Over the course of the last decade, countries throughout the world have introduced the Human Papilloma Virus vaccine as a standard immunisation to give to every young woman. The intention behind this move was clear: the jab provides protection against the main cause of cervical cancer, Human Papilloma Virus. And the beneficial effect was rapidly obvious: within 4 years of introducing the vaccine, immunised populations were showing around a 90% reduction in HPV infections. It was estimated that by 2014, the vaccine would prevent 345,000 cases of cervical cancer and 156,000 deaths in women vaccinated. Such a massively beneficial result from a seemingly simple, minimally invasive intervention like an injection seems like a no-brainer. Doesn’t it?
How do vaccines work?
Vaccines contain a tiny portion of the illness they’re designed to protect against. The idea is that they function like a training course for the immune system. The vaccine causes us to produce antibodies to fight the disease without actually infecting us. That means that if the vaccinated person later comes into contact with the disease, their immune system will recognise it and immediately produce the antibodies required to fight it.
Vaccines were a world-changing creation, eliminating incurable diseases that killed millions. It’s hard to deny, though, that they’re also a bit scary, especially when it comes to our children; handing your baby over to be injected with an illness, however tiny the dose, however beneficial the long-term effects, still feels like an abdication of every protective parental instinct there is. And let’s face it, few of us are scientists or have the training to really understand exactly what goes into a vaccine. All of which makes it not that surprising, therefore, that when someone claims that a vaccine has unwanted, dangerous side effects, we’re ready to listen.
The MMR scandal
Everyone has heard the suggestion that the Measles, Mumps and Rubella vaccine (MMR) can cause autism. There are still parents out there who refuse to allow their child to have this essential vaccine because of this fear. And you can understand why; autism is a life-changing and very challenging condition for families to deal with. And we don’t really know what causes it. It’s not surprising that the terror that it could come from a simple immunisation holds a lot of power over parents.
But the fact is that this claim (and it was never more than a scientifically flawed and damaging untruth) has been thoroughly, utterly and completely debunked, again and again. Andrew Wakefield, the man behind the 1998 research paper claiming a link between MMR and autism, has been struck off and disgraced, no longer allowed to work as a doctor. Yet still the rumour persists, because fundamentally, vaccinations scare us. And rates of immunisation against measles, mumps and rubella have fallen worldwide.
Measles and mumps outbreaks
That means that these diseases have made a comeback. Over the past year thousands of people across Europe have caught measles and 35 have died from it. US universities are experiencing outbreaks of mumps. Both are untreatable and have serious side effects, like sterility, meningitis and even death. These diseases are no joke, and they could be avoided through vaccination.
Reports of chronic pain caused by HPV
So how does what happened with MMR relate to HPV? Well, in the last few years, case reports have come to light across the world describing previously healthy young women who, after receiving the HPV vaccine, started showing symptoms of serious illnesses including postural orthostatic tachycardia syndrome (POTS) and complex regional pain syndrome. One report alone detailed 45 patients across 13 countries. In Japan they even withdrew the vaccination and set up a scheme to manage chronic pain developed by young women after the jab.
Complaints particularly came from Denmark and whistle-blower Dr Louise Brinth. Such was the weight of her statements that the Danish Health and Medicines Authority officially asked the European Medicines Agency (EMA) to look into the safety of the vaccine and establish if there really were links between this seemingly harmless immunisation and the development of serious, life-changing conditions.
What did the EMA review find?
In a nutshell: nothing. In 2015, the European Medicines Agency reviewed all the evidence suggesting that the HPV immunisation could lead to development of CRPS or POTS. Their conclusion was simply this: that although some young women did develop CRPS and/or POTS after their HPV vaccination, there was no causal link between the two. In other words, HPV did not cause these illnesses. In fact, the number of young women reporting the onset of CRPS and POTS after vaccination was consistent with the level of the illnesses that they would expect to find in the general public. To put it simply, the EMA said that these girls would have developed CRPS anyway, regardless of whether they had the injection or not.
Was the review sound?
But several scientists weren’t happy with the way the EMA ran its inquiry. Eventually the Nordic Cochrane group filed an official complaint in 2016, alleging that the report was flawed. Whilst the authorised public 40-page EMA report gave the appearance of unanimous agreement between scientists that the vaccine was entirely safe, a leaked, confidential, internal 256-page document painted another picture; according to the Cochrane group, it revealed “that several experts had the opinion that the vaccine might not be safe and called for further research”.
Cochrane Nordic highlighted a range of concerning issues. Firstly, the review was conducted in extreme secrecy, meaning that the scientists involved are not named and are bound by lifelong confidentiality. This contrasts with the working methods of many other similar organisations which make every effort to be transparent and accessible to the public and raises the question: exactly what are they trying to hide?
The complaint also emphasised how allowing the drug manufacturers to consult their own databases themselves, using their own search strategies, was fundamentally flawed. These companies inevitably have a huge vested interest in ensuring that their vaccine is not shown to cause serious harm. The Nordic group alleged that this meant that many cases were therefore excluded from the review, purely because of the way the searches were worded and that this was not an accident. They also suggested that results of the review’s trials were skewed by the decision to compare the vaccine with a potentially toxic aluminium solution rather than harmless saline.
Investigating the investigation
This week, the European Ombudsman has announced that the EMA didn’t do anything wrong in its review. They state it was “complete and independent”, and confirmed that “the available evidence does not support that […] CRPS and POTS are caused by HPV vaccines”.
So there you have it. No link is proven. According to the EMA and the drug companies, these young women would have developed CRPS no matter what and that’s that. As a CRPS sufferer though, I have to say it doesn’t completely put my mind at rest. It’s completely plausible that the timing of the HPV vaccine in relation to the onset of CRPS is nothing more than a coincidence. There’s even the possibility that the injection itself could be a big enough event to bring on CRPS in these cases. And yet, and yet…
My step-daughter will be given her HPV immunisation in the next few years. With my rational head on, I have to support it, as on paper the risk to her from cervical cancer is far greater than that from CRPS. But my non-rational, parental, protective head (which is the one I wear 99% of the time) will be following this story, waiting to see what happens and hoping desperately for some irrefutable proof, accepted by everyone, that HPV definitively does not cause CRPS. Of course, most doctors would say we have that already in the form of the EMA review. Doesn’t stop me worrying about someone sticking a needle in my girl though. And I don’t know if it ever will.