Vacinação contra o vírus do papiloma humano à luz da prevenção quaternária

Palavras-chave: Vacinas contra Papillomavirus, Prevenção Primária, Ética Clínica, Prevenção Quaternária

Resumo

Apesar dos benefícios demonstrados, a questão da vacinação massiva contra o HPV ainda está sujeita a intensas discussões e controvérsias. A proteção contra o câncer ainda não está comprovada e precisa de mais tempo para ser precisa sobre a quantificação da redução do câncer do colo do útero. A análise da relevância da vacina contra o HPV é muito complexa devido a vários níveis sobrepostos que devem ser considerados. Os autores analisam muitas das questões éticas, sociológicas, econômicas, políticas e, finalmente, científicas envolvidas nesta análise. A confiança da população nas vacinas foi afetada devido às práticas duvidosas de muitas empresas farmacêuticas. Diante dessa manipulação de informações em escala global, clínicos gerais, família e comunidade se organizaram para lutar contra a incerteza. A prevenção quaternária, conceito apoiado pela Organização Mundial de Médicos de Família, defende a aplicação de procedimentos eticamente aceitáveis nos cuidados médicos. Este artigo de opinião aborda algumas das múltiplas dimensões envolvidas para incentivar a reflexão sobre esta questão. 

Métricas

Carregando Métricas ...

Biografia do Autor

Miguel Pizzanelli, Facultad de Medicina de la Universidad de la República (UDELAR). Unidad Docente Asistencial Rural de Florida, Florida

Médico de Familia y Comunidad, trabajo en la Administracion de los Servicios de Salud del Estado como Director de la Red de Atención Primaria del departamento de Florida, Uruguay. Docente en la Unidad Docente Asistencial de Florida asociada al Departamento de Medicina Familiar y Comunitaria de la Facultad de Medicina de la Universidad de la República Oriental del Uruguay. Integrante del Grupo de Investigación PCAT.Uy. Secretario General de la Sociedad Uruguaya de Medicina Familiar y Comunitaria, miembro de CIMF-WONCA:

Referências

Healey D. The First Vaccine Wars [Internet]. [cited 2018 May 26]. Available from: https://davidhealy.org/the-first-vaccine-wars/

Habakus L, Holland M, eds. Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human

Rights, Our Health, and Our Children. New York: Skyhorse Publishing; 2011.

Covello VT, Mumpower J. Risk Analysis and Risk Management: An Historical Perspective. Risk Anal. 1985;5(2):103-20.

https://doi.org/10.1111/j.1539-6924.1985.tb00159.x

Larson HJ, de Figueiredo A, Xiahong Z, Schulz WS, Verger P, Johnston IG, et al. The State of Vaccine Confidence 2016: Global Insights

Through a 67-Country Survey. EBioMedicine. 2016;12:295-301. https://doi.org/10.1016/j.ebiom.2016.08.042

Vinodhini K, Shanmughapriya S, Das BC, Natarajaseenivasan K. Prevalence and risk factors of HPV infection among women from various

provinces of the world. Arch Gynecol Obstet. 2012;285(3):771-7. https://doi.org/10.1007/s00404-011-2155-8

Franco EL, Duarte-Franco E, Ferenczy A. Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. CMAJ [Internet]. 2001 Apr 3 [cited 2018 Jun 10];164(7):1017-25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80931/

Dijkstra MG, Zummeren M van, Rozendaal L, Kemenade FJ van, Helmerhorst TJM, Snijders PJF, et al. Safety of extending screening

intervals beyond five years in cervical screening programmes with testing for high risk human papillomavirus: 14 year follow-up of population based randomised cohort in the Netherlands. BMJ [Internet]. 2016 Oct 4 [cited 2018 Jun 10];355:i4924. https://doi.org/10.1136/bmj.i4924

Dumit J. Drugs For Life: How Pharmaceutical Companies Define Our Health. Durham and London. Duke University Press; 2012.

List of largest pharmaceutical settlements. In: Wikipedia [Internet]. 2018 [cited 2018 Jun 10]. Available from: https://en.wikipedia.org/w/

index.php?title=List_of_largest_pharmaceutical_settlements&oldid=837296457

No Gracias. La prescripción off-label, fuera de control (y puede ir a peor) [Internet]. nogracias.eu. 2015 [cited 2018 Jun 10]. Available

from: http://www.nogracias.eu/2015/02/11/la-prescripcion-label-fuera-de-control/

Gøtzsche P. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. London: Radcliffe Publishing; 2013.

