I’ve been battling the anti-vaccine religion for over 20 years, both online and in person. I know their pseudoscientific Gish gallops by heart, and I swear I if I could set up an auto-answer bot on Twitter and Facebook, I could save myself hours per day. But, like I’ve said many times, the HPV vaccine is one of the most hated vaccines on the market – every day anti-vax flapdoodle will try to portray these “dangerous” HPV vaccine adverse events that make it deadly or something.
So, what’s new on the Gardasil hatred? The infamous J.B. Handley, whom I’ve thoroughly criticized before and who was kicked off of the Medium website for pushing anti-vaccine gobbledygook, continues his shilling against the cancer-preventing vaccine by overstating HPV vaccine adverse events in a Facebook post.
And you know when someone throws down a pseudoscientific gauntlet about one of the most important vaccines for teens and young adults, it’s time to accept the challenge.
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. Accordingly, 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 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 subtypes) and 9-valent (against nine subtypes) 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. It targets the four HPV genotypes 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 before females or males 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.
What did Handley say about HPV vaccine adverse events?
The anti-vaccine shill Handley posted the above rant based on a “global statement” from a bunch of people who hate the HPV vaccine and claim to be “victims” of the vaccine. Some of the groups who participated are attorneys in Japan who are trying to push a lawsuit for a group of Japanese teenagers, which has not been adjudicated by any court in Japan. At this time, there is no evidence of any causality between their “injuries” and the HPV vaccine.
Well, it’s time to take down some of the more egregious statements from Handley (and by extension, this “global statement” from a bunch of attorneys). I’m not going to waste your time on every single point since I really do try to keep these articles to 2000-2500 words. It’s going to be difficult, but I really will give it an honest try.
The first words make me want to laugh out loud:
As reports of severe medical adverse events (AEs) associated with HPV vaccines continue to escalate worldwide, a group of scientists, medical professionals and victim group representatives from five nations…
Well, I’ve admitted that the victim’s attorneys are out to score a big award, but scientists? Medical professionals?
Well, let’s look at one of these “scientists” who presented at this forum. She is Mandeep Badial, who is the “science” officer for one of the organizations supporting this “global forum” (yeah, lots of scare quotes). The organization she supports has one of those names that betrays its goal – the UK Association of HPV Vaccine Injured Daughters (AHVID).
Not that I really care about credentials, unless you have some amazing ones and don’t deny the scientific consensus, but Badial literally has no scientific credentials or credibility. According to her website, she is a naturopath, an alternative medicine that utilizes just about every single bit of pseudoscientific quackery that you can imagine.
But don’t trust me about naturopaths, let’s look to the careful words of the loquacious Orac:
Basically, naturopaths are fake doctors, but they crave the acceptance of real physicians. Whether it’s because they really believe that they are physicians or because, deep down, they know they are fake doctors, I don’t know.
So the “scientist” that this global forum is not a scientist or a doctor. She has never published a single article on vaccines. She has no experience or education in evidence-based immunology, virology, epidemiology, microbiology, public health, or any other field related to vaccines. She studied naturopathy which is based on vitalism and folk remedies, not real science.
And she is their star scientist? I’d laugh, but we’re talking about a vaccine that can prevent over 31,000 cancers, and she’s is leading the “science” behind their vaccine denialism. Hang on, I need a break, I’m reading to throw my MacBook and iMac out the window.
HPV vaccine adverse events – facts
I’m not going to address every single claim made by Handley and this feed-the-lawyers forum. I’m going to turn it around and provide affirmative evidence that there is really no correlation between the HPV vaccine and serious adverse effects.
I wrote a whole article about HPV vaccine adverse events, and with millions of patients in powerful epidemiological studies, the research found none of those adverse events. Just because I’m lazy, I mostly cut and pasted some of the key points from my HPV vaccine adverse events review in response to Handley’s outlandish claims about the vaccine.
A large study of 790,000 Danish women who received the HPV vaccine found no increased risk of demyelinating diseases, such as transverse myelitis, multiple sclerosis, and other diseases compared to non-vaccinated Danish women. The authors concluded that,
In this study with nationwide coverage of 2 Scandinavian countries, qHPV vaccination was not associated with the development of multiple sclerosis or other demyelinating diseases. These findings do not support concerns about a causal relationship between qHPV vaccination and demyelinating diseases.
Another large study of over 1 million women found no safety signals for autoimmune diseases, neurological and venous thromboembolic (venous blood clots) events in HPV vaccinated women. The researchers deduced that,
This large cohort study found no evidence supporting associations between exposure to qHPV vaccine and autoimmune, neurological, and venous thromboembolic adverse events. Although associations for three autoimmune events were initially observed, on further assessment these were weak and not temporally related to vaccine exposure. Furthermore, the findings need to be interpreted considering the multiple outcomes assessed.
