Harvey Rodrick Grenville Ward

Bio: Harvey Rodrick Grenville Ward is an academic researcher from University of New South Wales. The author has contributed to research in topics: Premature ovarian failure & Postmarketing surveillance. The author has an hindex of 3, co-authored 4 publications receiving 95 citations.

Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination: A Case Series Seen in General Practice

Abstract: Three young women who developed premature ovarian insufficiency following quadrivalent human papillomavirus (HPV) vaccination presented to a general practitioner in rural New South Wales, Australia The unrelated girls were aged 16, 16, and 18 years at diagnosis Each had received HPV vaccinations prior to the onset of ovarian decline Vaccinations had been administered in different regions of the state of New South Wales and the 3 girls lived in different towns in that state Each had been prescribed the oral contraceptive pill to treat menstrual cycle abnormalities prior to investigation and diagnosis Vaccine research does not present an ovary histology report of tested rats but does present a testicular histology report Enduring ovarian capacity and duration of function following vaccination is unresearched in preclinical studies, clinical and postlicensure studies Postmarketing surveillance does not accurately represent diagnoses in adverse event notifications and can neither represent unnotified cases nor compare incident statistics with vaccine course administration rates The potential significance of a case series of adolescents with idiopathic premature ovarian insufficiency following HPV vaccination presenting to a general practice warrants further research Preservation of reproductive health is a primary concern in the recipient target group Since this group includes all prepubertal and pubertal young women, demonstration of ongoing, uncompromised safety for the ovary is urgently required This matter needs to be resolved for the purposes of population health and public vaccine confidence

Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination

Abstract: Premature ovarian failure in a well adolescent is a rare event. Its occurrence raises important questions about causation, which may signal other systemic concerns. This patient presented with amenorrhoea after identifying a change from her regular cycle to irregular and scant periods following vaccinations against human papillomavirus. She declined the oral contraceptives initially prescribed for amenorrhoea. The diagnostic tasks were to determine the reason for her secondary amenorrhoea and then to investigate for possible causes of the premature ovarian failure identified. Although the cause is unknown in 90% of cases, the remaining chief identifiable causes of this condition were excluded. Premature ovarian failure was then notified as a possible adverse event following this vaccination. The young woman was counselled regarding preservation of bone density, reproductive implications and relevant follow-up. This event could hold potential implications for population health and prompts further inquiry.

Ongoing inadequacy of quadrivalent HPV vaccine safety studies.

Abstract: The quality of quadrivalent human papillomavirus vaccine (QHPV) safety studies has been a source of conflict within the Cochrane Collaboration. The establishment of its safety for the young girl target age group has been a source of unease in other sectors including those with an interest in ovarian safety. Academic rigour and integrity in medical journal publications is guarded by editorial and peer-reviewed processes. The observation, however, that medical journals are at risk of becoming arms of the pharmaceutical industry1 highlights an increased scientific need for alert and active critique of industry-funded trials. Where biased publications are identified around one product there is perhaps a greater cause for concern. A problem identified by the Cochrane conflict is that internal validity and generalisability of published drug trials need more probing than afforded by current systematic analyses. Cochrane2 confirms the limitations of using vaccine components as controls, since these components may be important to safety analysis. The importance of correctly identifying all placebo components is also just this. The Cochrane QHPV review and its critique,3 however, did not identify the misrepresentation of safety trials’ control constituents in published Future I and Future II trials. Both trials represent their controls as ‘aluminum hydroxyphosphate sulfate’. However Future I,4 Future II5 and Villa et al ’s6 published trials passing both Cochrane’s inclusion standards and QHPV licensing failed to identify the additional presence of polysorbate 80 …

Safety and efficacy of external cephalic version after a previous caesarean delivery: A systematic review.

