In February 20-23, 2014, the international meeting Controversies in Gynecology and Obstetrics (COGI) devoted two sessions to examine advances in cervical cancer prevention including a comprehensive session on HPV vaccine effectiveness on Saturday the 22nd. The focus of attention of the meeting was on the HPV vaccination programs in the Asia Pacific region.
The panel of experts and the discussion with the audience recognized the continuous evaluations on safety provided by international and national review bodies such as the advisory board for safety monitoring at the World Health Organization (WHO), the US center for diseases control (CDC), the European CDC, The Global Alliance for vaccination and immunization (GAVI), The International Federation on Obstetrics and Gynecology (FIGO) advisory board, the Phase IV monitoring studies in the Nordic countries in Europe, Australia and the US and the surveillance programs in most of the 120 countries where HPV vaccines have been regulated and /or introduced. To date, some 200 million doses have been distributed worldwide and the generalized opinion in the scientific and Public Health communities is that these vaccines are generally very safe and given the very high efficacy shown in Phase III trials is being confirmed by the early population impact evaluations, the scientific community continues to recommend generalized introduction in all target populations in the world.
Of particular concern during the meeting was the recent situation arising, where a rare and ill-defined pain syndrome was attributed to HPV vaccination. To date no causality has been attributed directly to the vaccines. However the consequences of the media impact and some individual declarations of vaccine–skeptics have resulted in the cessation of active promotion of the vaccination campaign. The uncertainty generated in the general population, particularly in the parents of young girls is not only likely to damage vaccine uptake, but will unjustifiably delay the beneficial outcomes that were anticipated among young women.
The experts gathered at COGI recognized that vaccine scares have occurred with most new vaccines in the past. For the HPV vaccines, the balance between risks and benefit following careful independent evaluation of all suspicious cases reported to date has systematically concluded in favor of vaccine continuation. In none of the suspicious cases of adverse effects identified by monitoring and surveillance programs, has the vaccine been implicated as a cause but rather been associated in time (hours to weeks or months) with one vaccination episode and hence a chance coincidence. Vaccines have, over the decades, proven to be the most important preventive tool to eradicate major diseases such as small pox and have achieved dramatic reductions in disease burden such as measles, rubella, yellow fever and polio, to name a few. Cervical cancer remains amongst the most common cancers in women in the world and the most important one in many developing countries where screening practices are limited. Creating undocumented doubts on the safety of the HPV vaccines and allowing political and emotional influences to conflict with the scientific evidence in vaccine recommendation and promotion would results in delayed introduction and unnecessary delays in disease reduction among young women in Japan.
The experts gathered at COGI would like to support and encourage the medical community in Japan to continue their efforts to explain the scientific evidence on the HPV vaccine efficacy and safety and to continue deploying the recently initiated HPV vaccination program.
On behalf of the participants at the COGI event
Dr Suzanne Garland, Principal investigator of HPV vaccination trials in Australia; Dr Ryo Konno, HPV Japanese Expert Board for the Eradication of Cervical Cancer, Dr Swee Chong Quek, Gynecologist specialized in cervical cancer diagnosis and prevention, Dr F Xavier Bosch Cancer Epidemiologist and Dr Zion Ben Rafael, Chair of COGI
Macau February 22nd 2014