Handley claims that:
Studies of CRPS, CFS, and POTS which call into question the safety of HPV vaccines have been excluded on the grounds that the diagnosis is difficult and lacks specificity.
However, a recent meta-review (considered the pinnacle of the hierarchy of biomedical research) of over 100 different safety studies of the HPV vaccine, that included over 2.5 million individuals, found no increased risks of adverse events of special interest (AESI), which are events that can cause serious harm. The authors of this study concluded that,
There was no consistent evidence of an increased risk of any AESI, including demyelinating syndromes or neurological conditions such as complex regional pain or postural orthostatic tachycardia syndromes (POTS). The risk-benefit profile for HPV vaccines remains highly favourable.
In the United States, post-licensure vaccine safety monitoring and evaluation are conducted independently by federal agencies and vaccine manufacturers. From June 2006 through March 2014, approximately 67 million doses of HPV4 were distributed in the United States, and from October 2009 through March 2014, a total of 719,000 doses of HPV2 were distributed. Overall, HPV4 has accounted for approximately 99% of doses distributed since 2006. Multiple studies have provided evidence supporting HPV vaccine safety
In conclusion, our study of serious adverse event rates in qHPV (quadrivalent Gardasil)-vaccinated and qHPV-unvaccinated adult women 18-44 years of age did not raise any safety issues of concern.
There are at least 10 other large-scale clinical and epidemiological studies that reject the hypothesis of serious adverse events linked to HPV vaccines. These studies included hundreds of thousands or millions of patients. They are sufficiently powered so that they could potentially uncover even the rarest of adverse events. Yet, they found little to nothing.
But that science is all wrong because reasons
Despite the claims of J.B. Handley about HPV vaccine adverse events, there really is no evidence that that supports any of his, the woo-pushing naturopath’s, and the global greedy lawyer forum claims about HPV vaccine adverse effects. They rely upon anecdotes, research from multiple-retracted “scientists,” and other pseudoscience for their claims.
We rely on science, robust, non-cherry-picked science.
But Handley dismisses these dozens of powerful epidemiological studies because he simply doesn’t like them.
However, their epidemiological argument is fundamentally flawed;
Their epidemiological approach is not appropriately designed to detect the signals of HPV vaccine damage, characterized by diverse and multi-layered symptoms over a long period of time. They ignore the unusual mechanism of action of this vaccine, which keeps very high antibody titer up to as long as a decade.
Handley writes a lot of nonsensical words trying to dismiss these studies, but it’s like debating someone who can barely spell “epidemiological.” In fact, well designed and large studies can detect even low-level signals. Handley just wants to believe that parent’s anecdotes and random events that happen irrespective of vaccination status are real.
The whole point of well-designed epidemiological studies is to show what happens to a group that hasn’t been vaccinated versus the ones that do. Many of these claimed adverse events happen to teenagers and young adults all the time, and that’s what these studies have found.
A non-scientist cannot just dismiss scientific research because he disagrees with it. If Handley thinks he’s so damn smart, then take all of that anti-vaccine shill money he receives, provide a large grant to a team of respected epidemiologists, let them design and run the study, and let’s see the evidence. Unless they’re totally incompetent, I’m assuming they will find what we’ve already seen.
And there seems to be another problem that Handley completely ignores – biological plausibility. Is there a reasonable scientific pathway that leads from HPV vaccine to his claim of “vaccine damage?” He says that the vaccines “keeps very high antibody titer” as his reason. If someone is infected by the human papillomavirus they will have high antibody titers (and a significant risk of one of several cancers). Moreover, this isn’t an unusual mechanism, it’s how the immune system works.
It’s not even plausible, it’s ridiculous.
We have powerful evidence that HPV vaccine adverse events are generally limited to minor ones – patients fainting soon after vaccination. And no, it has nothing to do with the vaccine, it’s a typical reaction to any needle by lots of people. I was a licensed phlebotomist to make extra cash for beer and wings while I was in grad school, and regularly, a patient would faint just before I inserted the blood draw needle. It just happens.
We have tons of evidence that HPV types that are covered by the new Gardasil9 vaccine are linked to the vast majority of the 31,000 new cancer cases every year in the USA (and other countries across the world). Preventing all of these cancers is something Handley and other anti-vaxxers ignore, while focusing on almost nonexistent adverse events.
Gardasil prevents cancer. And it saves lives.
- 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.
- 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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