The anti-HPV vaccine crowd is now furious about New York Senate bill S298A, which is now in the Health Committee of that body. Basically, the bill would add the HPV vaccine to the vaccine schedule for all New York children born after January 1, 2008.
As I’ve mentioned before, many of us have observed that the anti-HPV vaccine beliefs are the strongest of them all in the anti-vaccine religion. Even among those who generally vaccinate their children will stop at the HPV vaccine, for reasons that make even less sense than their usual vaccine denial.
In response to the S298A, there has been a lot of nonsense being pushed about the vaccine. One of those anti-HPV vaccine memes reached the claws of this ancient dinosaur.
And you know what we do here? Yes, we’re going to skeptically demolish it with real science.
All about HPV and HPV vaccines
I know I add this section to every article I have written about HPV or the HPV vaccine. However, there are some readers who want to know more about HPV, and this section can help someone get up-to-speed quickly, so skip this section if you’ve read it a few times.
Genital and oral human papillomavirus (HPV) infections are the most common sexually transmitted infections (STI) in the USA. HPV is generally transmitted from personal contact during vaginal, anal or oral sex.
It’s important to note that there are more than 150 strains or subtypes of HPV that can infect humans – however, only 40 of these strains are linked to one or more different cancers. Of those 40 strains, most are extremely rare.
Although the early symptoms of HPV infections aren’t serious and many HPV infections resolve themselves without long-term harm, HPV infections are causally linked to many types of cancers in men and women. According to current medical research, here are some of the cancers that are linked to HPV:
In addition, there is some evidence that HPV infections are causally linked to skin and prostate cancers. The link to skin cancer is still preliminary, but there is much stronger evidence that HPV is linked to many prostate cancers.
HPV is believed to cause nearly 5% of all new cancers across the world, making it almost as dangerous as tobacco in that respect. According to the CDC, roughly 79 million Americans are infected with HPV – approximately 14 million Americans contract a new HPV every year. Most individuals don’t even know they have the infection until the onset of cancer. The CDC also states that over 43,000 HPV-related cancers are diagnosed in the USA every year. It may be several times that amount worldwide.
There were two HPV vaccines on the world market before 2014. GSK, also known as GlaxoSmithKline, produced Cervarix, a bivalent (protects against two HPV strains) vaccine. It has been withdrawn from the US market (although available in many other markets), because of the competition from the quadrivalent (immunizes against four different HPV strains) and 9-valent (against nine HPV strains) Gardasil vaccines.
Merck manufactures Gardasil, probably the most popular HPV vaccine in the world. The first version of the vaccine, quadrivalent Gardasil, targets the two HPV genotypes known to cause about 70% of cervical cancer and two other HPV genotypes that cause genital warts. In Europe and other markets, Gardasil is known as Silgard.
The newer Gardasil 9, approved by the FDA in 2014, is a 9-valent vaccine, protecting against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. It targets the four HPV strains found in the quadrivalent version, along with five additional ones that are linked to cervical and other HPV-related cancers. Both versions of Gardasil are prophylactic, meant to be given to females or males before they become exposed to possible HPV infection through intimate contact.
Gardasil is one of the easiest and best ways to prevent a few dangerous and, to abuse the definition slightly, common cancers that afflict men and women. Without a doubt, the HPV vaccine prevents 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.
Let me sum this all up so that if you come away from this section with nothing else, you get this summary. HPV is a sexually transmitted disease. HPV causes 43,000 cancers a year in the USA alone. The HPV vaccine prevents becoming infected by HPV, which means you are protected from these cancers.
About that anti-HPV vaccine meme
And here it is, with all of the names redacted to protect the ignorant ones (I usually don’t redact anything, but I was asked to do so in this case):
So, let’s take a look at each one of the misinformed claims that appear in this meme while debunking them with the scientific facts about the safety and effectiveness of the HPV vaccine.
The HPV vaccine does not destroy fertility
This ridiculous myth is based on an article by an international finance professor, Gayle DeLong, who has absolutely zero background or credibility in any field of vaccine science. None.
DeLong tried to use birth statistics to try to show that the HPV vaccine decreased fertility in young women. And she used the most nonsensical, unscientific approach to do this.
DeLong looked at birth rates for women 25-29 from 2007 through 2015. The problem with her numbers is that the HPV vaccine was not available until 2006, so only 60% of that group were even eligible to receive the vaccine. This is a fundamentally amateurish mistake by someone who is not only clueless about vaccines but is also clueless about epidemiology. She should stay in her own lane, studying international finance.
DeLong seems to not understand or examine confounding variables. Confounders are variables that can lead to a spurious association. In these types of observational studies, researchers must examine those confounders or the study is invalid.
But there’s more. If we are going to undertake a large epidemiological study, we would want to design it in a way to either reduce the effect of or account for the confounding variable. User Mike Stevens pointed out several of these variables (yes there was an extensive discussion of this paper on another article I published) that make the study almost invalid:
1. Women who access sexual health and contraceptive services are both more likely to get vaccinated and more likely to use contraception.
2. Educational attainment, racial and socioeconomic factors, which influence both birth rate and vaccination rates.
3. Women who choose to become pregnant are more likely to be in stable, long term relationships and less likely to want protection against STIs.
4. Religious ideology – some fundamentalists oppose both contraception and vaccination.
It appears that DeLong was doing the one thing that almost defines pseudoscience – she created a conclusion, then found all of the data that supports her pre-conceived conclusion. In real science, something that is not a part of DeLong’s education or training, one must look at all the data that supports or rejects a hypothesis.
