By Dr Maya Valecha*
Recently, there has been propaganda for magnifying the risk of cervical cancer. The problem seemed so insignificant or unknown till some time back that one health journalist in a prominent newspaper gave the picture of cervical bones in the article of human papillomavirus (HPV) vaccine two years back.
Cervical cancer is the cancer of the lowest part of uterus from where the menstrual blood comes out, and when the baby comes out of womb, that small aperture becomes 10 cm wide.
According to the propaganda around the cervical cancer, every year around 70,000 women die of the disease in India, and that is 20% of the world burden of the disease. But those who propagate this forget that 40% of poor people of the world stay in India. Indeed, one of the major causes of cervical cancer is closely related to poverty. Around 2,500 children in India die daily because of malnourishment related causes. Yet, nobody cares to spend crores of rupees and fix targets to solve it.
Misinformation around cervical cancer is rampant. One of the writers on the current HPV vaccine trial paper writes, “HPV is a major cause of cervical cancer, with 12 HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) identified as oncogenic.”
However, as per several scientific studies, HPV is found to be an important but not sufficient cause for cervical cancer. There are other important associated factors too. Up to 17% cases of cervical cancer were found not associated with HPV. Also, 7.5 to 16.9% of healthy women carry HPV but are not infected with cervical cancer. In 95% of cases, infection, even with cytological abnormalities, gets resolved spontaneously, without any treatment and antibodies, as future protection is formed within.
So where is the need for 100% of girls to get vaccinated?
Now, what are the factors that are found for the development of cervical cancer? Large number of pregnancies or children for any woman, malnutrition, poor hygiene of genital parts, multiple sexual partners without any personal protection(like condom), smoking, contraceptive pills. A Maharashtra study found even widowhood is associated with this.
We can see that majority of these factors are associated with poverty. Prostitution is also forced or is need based and is found among poor girls only.
Yet it is said that cervical cancer is the second most common cancer among women, the first one being breast cancer, which accounts for 35% of all cancers, followed by cervical cancer, 8 to 9 %. Further, we have14.7 per 1,00,000 (0.0147%) cases of cervical cancer at the age of 55 to 59 years of age and 9.2% per 1,00,000 women at that age die of cervical cancer.
Yet, the new vaccine is being trumpeted as the solution.
When big numbers are being propagated, it is not revealed that for the last 30 years cervical cancer is decreasing by 1.8% every year. The maximum decline occurred in India between 1998 and 2005, when no vaccine was found anywhere in the world. The World Health Organisation (WHO) recognised HPV as the cause of cancer in 1996. The situation has changed because of improved socioeconomic conditions, hygiene, lesser number of children, etc.
A first-of-its-kind community-based survey on usage and awareness about the vaccine in Delhi and Rohtak in 2022 showed that only 0.6% of 1,020 women who participated in the exercise had availed it. So, incidence is decreasing without vaccine.
In many countries screening alone has decreased the incidence drastically. But screening has its own disadvantages of over-diagnosis, because CN1, CN2 and initial cellular changes which most of the time resolve spontaneously might raise false alarm.
In India without vigorous screening, it has decreased, and in Bangladesh with lesser screening than India, incidence is lower because malnutrition is less than India.
It is important to see what kind of vaccine they want to give to all 100% of young girls.
This vaccine claims to stop infection of only 4 types of HPV out of 150+ types of this virus. Lay persons call it anti-cancer vaccine, which is not true. Cancers found without HPV or by other strains are not prevented by this vaccine.
Researchers in the New Castle University and the Queen Mary University, London, conducted a critical appraisal of published Phase 2 and 3 efficacy trials in relation to the prevention of cervical cancer in women. Their analysis shows the trials themselves generated significant uncertainties undermining claims of efficacy in these data.
The study says, “Trials may have overestimated efficacy by combining high-grade cervical disease with low-grade cervical changes that occur more frequently but often resolve spontaneously without progressing. We found insufficient data to clearly conclude that HPV vaccine prevents the higher-grade abnormal cell changes that can eventually develop into cervical cancer.”
Worse, as against the norm of six years’ trial, only 6 to 7 months’ trial has been undertaken to prove the efficacy of the vaccine. Six years’ trials are insufficient, as the age of cancer appears much later. Though the WHO says that there is no infection for 6 months, and there is development of antibodies, the vaccine has been approved. While 4 strains are claimed to be suppressed by this vaccine, other strains start growing, as is clear from the Cervarix trial. There was increase in type 51 and type 58 strains.
