Knock-on effect from HPV vaccine concerns

The reduction in uptake of the cervical cancer vaccine may influence a reduction in uptake of other childhood vaccines, a HSE health chief warns.

Assistant national director for health protection, Dr Kevin Kelleher, told a meeting of the Oireachtas health committee that this reduction “may be due to vaccine complacency, as many of the diseases are not visible now, due to the success of vaccination, or are not perceived to be serious and life-threatening.

“Ongoing, concerted efforts are required from all healthcare professionals and opinion leaders to improve and maintain vaccine confidence in HPV and all vaccines.”

The human papillomavirus (HPV) vaccine was introduced for all 12 to 13-year-old girls in Ireland in 2010. Uptake has dropped from 87% to 50%.

Dr Kelleher said that because of parental concerns about HPV vaccine safety, which have no scientific basis, a large number of girls are at a future risk of cervical cancer.

The chairwoman of the National Immunisation Advisory Committee at the Royal College of Physicians of Ireland, Prof Karina Butler, said HPV causes up to 420 cancer cases, and 130 cancer deaths, each year: “HPV vaccine can prevent most of these cases. The evidence of benefit is very strong. HPV vaccines represent a major step forward in combatting cancer. They are safe.”

Consultant obstetrician and gynaecological oncologist, Prof Donal Brennan, said he can understand why parents of 13-year-old girls could not imagine them dying of cervical cancer, but that survivors know the risk.

Prof Brennan said 3,000 women in Ireland are suffering the consequences of cervical cancer treatment. He attended a woman who was pregnant after six failed cycles of IVF. She had early bleeding in pregnancy and was found to have an advanced stage of cervical cancer: “She has had a year of severe medical treatment and, unfortunately, her little girl, who is beautiful, has a significant hearing loss. I asked this lady, when I saw her last week, if she would vaccinate her daughter and she said: ‘Well, what do you think, doctor?’”

Dr Kelleher said uptake of the flu vaccination among hospital healthcare workers remains low, at 31%, though this increased from 22% last year, with the rate for nurses doubling: “Our problem has been primarily with nurses around their uptake of the vaccine, and we have been working very hard to try and understand that.”

Leadership from the nursing profession makes a big difference, but so do incentives, according to Dr Kelleher, who said there is “extremely good” evidence in medical literature that giving nurses chocolates works.

However, the general secretary of the Irish Nurses’ and Midwives’ Organisation, Liam Doran, reacted angrily on RTÉ radio to the comments: “That’s a perfect example, if you ever needed yet another one, of why Irish nurses and midwives walk away from the Irish health service. Yes, we would like the uptake of the flu vaccine to be higher, but it is not based upon a question of giving people chocolates.”

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