As I mentioned in a previous article, reading articles about vaccines leads to many tragic and heartfelt stories. But as a scientist, I have to separate the emotional aspects of a story from the science-based evidence. This post is particularly tough because this story is so devastating, that I wanted to ignore it (and have ignored for a few days), but it has become a rallying point for the anti-vaccine religion against the HPV cancer-preventing vaccines. The internet is saying Gardasil killed Colton Berrett, but the scientific evidence says otherwise. Time to take a look.
The anti-vaccine religion hates almost all vaccines equally, but they hold a special level of hatred for the HPV cancer-preventing vaccine. There are boatloads of rumors, myths and outright lies about the vaccine, that I have debunked one by one over the past six years – unfortunately, these stories lead many people to say “no” to the vaccine.
Despite the vast body of evidence from huge case-control studies, that have established that individuals who receive the HPV vaccine are no more at risk for serious adverse events than the general unvaccinated population, there is a small group of people who try to convince the world otherwise.
Christopher Shaw and Lucija Tomljenovic have notoriously pushed “published” articles that have hypothesized that the HPV vaccines have some inherent danger. Yet, the anti-vaccine forces conveniently ignore the fact that their articles have been frequently been retracted for being of poor quality, or, having faked data.
And this leads us to the tragic story of Colton, a Utah teen who received the Gardasil vaccine, then contracted a neurodegenerative disease, and eventually died. His parents, the Vaxxed fraudumentary crowd, and the whole anti-vaccine world blame the HPV vaccine. And the clickbait headlines from the usual suspects in the anti-vaccine world attempt to scare anyone from getting the cancer-preventing vaccine – “Colten Berrett dies from his Gardasil HPV vaccine injuries” is a typical one.
Of course, I’m a scientist, and I only consider legitimate scientific evidence in applying causality – we need to look carefully at whether Gardasil killed Colton Berrett. And the real story is that no, Gardasil had nothing to do with this tragedy, as much as the anti-vaccine religion would like it to be so.
Despite how sad this story might be to all of us, it is time to examine the claims of a link, by reviewing real medical evidence.
Colton Berrett’s story
Most of the anti-vaccine websites accurately tell young Colton’s story up to a certain point. Another story with a clickbait headline, “Colton Berrett: Another Teen Sacrificed by the HPV Vaccine, Has Died” summarizes the facts of the story fairly accurately, up until they leap to unsupported conclusions:
A medical physical was required for Colton to attend a scout camp. This was prior to his 8th grade school year. His pediatrician and long-time family doctor recommended the HPV Vaccine to his mother, Kathleen. His doctor claimed the HPV Vaccine could help prevent cancer, and even if Colton was not promiscuous, he could give the virus to his future wife. Like many parents, Kathleen trusted her doctor. She confidently shared, ‘The doctor is the one who went to school, and of course you’re going to do what he recommends.’
Colton was administered the third round of the Gardasil/ HPV Vaccine on February 1, 2014, about a month and a half just shy of his 14th birthday. About two weeks after, he experienced a painful neck ache following the vaccine and was given Tylenol to alleviate the pain. Adventurous by nature, the next day, Colton and his dad went motor-cross riding to use Colton’s new bike. That day when he arrived home, he became pale, started to feel nauseous, and was not well that evening – he headed to bed. Kathleen continued to check on him throughout the night and Colton expressed he could not use his right arm. Intuitively, Kathleen worried if he had spinal meningitis and if her son was going paralyzed. A mother’s or any concerned parent’s nightmare.
Colton’s dad brought Colton to urgent care at Primary Children’s Hospital in Salt Lake City the next morning, on Monday, February 17, 2014. Colton was almost completely paralyzed and that was the beginning of his 88 day hospital stay. Doctors and staff discovered through speaking with Colton’s parents that he was healthy, active, and not sick, until he received the HPV Vaccine two weeks earlier and experienced the neck ache. It was agreed that Colton suffered a severe adverse reaction and vaccine injury to the Gardasil vaccine. The doctors reported his vaccine injury to the Vaccine Adverse Event Reporting System (VAERS).
