London - My 12-year-old, my first child of three, is at that enchanting stage between girlhood and teenage years; still happy to sit on my knee and cart her teddies around, while expressing surprisingly sophisticated opinions.
She is not totally naive about sex — we have discussed most things. But she is not precocious. Boys are still largely the enemy rather than alluring. Children might be becoming sexualised younger, but flirting is not on her radar.
Physically, girls her age vary enormously — some so developed, or so made-up, they could pass for 25. A slight little thing who loves reading, she is not one of them.
But I have to think about her in that light now, because this week she could have the HPV vaccine, offered to girls in the UK in year eight. HPV is the sexually transmitted human papillomavirus, which is very common and usually has no ill-effects, but which in a few instances causes changes to cells which can become cancerous.
In the UK, about 3 000 women a year are diagnosed with cervical cancer, and it is estimated about 400 lives could be saved every year by vaccinating girls before they are infected.
The vaccine used in the UK is Gardasil. It consists of two jabs, no more than 24 months apart (it “takes” more easily under 15 so if you have it after that you need three).
So far, so good. But the HPV vaccine is not without its detractors, as any mother of a young daughter will have noticed.
Just this summer there have been more reports of side-effects among girls who believe that the HPV vaccine reduced them to ghosts of their former selves, suffering tiredness, fits and even becoming reliant on a wheelchair.
Teenagers like 15-year-old Katie Green, from Worcestershire, who went from being sporty type to one who can run no more than a few steps. Or Erin Morgan, 15, from Stockport, who suffers daily seizures that started three days after having the jab in 2013.
There is even a UK organisation called The Association Of HPV Vaccine Injured Daughters.
No one wants to play Russian roulette with their daughter’s health. What might look like a long-shot to a doctor or a pharmaceutical company feels distinctly precarious to a parent. Acceptable collateral damage? No thanks.
Add to this the lawsuits launched against local health authorities and the makers of the vaccines Gardasil (Merck/Sanofi Pasteur) and Cervarix (GSK) worldwide, including Spain, France, India and Japan. Japan even withdrew the vaccine after multiple complaints, although you can still get it there.
And The European Medicines Agency is conducting a safety review, prompted by Denmark.
There, numerous complaints of “syncope” (fainting) and PoTS (postural orthostatic tachycardia syndrome — a condition where the heart rate increases after sitting or standing up, with resulting dizziness) were reported to Frederiksberg Hospital, and a neurologist began to notice a sizeable number of the sufferers had had the HPV vaccine.
Of course, there are also heart-breaking stories of young women dying of cervical cancer, too young for a smear test. But these cases are rare — in 2011 (the last avail-able data) there were 47 cases of cervical cancer in the under-25s and no deaths.
As a mother, not a scientist, I have to try to assess whether this jab is a good idea for my daughter. And when pharmaceutical companies insist adverse reactions are a coincidence, this is not easy. The official line is “the benefits outweigh the risks”, but what does that mean?
There is a problem around vaccine information, possibly dating from the MMR scandal when medical researcher Andrew Wakefield’s notorious study, which suggested a link between MMR and autism, was discredited. Since then, very little has been written independently by the medical profession about vaccines; there is too much fear for independent critical research on a large scale. It almost feels like a news blackout.
I ring my GP in West London, Dr James Stratford-Martin, who says that “vaccines have always been controversial” because of their very nature: the administering of a potentially toxic — or at least alien — substance to a healthy person.
“When people see pictures of old hospital wards full of children with iron lungs they can’t believe it,” he adds, referring to the days before the polio vaccine. In the West, “the benefits of vaccines are quickly forgotten”.
And vaccination schemes only work when most of the population — at least 80 or 90 percent — are vaccinated. This “herd immunity” makes it difficult for infectious diseases to spread — if someone with HPV is surrounded by people who are vaccinated against it, the infection cannot easily be passed on.
But the consensus is the HPV vaccine lasts for about six years, so by the time my daughter is 18 it might stop working. Then what?
And it is hardly as if, after the jab, sex suddenly becomes safe sex. There are still STDs, and the types of HPV not covered by the jab, to think about — let alone the risk of pregnancy.
And the statistics still leave me uncertain. The MHRA (the Medicines and Healthcare products Regulatory Agency, responsible for monitoring vaccines) says that out of nearly 300 000 girls vaccinated in the UK between September 2013 and June 2014, 376 reported 1 295 complications.
Although the MHRA’s spokesperson is keen to stress “a report of a suspected side-effect does not prove it was caused by the vaccine”, that is a high number if genuinely attributable to the vaccine.
Plus, the MHRA estimates only 10 percent of reactions are reported. The spokesperson stresses that, “vaccine safety is of paramount importance and under constant review”.
Sometimes it feels war has broken out between those for vaccinations and those against, so aggressive is the tone.
An anonymous doctor tells me: “There is no doubt that there is financial corruption in the health industry. There is simply too much money at stake and too many overlapping interests. Most studies are done by drugs companies producing the vaccine — who else is willing to invest that time and money?
“And most government advisers are compromised by their relationship with the drugs companies.”
He’s not suggesting Gardasil was “fast-tracked” corruptly — but it didn’t go through the usual 12-year trial and the first patients are effectively guinea pigs.
The NHS’s responsibility is huge — the vaccination costs £180 (about R3 200) of public money per person. But it is rare you find a jab that can stop a form of cancer.
Cervical cancer expert Dr Adeola Olaitan, a gynaecological oncologist at University College London Hospital, says: “Based on the data, the indications are that the vaccine is safe in the majority of young girls. There is an association with syncope particularly with the latest upgraded HPV vaccine — Gardasil 9 — and the US has advised it should be administered with recipients sitting or lying.
“About 79 million doses have been administered worldwide and most reported side-effects are transient and minor.
“The risk benefit analysis has to be measured against the risk of cervical cancer and other HPV-associated conditions and my reading suggests the balance is in favour of vaccination.”
My daughter is not keen to have the vaccine, but she is only 12 so I must give a lead. At the school gates, there are mothers who are unquestioningly pro-vaccine and the odd homeopathic, granola-eating type, who is anti. Most, like me, are bewildered.
I am veering towards opting out. By the end of November — when the European Medical Agency announces the findings of its safety review — there will more information, which will either be more, or less, heartening.
For now, this jab in the arm seems like a shot in the dark.
Daily Mail