There are so many outlandish and unsupported claims about the HPV vaccine, it’s difficult to keep up with them all. One of the most outrageous lies about the HPV vaccine is that it causes autoimmune diseases, despite the robust epidemiological or clinical evidence that firmly establishes the safety of the HPV vaccine, especially with respect to autoimmune diseases.
Autoimmune diseases are conditions where the immune system has an abnormal response to normal cells in the body. Celiac disease, type 1 diabetes mellitus, multiple sclerosis, and many other conditions are as a result of an autoimmune disorder. We don’t know what causes the autoimmunity, but there is almost no biological plausibility that any vaccine could induce the disease.
Despite the lack of a reasonable biological mechanism leading from the HPV vaccine to any of the multitudes of autoimmune diseases, the anti-vaccine forces continue to try to establish a link. For example, Yehuda Shoenfeld has pushed a ridiculed hypothesis that the vaccine causes something he calls autoimmune syndrome induced by adjuvants (ASIA). Not a single respected scientist buys into ASIA, and Shoenfeld has presented no vigorous clinical or epidemiological evidence supporting its existence.
Not to pile onto the anti-vaccine tropes about the vaccine, but a large, and new, Canadian study has once again shown us that there are no links between the HPV vaccine and autoimmune diseases. This adds to the body of evidence that, for real science, reinforces the conclusion that the HPV vaccine is an incredibly safe vaccine.
All about HPV vaccines
Many of you have read this section an enormous number of times, however, for some of the readers of this blog, this article might be their first bit of research into the human papillomavirus (HPV) vaccine. Thus, it’s important to get a brief overview of HPV and the vaccines. If you’ve read this section before, just skip to the next section if you want.
Genital and oral 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. 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:
These are all dangerous and disfiguring cancers that can be mostly prevented by the HPV cancer vaccine. If you’re a male, and you think that these are mostly female cancers, penile cancer can lead to amputation of your penis. Just think about that guys.
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 31,000 HPV-related cancers are diagnosed in the USA every year.
There were two HPV vaccines on the world market before 2014. GSK, also known as GlaxoSmithKline manufactured 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 deadly cancers that are related to HPV. It is definitely a cancer-preventing vaccine.
(Just a quick note. There are actually two cancer-preventing vaccines. Along with the HPV vaccines, the hepatitis B vaccine is also important for the prevention of some cancers. The vaccine prevents hepatitis B viral infections. Chronic hepatitis B infections can lead to liver cirrhosis or cancer. Liver cancer is actually one of the few cancers in the USA where the incidence has increased over the past few years. And if you follow the anti-vaccine rhetoric, you know the hepatitis B vaccine is almost as controversial as the HPV vaccine.)
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.
Autoimmune diseases and the HPV vaccine – the Canada study
A study by Erin Lieu et al., published in the Canadian Medical Association Journal, showed that girls given the quadrivalent Gardasil showed no increased risk of developing autoimmune diseases. Lieu and colleagues utilized a population-based retrospective cohort study using Ontario’s health and vaccination databases.
The research team examined data from nearly 291,000 girls, aged 12 to 17 years, who were eligible for the HPV vaccination between 2007 and 2013. Approximately 62.2% (or nearly 181,000 girls) received at least one dose of Gardasil – 81.8% of those girls received all three recommended doses. The remaining 110,000 girls received no HPV vaccine.
Of the 181,000 girls who received the vaccine, 681 would eventually be diagnosed with autoimmune diseases – 77 of them between one week and two months after vaccination. However, this data is consistent with rates for autoimmune diseases in a general population. Furthermore, the study found no statistically significant risk of autoimmune diseases for the vaccinated group compared to the unvaccinated group.
The authors concluded:
This large, population-based study did not finda significant risk of autoimmune disorders following HPV4 vaccination among girls aged 12-17 years, including girls with a history of immune-mediated disorders. Moreover our results were robust to numerous sensitivity analyses.
Summary
And, once again, we have solid data that Gardasil is not linked to autoimmune diseases. In this massive study, the researchers looked at a large group of vaccinated vs. unvaccinated girls, and they didn’t find anything.
This adds to the body of overwhelming evidence that the HPV vaccine is very safe. And, it is very effective in preventing cancers.
Parents and healthcare providers should look at the evidence and be reassured that the HPV vaccine is a powerful cancer-prevention which is very safe.
Citations
- Liu EY, Smith LM, Ellis AK, Whitaker H, Law B, Kwong JC, Farrington P, Lévesque LE. Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: the Ontario Grade 8 HPV Vaccine Cohort Study. CMAJ. 2018 May 28;190(21):E648-E655. doi: 10.1503/cmaj.170871. PubMed PMID: 29807937; PubMed Central PMCID: PMC5973886.
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