HPV vaccine

After my last blog post there was a comment about the Human Papilloma Virus (HPV) vaccine.  I’d like to say a bit about that vaccine to be sure that people have the science and not the rumors.

HPV vaccine was approved for females aged 9-26 years in 2006 and males–same age–in 2015.  Most people infected with HPV are unaware of it–prior to the HPV vaccine it is estimated that 80% of American adults had been infected whether they know it or not.  There are many strains of the virus.  Some cause cervical cancer and others cause only painful, nasty genital warts.

There are 2 HPV vaccines currently on the market.  Gardasil (Merck) covers a broad range of virus serotypes and gives good protection against both cancer and wart causing strains and is approved for both males and females. Cervarix, (GlaxoSmithKline) prioritizes cancer causing strains giving somewhat greater protection against cancer and less for only warts. It is approved for females only.

We have had mixed success in gaining public acceptance for HPV vaccine.  This is unfortunate because, needless to say, cervical cancer is a serious public health concern and preventing it can only be a benefit to our society.  Due partially to its nominal association with adolescent and pre-marital (especially female) sexuality there has been an inordinate amount of controversy surrounding HPV.  It has even filtered into national political debates.  And despite only partial coverage we have seen a marked drop in the incidence of HPV infection in vaccinated young adults.  This is important to remember.  Among the numerous inaccurate claims for adverse reactions from HPV is increased incidence of Guillain Barre syndrome (GBS), a serious neurologic disorder.  Now, while the decreasing rate of HPV infection is well documented, there has been no such increase in the incidence of GBS generally or among teenagers and young adults.  Remember: we must be careful in assuming that temporal association establishes causation.  The rooster crowing each dawn does not cause the sunrise.  There is an old joke about what a doctor should do if a person walks out of his office and drops dead.  Answer?  Turn him around and make it look like he was walking in.   The point is that reports of “a child got x vaccine and then got y disease”is not necessarily “evidence” but is at least as likely to be a coincidence.  It takes much more rigorous analysis to establish “evidence.”

One other assertion by HPV vaccine opponents is that it could empower young women to more active (read : promiscuous) sex lives.  Not supported by good evidence, we have found.

There is so much more false information about HPV vaccine out there. Here’s a good summary of the various claims and the scientific reality .

The immunization schedule calls for 3 shots over a minimum of 6 months.  Its ok for it to take longer and there is no time limit requiring the patient to “start over.”  Please give me a call with questions and we can discuss HPV vaccine.  I strongly recommend it.

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