Pakeha rejecting Gardasil vaccine
A vaccine that tackles the virus that causes genital warts and cervical cancer has been proven to be fighting off infection - but many Pakeha families are rejecting immunisation - claiming their girls don’t need it yet.
A study published in the latest New Zealand Medical Journal has found a major reduction in genital warts caused by the human papilloma virus (HPV) in Auckland thanks to the Gardasil vaccine’s introduction in 2008 - particularly among Maori and Pasifika girls.
Yet it also found almost half of the rest were un-vaccinated against HPV.
Director of Public Health Caroline McElnay said the Ministry of Health found Pakeha parents supported the vaccine. ‘‘In principle, but believe that their daughters did not need it until they are older. Parents also perceived the HPV vaccine as not for their daughters because of a perceived lack of sexual maturity.’’
Nationally, the figure for the latest group of Pakeha girls immunised was at 60 per cent - it was 43 per cent in 2008 - but they still had the lowest vaccine uptake of any other group.
But the ministry has had to enhance its education campaign for parents - explaining the vaccine is for providing immunity before girls became sexually active.
Global, documented opposition to Gardasil springs from fears it inspires promiscuity, to claims of adverse health effects.
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The NZMJ study’s co-author, Dr Jeannie Oliphant, said almost everyone was likely to be exposed to genital skin HPV types from first sexual contact onwards: ‘‘Which is why it is so important, of course, to have the vaccine before you become sexually active.’’
The study found among Auckland girls who turned 14 in 2013, 77 per cent Pasifika were vaccinated, 62 per cent of Maori and 52 per cent of ‘‘others’’.
The study found a 93.4 per cent reduction in genital warts among Maori/Pasifika girls, but 80.2 per cent among Pakeha.
It would take much longer to see whether the warts decline is mirrored in cervical cancer, as the disease developed slowly, Oliphant said.
Maori women die from cervical cancer at a disproportionate rate, and the initial ministry Gardasil marketing focused on them.
Their vaccine uptake was ‘‘great news’’, as was the decision to extend it to boys from early 2017, Oliphant said.
‘‘It was really exciting to see just how effective the HPV vaccine is in New Zealand.’’
The study noted the speed of the decrease in genital wart rates among young women was not reflected among males yet.
Gay and bisexual young men were also unlikely to benefit from vaccinated girls’ herd immunity.
Immunisation expert Dr Helen Petousis-Harris said Gardasil 9 had the lowest uptake of any vaccine here, despite having among the best vaccine safety profiles globally.
She believed overseas media coverage of claimed adverse health effects may explain it, along with fear of chemicals, and moral discomfort.
Medically-untrained parents who ‘‘researched’’ online were not educated in how to balance anecdote against statistics and risk, or determine reputable from fringe studies, she added.
A ‘‘communications problem’’ emerged as anti-vaxxers countering health authorities’ advice with anecdote - claiming any health conditions emerging after a jab must be caused by it.
‘‘It’s their child and people feel emotion - and I’m trying to come in with my graph or boring observational study and I’m competing with a personal story. For a lot of people there’s just no comparison - they are going to side with the personal story which makes sense to them.’’
Some parents’ fears were likely driven by ‘‘omission bias’’ - feeling responsible for allowing something they perceive caused injury such as a vaccine - but not for inaction causing harm later: ‘‘It’s: ‘the cancer just happened - I didn’t bring it about.’ ‘‘
HPV is the most common sexually transmitted infection worldwide - yet most people don’t know they have it. Eighty per cent of people will have any of the 150 types of HPV infection at some point in their lifetime.
It is impossible to know who gave it to them or when, as it takes months to years to develop.
Condoms cannot fully protect against HPV as it is transmitted via skin contact.
Genital warts result from some HPV types. But the cancer-causing types - which result mostly in cervical, but also vaginal, penile, anal, and mouth cancers - have no initial symptoms.