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More on the HPV vaccine, my issues with media coverage, and what parents and teenagers need to know

September 2nd, 2008

Dr Petra

Update 06/10/10
Please note this blog is not anti vaccines. It discusses issues about the HPV vaccine and sex education policy in the UK. If you see this quoted on an anti vaccine blog please be aware it’s being used out of context.

This is a long blog, but please read on if you’re interested in the HPV vaccination roll out across the UK, media coverage of the drug, and information for parents, healthcare practitioners and teens.

Last year I blogged about the proposed compulsory vaccination programme for teenage girls to protect them from cervical cancer. At the time it seemed like the government were going to roll out a mandatory vaccination programme, but they later announced the vaccination would be made available this year – but on the basis of parental choice.

I welcome any vaccination that could save women’s lives and reduce the chances of suffering from cervical cancer which is a dreadful condition. But I also had questions about the proposed roll out of the vaccine across the UK and the implications such a programme would have for the sex education and sexual health of young people.

Like many people I also wondered how much the proposed scheme would cost the NHS (although that information doesn’t seem to be publicly available). While the government has claimed a vaccine that prevented some cervical cancers would reduce the costs of treating cervical cancer, charities have argued that spending money on preventing people getting HPV in the first place would be more cost effective.

Presumably mandatory sex education could save us even more cash in terms of preventing STIs, cutting down on treatment and testing costs and reducing infertility. But we don’t know because the government haven’t publicly compared these different cost packages. All we know is that the vaccine they’ve selected for the UK is the cheaper of two vaccination brands. They have opted for GSK’s Cervarix over Merck’s Gardasil. [That is neither sinister nor surprising, but would make more sense if we had a comparison with what sex education might also cost].

I was made very anxious when I was approached by the communications company promoting Cervarix to speak at a press conference for journalists. In a telephone conversation a spokesperson told me I didn’t have to mention the drug at the press conference, they just wanted me to speak in my role as agony aunt about young people’s sex lives. Although they said if I did want to say nice things about the drug that would be good. My presence would reassure journalists, I was told, and make them more likely to report the vaccine positively. I would be paid a fee in return for my services. When I informed them I work from an evidence-based perspective and could only speak if I discussed with journalists the questions I’d raised in the blog (about sex education/prevention messages) I was told that wasn’t what they wanted. Perhaps unsurprisingly I didn’t take part in any press events for the drug.

I wasn’t alone with my concerns. Medical journals had questioned aspects of the vaccine. Although there has been some critical coverage this has taken place in the US more than it has in the UK, and most of these conversations have taken place in blogs. Where they’ve happened in the mainstream media the debate has mostly been around the costs of vaccination schemes rather than wider issues of sex education or the role of pharmaceutical companies.

That said, some US media spoofs of direct to consumer drug company adverts for the vaccination (which we don’t have in the UK thank goodness) have at least provided some comic relief from a very serious issue…..

I’m not saying we should ignore the vaccine, just that we ought to ask wider questions about how it has been promoted, marketed, and what implications it might have for teenagers and parents.

I sent the first blog I wrote on this issue to the women’s pages of a number of newspapers as well as women’s magazines. The blog contained questions for journalists, plus links to academic journals that explained more about the vaccine which parents might want to read while deciding on vaccinating their daughters. I hoped making the information available to journalists might mean they could share it with parents and teenagers.

Most publications I sent this to ignored it. A few replied thanking me for sending the information, but very firmly told me they thought it ‘wasn’t newsworthy’.

This was a shame because this is one of the most newsworthy things I can think of. There are stories here about gender (why are girls being vaccinated?), health promotion, healthcare budgets, mandatory sex education (and why the current government is dragging its heels on this), and what teens and parents actually think the vaccine will do. Why haven’t we been hearing more about these issues?

Now the vaccine’s available in Scotland, shortly to become available in the UK. And rather than asking questions that should have been posed by any investigative journalist last year when places like the Journal of the American Medical Association were debating the issue, we’re now seeing rather pointless debates in the press on is ‘vaccination a good thing? (answer yes or no)’ or ‘will the vaccination make teenagers more promiscuous?’ or ‘surely anything that cures CANCER shouldn’t be criticised!’.

This isn’t getting to the crux of the issue around how the drug has been marketed and promoted, what it can actually do (not cure cancer, that’s for sure) or answering wider questions parents might have. It isn’t allowing us to raise our concerns over getting sex education higher up the political agenda. But it is allowing some rather disturbing anti-women debates to flourish, has brought the conspiracy theory brigade out in force, while the anti-vaccination camp have chimed in by with their mantra that all vaccinations are bad and no parent should allow their children to be subjected to them.

And I was dismayed to find myself nearly allied with the anti-vaccination lobby today. I ended up on the wrong side of one of these false debates when the Scotsman newspaper’s website included excerpts from my first blog on the HPV vaccine in their ‘Burning Issue’ debate. Nobody from the paper asked my permission to quote from the blog (or alter the meaning of my blog in their edit). I only found out about it when I discovered from other journalists that I was apparently ‘the number one expert opposed to the vaccination programme’. (The paper has since apologised for this oversight).

This is a particular problem for me since at no point have I told people they shouldn’t vaccinate their daughters. Nor have I claimed the vaccine will make teens promiscuous. I do not want to be a cheerleader for those who oppose all forms of vaccinations or the anti-sex brigade. I have every sympathy for anyone with cancer. All I have done raised questions journalists and healthcare providers should be asking to get answers parents need – with links to reliable, thought provoking evidence and clearly linked sources.

Which is why it is so annoying the media missed the boat on this story and are now retreating to safe positions of scaremongering, polarised debates, and teen blaming.

It’s not too late for us to ask questions about the vaccination programme and sex education provision.

But most importantly we need to immediately tend to the needs of parents and teenagers. The drug is now available and many parents will want to get their daughters vaccinated. We all want to protect our children. I can’t tell you what to do. But I can encourage you to look at the evidence before you decide, talk to healthcare professionals as well if it helps, and get answers to your questions about the vaccine.

For those of you who on getting your daughter the jab do her a favour and at the same time ensure your school offers sex education. If you have a son, also pressure your school to offer sex ed.

Promote confidence, assertiveness, talking about sex, pleasure, respect, choice and condom use with your children.

If you decide not to have your daughter vaccinated, make sure this is on the basis of weighing up the scientific evidence. Please don’t make the decision because of other media scaremongering over different vaccinations, or because you’ve read about some herbal cure you might use instead. And if you opt not to have the vaccine you must ensure your daughter has excellent sex education and knows about how condoms will protect her sexual health when she becomes sexually active.

For any of us who are concerned about this issue, we should all make an effort to campaign for compulsory sex education within schools. There’s no point in offering a vaccine that only protects against certain forms of cervical cancer if we don’t equip our kids with the life skills to negotiate an increasingly sexualised culture with dignity and strength.

If every parent who opts in or out of the vaccination programme writes to their MP and demands compulsory sex education we will be able to make this into an election issue – and make our kids safer as a result.

Because a vaccine can only do so much. Parent power can do a whole lot more.

Protect your daughters – and your sons. Write to your MP today.

Update 06/10/10
Please note this blog is not anti vaccines. It discusses issues about the HPV vaccine and sex education policy in the UK. If you see this quoted on an anti vaccine blog please be aware it’s being used out of context.

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