Monday 10 October 2016

Vaccination night terrors

Since 2010 it has been policy in Ireland to offer free vaccination against Human Papilloma Virus HPV in Year 1 of secondary school. The brand-name is Gardasil and it's made by Merck; a very similar Me-Too drug Cervarix, made by GlaxoSmithKline GSK is also available. A couple of years ago, the uptake of this prophylaxis was 87% but reports last week say that 2015 compliance is down to 70%. That's a significant drop-off and Dr Brenda Corcoran from the HSE's National Immunisation Office was wheeled out to put her finger in the dyke [quite possibly a most unfortunate metaphor] and stop the flood of misinformation. I heard her on the wireless driving to work and co-incidentally The Beloved was listening to the same programme in the kitchen at home. We had a discussion at dinner that night and it was clear that we'd each taken a completely different message from the talk. Both using it to cement further our previously held positions. I've had multiple occasions to disapprove his sort of robust certainty in others, tsk us, tsk me.

TB more or less echoed Mandy Rice-Davis with "well she would say that", and elaborated her views on the precautionary principal [previo] and primum non nocere. There were too many cases in her memory / life-time when The Man had told us that there was nothing to see here only to be brought before a tribunal of enquiry 20 years later to explain how He had heedlessly screwed-over the lives of the innocent. For one: the contaminated anti-D scandal which I wrote about last month. Suspicion of The Man and embracing an anti-vax position goes down with gluten-free bread, lactose-free milk, 'herbal' teas, tree-hugging and home-education with many of our friends.

We've had two families and in the 18 years which separated them, we changed our position on vaccination.
  • First we had The Boy, when we were young&foolish . . . and immortal. We decided not to get him immunised against MMR [measles, mumps, rubella] because we couldn't face the thought that, by an active intervention now, we'd precipitate an adverse change in our precious. We'd take our chances with what fate delivered later. Two years later, fate delivered measles, which was no fun, but he didn't become one of the 300 children who die every day from measles nor experience "blindness, encephalitis, severe diarrhoea and related dehydration, ear infections leading to deafness, or severe respiratory complications". When we enrolled him in a health-care plan in Boston 4 years later, the doctor looked at us like we had bones through our noses: "Measles? don't you have MMR in Ireland?". So we know that the consequences of not vaccination can be survived.
  • 18 and 20 years on, we had Dau.I and Dau.II in quick succession and took a community-health herd-immunity position. The Boy had come through the measles because he was well-fed and well-cared for in a warm dry house [we went to stay with my parents] and we had the best medical back-up if necessary. The girls were in the same status [except the warm house - it was heated only be open fires and bloody freezing] and much more fortunate than the poor and dispossessed who lived round the corner from our farmhouse. By getting them vaccinated we would help boost the take-up to levels where the measles virus couldn't find sufficient unprotected children to propagate through the population . . . end of measles, it worked for smallpox , and has eliminated polio from the Western World. 13 years later, Dau.I contracted mumps, so we know that vaccines are not 100% effective.
But the point about vaccination is that we must all put aside the anecdotal arguments and follow the data. Nevertheless, I'll share another telling anecdote. At The Institute, I share an office with a part-time teacher whose Mo Th Fr day job is being a pharmacist. Like many in her profession, she is a fund of good sense and sound advice. A few days ago one of our colleagues came in for a gs&sa consultation. His 14 year old daughter had changed from being a bouncy outgoing girl into a moody and lethargic adolescent and her father wondered whether the HPV shot she'd had a couple of years earlier was responsible. There has been a LOT of press coverage recently about such connexions. The pharmacist had heard all the commentary and fielded similar questions regularly over the counter at her day job. After some to-and-fro, she suggested, as the mother of a similarly aged teenage boy, that if the child was tired it might be a good idea to take her smart-phone off her when she went to bed "thank you, you won't need that asleep". Before we blame Merck, the makers of Gardasil, we might at least test the hypothesis that perpetual tiredness is due to sleep-deficit, from restlessly checking the ould social media 200 times a day. Data tomo.

1 comment:

  1. Alan Corcoran should read this post - he had a lady in South East Radio studios the other day describing just such symptoms in her daughter and again hoping that the HPV vaccine might explain them.