According to numerous stories, Colton was diagnosed with acute longitudinal transverse myelitis (TM), which is a neurological condition in which the spinal cord is inflamed, which, in turn, damages nerve fibers and leads to demyelination. At that point, the nerves have decreased electrical conductivity which then leads to paralysis.
In Colton’s case, the transverse myelitis was extensive, affecting vertebrae C1 (cervical-1) through T-12 (thoracic-12). That is a substantial portion of the entire length of the spinal column.
Initially, the TM caused paralysis in Coton’s neck and right arm. Eventually, he lost function in his left arm and became paralyzed. He eventually had lost the ability to breathe easily, so he was intubated and a ventilator was connected to allow him to breathe. Over time, the paralysis spread through his body, and he eventually lost the ability to speak.
Unfortunately, Colton required therapy to avoid infections and pneumonia, hot and cold packs to help regulate body temperature and connection to a 7 kg (15 lb) ventilator that his family described as his “ball and chain.” He died on 8 January 2018 from the disease (according to his parents, from suicide).
Of course, the predators at Vaxxed jumped all over the story:
At this point, we have a terribly sad story of a young man contracting a disturbing and horrible neurodegenerative disease, and eventually dying. I empathize with the parents of this young man. It is a shocking and heart-rending story, one that makes anyone with any emotions cry.
But we need to do some science here to determine if we can truly support or reject the claim that Gardasil killed Colton Berrett.
What causes transverse myelitis?
According to the NIH (National Institutes of Health) National Institute of Neurological Disorders and Stroke (NINDS), America’s leading research institution for neurological disorders like TM, the causes of transverse myelitis are mostly unknown. There seem to be some antibodies produced might be correlated with the demyelination, but there’s no definitive research showing how this happens.
In general, transverse myelitis is associated with:
- Bacterial Infections – Mycoplasma pneumoniae, Lyme disease, Bartonella henselae have been associated with TM.
- Viral Infections – herpes simplex, herpes zoster (shingles), cytomegalovirus, Epstein-Barr virus, HIV/AIDS may be related to TM.
- Immune system disorders – autoimmune diseases, abnormal immune responses to cancer, post-infection phenomenon, and multiple sclerosis may be linked to TM.
- Fungal infections
- Other inflammatory disorders – various conditions that also affect the spinal cord may be implicated with TM. These include that can affect the spinal cord, such as sarcoidosis, systemic lupus erythematosus, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, and other related disorders
- Vascular disorders – arteriovenous malformation, dural arterial-venous fistula, intraspinal cavernous malformations, or disk embolism have been hypothesized to be related to TM.
A research paper claims that are 37 cases of TM, out of hundreds of millions of doses of vaccines, that may be related to vaccines (that does not include Gardasil). However, the paper was co-authored by Yehuda Shoenfeld, who has a long history of anti-vaccine rhetoric, and whose pseudoscientific theories about Gardasil have been thoroughly debunked.
Furthermore, and this must be triple underlined, TM is not a slow-developing disease. In fact, the time frame between cause and symptoms of acute forms of transverse myelitis can be as little as a few hours or at most, a few days. Two weeks, which is what Colton’s family claims is the time from the dose of Gardasil until the appearance of symptoms, is way outside of the temporal range for cause and effect of TM.
At this point, someone is going to yell out, “see you don’t know, so it could be Gardasil.” That’s not scientific, that’s a logical fallacy called the argument from ignorance. First, we lack any plausible connection between HPV vaccines and transverse myelitis. Moreover, we have robust and voluminous evidence that the HPV vaccines are not related to transverse myelitis. Inventing some connection does not make it so.
Gardasil and transverse myelitis – any evidence?
Biological plausibility is always my first step in determining if one thing is related to another. For example, maybe we find that broken arms in children are correlated to two weeks post vaccination.
Is it biologically plausible that a vaccine causes weakened bones in just a few days? No, I cannot conceive of a biological pathway from vaccine to a broken bone. Is it plausible that children go out and play and break their arms after vaccinations? That would be much more plausible.
