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Human papillomavirus immunisation of adolescent girls: improving coverage through multisectoral collaboration in Malaysia

HPV Vaccine On TrialNote: "Universal vaccination" as a goal? Let's hope the authors read The HPV Vaccine On Trial.


BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4602 (Published 07 December 2018) Cite this as: BMJ 2018;363:k4602

https://www.bmj.com/content/363/bmj.k4602

Saidatul Buang and colleagues report on collaborative efforts to introduce HPV vaccination in Malaysia and increase coverage

Human papillomavirus immunisation of adolescent girls: improving coverage through multisectoral collaboration in Malaysia

Cervical cancer is the fourth most common cancer in women globally.1 Human papillomavirus (HPV) types 16 and 18 collectively cause 70% of cervical cancers and precancerous cervical lesions.1 The UN joint global programme on cervical cancer prevention and control includes HPV immunisation for girls as one of its three priorities at country level, together with screening and treatment for cervical pre-cancer, and diagnosis and treatment of invasive cervical cancer.2 In Malaysia, the age standardised cervical cancer rate is 7.8 per 100 000 females, making it the third most common cancer in women, with 4352 new cases reported for 2007-11.3 Malaysia’s HPV immunisation programme was introduced in 2010, within a healthcare system that has a credible track record (box 1, table 1). We present a case study of this programme and explore the role of multisectoral collaboration in achieving near universal immunisation of an estimated annual cohort of 250 000 13 year old girls.

Comments

Jeannette Bishop

"Call to action: RIAT restoration of a previously unpublished methodology in Gardasil vaccine trials"
https://www.bmj.com/content/346/bmj.f2865/rr-7

Morag

HPV Vaccine -immunisations in Scotland/NHS inform
https/www.nhsinform.scot/healthyliving/immunisations/vaccines/hpv vaccine 10 oct 2018
[Point 5-further information ] Audio leaflet ,indicates , No Legal responsibility for any errors,omissions or misleading statements? Oh What! but if the NHS does not want to accept ownership of the scripted prescriptive information then WHO does?

PEO1574 HPV Vaccine Safety. Getting involved Scottish Parliament 21 August 2015
Denial of vaccine injury, apparently rampant! same deaf ear response as Jone Stone and Angus Files excellent presentation about fractured /failed MMR Vaccine safety ?

Government Ready with [Plan B ] For Named Person - The Scotsman 11 August 2018
https/www.scotsman 11 Aug 2018 .
Flashpoints for challenging behaviour in the political sector , earmarked, ringfenced, dovetailed. and streamlined, behavioural defective policies, getting spearheaded to the spot for another nose to tail scoping exercise !

John Stone

Cia,

But I see no case for the licensing or marketing of these products - it took many millions of dollars but there were never ever any reason to believe they would prevent cervical cancer, every reason to believe it would cause damage. If you want to tell people that before giving it to the you will be telling the truth- if you tell them anything else you will be misleading them. The only person who could possibly want it is Dorit Reiss who apparently gets off on it - the FDA licensed it for 45 year-old women just in time for her.

cia parker

John,

That's why I HIGHLY recommend that everyone contemplating the vaccine be as fully informed as possible about its track record as to safety and what we've seen as to efficacy. It won't be fully known for several more decades. It should NEVER be compulsory.

I'd love it if no one wanted it, no one took it, and the homeopathic nosode for it were shown to be both safe and effective and universally available. In the meantime, I haven't researched the latest news on it, but it DOES seem to produce antibodies to the most common strains of HPV virus causing cancer and/or warts. So girls should know that, read about cervical cancer, read about the horrendous accounts of vaccine damage, and then make their choice. Most girls who get it have no apparent reactions: I have a friend in St. Louis who got it with no apparent reactions. And a friend whose daughter was in her twenties when she got pre-cancerous lesions. But without having any real answer to the problem of inadequate medical services for most women in the Third World, I think the vaccine should be on the list of options to consider. Maybe there should be large campaigns to promote infant circumcision of male babies, since their future partners do not get cervical cancer. (Monogamous Jewish women and Catholic nuns never get it.) That would be a cheap and easy way to approach the problem as well, though it would also depend on informed consent.

Primum non nocere would mean that no medical treatment were ever available for anything, since EVERY procedure and treatment causes damage, sometimes extreme or fatal, to some. You've always got to research it and ultimately make a decision, and whatever decision you make may turn out to be the wrong one in your particular case. I would NEVER get the HPV vaccine (as Dorit recently did, (see FB), up to her second dose now, while -), and would NEVER get it for C, or recommend it for anyone in the First World. I can't say anything without further research about women in the Third World with little or no access to modern medical practices. No, I guess I'd highly recommend they see a homeopath for the nosode.

Angus Files

The only safe vaccine is one that isn`t used period no caveat of if`s and no but`s applicable.

Pharma For Prison

MMR RIP

John Stone

Cia,

It would be all very well but the evidence that the product is effective let alone safe is lacking (the fact that it is meant to achieve an effect or might achieve it is not the same as achieving it - surrogate markers will scarcely do). The money would certainly be better applied providing pap screening. I left this comment under the article:

https://www.bmj.com/content/363/bmj.k4602/rr

Primum non nocere?

Re: Human papillomavirus immunisation of adolescent girls: improving coverage through multisectoral collaboration in Malaysia Saidatul N Buang, Safurah Ja’afar, Indra Pathmanathan, Victoria Saint. 363:doi 10.1136/bmj.k4602

In the light of persistent and mounting concerns should we not rather be considering whether these programmes ought to continue?

