Dr James Burger

thumela vaccineVaccinating has been a controversial topic that causes tension between doctors and those who follow more alternative medicine (with alternative facts). While I know that there is room by big pharma to manipulate results of studies and we must take both new and old evidence with a pinch of Himalayan pink salt, there is a large body of robust evidence that goes against the anti-vaxxer movement.

After my news feed having a number of further articles being shared regarding vaccinations, I thought a little throwback to a piece I wrote in 2015 while on holiday sipping on a G&T to keep the mosquitos at bay. Unfortunately, there is still a need to re-share this note from 16 April 2015:

I have been asked by one of my friends to comment on an article regarding the safety of HPV vaccines, which have been relatively recently popularised as a way to prevent cervical cancer and try to reduce the incidence of a truly preventable cancer. Thanks for giving me a chance to discuss this before these anti-HPV vaccination articles get perpetuated too much! For those who want to read it, it is available at: http://thefreethoughtproject.com/lead-developer-hpv-vaccines-clean-warns-parents-young-girls-its-giant-deadly-scam/  (I put the link here with great hesitancy as I am helping them to receive an income for this article)

I am a medical doctor and apart from having been exposed to this topic multiple times at university, I’ve actually done quite a bit of research into it. The topic is a popular one in South Africa especially, and I have a number of friends and family members who were deliberating whether to receive the vaccine a few years ago and I needed to be informed.

I’m sure that everyone can appreciate the need to analyse information before you assimilate it and I am sure that at school and university, especially in the more medical and scientific courses, there is emphasis placed on the need to critically appraise pieces of information such as this one.

Before we discuss the article, let’s put cervical cancer and the vaccine into context as the article somewhat minimises the problem. Cervical cancer is the 4th most common cancer in women aged 15-44 years and your risk of developing cervical cancer and the risk of dying from it depend on where you live. In the United States, an estimated 13 162 women develop cervical cancer per year and an estimated 5 214 (40%) will die from the disease. Obviously to the writer of the article that is not a number worth worrying about and they consider the risk of cervical cancer “extremely low.”

The main problem with cervical cancer though, is that 86% of new cervical cancer cases will be seen in developing countries. According to the National Cancer Registry (NCR) of 2004, 1 in 36 women in South Africa will be diagnosed with Cervical Cancer. Screening is less effective in developing countries and the risk of dying from cervical cancer in Africa once it is diagnosed is a whopping 78%. Again, please remember that this is a preventable cancer.

The concept of anti-vaccination campaigns has been popularised by people who have either misinterpreted statements or research or, although I hate to say it, purposefully manipulated it to suit their own agendas. The vast majority of people who have read the research and have thought about the topic at hand have come to the conclusion that vaccinating their children is for the best. After having looked at all the evidence regarding vaccinations, I, for one, am going to vaccinate my children.

Although we can never be a hundred percent certain of things, we are continually striving to improve our knowledge and do research. Current evidence all points one way, vaccines do not cause autism, and vaccines are by and large very safe, preventing a huge amount of illness, disease, and unneeded deaths of children and adults alike.

So, let’s discuss the article and the dangers of how a little bit of information can be used to create widespread panic and manipulate people towards an agenda. Please note that this is basically exactly the same article which has been around since 2009, just being recirculated and presented as new information to generate page hits. 2009 is when the original statements were made by Dr Harper, who later actually explained how the comments were taken out of context and extrapolated.  Naturally, anti-vaxxers attributed this to her having been “bought” by pharmaceutical companies.

I’ll first touch on a couple of truths in the article, cleverly placed early on in order to establish a false sense of credibility for the entire article, which is one of the many manipulation ploys in the article.
1)      We are unsure of how long the HPV vaccines remain effective for. True. We will not be able to ensure lifelong protection, although current studies show that they are effective for at least 14 years. Obviously, it is very difficult to do long-term follow up on a new vaccine or medication, as you can only with certainty predict outcomes for as long as your trial runs; if you want to do a 50-year follow up, you will need to do your trials for a very long time and people will never see the benefit of the medication/vaccine. We may well require a booster dose in order to continue to protect our patients and children from cervical cancer, although this requires further research and will come with time.

2)      The article quoted the Vaccine Adverse Event Reporting System (VAERS), which is a system put in place in order to monitor vaccine safety and collects and analyses reports on adverse events related to vaccines. Completely legitimate reporting system. True. Which reported a number of adverse events related to the vaccine (quoted as 15,037 by the article): True albeit for one word omitted. It is, however, one very, very important word.
The VAERS merely collects raw data of anyone who reports a POSSIBLE adverse event after having received the vaccine. This is in no way definitely causal in nature. The way the information is presented in the article is no different to if I had a multivitamin this morning and then, after hitting my left hand in the car door this afternoon, report that my hand became tender and swollen. Yes, I developed a tender and swollen hand after having the multivitamin, but one surely can see that you cannot make that assumption that they are related. Sure, if a large number of people suddenly develop swollen tender left hands after taking that pill you could suggest that there might be a link (albeit in the multivitamin-swollen-left-hand case, unlikely), but you cannot merely jump to that conclusion. This is especially true when there is no identifiable pattern between the vaccine and the events, which is the case with the HPV vaccines.

