Most Americans don’t know HPV vaccine prevents cancer

© Wikipedia Commons, 2013
© Wikipedia Commons, 2013

The blogosphere has been chatting a lot lately about Gardasil (formally known as the HPV quadrivalent vaccine and also called Silgard in Europe), mainly because of  Katie Couric, a fairly popular USA-based journalist with her own eponymous TV talk show, Katie, who did a falsely balanced anti-Gardasil episode that completely ignored real science.  

The vast majority of Americans haven’t been vaccinated against HPV (human papillomavirus) and are unsure about the shots’ effectiveness in preventing cancers, according to a presentation to the American Association for Cancer Research based on data culled from a survey of 1700 individuals in the Health Information National Trends Survey (HINTS) sponsored by the National Cancer Institute. The CDC states that HPV is directly responsible for cervical canceranal cancervulvar cancervaginal canceroropharyngeal cancer and penile cancer. These are all deadly, disfiguring, and potentially preventable cancers through the use of HPV vaccines. 

Worse yet, according to lead researcher, Kassandra Alcaraz, director of health disparities research at the American Cancer Society, the new study found that just one in three U.S. girls and less than 5% of U.S. boys has received the full recommended course of three shots of the HPV quadrivalent vaccine. Part of the reason for the low vaccine uptake rate was that the survey found that around 70% of Americans were unsure of the vaccine’s role in preventing cancers in both men and women. Continue reading “Most Americans don’t know HPV vaccine prevents cancer”

Katie Couric doubles down on the Gardasil false balance

katie-couric-hpv

Revised 10 December 2013.

If you weren’t aware, on 4 December 2013, Katie Couric, a fairly popular USA-based journalist with her own eponymous TV talk show, Katie, did a report about Gardasil (formally known as the HPV quadrivalent vaccine and also called Silgard in Europe). Essentially, Couric interviewed several individuals who claim, without any evidence (and lacking any clue about statistical analysis) that Gardasil harmed their children. Couric gave about a minute of time to ONE physician to explain the safety and effectiveness of Gardasil, as opposed to the heartbreaking, but ultimately irrelevant, stories from parents who needed to blame something for what had happened, and chose Gardasil. As opposed to depression, diet soda, bottled water, air pollution, bad TV shows, or that fake butter that the movie theaters use.

As I wrote before, Gardasil is incredibly safe, as shown in massive and well-designed epidemiological studies. It prevents HPV (human papillomavirus) infection, a sexually transmitted disease. And in case you think it’s just some benign virus, HPV is directly responsible for cervical cancer, anal cancer, vulvar cancer, vaginal cancer, oropharyngeal cancer and penile cancer. These are all deadly, disfiguring, and potentially preventable cancers through the use of HPV vaccines.

In other words, Couric, in the ultimate example of false balance–Couric believed that both sides of a scientific “debate” are equivalent in quality of opinion and evidence. But rarely is this true, especially in scientific principles that have been well-studied and supported by a massive amount of evidence. The safety and efficacy of vaccines is supported by the vast consensus of real science. The antivaccination side has no evidence, so it must rely upon logical fallacies and cherry picked data, and lack any real, world-class contingent of scientists who have stepped up to change the consensus with real evidence. Continue reading “Katie Couric doubles down on the Gardasil false balance”

The beginning of the end of Gardasil–probably not

 

Safe. Prevents cancer.
Safe. Prevents cancer.

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:

  1. 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.
  2. VAERS data (yes, the article decided to use VAERS) is merely observational. It is not controlled, it does not show causality, and it is abused by those who fail to understand the scientific and epidemiological value of the data.
  3. 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.
  4. 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.
  5. Oh, and the author blames Bill Gates in some complicated, nonsensical conspiracy theory about killing girls with HPV vaccines. It’s clear that for the vaccine deniers, since they don’t have real scientific evidence, they need to blame Bill Gates. And blame him again if that doesn’t work

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.

If you need to search for scientific information and evidence about vaccines try the Science-based Vaccine Search Engine.

Key citations:

Why we vaccinate – reduction in HPV incidence in UK

HPV incidence

The HPV quadrivalent vaccine, also known as Gardasil (or Silgard in Europe) 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 also they 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.

The HPV 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 absolute safety of the HPV vaccine is not in question except by those who engage in logical fallacies and anecdote.