Normal screening is done at 36 months, but during the trials for the cervical cancer vaccine, they do it at 6 months -- so before it gets resolved on its own, they would label it as cervical cancer.
Forget cervical cancer, the question is whether it prevents even the infection.
Premature Ovarian Failure is found to increase significantly with these vaccines in a large-scale adverse event spontaneous reporting system. Aluminium is supposed to be the cause and, almost all, including the one introduced in our country, has aluminium in it.
This causes infertility, yet those propagating cervical cancer say, they don’t have any data on this side-effect! Who will be responsible for the crores of girls who themselves and their parents don’t even know of it. Literature of Cervavac says they do not have any data on this.
As for lactation, they don’t know if antigen or antibody is secreted in the milk and still, they write that it can be given during lactation. Who will be responsible if the child gets affected by these antigens or antibodies?
Those supporting HPV vaccine have not used saline water as placebo in Cervavac trial, though they say, only 1% serious side effects in other vaccines is caused by Cervavac, hence there is no increase in serious side-effects!
Paralysis, blindness, autoimmune disorders and even deaths are reported side-effects in HPV vaccines; however, they are rare, and for most of the girls, awareness about risk factors and elimination is just enough.
A paper from Sweden reports increase in cervical cancer in those who are vaccinated. The author is so scared of the vaccine lobby, that he even hides her/his identity. But the editors made the article available even after retraction because the study was found to be perfect.
Now that brings us to the point as to how to deal with this problem. Let us be very clear that this is not a question of one vaccine. Pneumonia vaccine which can prevent 4 out of 100 cases is also increasingly becoming part of government programmes.
*Physician-activist based in Gujarat. This article is based on the author's online lecture organised by the Awaken India Movement
Recently, there has been propaganda for magnifying the risk of cervical cancer. The problem seemed so insignificant or unknown till some time back that one health journalist in a prominent newspaper gave the picture of cervical bones in the article of human papillomavirus (HPV) vaccine two years back.
Cervical cancer is the cancer of the lowest part of uterus from where the menstrual blood comes out, and when the baby comes out of womb, that small aperture becomes 10 cm wide.
According to the propaganda around the cervical cancer, every year around 70,000 women die of the disease in India, and that is 20% of the world burden of the disease. But those who propagate this forget that 40% of poor people of the world stay in India. Indeed, one of the major causes of cervical cancer is closely related to poverty. Around 2,500 children in India die daily because of malnourishment related causes. Yet, nobody cares to spend crores of rupees and fix targets to solve it.
Misinformation around cervical cancer is rampant. One of the writers on the current HPV vaccine trial paper writes, “HPV is a major cause of cervical cancer, with 12 HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) identified as oncogenic.”
However, as per several scientific studies, HPV is found to be an important but not sufficient cause for cervical cancer. There are other important associated factors too. Up to 17% cases of cervical cancer were found not associated with HPV. Also, 7.5 to 16.9% of healthy women carry HPV but are not infected with cervical cancer. In 95% of cases, infection, even with cytological abnormalities, gets resolved spontaneously, without any treatment and antibodies, as future protection is formed within.
So where is the need for 100% of girls to get vaccinated?
Now, what are the factors that are found for the development of cervical cancer? Large number of pregnancies or children for any woman, malnutrition, poor hygiene of genital parts, multiple sexual partners without any personal protection(like condom), smoking, contraceptive pills. A Maharashtra study found even widowhood is associated with this.
We can see that majority of these factors are associated with poverty. Prostitution is also forced or is need based and is found among poor girls only.
Yet it is said that cervical cancer is the second most common cancer among women, the first one being breast cancer, which accounts for 35% of all cancers, followed by cervical cancer, 8 to 9 %. Further, we have14.7 per 1,00,000 (0.0147%) cases of cervical cancer at the age of 55 to 59 years of age and 9.2% per 1,00,000 women at that age die of cervical cancer.
Yet, the new vaccine is being trumpeted as the solution.
When big numbers are being propagated, it is not revealed that for the last 30 years cervical cancer is decreasing by 1.8% every year. The maximum decline occurred in India between 1998 and 2005, when no vaccine was found anywhere in the world. The World Health Organisation (WHO) recognised HPV as the cause of cancer in 1996. The situation has changed because of improved socioeconomic conditions, hygiene, lesser number of children, etc.