Short bibliography:

Jørgensen L, Gøtzsche PC, Jefferson T.'The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias', BMJ Evid Based Med. 2018 Oct;23(5):165-168. doi: 10.1136/bmjebm-2018-111012. Epub 2018 Jul 27

Nigel Hawkes, 'Cochrane director’s expulsion results in four board members resigning', BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3945 (Published 17 September 2018)

Lars Jørgensen, Peter Doshi, Peter Gøtzsche, Tom Jefferson, 'Challenges of independent assessment of potential harms of HPV vaccines', BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3694 (Published 24 September 2018)

Riva C, Tinari S, Spinosa JP. 'Lessons learnt on transparency, scientific process and
publication ethics. The short story of a long journey to get into the public domain
unpublished data, methodological flaws and bias of the Cochrane HPV vaccines review.'
BMJ Evidence-Based Medicine Published Online First: 06 December 2018. doi:
10.1136/bmjebm-2018-111119

Emma Shardlow, Matthew Mold and Christopher Exley, 'Unraveling the enigma: elucidating the relationship between the physicochemical properties of aluminium-based adjuvants and their immunological mechanisms of action,', 7 November 2018, Allergy, Asthma & Clinical Immunology201814:80 https://doi.org/10.1186/s13223-018-0305-2

Gayle Delong, 'A lowered probability of pregnancy in females in the USA aged 25–29 who received a human papillomavirus vaccine injection', Journal of Toxicology and Environmental Health, https://www.tandfonline.com/doi/abs/10.1080/15287394.2018.1477640

Lee SH, 'Detection of human papillomavirus (HPV) L1 gene DNA possibly bound to particulate aluminum adjuvant in the HPV vaccine Gardasil, J Inorg Biochem. 2012 Dec;117:85-92. doi: 10.1016/j.jinorgbio.2012.08.015. Epub 2012 Aug 30.

Lee SH, 'Melting profiles may affect detection of residual HPV L1 gene DNA fragments in Gardasil®.', Curr Med Chem. 2014 Mar;21(7):932-40.

Lee SH, Vigliotti JS, Vigliotti V, Jones W, 'From Human Papillomavirus (HPV) Detection to Cervical Cancer Prevention in Clinical Practice', Cancers (Basel). 2014 Oct 2;6(4):2072-99. doi: 10.3390/cancers6042072.

Mary Holland, Kim Mack Rosenberg and Eileen Iorio, 'The HPV Vaccine On Trial: Seeking Justice for a Generation Betrayed' with an introduction by Luc Montagnier, Skyhorse, 2 October 2018

cia parker

I hate the HPV vaccine and fully recognize how dangerous it is. And it should never be given without the full and informed consent of the patient. However, in Malaysia, as in most Third World countries, not many women have access to the Pap and DNA tests which permit early recognition and treatment of suspicious lesions. Cervical cancer is much more common there than anywhere in the developed world. There is a homeopathic nosode for it. All I'm saying is that we need to think about the problems of each area which is considering or promoting vaccination for anything. Malaysia is not a place that you can say unequivocally that the vaccine is more dangerous than the disease. Maybe it is, and I'd like to see large-scale studies done (of both the vaccine and the nosode) to establish which it is, and then let women and girls decide for themselves where the greater danger lies. We had a neighbor who died of cervical cancer a month after my daughter was born, and she was the wife of a rich man, who got regular Pap tests, but died horribly anyway. I didn't know this before, but it's fairly common for the test to take cells from healthy areas and miss the cancerous ones. Nowadays I think the DNA test would give definitive results, but how many women in the Third World would be able to get it and then get modern treatment for it?

Angus Files

They cant give it away for free even ...forget consent and trials..world of bought believe.

Indian Parliament Comes Down Hard on Cervical Cancer Trial
By Pallava BaglaSep. 9, 2013 , 12:15 PM

https://www.sciencemag.org/news/2013/09/indian-parliament-comes-down-hard-cervical-cancer-trial

"Some commentators see merit in that argument. The three-dose HPV series costs approximately $150 in India. The fact that Merck, which makes Gardasil, and GlaxoSmithKline, maker of Cervarix, donated almost $6 million worth of their vaccines to the PATH trial “was not philanthropy,” asserts Chandra M. Gulhati, editor of the Monthly Index of Medical Specialities, an influential journal in India. “It is shocking to see how an American organization used surreptitious methods to establish itself in India,” he charges. “This is an obvious case where Indians were being used as guinea pigs,” contends Samiran Nundy, a gastrointestinal expert at the Sir Ganga Ram Hospital in New Delhi and editor emeritus of the National Medical Journal of India."

Pharma For Prison

MMR RIP

Hans Litten

Move along please, nothing to see here ..... $4bn safe and effective (milestone passed)

Federal Vaccine Court Quietly Pays Out Billions
By Eli Wolfe on December 12, 2018

A chickenpox outbreak at a private school in North Carolina drew extensive national news coverage in November. The thrust of most stories was the public health threat of unvaccinated children and superstitious beliefs about vaccine risks.

But there was little fanfare when, about the same time, an obscure federal program that compensates victims of vaccine injuries passed a milestone. Payouts by the national Vaccine Injury Compensation Program, or VICP, have now topped $4 billion.

https://www.fairwarning.org/2018/12/vaccine-court-pays-billions/

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