So is it plausible that the HPV vaccine is related to TM? Not really. The HPV antigens in Gardasil cannot conceivably pass through the blood-brain barrier because they are hydrophilic proteins, which are specifically blocked by the barrier. So right there, it is implausible to think that the HPV antigens have any link to TM.
Of course, other components of the vaccine, specifically the aluminum adjuvant, are claimed to have some causal effect on neurodegenerative diseases. Notwithstanding the tiny subclinical amount of aluminum in the HPV vaccines, there is no evidence that the aluminum in vaccines is related to any neurological condition, like transverse myelitis. Two of the huge proponents of this myth about Gardasil are the aforementioned Shaw and Tomljenovic, whose articles about aluminum in HPV vaccines and neurodegenerative diseases have been highly criticized and retracted.
But more importantly, there are plenty of published articles of robust evidence derived from huge epidemiological studies that have established that there are no links between Gardasil and neurological disorders such as transverse myelitis.
Let’s review the most important:
- A large study of 790,000 Danish women who received the HPV vaccine found no increased risk of demyelinating diseases, such as transverse myelitis, compared to non-vaccinated Danish women.
- Another large study of over 1 million women found no safety signals for autoimmune diseases, including TM, in HPV vaccinated women.
- A recent meta-review (considered the pinnacle of biomedical research) of over 100 different safety studies of the HPV vaccine, that included over 2.5 million individuals, found no increased risk of transverse myelitis.
- A peer-reviewed CDC review of 8 years of clinical and epidemiological studies found no serious adverse events including TM.
- Another recent meta-review found no link between Gardasil and autoimmune demyelinating diseases (which includes TM).
- A study of over 3 million Scandinavian women found no link between the vaccine and demyelinating diseases.
I know some people reading this article who hate Gardasil will cherry pick studies from our friends Shaw, Tomljenovic, Shoenfeld, and Exley – those studies have either been published in low impact factor journals, been retracted, or been roundly rejected by the scientific community. Yet, we have studies of millions of people where we can find no statistical signal of a link between transverse myelitis and Gardasil. Even when we went looking really hard.
These same people will try to claim that Gardasil got some special treatment from European and American drug regulators. That myth is so easily debunked.
We have meta-reviews of hundreds of studies (this is the opposite of cherry-picking) that have shown no statistical link between Gardasil and transverse myelitis.
I looked hard for anything that would support the plausibility or firm evidence of a link between HPV vaccines and TM – I found nothing that would meet the standards of robust evidence. But I didn’t have to look hard to find substantial evidence that there is no link, and certainly no causality, between Gardasil and TM.
But Gardasil killed Colton Berrett?
There is simply no evidence that there is a link. As traumatic and difficult as it is to understand Colton’s death from a rare disease, transverse myelitis could have been caused by dozens of factors, not including Gardasil.
His parents probably feel helpless and need to blame something, anything. For that, I am terribly sympathetic. I have three daughters, and if any of them died before me, I’d be looking for something to hate. Gardasil seems so convenient.
Yes, Gardasil did precede the onset of symptoms by a couple of weeks – but humans fall for post hoc propter ergo hoc – they think that if an event follows a previous event, then obviously the previous one caused the second event. That’s the foundation of many superstitions and myths. A thorough examination can show what the cause will be, and it probably won’t be the vaccine.
Sadly, transverse myelitis happens with or without a vaccination – it occurs frequently enough that it coincidentally happens after a vaccination. Maybe something happened prior to the onset of symptoms – maybe he had a cold or flu, maybe he ate a bad hamburger. There are just so many causes.
The parents, with what appears to be prompting from the anti-vaccine religious festival, the Vaxxed tour, want it to be Gardasil. But scientific facts say otherwise.
Orac wrote about this story too. His conclusion would be mine:
The story of Colton Berrett is one of the most tragic stories that I have ever encountered, and, remember, I have blogged about several of the children with incurable cancer treated by cancer quack Stanislaw Burzynski. A highly active and happy child, he was unfortunate enough to develop a horrific disease that robbed him of much of his ability to do what he loved the most and rendered him completely dependent upon others for many of his basic activities. He faced a lifetime ahead of him in which he was unlikely ever to get significantly better or recover much more function than he had already recovered.