Lane C. Shyness: How Normal Behavior Became a Sickness. New Haven: Yale University Press; 2008.

Moynihan R, Cassels A. Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients. New

York: Nation Books New York; 2005.

Prasad VK, Cifu AS. Ending medical reversal: improving outcomes, saving lives. Baltimore: Johns Hopkins University Press; 2015.

Welch G, Schwartz L, Woloshin S. Overdiagnosed: Making People Sick in the Pursuit of Health. Boston: Beacon Press; 2011.

Sridhar CR. Bad Pharma: How drug companies mislead doctors and harm patients. J Can Res Ther [Internet]. 2013 [cited 2018 Jun

;9:339-40. Available from: http://www.cancerjournal.net/text.asp?2013/9/2/339/113431.

Martínez-Lavín M, Amezcua-Guerra L. Serious adverse events after HPV vaccination: a critical review of randomized trials and

post-marketing case series. Clin Rheumatol. 2017;36(10):2169-78. https://doi.org/10.1007/s10067-017-3768-5

Beppu H, Minaguchi M, Uchide K, Kumamoto K, Sekiguchi M, Yaju Y. Lessons learnt in Japan from adverse reactions to the HPV vaccine:

a medical ethics perspective. Indian J Med Ethics. 2017;2(2):82-8. https://doi.org/10.20529/IJME.2017.021

Cervarix vaccine issues trigger health notice. The Japan Times Online [Internet]. 2013 Jun 15 [cited 2018 Jun 29]; Available from:

https://www.japantimes.co.jp/news/2013/06/15/national/cervix-vaccine-issues-trigger-health-notice/

Shu-ichi Ikeda, Hineno K, Scheibenbogen C, Heidecke H, Schulze-Forster K, Junker J, et al. Autoantibodies against Autonomic Nerve Receptors in Adolescent Japanese Girls after Immunization with Human Papillomavirus Vaccine. Ann Arthritis Clin Rheumatol. 2019;2(2):1014. [online] Remedypublications.com. Available at: http://www.remedypublications.com/annals-of-arthritis-and-clinicalrheumatology/articles/pdfs_folder/aacr-v2-id1014.pdf?fbclid=IwAR3eySwYrcme_T3sRhpf-JpZqotyr86QdamebiheLncD2NGXk3SJEE. [Accessed 28 Oct. 2019].

Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag [Internet]. 2015 Feb 4;

[cited 2018 Jun 29];4(2):61-4. https://doi.org/10.15171/ijhpm.2015.24

Pizzanelli M. NotasL@cas/M@dNotes [Internet].

NotasL@cas/M@dNotes. [cited 2018 Jun 29]. Available from: https://notaslocasmadnotes.

wordpress.com/

Pizzanelli M. Actualización de NotaL@ca: Octubre 2017: Referencias sobre Vacuna HPV / M@dNote: HPV vaccine references – NotasL@

cas/M@dNotes [Internet]. 2017 [cited 2018 Jun 30]. Available from: https://notaslocasmadnotes.wordpress.com/2017/10/16/esta-notalcase-

ha-actualizado-oct-2017-referencias-sobre-vacuna-hpv-mdnote-hpv-vaccine-references/

Jørgensen L, Gøtzsche PC, Jefferson T. The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias. BMJ

Evid Based Med [Internet]. 2018 Oct 1 [cited 2019 May 11];23(5):165-8. https://doi.org/10.1136/bmjebm-2018-111012

Sociedad Uruguaya de Medicina Familiar y Comunitaria (UY), Grupo de Grupo de Trabajo en Prevención Cuaternaria de Uruguay.

Evaluación crítica sobre la vacuna contra el VPH. – Sumefac [Internet]. SUMEFAC. 2018 [cited 2018 May 26]. Available from: http://

sumefac.com/2018/05/18/evaluacion-critica-sobre-la-vacuna-contra-el-vph/

Publicado
2019-11-04
Como Citar
Pizzanelli, M., & Jamoulle, M. (2019). Vacinação contra o vírus do papiloma humano à luz da prevenção quaternária. Revista Brasileira De Medicina De Família E Comunidade, 14(41), 1800. https://doi.org/10.5712/rbmfc14(41)1800
Seção
Perspectivas