From 2006 to 2013, there were reportedly about 57 million doses of HPV vaccines distributed and there were about 22,000 adverse events reported. As per the CDC, 92% of these were non-serious (an example is pain at the site of injection, which obviously can occur after an injection), with the other 8% including “headache, nausea, vomiting, fatigue, dizziness, syncope, and generalized weakness”.

A study in 2011 by the Vaccine Safety Datalink studied the incidence of the examples the article suggested were caused by the vaccine. These included Guillain-Barré syndrome, strokes, blood clots (also known as venous thromboembolism), appendicitis, seizures/fits, syncope/fainting, allergic reactions, and anaphylaxis (a severe form of allergic reaction). However, NONE of these events were found more commonly in people given the vaccine than in the normal population, ie people who were not given the vaccine. It’s like saying that if you doing a trial and someone gets hit by a truck, that the medication causes some people to be hit by trucks. It is amazing how easily one can manipulate data to suit an agenda merely by taking out the comparison group.

So let’s get on to the other obvious flaws in the article. Firstly, you have to look at the source. In this case it is thefreethoughtproject.com, hardly a world renowned scientific journal. Not to say that statements on these sites are never true; I am merely stating that one should be careful when analysing what you read. This article is formed in the classic “click bait” way in order to increase its hits and shares. As one can see from the site’s other articles, all of the articles are sensationalised (well, from the ones which I saw; forgive me for not perusing the site at too much length).

From the wording of the article one can clearly see the sensationalised reporting, using leading phrases and hyperbole which attempt to force you to interpret the data in a certain way. For example, statements such as “latest in a long string of experts” are used, without any justification or examples of who these previous so-called “experts” were.

The article states, that “Although these two vaccines are marketed as protection against cervical cancer, this claim is purely hypothetical” and “there is no demonstrated relationship between the condition being vaccinated for and the rare cancers that the vaccine might prevent” (note the use of the word rare, to try to influence the way the reader thinks about the cost-benefit of the vaccine; although as I have previously stated, the cancer is anything but rare). The article states that the “from the manufacturers own admissions, the vaccine only works on 4 strains out of 40 for a specific venereal disease that dies on its own in a relatively short period, so the chance of it actually helping an individual is about about the same as the chance of her being struck by a meteorite.” Sensationalised much? The vaccine is targeted at 4 of the strains of HPV, but not any random 4 mind you. Two of the strains (Type 16 and 18) are proven to be CAUSALLY RELATED in 70% of cervical cancers, and the other two (6 and 8) cover the most common causes of genital warts, the STI.

Should you not want to vaccinate your child against genital warts because you feel that your child will not sleep around, please just remember that people do engage in sexual activity from a younger age than one might expect, especially in the modern era.

The article reports that studies have only above age 12, although there have been multiple studies from age 9. For example, Prof Bonnani et al, released a study entitled “A summary of the post-licensure surveillance initiatives for GARDASIL/SILGARD®” and reiterated that “across 5 phase 3 clinical trials involving 21,480 females aged 9–26 years and boys aged 9–16 years, vaccination was associated with more injection-site pain than placebo but similar incidences of systemic and serious AEs [adverse effects] and new medical conditions potentially consistent with autoimmune phenomena”

The article quotes official sounding organisations such as the National Vaccine Information Center which are not as formal as they sound. This organisation for example is a known anti-vaccination organisation whose aim is almost purely to oppose governmental initiatives regarding vaccines.

I could go paragraph by paragraph but this type of article frustrates me to such an extent that I am sure I would throw my laptop at something. I, however, hope that I have suitably demonstrated how articles such as this one can be used to instigate mass panic regarding health promotion schemes.

America (amongst other places where the “Anti-Vax movement” has taken a stronger hold through manipulation and misrepresented data) has seen huge spikes in the incidence of Measles, etc which are literally killing babies. I do not use that in the way modern teenagers do. Babies are literally dying as a direct result of the antivaccination campaigns which are themselves trying to reduce child morbidity and mortality, albeit in a misguided and misinformed fashion. If you have counselled a parent about how their child died of a PREVENTABLE illness, you will understand why I am so passionate about this. If you were to advise a parent or a friend not to vaccinate their child and that happened to them, where they lost a child as a result, I could never imagine the guilt you would feel.

I am not coming out and saying that you should never question what a doctor tells you; doctors and experts are human and can make mistakes. I just implore you, please do your children a favour and do some research before you make a decision. Include your doctor in the discussion. Even if you hardly know me, feel free to ask me and I’ll do the research with you.

So let’s all do our part on social media, too. Before sharing that bit of interesting information shaming a vaccine or proclaiming a miracle drug, do a little research. You’ll often be surprised at what you find.

A little bit of research goes a long way.  We want to protect our patients. That’s where this question of the anti-vaxxers about the safety of vaccines comes in I’m sure. So while I applaud your interest in not taking someone’s word for something, please make sure you are not just taking one person’s word over another’s without thinking for yourself. We all must continually reevaluate the evidence presented to us and if necessary conduct our own trials to ensure we keep our children and our patients safe.

*The views and opinions expressed in this article are that of the author and not necessarily of Thumela as a whole*
If you wish to submit an article of your own, please contact us at james@thumela.org