Furthermore, real scientific data from the CDC (pdf) shows that the birthrate for this age group of women has been dropping steadily since the mid-1990s, over a decade before the HPV vaccine became available in the USA. Again, she selected the data group that supported her belief that the HPV vaccine harmed the fertility rate, without examining the fertility rate prior to the vaccine.
Moreover, this fertility study fails in two other major ways:
- There is no evidence of a causal relationship between the HPV vaccine and infertility. The studies that DeLong references in her paper are case studies, which rank near the bottom of the hierarchy of biomedical research. There is no possible way to use them to show any type of biologically plausible link between the vaccine and primary ovarian failure (POF). But DeLong wants to use this nonsense as support for her findings.
- DeLong ignored the huge body of evidence that includes massive, multi-million patient studies that have not detected POF after receiving the HPV vaccine. None. In fact, a review of HPV vaccine research did not find any relationship between the vaccine and POF.
There is simply no repeated, robust, published data that supports DeLong’s claims. The HPV vaccine (or HPV itself) are not related to infertility or ovarian failure.
So, no, the HPV vaccine is not going to sterilize a generation of kids – that is one of the most ignorant statements ever from these people.
Photo by Alicia Petresc on Unsplash
The HPV vaccine does not paralyze or kill anyone
Here are reviews of 12 large, robust, peer-reviewed studies that have not shown any incidence of death or paralysis from the HPV vaccines. Not one.
- Gardasil safety supported by a large study of 200 thousand young women. 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, an 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.”
- 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.
- Even though there was no plausibility, researchers found that the HPV vaccine was unrelated to an increase the risk of multiple sclerosis (MS) or some other acquired central nervous system demyelinating syndrome (CNS ADS).
- Another huge study, including nearly 2 million doses of HPV quadrivalent vaccine, showed no increased risk of multiple sclerosis or other demyelinating neurological disorders in vaccinated vs. unvaccinated groups.
- A review of all of the post-licensure studies of quadrivalent HPV vaccines provides strong evidence that Gardasil is extremely safe.
- The HPV vaccine and autoimmune diseases – no link in new 2 million patient study
- Cervical cancer vaccine – Gardasil 9 shows long-term effectiveness – another clinical study shows that Gardasil 9 reduces the risk of cervical cancer by over 90%.
- Cancer preventing vaccine safe for women – no excuses for HPV vaccine – another study, this time with over 3 million women shows the vaccine to be extraordinarily safe for women who receive Gardasil.
- Does the HPV vaccine cause multiple sclerosis? No link found in a large scientific review. Despite looking really hard at the data, researchers could find no link between the HPV vaccine and multiple sclerosis.
- Primary ovarian insufficiency unrelated to HPV vaccine – anti-vaxxers will move goalposts – another anti-vaccine trope debunked by real scientific and clinical evidence.
The myths about the HPV vaccine deaths and paralysis come from a complete misunderstanding of the package insert, actually not a very useful document except for a couple of important sections. Almost all of the serious adverse reactions listed in package inserts are not related to the drug. For example, the Gardasil package states that some vaccinated individuals died in automobile accidents – unless I’m missing something, that has little to do with the vaccine.
And there are stories, such as the one about Colton Berrett, whose mother blames Gardasil for his death, yet when any reasonable individual examines the evidence, it points a whole other cause unrelated to the vaccine.
The anti-HPV vaccine crowd like to grab a scintilla of a rumor to blow it up to “it’s a dangerous vaccine.” The evidence does not support that claim.
Other spurious claims from the anti-HPV vaccine zealots
Let’s go through the final claims one by one so that you’re not taking two years to read this article.
- Over 100 strains of HPV. There are actually over 150 strains of HPV, but that isn’t the point. They claim that because Gardasil only protects against four of them (it’s actually nine today), it really is useless. Of the 150 strains, only 40 are associated with cancers. And of those 40, only a handful (the ones covered by Gardasil9) are prevalent. Yes, you might get unlucky and get one of those other 31 strains of HPV, but you’d still be protected against the most common.
- Effectiveness of the HPV vaccine. The anti-vaxxers would like us to believe that there is no evidence that the vaccine works, but that’s simply not true. We have several studies that have established that after the introduction of the HPV vaccines in several countries the rate of cervical cancer. Since women were the first to get the vaccine, we are, of course, focused on cervical cancer, but as the cohort of vaccinated young teens gets older, we will see a similar decrease in other cancers that afflict both men and women.
- HPV epidemic. The anti-vaxxers like to claim that HPV isn’t dangerous (most clear up without any issue) and that there aren’t many people with it. In fact, 79 million Americans have the virus. Yes, most of them will not, but we see over 40,000 HPV-related cancers every single year in the USA. New York is about 6% of the US population, so that would mean around 2400 HPV-related cancer cases in that state alone. Anti-vaxxers have this very strange belief that vaccines would only matter if 100% of people who caught a disease suffered from it – there are so few ways to prevent cancer, and this vaccine is one of them. Sure, it’s not going to prevent millions of cancer cases, but it will prevent a lot.
Summary, the tl;dr version
The anti-HPV vaccine crowd has invented more misinformation about this vaccine than they have for all other vaccines, except for maybe the MMR vaccine, which is NOT linked to autism.
- The HPV vaccine is not linked to infertility or ovarian insufficiency.
- The HPV vaccine does not cause death or paralysis.
- The HPV vaccine prevents the most prevalent strains of cancer-causing human papillomavirus.
- The HPV vaccine is extraordinarily safe.
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