HPV Infection Rates Plummet With Vaccination – Forbes
Controversy has followed human papillomavirus (HPV) vaccines such as Gardisil (NYSE:MRK) since their introduction. This is despite study after study that have confirmed their safety and efficacy. Most of this controversy is based not on the real, documented effects of the vaccine; controversy has ridden in on the wave of the anti-vaccine movement. There is little debate among doctors about the benefits of the shot. Doctors reading the anti-vaccination propaganda quickly find themselves falling down the rabbit hole into a Wonderland of religious puritanism, alternative medicine sales pitches, and conspiracy theories. Let’s unwrap some of this.
What is HPV?
HPV is virus that is passed through sexual contact. Some strains cause genial warts (annoying), others can cause cancer (life-threatening). The most common cancer caused by it is cervical cancer, but it also causes anal cancer and some mouth and throat cancers. Cervical cancer is the fourth most common cancer in women worldwide and kills about a quarter of a million women each year. The burden is especially high in developing nations.
For women with access to healthcare, cervical cancer screening in the US is pretty good, and organizations like Planned Parenthood fill in a lot of the gaps. Sexually active women (gay and straight) should get Pap smears every year (although recommendations vary). This test looks for the abnormal cells caused by the virus, cells that can turn cancerous. As many women know, this can be inconvenient at best, terrifying at worst as when your doctor calls you to come in for “just a few more tests”. And now it looks like the vaccine may bring us a future where Pap smears aren’t needed.
The HPV vaccine should be given before people become sexually active. Since its introduction, HPV infections, especially in women, have plummeted in the US (both on the cervix and in the mouth). Because nearly all cervical cancers are caused by the virus, we should see a drop in cases over the next several years. This is a remarkable success, so much so that we will need to re-think our strategies for cervical cancer screenings, perhaps increasing the age at which screening starts, and how often it is needed.
That’s great news! So what’s the problem?
There has been push-back against HPV vaccination from a few quarters. It is tempting to dismiss this as crazy talk, but if we don’t address it, we will lose the chance to prevent a set of nasty cancers.
First, there is the usual American religious puritanism. You can google it if you really want to, or take my word that there is an outcry among some that vaccination to prevent sexually transmitted diseases will–get this–make young people have more sex. It turns out that this isn’t true, but I doubt that will quiet the puritans. Culturally, we Americans have a deep fear of sexuality, and we like to think that we can actually prevent other people from having sex. We can’t. But we can protect them.
The biggest barrier to vaccination, though, is the anti-vaccination movement, or movements really. Most of the arguments from this group are about vaccine safety and various sorts of conspiracy theories. We can’t really do much about the conspiracy theorists. But we can educate the public about vaccine safety. HPV vaccination is incredibly safe. We measure this in a few ways, but the most important are observations made on large groups of people, seeing if certain problems occur more in vaccinated or unvaccinated people. Researchers are devoting enormous resources to answering a question that has already been answered. One of the studies shows the lengths scientists are going to satisfy anti-vaccination activists (paywall). The researchers looked to see if there were more cases of autoimmune diseases (something that you see online a lot) in people who got the shot. There were not. A letter to the editor of the journal questioned their methods, so they went back to the data, looked even more broadly, included more diseases in the analysis, and still could not find any connection between the vaccine and autoimmune diseases such as lupus and rheumatoid arthritis.
It was a good example of science working the right way, with the back and forth that makes science such a good way to understand the world. But most of what you see online is not like this. Most of the criticism is based on stories passed along on social media and on the Vaccine Adverse Events Reporting System (VAERS). This is the system that allows anyone to lodge any complaint that they think might have to do with a vaccine. Once the report is made, VAERS looks for any connection to the vaccine. You could, for example, call up VAERS and tell them that your daughter got the shot and then was hit by a car. They take these reports seriously, but that doesn’t mean Gardasil causes people to be hit by cars.
The overwhelming amount of scientific data show that the HPV vaccine is safe and effective. It is the second vaccine that can actually prevent cancers (the first is the hepatitis B vaccine). The science on this is as solid as it gets. Unfortunately certain groups are spreading very believable lies that will ultimately lead to people dying of cancer.