to the vaccination with many more stories of active children now struggling to get out of bed due to lethargy, headaches and joint pain emerging daily. Many parents similarly believe that these illnesses are linked to the vaccine. Ireland is not unique in this matter, as this pattern has also be identified in other EU nations such as Spain, where in 2014 the parents of a teenage girl sued the manufacturers of the HPV vaccine and the state authorities for injuries allegedly caused by the vaccination. In France, a judge awarded damages to a young girl with MS, concluding that Gardasil was 50% responsible for the “permanent injury”, while attributing the other 50% to the teenager’s genetic pre-disposition for autoimmune disorders.

“Their assertions are simply not supported by the copious amount of clinical evidence, nor have these trends been seen in the upward of 200 million doses of Gardasil given worldwide to date.”

In December 2015, Fiona Kirby of REGRET attempted to obtain an injunction for the withdrawal of Gardasil in the High Court, arguing that upwards of 140 girls are suffering “severe non-specific reactions” to the vaccination. Although the injunction was ultimately refused, REGRET’s public profile only rose in significance and the story of the failed court case achieved worldwide media coverage. David Robert Grimes, a physicist and cancer researcher at Oxford University, acknowledged the emotive elements of the action in an article in The Guardian, however he maintained: “Their assertions are simply not supported by the copious amount of clinical evidence, nor have these trends been seen in the upward of 200 million doses of Gardasil given worldwide to date.”

The anti-vaccination cause has benefited from further media exposure, with a documentary spanning the severe side effects supposedly caused by the vaccine broadcasted by TV3 in December 2015. Following the airing of the documentary, the HSE was forced to issue a statement defending its use of the vaccination: “All international regulatory authorities, including those in the USA, Australia and the UK and the World Health Organisation, investigate vaccine side effects, and they and the Irish regulators have stated that Gardasil has a good safety record.” A complete list of the official agencies who recommend the vaccination, including the World Health Organisation (WHO) and the International Federation of Obstetricians and Gynaecologists, is available on the HSE website.

Speaking to TheJournal.ie, Mills acknowledges that many have developed chronic fatigue syndrome after the administering of the vaccination but frets that these campaigns can have a wider effect on the country as a whole: “Based on some individuals who have had chronic fatigues syndrome, some campaigns are claiming that it is associated with the vaccine. The result of that is that uptake of the vaccine has declined and when the uptake goes below a certain threshold then the overall benefit to the community is almost lost.” He has presented various other theories that could lead to the perceived side effects, but acknowledges that the cause of this illness is very hard to prove. However, it remains clear that speculative reporting in the media on possible links between the vaccine and the illness is growing extremely frustrating for those in the immunology community.

“[…]those opposed to vaccinations continue to spread anxiety and despair by perpetuating the autism myth, including US President Donald Trump, who has tweeted incessantly on the issue.”

Growing fears and falling numbers of participation in the HSE school vaccination schemes is reminiscent of the beginnings of the worldwide panic in 1998 that surrounded claims that the MMR vaccine led to autism, a claim that was ultimately disproved. The results of the world’s largest study into this claim were published in 2015, with over 95,000 children involved in the gathering of data. Researchers found that the MMR vaccine did not increase risk for autism spectrum disorder, even among the 2000 children in the study that were considered high risk for developing the disorder. In spite of this, those opposed to vaccinations continue to spread anxiety and despair by perpetuating the autism myth, including US President Donald Trump, who has tweeted incessantly on the issue. It is widely agreed that a similar study of the HPV vaccine should be undertaken, as it seems to be the only successful method of gaining a singular belief in the safety of a vaccine.

Mills concludes that while it may be impossible to end the debate on vaccinations, he urges people to end their naivety by not trusting everything they read online: “Of course there are two sides to the argument, I’m not saying all vaccines are 100% safe. There are risks but you have to weigh up the benefits and the risks and let people make an informed choice based on sound scientific evidence. Not based on hearsay on social media.” His public lecture “Vaccines- benefits, risks, myths and the Trump effect” took place in Trinity College on Wednesday 15th February.