This past week, I read a
new article published in Pediatrics that described how educating either teenagers or their parents about HPV vaccinations had little effect on the overall vaccination rate for the vaccine. Essentially, the researchers found that it was a 50:50 probability that any teen would get the vaccine, regardless of their knowledge of HPV and the vaccine itself.
So I thought about why that Pediatrics study found that education about HPV and Gardasil didn't move the needle on vaccination uptake. It's possible that the benefits of the vaccine is overwhelmed by two factors–first, that there's a disconnect between personal activities today vs. a disease that may or may not show up 20-30 years from now; and second, that the invented concerns about the HPV quadrivalent vaccine, promulgated by the usual suspects in the antivaccination world, makes people think that there is a clear risk from the vaccine which is not balanced by preventing cancer decades from now. It's frustrating.
What is HPV? What is Gardasil?
We should start by summarizing our knowledge of HPV and the vaccine that prevents the infection:
Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the USA. There are more than 40 HPV sub-types that can infect the genital areas of males and females. These same HPV types can also infect the mouth and throat. They are transmitted from personal contact during vaginal, anal or oral sex.
Some HPV subtypes, such as HPV-6 and HPV-11, can cause warts around the genitals or anus, but have low (but not 0) risk of causing cancers. However, the higher risk subtypes, such as HPV 16 and 18, not only cause approximately 70% of cervical cancers, but they cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. HPV is estimated to be the cause of nearly 5% of all new cancers across the world.
According to the CDC, roughly 79 million Americans are infected with HPV–approximately 14 million Americans contract HPV every year. Most individuals don’t even know they have the infection until the onset of cancer.
The HPV quadrivalent vaccine, known as Gardasil (or Silgard in Europe), can prevent infection by human papillomavirus, substantially reducing the risk of these types of cancers. An HPV bivalent vaccine, known as Cervarix, is used in some countries, but only provides protection again two of the subtypes most associated with cervical cancer.
Currently in the United States, the Advisory Committee on Immunization Practices (ACIP) recommends that preteen girls and boys aged 11 or 12 are vaccinated against HPV. The immunization is also recommended for teenage girls and young women up to the age of 26 who did not receive it when they were younger, and teenage boys and young men up to the age of 21.
I've just boiled down the reasons for getting the vaccine–it prevents cancer. All the junk science you read about eating this food or taking that supplement to prevent cancer is based on nonsense and bad science. But let me reiterate–Gardasil can prevent cancers, and some pretty nasty dangerous cancers.
I've written nearly 50 articles about the HPV vaccine, mostly debunking myths, but also reviewing some of the best literature published today. I thought I'd bring them together in one place, so that it can work as a link of links for HPV vaccine information and myth debunking. I'll just link to my articles that deal with the subject, and within those articles will be links and citations for the peer-reviewed articles, which hopefully will help the reader, if you are concerned about Gardasil, or maybe you'll pass it to someone else, if they are on the fence.
Gardasil is safe
- In a large study, that included nearly 200,000 young females who had received the vaccine, the researchers found that the vaccine was only associated with same-day syncope (fainting) and skin infections in the two weeks after vaccination. The authors stated that, “this study did not detect evidence of new safety concerns among females 9 to 26 years of age secondary to vaccination with HPV4.”
- In another huge study, that included nearly 1 million young females, a HPV vaccinated cohort was compared to an unvaccinated cohort. The authors concluded that "this study identified no safety signals with respect to autoimmune, neurological, and venous thromboembolic events after the qHPV vaccine had been administered."
- Digging for data in VAERS, the Vaccine Adverse Event Reporting System, in an attempt to show some relationship between report adverse events and Gardasil is a form of "dumpster diving" for data. VAERS, a passive reporting system, is barely more than an anecdotal reporting system, not scientific. There is no review of medical records, a inquest into a causal relationship, or anything else that real clinicians would use to ascertain causality.
- Gardasil does not cause blood clots.
- Eight years of post licensure studies have shown no significant relationship between the vaccine and serious adverse events.
- An eight year clinical trial comparing the HPV vaccine vs. a saline control group (the saline control group eventually received the vaccine, after the study endpoints were reached) show no difference in adverse events.
Gardasil is effective
Other myths
- A French Court hands down a ludicrous decision stating that Gardasil caused damage to a young girl. Courts are not capable of deciding about scientific facts, unless you're trying to create a vaccine manufactroversy.
- A "lead researcher," Dr. Diane Harper, for Gardasil makes confusing and incorrect comments about Gardasil. And continues to publish peer-reviewed articles in support of Gardasil. And probably wasn't the "lead researcher," just one of many researchers.
- Gardasil does not make teens more promiscuous, despite a certain church's adamant refusal to allow their teens to get the vaccine.
- Japan's Ministry of Health did withdraw its recommendation for the vaccine, but only because they used bad mathematics. They accepted supposed "adverse events" after Gardasil vaccine as causal, even though the rate after vaccination was LOWER than the general non-vaccinated population.
- A French researcher claimed that he had "inside knowledge" of the Merck's activities in manipulating data about the dangers of Gardasil. Interesting that he never worked for Merck, actually worked for a drug distributor (they don't develop or research vaccines), and was made redundant when Merck acquired the distributor. In other words, he had no inside knowledge.
As I've said a thousands times, there are no debates about vaccines, and certainly none about Gardasil. The real science, published in real medical journals, and reviewed by experts in epidemiology, virology, infectious diseases, cancer, and other biomedical researchers, is all that matters. If the other "side" wants to be taken seriously, they need to get a Ph.D., get into real research, and publish real papers. I'm going to guess that if they did that, they would realize that vaccines are safe and effective, and they'd become as loud an advocate as I am.
Let's be clear. Gardasil prevents cancer. And it's about as safe a vaccine that's ever been made. Every teenager in the USA, where the vaccine is essentially free (drop a comment if you can't get it for free, and I'll point you in the right direction), should get the vaccine.
Key citations: