One of the most popular zombie memes and tropes of the anti-vaccination movement is that Japan bans Gardasil – oh noes! Of course, like a lot of the junk information passed along by the anti-vaccine crowd, it’s completely false, unless you’re willing to take anything they say on faith.
I wrote an article about how to critically analyze pseudoscience and misinformation so that you might skeptically analyze evidence supporting a claim, even if it appeared to be accurate. On Facebook, Twitter and many internet sites (including Wikipedia), there is an amazing tendency of individuals to accept what is written as “the truth” without spending the effort to determine if what is written is based on accurate science.
Twitter, of course, limits itself to 140 characters, which means you either have to click on a link to get more information, or just accept that what is stated within the 140 characters is factual. And if you can make a complex scientific argument in 140 characters, that would be impressive.
As I’ve written before, there are precious few ways to prevent cancer. But one of the best cancer prevention strategies is the HPV vaccine, which can prevent numerous cancers such as cervical, oral, penile and anal, all serious, and all dangerous. Maybe we should just rename Gardasil to “HPV cancer vaccine,” which could make everyone sit up and notice.
The HPV vaccination rate remains depressingly low in the USA. According to recent research, 39.7% of adolescent girls aged 13-17 received all three doses of the vaccine in 2014 up from 37.6% in 2013. HPV vaccination rates among teen boys are much lower than for girls, 21.6% in 2014 up from 13.4% in 2013.
There are probably a lot of reasons for the low HPV cancer vaccine uptake rate, so I thought I’d go through the most “popular” ones, debunking them one by one.
Hopefully, the reader can use this article as a checklist of the tropes and myths of the anti-Gardasil crowd with quick answers to them. Maybe you’ll convince one person to get their son or daughter vaccinated against HPV related cancers.
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. Additionally, some HPV types can also infect the mouth and throat. HPV is generally transmitted from personal contact during vaginal, anal or oral sex.
HPV is linked to cancers in men and women, and because there are so many subtypes, research has established which HPV types are related to which cancers. Because HPV is sexually transmitted, most of the infections occur near the mouth, throat, anus and genital areas–and most HPV related cancers begin there.
HPV is believed to cause nearly 5% of all new cancers across the world, making it almost as dangerous with regards to cancer as tobacco. 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. About 27,000 HPV-related cancers are diagnosed in the USA every year.
Given the 95% vaccine uptake rate, it begs the questions of why I push so hard for vaccination–because I want to protect the lives of children, and those 5% who aren’t vaccinated are at risk of serious disease and even death. And vaccines are the safest way to protect a child–protect them from death.
Nearly 55% of the readers of this blog are not American (a couple of years ago,this blog got a regular reader from Iran, which meant that all countries were represented amongst this blog’s readers). I have been accused of being a bit American-centric, but at the same time, I was also curious about vaccine uptake worldwide. Continue reading “Worldwide vaccine uptake-2014”
More fear mongering from the antivaccination forces, this time claiming that “mainstream news media is widely reporting today that a French teenager has filed a lawsuit against French pharmaceutical company, Sanofi Pasteur, and France’s health regulators, over side-effects that were caused by the Gardasil HPV vaccine.” The plaintiff is claiming that the vaccine induced multiple sclerosis (MS), a neurological disease that results from inflammation of neurons. The best available evidence is that MS is caused by a virus, which someday will be prevented with a vaccine!
Formally known as the HPV quadrivalent vaccine, Gardasil (or Silgard in Europe) is a vaccine that prevents infection by the human papillomavirus, a sexually transmitted disease. The vaccine specifically targets subtypes 16 and 18, that cause not only approximately 70% of cervical cancers, but they also cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. It also targets HPV6 and HPV11, which account for approximately 90% of external genital warts. The viruses are generally passed through genital contact, almost always as a result of vaginal, oral and anal sex.
Let’s be clear here. Gardasil prevents cancers–serious, life threatening cancers.
Furthermore, the HPV quadrivalent vaccine has been shown to be extraordinarily safe in two different and large epidemiological studies, one with over 700,000 doses and the other with over 350,000 doses. The relative safety of the HPV vaccine is not in question except by those who engage in logical fallacies and anecdotes. The size of these two studies were so large, so impressive, that they would have uncovered extremely rare events, and there were none.
We have discussed this issue before. Teenagers are at risk of many chronic diseases that are coincidental to vaccines. For example, the rate for MS in some populations in Europe is close to 200 per 100,000. Without any substantial and incontrovertible evidence that the HPV vaccine is linked to MS, and with substantial evidence that MS is caused by viruses and is fairly prevalent in Europe, one can only conclude scientifically that this child had a coincidental MS attack. That is sad, and I wish we could have prevented the disease, and someday we might–but blaming Gardasil is simply irresponsible, since we have evidence it saves lives.
So, let’s debunk some of the crazy points made by the fear-mongering anti-Gardasil article:
No, we have no evidence that Gardasil caused MS. In fact, we have evidence otherwise, since the background rate of MS in Europe is substantial.
A lawsuit certainly does not imply causality, especially since nothing has been adjudicated so far. And even if the French legal system finds for the plaintiff, it does not provide evidence of causality. Courts are terrible evaluators of scientific data.
Japan did not stop using Gardasil vaccine. The Japanese Health Ministry, under pressure from the anti-science crowd, withdrew its recommendation for the vaccine based on adverse events that were actually BELOW the rates of those same events in the general population. In other words, they failed to take any epidemiology courses.
Therefore, the HPV vaccine is safe, based on over 1 million doses in controlled studies. HPV vaccine prevents the virus that causes some serious, deadly cancers. Multiple sclerosis is probably not caused by the HPV vaccine (or any vaccine to be factual). Multiple sclerosis is probably caused by a virus that one day will be prevented by a vaccine developed by real scientists (and if I’m still writing then, rest assured the vaccine deniers will risk their children contracting MS to whine nonsensically about that new vaccine).
Gardasil saves lives. And I’ve shown that scientific fact based on solid scientific, published evidence.
I was going to put some snarky comment in the title like, “but wait, what about the statistics.” Because we know that this isn’t a good decision, and that the vaccine deniers will be all over it like Mr. Andy Wakefield’sfraudulent and retracted study claiming that vaccines cause autism. But let’s move on to what happened.
The health ministry decided June 14 to withdraw its recommendation for a vaccination to protect girls against cervical cancer after hundreds complained about possible side effects, including long-term pain and numbness.
The Ministry of Health, Labor and Welfare is not suspending the use of the vaccination, but it has instructed local governments not to promote the use of the medicine while studies are conducted on the matter.
So far, an estimated 3.28 million people have received the vaccination. However, 1,968 cases of possible side effects, including body pain, have been reported.
The ministry’s task force discussed 43 of those cases. However, a cause-and-effect relationship between the vaccination and the pain and numbness could not be established, so the task force members called for further studies by the ministry.
The ministry’s investigation is expected to take several months. It will then decide whether to reinstate or continue to withhold its recommendation for the vaccination.
So, the health ministry is going to withhold recommendation of the HPV vaccination because they notice 43 cases for which they couldn’t establish a causal relationship to the vaccine. In other words, 0.0013% of cases, a number so small that it’s pretty close to impossible to affix any statistical significance to it. In fact, random background “noise” (that is that some whole body pain could be expected in any random sampling of vaccinated or unvaccinated individuals) of this type of observation is as plausible as correlation (let alone causation) to the vaccine. In fact, the Health Ministry failed to provide us with data concerning the level of these side effects in the general population. Nor how soon after vaccination. Nor anything potentially useful in a scientific analysis.
What’s worse is that, according to the same article, about 2700 women in Japan die every year from HPV related cancers. So, because of complaints from the antivaccination lunatics in Japan (didn’t know they had any, but I shouldn’t be surprised), and bad statistics (43 potential cases of “body pain” out of 3,280,000 vaccinations), the Health Ministry stops recommending the vaccine. Exactly what were these people thinking?
Finally, let’s be clear here. The vaccine hasn’t been pulled from the market nor has it been outlawed; teenagers can still get the vaccine. And this was a very unusual move, since only 3 years ago, Japan’s parliament added the HPV vaccine to the mandatory schedule. Hopefully, this committee will look at the numbers from a statistical and scientific point of view and fix this stupidity.