In a recent study published in the journal Vaccine, researchers examined the HPV 16/18 infection rate in a randomized group of 4,178 young women, aged 16-24 years who were undergoing screening in community health services in the United Kingdom.

One of the key results was that in the group of 16-18 years, where the HPV infection rate dropped from 17.6% in a survey done prior to the introduction of the vaccine down to 6.6% post-vaccination. This group also showed the highest HPV immunization coverage, about 65%.

The authors concluded that:

[infobox icon=”quote-left”]These findings are the first indication that the national HPV immunisation programme is successfully preventing HPV 16/18 infection in sexually active young women in England. The reductions seen suggest, for the estimated coverage, high vaccine effectiveness and some herd-protection benefits.[/infobox]

These results mirror a study which established the substantial and dramatic drop in HPV infections after the release of the HPV vaccine in the United States. We can only conclude that the HPV vaccines caused a significant reduction in HPV incidence in UK and the USA. The HPV vaccine is effective.

The HPV vaccine is safe. The HPV vaccine prevents the HPV infection. And preventing HPV infections stop 60-95% of some serious and dangerous cancers and other annoyances such as penis pimples. Why is the decision to vaccinate with Gardasil even under discussion? Once again, here is scientific evidence that a vaccine saves lives.

Key citations:

 

One-dose HPV-vaccination still works to prevent cancer

The HPV vaccine prevents infection by human papillomavirus, a sexually transmitted disease, specifically subtypes 16 and 18, that not only cause approximately 70% of cervical cancers, but also they cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers.

The viruses are generally passed through genital contact, almost always as a result of vaginal, oral and anal sex. There is strong clinical evidence that the incidence of HPV infections have declined since the launch of the HPV vaccine and the subsequent steady rate of HPV vaccination.

In a community-based phase III trial of Cervarix (bivalent HPV vaccine) in Costa Rica, researchers reported that the Costa Rica Vaccine Trial (CVT) showed that the four-year vaccine efficacy against 12-month HPV subtypes 16 and 18 (HPV16/18) persistent infections was similarly high among women who received one, two, or the recommended three doses of the bivalent HPV16/18 vaccine. The researchers examined nearly 7,500 women, aged 18-25, in Costa Rica to determine both vaccine uptake (what percentage were vaccinated), number of doses, and HPV16/18 antibodies.

Some of the key results:

  • About 80% of the participants did get all three recommended doses, leaving about 20% who got one or two doses.
  • Researchers analyzed blood samples for HPV16/18 antibodies in randomized subsets who received one, two or three doses.
  • Antibodies to HPV16/18 was observed in 100% of women 48 months after vaccination with one, two or three doses. The only difference noticed that it appeared to take a slightly longer average period of time for 100% of the one-dose group.
  • Almost all participants in all vaccine dose groups were seropositive at approximately 1 month after receiving the first vaccine dose and remained seropositive throughout the 48 months follow-up period.
  • The researchers also compared “a natural infection group” against those who were vaccinated with Cervarix. For those vaccine deniers who say “natural infection is better”, the titers of HPV16/18 antibodies were 14-24X higher with two-doses of the vaccine, while the titers were 5-9X higher with one-dose vaccinations.

hpv-vaccine-controversy

The authors concluded:

The high efficacy after single dose suggests that long-term protection may not require the 5- fold higher titers induced by three doses of the vaccine. Fewer doses would be less expensive and logistically easier to deliver, therefore increasing vaccine accessibility worldwide. The findings also suggest that second generation vaccines might be strongly protective even if they do not induce the high levels of antibodies induced by the licensed vaccines as used according to current recommendations.

We know that the HPV vaccine is safe. Really safe in huge epidemiological studies. And we now have more evidence that it works, and it works better in protecting against HPV infections than so-called “natural immunity.” Unless you believe in lies from the antivaccinationists, HPV vaccines are one of the best ways to protect yourself from cancers.

 

If you need to search for accurate information and evidence about vaccines try the Science-based Vaccine Search Engine.