What makes the tragedy so much worse is how the antivacine vultures responsible for VAXXED have swarmed around the family since discovering his case, encouraging his mother to buy into the false notion that Gardasil injured her son to the point where he was so damaged that he took his own life and blaming Gardasil for his suffering and death. Their behavior, their exploitation of Colton and his family, is beyond despicable.
All about HPV vaccines
I know, I’ve written about this vaccine 100 times, so you’ve read the following few paragraphs enough times to quote them without looking. Actually, I add information as necessary to make sure you have up-to-date facts and figures about the HPV vaccine.
However, for some of you, this might be your first bit of research into the human papillomavirus (HPV) vaccine, so it’s important to get a brief overview of HPV and the vaccines. If you’ve read this before, just skip to the next section if you want.
Genital and oral HPV are the most common sexually transmitted infections (STI) in the USA. There are more than 150 strains or subtypes of HPV that can infect humans, although only 40 of these strains are linked to a variety of cancers. HPV is generally transmitted from personal contact during vaginal, anal or oral sex.
Although the early symptoms of HPV infections aren’t serious, those infections are closely 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 with respect to cancer. 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. About 27,000 HPV-related cancers are diagnosed in the USA every year.
There were two HPV vaccines on the market before 2014. GSK, also known as GlaxoSmithKline manufactured Cervarix, a bivalent vaccine, but it has been withdrawn from the US market, because of the competition from the other HPV vaccines. In Europe and other markets, Gardasil is known as Silgard.
Merck manufactures the other HPV vaccines. Its first vaccine, the quadrivalent Gardasil, targets the two HPV genotypes known to cause about 70% of cervical cancer and two other HPV genotypes that cause genital warts. The newer Gardasil 9, approved by the FDA in 2014, is a 9-valent vaccine. It targets the four HPV genotypes in the quadrivalent version, along with five additional ones that are linked to cervical and other types of cancer. Both versions of Gardasil are prophylactic, meant to be given before females or males become exposed to possible HPV infection through intimate contact.
- Agmon-Levin N, Kivity S, Szyper-Kravitz M, Shoenfeld Y. Transverse myelitis and vaccines: a multi-analysis. Lupus. 2009 Nov;18(13):1198-204. doi: 10.1177/0961203309345730. Review. PubMed PMID: 19880568.
- Arnheim-Dahlström L, Pasternak B, Svanström H, Sparén P, Hviid A. Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study. BMJ 2013 Oct;347:f5906 doi: 10.1136/bmj.f5906.
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- Hviid A, Svanström H, Scheller NM, Grönlund O, Pasternak B, Arnheim-Dahlström L. Human papillomavirus vaccination of adult women and risk of autoimmune and neurological diseases. J Intern Med. 2017 Oct 18. doi: 10.1111/joim.12694. [Epub ahead of print] PubMed PMID: 29044769.
- Phillips A, Patel C, Pillsbury A, Brotherton J, Macartney K. Safety of Human Papillomavirus Vaccines: An Updated Review. Drug Saf. 2017 Dec 26. doi: 10.1007/s40264-017-0625-z. [Epub ahead of print] Review. PubMed PMID: 29280070.
- Scheller NM, Svanström H, Pasternak B, Arnheim-Dahlström L, Sundström K, Fink K, Hviid A. Quadrivalent HPV vaccination and risk of multiple sclerosis and other demyelinating diseases of the central nervous system. JAMA. 2015 Jan 6;313(1):54-61. doi: 10.1001/jama.2014.16946. PubMed PMID: 25562266.
- Stokley S, Jeyarajah J, Yankey D, Cano M, Gee J, Roark J, Curtis RC, Markowitz L; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC. Human papillomavirus vaccination coverage among adolescents, 2007-2013, and postlicensure vaccine safety monitoring, 2006-2014 – United States. MMWR Morb Mortal Wkly Rep. 2014 Jul 25;63(29):620-4. PubMed PMID: 25055185.
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