A single jab can help stop cervical cancer. How could Sinn Féin run an Áras hopeful who undermined it?

EVER since the extent of the CervicalCheck scandal came to light in April, Sinn Féin has, quite correctly, been a strident voice in holding both the HSE and the Government to account for their failings in dealing with the cases of the more than 200 women whose cancerous smear tests were misread.

With no apparent political opportunism, only a commitment to establish the facts and the way forward, the party’s health spokesman Louise O’Reilly TD has been especially dogged, and impressive.

There are, of course, many lessons to be learned from the tragic events that have unfolded, lessons that hopefully will prevent a recurrence of this trauma in the future. The simplest of these is to do our very best to ensure that today’s young girls and women never will develop cervical cancer at all, and the only chance of doing that is to vaccinate them against the HPV virus, which is known to cause 99% of cervical cancer cases.

That’s why it seems at the very least odd, if not downright reckless, of the frontrunner to be Sinn Féin’s nominee for the Presidency, MEP Liadh Ní Riada, to have stopped one of her daughters receiving the HPV vaccine. In a 2016 interview on Cork’s 96FM, Ms Ní Riada said she had spoken to medical professionals and they ‘didn’t inspire huge confidence’ in the vaccine.

Sorry, but who exactly are these medical professionals with whom she spoke? Given that no qualified medical professional in the country has publicly questioned the safety of the vaccine, will Ms Ní Riada let us know their names and their credentials? After all, if as properly qualified doctors they genuinely have such concerns, they have a moral and ethical duty to speak out, don’t they?

She also must clarify her comments. This week, she claimed she never actually said she was ‘against’ the vaccine, and added: ‘I clearly was voicing my concern as a parent, not as an MEP, and that was the premise of the interview.’

Really? Can you just stop being an MEP whe it suits? At a time when the debate about the efficacy of the Gardasil and Cervarix vaccines was even more animated than it is now, she surely must have known that her political role would hugely have influenced the decision by the producers to invite her on the show.

She also rather oddly said that the HSE was ‘in a bit of a shambles [so] you kind of question how much you can trust that this is 100% safe’. Her assessment of the HSE might indeed be correct, but to conflate the bureaucratic failings of the national health service with the efficacy of a vaccine is frankly ridiculous.

As a public representative, it was incumbent on her to deal solely with scientific fact, rather than quoting anonymously the anecdotal observations of friends, or on her personal opinion of the HSE. And the fact is that the HPV vaccine is very likely the single most trialled, tested, monitored and approved vaccine in the history of medicine.

The World Health Organisation points out that cancer of the cervix is the fourth most common cause of cancer in women worldwide, with more than 250,000 deaths every year. It would have absolutely nothing to gain by promoting a vaccine that itself would prove more harmful than the disease it is designed to prevent, and therefore has been rigorous in its ongoing evaluation of Gardasil and Cervarix.

Scares

In its most recent summary, published in July 2017, the WHO noted that 270million doses of the vaccine have been administered since it was launched in 2006. The risk of anaphylaxis, a serious, life-threatening allergic reaction, was found to be 1.7 cases per one million doses, while the risk of syncope, or fainting, was shown to be an anxiety or stressrelated reaction to the injection (and remember, for many children and teenagers, this will be the first injection for which they actually are sentient, so such responses are entirely understandable).

Nor, despite the claims of many of the so-called anti-vaxxers, could the WHO establish any link between the vaccine and Guillain-Barré syndrome, a muscle weakness caused by the immune system damaging the peripheral nervous system. Indeed, an uptick in GBS cases after an immunisation programme against swine ’flu in 1976 was attributed to the influenza vaccine used at the time; only later did research show that the ’flu itself can induce GBS. In short, a lot of people now, as was the case then, are adding two and two and getting five.

Closer to home, the European Medicines Agency could establish no link between the HPV vaccine and the two conditions its detractors most commonly attribute to it. Complex regional pain syndrome affects the limbs, while postural orthostatic tachycardia syndrome is a condition where the heart rate increases abnormally on sitting or standing up, with attendant symptoms such as dizziness, fainting, weakness, headaches, nausea and fatigue. These conditions are present in the general population anyway, with about 150 cases for each seen in every million girls and young women aged between ten and 19 years. The occurrence of both conditions was no different among vaccinated girls and unvaccinated girls, and the EMA concluded that there was no causal link between them and the HPV vaccine.

The rejection of science and facts in general, in favour of anecdote and some vaguely expressed personal feeling, is a scourge of our time, and it is fuelled by unverified chancers using the internet to spread fear. Personally, I choose to believe the peer-reviewed advice and established methodology of medicines agencies over the opinions of celebrity anti-vaxxers: but when you say that, the anti-vaxxers claim you are in thrall to Big Pharma. It has, they tell you, too much to lose unless it constantly pushes new products.

The bit I don’t get is that the vast majority of people saying this themselves are among the first generations who have been vaccinated against diseases that previously caused epidemics of death and misery – smallpox, polio, mumps, measles and rubella. The anti-vaxxers say this is the consequence of better sanitation and not vaccination, which rather ignores the fact that measles is an airborne infection passed on through physical contact, or a sneeze or cough. Bogus scares about the MMR vaccine have, however, reduced uptake in Ireland to below the 95% threshold that guarantees so-called herd immunity. The result? Outbreaks of measles this year in Dublin and Limerick. This is terribly frustrating.

In 2016, the WHO declared Ireland free of rubella. We never will be entirely free of cervical cancer, because even the latest nine-valent version of Gardasil does not target all the strains of HPV that cause it. In 20 years’ time, though, it would be wonderful to see the incidence reduced almost to zero. It would be incredible to know that positive smear tests almost would be a thing of the past.

In the United States, President Trump has given succour to the anti-vaxx movementand stoked the fire by tweeting about links between the MMR vaccine and autism. Do we really want a President here who might make the same uneducated and dangerous correlation between the HPV vaccine and conditions that naturally occur in the general population anyway? Especially when the clear and unambiguous advice from the WHO, the European Medicines Agency, the HSE and Irish Cancer Society is that you vaccinate your daughters and, soon hopefully, your sons too.