 

Key citations:

Anti-vaccine lunacy–more lies about Gardasil

One of the hallmarks of pseudoscience is an over-reliance on confirmation rather than refutation of a hypothesis. The antivaccine crowd are well-known for this particular violation of the scientific method. As discussed previously, science works on refutation–creating experiments that might actually disprove a hypothesis as a method to develop evidence in support of it. The anti-vaccination crowd actually hypothesizes (but not in a scientific sense) that a vaccine or set of vaccines was the causal factor in some side effect (autism, death, or whatever else), then they should establish an experiment (double-blinded of course) that would refute that hypothesis. If at some point, the data cannot refute it, then the anti-vaccinationists would have supporting data for their particular supposition. 

But instead of actually performing experiments (which cost money, which may show that they are wrong, or which might not be ethical), they resort to mining data to prove their point. Data mining is dangerous, because confirmation bias, that is, finding information or data that supports a belief while ignoring all other data that does not, makes the data suspect or even useless.

So, in that vein, the anti-vaccinationists often mine data from any database they can find, such as the Vaccine Adverse Event Reporting System (VAERS),  which is a program for vaccine safety, managed by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS functions as a post-marketing safety surveillance program (similar to other programs for almost every regulated medical device and pharmaceutical) which collects information about adverse events (whether related or unrelated to the vaccine) that occur after administration of vaccines.

VAERS has numerous limitations, including lack of scientifically designed questions, unverified reports, underreporting, inconsistent data quality, and absence of an unvaccinated control group. VAERS is basically a collector of information, but has limited value in making conclusions since it does not provide information that is obtained in a controlled manner.  However, it does have some usefulness, in that certain trends may be spotted given enough time and data points. Continue reading “Anti-vaccine lunacy–more lies about Gardasil”

Smoking cannabis doesn’t cure cancer but it may cause it

Marijuana_Cures_CancerAs I have written before, there is a lot of controversy about medical uses for marijuana, although it appears to be much more of a political debate than a scientific one. There just isn’t much evidence that supports a hypothesis that marijuana has any significant therapeutic effect on diseases like cancer, neurological disorders, or other diseases.

Scientists have long suspected that smoking marijuana could be linked to lung cancer, but there has only been weak evidence supporting a causality.  Recently, a 40 year review of  over 49,000 men strongly suggests that smoking cannabis does indeed increase the risk of lung cancer. The study examined 49,321 men between the ages of 18 and 20 who were being enlisted in the Swedish military between 1969 and 1970, examining their health and lifestyle issues, along with their use of marijuana. The researchers reviewed other potential risk factors such as respiratory disease, other types of smoking, and socioeconomic status. Continue reading “Smoking cannabis doesn’t cure cancer but it may cause it”

Polio vaccine does not cause cancer–update

This article has been substantially updated with more information. Please check it out.

Vaccine myths are annoying, not just because they are dangerous to the public health, but because they are like the diseases prevented by vaccines, because the myths keep returning to infect the public, just when you’re not watching. It’s bad enough that social media sites (Facebook, Twitter, blogs, Google, reddit) continuously send out this pseudoscientific myths, but it’s the ersatz “news” sites that do the same. They retread old myths as if they are “breaking news”, which requires we skeptics and pro-science writers to jump out like a vaccine trained immune system to thoroughly destroy these antivaccine myths.

I have long ago accepted that there are just ignorant and plainly delusional people who will buy into any pseudoscience that shows up on their radar screen, without utilizing a single neuron for critical analysis. However, I also understand that there are people on the fence about vaccines (or any other issue with a pseudoscience counterargument), who will appreciate a thorough debunking of ignorant lies.

For example, I wrote an article a while ago about some nonsense meme on Facebook that contended that eating ripe bananas cured cancer because the bananas contained a protein called tumor necrosis factor (TNF). It was based on some “Japanese scientific study,” which took significant effort to find. After a critical and thorough reading of the article, I concluded that: the study made no claim that bananas made TNF, AND even if bananas did, you couldn’t ingest enough bananas to get a bioactive dose of TNF, AND even if you could, you wouldn’t absorb any TNF through the digestive tract, AND TNF doesn’t do what the meme writer thought it does (TNF is badly named, and does not directly attack cancers). In other words, the myth lacks any truth, except, maybe that bananas are yellow.

This is by far the most popular article I’ve ever written with probably close to 100,000 page hits. The reason is that every 2-3 weeks, the myth about bananas arises out of the background noise of the internet, people (unknown to me) use my article to debunk the banana myth in the comments section, and the myth slowly dies. But it never really completely dies. It’s only 99% dead. It’s a zombie which keeps coming back to life.