A first-of-its-kind community-based survey on usage and awareness about the vaccine in Delhi and Rohtak in 2022 showed that only 0.6% of 1,020 women who participated in the exercise had availed it. So, incidence is decreasing without vaccine.
In many countries screening alone has decreased the incidence drastically. But screening has its own disadvantages of over-diagnosis, because CN1, CN2 and initial cellular changes which most of the time resolve spontaneously might raise false alarm.
In India without vigorous screening, it has decreased, and in Bangladesh with lesser screening than India, incidence is lower because malnutrition is less than India.
It is important to see what kind of vaccine they want to give to all 100% of young girls.
This vaccine claims to stop infection of only 4 types of HPV out of 150+ types of this virus. Lay persons call it anti-cancer vaccine, which is not true. Cancers found without HPV or by other strains are not prevented by this vaccine.
Researchers in the New Castle University and the Queen Mary University, London, conducted a critical appraisal of published Phase 2 and 3 efficacy trials in relation to the prevention of cervical cancer in women. Their analysis shows the trials themselves generated significant uncertainties undermining claims of efficacy in these data.
The study says, “Trials may have overestimated efficacy by combining high-grade cervical disease with low-grade cervical changes that occur more frequently but often resolve spontaneously without progressing. We found insufficient data to clearly conclude that HPV vaccine prevents the higher-grade abnormal cell changes that can eventually develop into cervical cancer.”
Worse, as against the norm of six years’ trial, only 6 to 7 months’ trial has been undertaken to prove the efficacy of the vaccine. Six years’ trials are insufficient, as the age of cancer appears much later. Though the WHO says that there is no infection for 6 months, and there is development of antibodies, the vaccine has been approved. While 4 strains are claimed to be suppressed by this vaccine, other strains start growing, as is clear from the Cervarix trial. There was increase in type 51 and type 58 strains.
Normal screening is done at 36 months, but during the trials for the cervical cancer vaccine, they do it at 6 months -- so before it gets resolved on its own, they would label it as cervical cancer.
Forget cervical cancer, the question is whether it prevents even the infection.
Premature Ovarian Failure is found to increase significantly with these vaccines in a large-scale adverse event spontaneous reporting system. Aluminium is supposed to be the cause and, almost all, including the one introduced in our country, has aluminium in it.
This causes infertility, yet those propagating cervical cancer say, they don’t have any data on this side-effect! Who will be responsible for the crores of girls who themselves and their parents don’t even know of it. Literature of Cervavac says they do not have any data on this.
As for lactation, they don’t know if antigen or antibody is secreted in the milk and still, they write that it can be given during lactation. Who will be responsible if the child gets affected by these antigens or antibodies?
Those supporting HPV vaccine have not used saline water as placebo in Cervavac trial, though they say, only 1% serious side effects in other vaccines is caused by Cervavac, hence there is no increase in serious side-effects!
Paralysis, blindness, autoimmune disorders and even deaths are reported side-effects in HPV vaccines; however, they are rare, and for most of the girls, awareness about risk factors and elimination is just enough.
A paper from Sweden reports increase in cervical cancer in those who are vaccinated. The author is so scared of the vaccine lobby, that he even hides her/his identity. But the editors made the article available even after retraction because the study was found to be perfect.
Now that brings us to the point as to how to deal with this problem. Let us be very clear that this is not a question of one vaccine. Pneumonia vaccine which can prevent 4 out of 100 cases is also increasingly becoming part of government programmes.
As per several scientific studies, HPV is found to be an important but not sufficient cause for cervical cancer
I have done some calculations. Recently Adar Punawala declared that HPV vax will be made part of government programmes. On 14th September 2022 the 1st analysis appeared on Universal Health Organisation website. Many of us started speaking against it, but on January 2023 without much publicity the Union health ministry gave orders to 7 states to start vaccinating girls, and then the programme was extended to other states. Plan was made to vaccinate 6.8 crore girls by 2025, 1.12 crore every year.
Each dose costs Rs 2,000. Two doses are to be given to everyone. At this rate, Rs 27,200 crore by 2025 will go the Serum Institute of India (SII), and then Rs 8,480 crore every year.
