Vaccination of girls against human papillomavirus (HPV) was included in the Danish vaccination programme in 2009. Since 2013, the Danish Medicines Agency received an increasing number of reports of suspected adverse events which resulted in public concerns about vaccine safety and a dramatic decrease in vaccine uptake. By March 2017, only 35% of girls born in 2004 have received at least 1 HPV vaccine compared with a 92% uptake in birth cohorts 1998-2000. This fall represent an alarming setback for cancer prevention.
The suspected adverse events consist mainly of medically unexplained symptoms without a documented causal link to the vaccine. Massive attention in social media and news media have certainly been pivotal in amplifying vaccine skepticism in the target groups.
Actions taken in Denmark include
The establishment of treatment centres for patients who suffer from perceived adverse events
Research into the epidemiology of the crisis, including role of media and excess morbidity prior to first vaccination
Registry based research to explore any undetected side effects
A campaign to regain trust to the programme
Research has, among other, suggested that females who report adverse events prior to the first HPV vaccines have increased health care seeking behavior and excess morbidity from medically unexplained symptoms compared with controls. This indicate that the symptoms are coincidental with the vaccine and not caused by it.
This finding provided some reassurance as regards concerns about vaccine safety, but is clearly not enough to regain the trust. A stronger communication emphasis on cancer prevention, the particular aspects of cervical cancer as a disease of young women, and international aspects are some messages that need to be reinforced to regain trust.