Thus, the best we skeptics can do is keep debunking these social media fables and tall tales, and move along to refuting the next one in line. At least I can save time by not having to write the article again, we can just update with any new information and re-debunk (yes, I have the absolute right to invent words). Continue reading “Polio vaccine does not cause cancer–update”

The importance of the HPV vaccine to gay men

cover-your-buttMany of us who provide scientific information about HPV quadrivalent vaccine, also known as Gardasil (or Silgard in Europe), tend to focus on its effects on preventing cancers in women, so articles are inclined to pay attention to vaccinating teenage girls rather than boys. But, if you carefully analyze the disease, human papillomavirus, a sexually transmitted disease, its subtypes 16 and 18 not only cause approximately 70% of cervical cancers, but they cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. The viruses are generally passed through genital contact, almost always as a result of vaginal, oral and anal sex. 

These HPV-related cancers can be prevented as long as you can prevent the HPV infection itself, either through never having genital contact with an infected person (and since about 79 million adult Americans are infected with the virus, that’s going to be difficult) or the HPV vaccine. The vaccine is a vitally important part of the war against HPV, it prevents the transmission of certain types (pdf) of human papillomavirus (HPV), specifically types 6, 11, 16 and 18. These subtypes of HPV are most often implicated in these cancers. Continue reading “The importance of the HPV vaccine to gay men”

Marijuana and cancer – Sanjay Gupta’s anecdotes are not science

Editor’s note–this article has been updated and included into a multi-part series on marijuana and medicine. Check it out there. 

Unless you were hiking in the Amazon River jungles, with no access to the internet or American TV, you probably have heard that CNN’s chief medical correspondent, Dr. Sanjay Gupta, changed his mind about marijuana (or “weed” as he keeps saying). Of course, this has become big news, because he’s such a “respected doctor” (why is that? Because he’s on TV?), and because a few years ago he was vociferously anti-cannabis.

I have no doubt that Dr. Gupta’s “conversion” to being pro-weed is genuine (and that his previous stance of anti-weed was similarly authentic), but we need to weed out what is real and what’s just smoke about his comments. His first major point about cannabis* was that the United States Drug Enforcement Agency (DEA) considers marijuana to be a Schedule 1 drug, which is defined as “drugs with no currently accepted medical use and a high potential for abuse.”

Dr. Gupta thinks this classification is ridiculous, and on the surface, many people, even those who are not devoted pot smokers, would probably agree. However, this is a political discussion, at least in the USA, and it is hardly a medical/scientific one. The chances of any political party having the fortitude to correct this classification is about as close to 0 as you can get, without actually stating that there is a 0 chance. But if Gupta wants to make a big deal of this, or that he’s so self-centered that he thinks he’ll change the mind of politicians, more power to him. But for me as a skeptic, it is not the most important thing he says.

In his article, he mentions a young girl who “started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.” This is simply an anecdote of no quality whatsoever. Did he thoroughly investigate her case to determine if the number of seizures actually went down? Do we know that cannabis has anything to do with the change? Is this nothing more than a Post hoc ergo propter hoc fallacy, that just because she consumed cannabis and the seizures decreased does not mean anything about cannabis’ causative properties with regards to this type of seizure. And then, Dr. Gupta continues with the anecdotes by stating, “I have seen more patients like Charlotte first hand, spent time with them and come to the realization that it is irresponsible not to provide the best care we can as a medical community, care that could involve marijuana.” Why do these TV doctors (like Dr. Oz) think that their anecdotes are better than anyone else’s.

Anecdotes are useless because they aren’t controlled, because they are subject to all levels of bias, and because these stories aren’t peer-reviewed. In other words, anecdotes have no value in science-based medicine. Anecdotes do have value in formulating testable scientific hypotheses, but assuming that anecdote=data, and more anecdotes=more data is simply pseudoscientific. I don’t care what Sanjay Gupta writes or says publicly, but providing these stories as “evidence” that marijuana has a medical benefit is essential like telling me that he observed homeopathy (which is just water) working. It’s laughable.

Continue reading “Marijuana and cancer – Sanjay Gupta’s anecdotes are not science”