Each dose costs Rs 2,000. Two doses are to be given to everyone. At this rate, Rs 27,200 crore by 2025 will go the Serum Institute of India (SII), and then Rs 8,480 crore every year.
The pneumonia vaccine’s cost is Rs 5,000 per dose, and 3 doses are to be given per child. Even with decreasing total health budgets, more and more states are included every year in the pneumonia vaccine plan.
Pneumococcal Conjugate Vaccine (PCV) was launched in May 2017 for reducing infant mortality and morbidity caused by pneumococcal pneumonia. It has been introduced in Bihar, Himachal Pradesh, Madhya Pradesh, 19 districts of Uttar Pradesh and 18 districts of Rajasthan.
The multi-centre phase3 efficacy and safety clinical trial on Rotovac was India's first and largest efficacy clinical trial on vaccines. It was successfully completed in September 2013 after a 2-year follow up with infants.
The rotavirus vaccine costs Rs 850; it was produced by Bharat Biotech and given across 11 states, and it will be expanded to all states. The programme started in 2016, and a lot of doubts about trials were raised. Even after the Prime Minister’s Office (PMO) asked for data, the company did not give trial results, even though the Government of India had funded the trials.
According to an article by Supreme Court advocate Neha Rathi, the Ministry of Health and Family Welfare told the Delhi High Court that “site specific data on safety is inappropriate for release as per protocol and its inappropriate interpretation or publication would lead to disinformation about the product (that has been) developed by government with great effort and expense, and will give unfair advantage to multinational products which were never tested in India, (and) yet (were) licenced.”
In other words, the safety data is not being disclosed to enable the vaccine to be sold, yet the costs incurred in the trial are allowed to be recovered.
We all know how Rs 35,000 crore was spent for Covid vaccine. So, these private pharma companies are earning from the tax collected from the common people by the government, causing harm to our health. With more money, they capture more power to control all institutions and propaganda.
All this does not mean one should stop efforts. Awareness campaigns need to be launched so that the system stops supporting the profiteers. There is a need to promote public health facilities. It is the private sector that sabotages and destroys the public sector for profit.
One cannot allow the profiteers to play with our life. The ownership and management of the vital sector must be in the hands of people and healthcare professionals in a participatory democracy.
The multi-centre phase3 efficacy and safety clinical trial on Rotovac was India's first and largest efficacy clinical trial on vaccines. It was successfully completed in September 2013 after a 2-year follow up with infants.
The rotavirus vaccine costs Rs 850; it was produced by Bharat Biotech and given across 11 states, and it will be expanded to all states. The programme started in 2016, and a lot of doubts about trials were raised. Even after the Prime Minister’s Office (PMO) asked for data, the company did not give trial results, even though the Government of India had funded the trials.
According to an article by Supreme Court advocate Neha Rathi, the Ministry of Health and Family Welfare told the Delhi High Court that “site specific data on safety is inappropriate for release as per protocol and its inappropriate interpretation or publication would lead to disinformation about the product (that has been) developed by government with great effort and expense, and will give unfair advantage to multinational products which were never tested in India, (and) yet (were) licenced.”
In other words, the safety data is not being disclosed to enable the vaccine to be sold, yet the costs incurred in the trial are allowed to be recovered.
We all know how Rs 35,000 crore was spent for Covid vaccine. So, these private pharma companies are earning from the tax collected from the common people by the government, causing harm to our health. With more money, they capture more power to control all institutions and propaganda.
All this does not mean one should stop efforts. Awareness campaigns need to be launched so that the system stops supporting the profiteers. There is a need to promote public health facilities. It is the private sector that sabotages and destroys the public sector for profit.
One cannot allow the profiteers to play with our life. The ownership and management of the vital sector must be in the hands of people and healthcare professionals in a participatory democracy.
But, along with that to get the system back from these profiteers we have to run a parallel fight. We have to first start with establishing our right on all public health facilities. Our control on policy making will start from the place where the policies are implemented and not only during crisis but on regular basis.
Slowly it will be clear that as in all other sectors, it is the private sector that sabotages and destroys the public sector and then for their profit they destroy the life on earth. We cannot allow them to play with our life. To have control in our hands, ownership and management of this vital sector has to be with people and healthcare professionals by participatory democracy.
---*Physician-activist based in Gujarat. This article is based on the author's online lecture organised by the Awaken India Movement
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