Abstract: BACKGROUND External cephalic version (ECV) is a common procedure and has been shown to be safe and effective in turning a baby from a breech to cephalic presentation. However, whether ECV is safe and effective in women with a scarred uterus from a previous caesarean section remains contentious. AIM To evaluate the safety and efficacy of external cephalic version in women with a singleton breech pregnancy and at least one previous caesarean delivery. MATERIAL AND METHODS Literature searches were conducted on MEDLINE, PUBMED, EMBASE, CINAHL and SCOPUS up to June 2020. The search strategy included the following keywords: ('external cephalic version OR ECV') AND ('previous OR prior OR past' AND 'caesarean OR caesarean OR uterine scar'). Studies were included if they evaluated the efficacy and/or safety of external cephalic version in women after 36 weeks' gestation with a singleton breech pregnancy and at least one previous caesarean delivery. RESULTS Nine studies were included in the review. ECV success rates and subsequent vaginal delivery rates ranged from 50 to 100% and from 50 to 74.9%, respectively. ECV complications reported included abnormal fetal heart rate, abnormal cardiotocography and transient vaginal bleeding. No studies reported cases of uterine rupture. CONCLUSIONS ECV in women with a previous caesarean delivery is a relatively successful and low-risk procedure compared to women without a previous caesarean delivery. The results from this systematic review provide useful information for professional bodies in updating clinical guidelines such that ECV may be offered to women with one previous caesarean delivery.

Human Papilloma Virus Vaccine and Primary Ovarian Failure: Another Facet of the Autoimmune/Inflammatory Syndrome Induced by Adjuvants

Abstract: Problem Post-vaccination autoimmune phenomena are a major facet of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and different vaccines, including HPV, have been identified as possible causes. Method of study The medical history of three young women who presented with secondary amenorrhea following HPV vaccination was collected. Data regarding type of vaccine, number of vaccination, personal, clinical and serological features, as well as response to treatments were analyzed. Results All three patients developed secondary amenorrhea following HPV vaccinations, which did not resolve upon treatment with hormone replacement therapies. In all three cases sexual development was normal and genetic screen revealed no pertinent abnormalities (i.e., Turner's syndrome, Fragile X test were all negative). Serological evaluations showed low levels of estradiol and increased FSH and LH and in two cases, specific auto-antibodies were detected (antiovarian and anti thyroid), suggesting that the HPV vaccine triggered an autoimmune response. Pelvic ultrasound did not reveal any abnormalities in any of the three cases. All three patients experienced a range of common non-specific post-vaccine symptoms including nausea, headache, sleep disturbances, arthralgia and a range of cognitive and psychiatric disturbances. According to these clinical features, a diagnosis of primary ovarian failure (POF) was determined which also fulfilled the required criteria for the ASIA syndrome. Conclusion We documented here the evidence of the potential of the HPV vaccine to trigger a life-disabling autoimmune condition. The increasing number of similar reports of post HPV vaccine-linked autoimmunity and the uncertainty of long-term clinical benefits of HPV vaccination are a matter of public health that warrants further rigorous inquiry.

Safety of Human Papillomavirus Vaccines: An Updated Review.

Abstract: Human papillomavirus (HPV) vaccines are now included in immunisation programmes in 71 countries. Unfortunately, uptake has been impacted in some countries by reduced confidence in the safety of the HPV vaccine. In 2013, we published an extensive review demonstrating a reassuring safety profile for bivalent (2vHPV) and quadrivalent (4vHPV) vaccines. A nonavalent (9vHPV) vaccine is now available and HPV immunisation programmes have been extended to males in 11 countries. The aim of this updated narrative review was to examine the evidence on HPV vaccine safety, focusing on the 9vHPV vaccine, special populations and adverse events of special interest (AESI). The previous searches were replicated to identify studies to August 2016, including additional search terms for AESI. We identified 109 studies, including 15 population-based studies in over 2.5 million vaccinated individuals across six countries. All vaccines demonstrated an acceptable safety profile; injection-site reactions were slightly more common for 9vHPV vaccine than for 4vHPV vaccine. There was no consistent evidence of an increased risk of any AESI, including demyelinating syndromes or neurological conditions such as complex regional pain or postural orthostatic tachycardia syndromes. The risk–benefit profile for HPV vaccines remains highly favourable.

Primary ovarian insufficiency in the adolescent.

Abstract: Purpose of reviewTo raise awareness about the importance of early diagnosis of primary ovarian insufficiency (POI) in the adolescent.Recent findingsMenstrual cycle irregularity or amenorrhea in the adolescent has historically been treated with oral contraceptives or ignored, with no evaluation done