Vaccine scares are here again. This time it is the tragic news that a 14 year old girl died after receiving her HPV vaccination, with a predictable response from some quarters…

On this occasion, I’m going to take the road less travelled. Numerous scientific commentators will be sure to point out that there is not necessarily any connection between the events, and that even if there were, the risks of vaccination remain tiny in comparison to the lifetime risk of developing cervical cancer.

But it would be wrong to only consider this story as a case report. It’s also a story, and many, even most people hearing about it on the news will interpret it as a narrative: they will be struck by the irony of parents wanting to protect their daughter, through a vaccine which is voluntary in the UK, only for her to succumb far sooner than they could have ever expected. Whether or not there is any connection, this single tragedy will resonate far more than the thousands of lives which will be saved. Those saved lives are an absence of death, even of illness, and we tend not to perceive such things in the same way.

A classic ethical dilemma asks whether subjects would be willing to save bystanders on a railway platform from a runaway train, by changing the points to divert the train onto another platform where it will kill only one person. Most people say that they would divert the train and kill the lone commuter. But when the question is recast such that there is a crowded train headed out of control towards a precipice, and to prevent it plummeting over the edge we have to push a single large gentleman off an overlooking bridge onto the track to derail the train before the crash, most people balk.

I think something similar can apply when we talk about vaccination. It should not be a great surprise if, when vaccinating millions, we observe events which have a one in a million chance of occurring. But even though the risk is small, minuscule, we are deliberately exposing vaccinees to it. Hence the vaccine is held responsible, whereas the depredations of disease can somehow be viewed as natural. To put it another way, if somebody dies of a disease it is nobody’s fault, but if they die following vaccination, then it is the fault of the dastardly government, big pharma, whoever.

It is interesting to note that following the 9/11 terrorist attacks there were serious discussions about whether smallpox vaccination should be recommenced in the US, to protect against any future bioterrorist incident. Such a vaccination programme would be expected to be at the cost of some lives, through adverse reactions, and this may explain why the plan was shelved.

According to reports, in the case of HPV the vaccine cannot be held to be responsible. However, I suspect that this will be insufficient to prevent a panic. Suspicious parents will be quick to suggest a cover up, even those who should know better. But really, it’s as safe as can be reasonably expected, and it will save lives. It probably has already saved the lives of women who would have been exposed to HPV in coming years, and then suffered the consequences. But heck, maybe I’m wrong. A poll on the Daily Mail’s website reveals a majority, at present, against suspension of the vaccination campaign. When saner voices prevail even at the Daily Mail, there is hope for us all.