HPV vaccine and multiple sclerosis – no increased risk

I’ve written over about 50 articles about the safety and effectiveness of the HPV quadrivalent vaccine, known as Gardasil (or Silgard in Europe) which reduces the risk of catching human papillomavirus (HPV), one of the most common sexually transmitted infections (STI) in the USA.

There are more than 40 HPV sub-types that can infect the genital areas of males and females. Additionally, some HPV types can also infect the mouth and throat. HPV is generally transmitted from personal contact during vaginal, anal or oral sex. I have written more detail about HPV infections if you are interested.

HPV is linked to cancers in men and women, and because there are so many subtypes, research has established which HPV types are linked to certain cancers. In effect, the HPV vaccine is considered one of the handful effective means of preventing cancer. You can drink all the kale/blueberry/protein shakes you want, and it’s probably going to have little or no effect on cancer risks, yet a simple and effective vaccine like Gardasil prevents serious and dangerous cancers. 

HPV-vaccine-infographic-GAVI

HPV and Gardasil

Worldwide, about 2 million new cancer cases are caused by infectious diseases every year. More than 600,000 of these are caused by human papillomaviruses. The HPV vaccine should be near the top of the list for vaccinations for young teen girls and boys. We could just end this cancer in a generation with higher uptake of the HPV vaccine.

But there’s the rub. The uptake of HPV vaccine has stalled over the past few years, to only about 60% of teenage girls receiving all three doses of the HPV vaccine, probably the lowest level of vaccination for any of the major vaccines. And we have outstanding evidence that when the HPV vaccine was released, the HPV infection rate drops. So it works.

And it is safe. In huge study after huge study after another huge study, all of the evidence unequivocally shows that the HPV vaccine is incredibly safe, probably one of the safest vaccines out there. So the HPV vaccine prevents HPV which reduces the risk of cancer and is incredibly safe. Then why aren’t 99.9% of teenagers vaccinated?

Well, parents’ concerns about HPV seem to exceed their concerns about all other vaccines. Part of the reason is that Gardasil (and its counterparts in other countries, Cervarix and Silgard) are given to older children to protect against a virus that is mostly (but not always) transmitted through sexual contact. So part of the hesitance to the vaccine is a myth about teenagers becoming more promiscuous if they have the vaccine. This is simply untrue.

There is also the dumpster diving use passive data from the Vaccine Adverse Event Reporting System (VAERS), a system where individuals can report supposed adverse events post-vaccination, to “prove” certain adverse events. The reports can be made online, by fax or by mail. However, there are no investigations to show any type of causality between the vaccination event and the claimed mortality that are reported to the VAERS database, and, frankly, it can be gamed by those with nefarious intentions.

 
 

Observations about Gardasil

VAERS is a feel-good system for those who think that there’s a link between vaccines and something terrible, but without an active investigation, the data is just above the level of totally meaningless. Most epidemiologists know it is valueless.

Even the VAERS system itself says that the data cannot be used to ascertain the difference between coincidence and true causality. There is a background rate for mortality, across all causes, irrespective of whether an individual is vaccinated or not, and unless you understand the background rate, the vaccine “mortality” rate has no scientific meaning. In fact, we could provide a Starbucks coffee drinking in the car “mortality rate”, which may or may not have any causality whatsoever.

Tara Haelle discussed one of the numerous little myths about Gardasil:

handful of case studies have reported on multiple sclerosis or another demyelinating disease starting after HPV vaccination, such as one describing five patients whose symptoms began within three weeks of vaccination. These are the sorts of case studies that anti-vaccine advocates cherry-pick in promoting fear and misinformation about vaccines.

Such studies are actually very important to investigating vaccine safety because they alert the medical community to a condition that occurred around the same time as a vaccination and *might* be related – but it’s important to remember that they can’t actually show that there was a link at all. These reports aren’t canaries in the coal mine. Rather, they’re calling attention to something worth studying further.

I don’t like case studies, putting them near the bottom (right above garbage from Natural News or other such nonsense websites) of real scientific data. They are observations only, and they are essentially meaningless in evidence-based medicine. But, as Ms Haelle states, they can call attention to further study.

Huge study looking at Gardasil adverse effects

In a recent issue of JAMA, researchers assessed the correlation between the HPV vaccine and multiple sclerosis (MS) – the looked at the risk of  MS and other similar central nervous system diseases after receiving Gardasil, the quadrivalent HPV vaccine. The study utilized a large patient population, and the results pretty clear:

  • The study examined 3.9 million women and girls, including 790,000 who had received the Gardasil vaccine. The total amount of Gardasil doses was over 2 million.
  • The study looked at the medical records of all females aged 10 years to 44 years in Denmark and Sweden, followed up from 2006 to 2013.
  • After excluding those who had already been diagnosed with multiple sclerosis or another demyelinating neurological conditions, the researchers tracked all first-time diagnoses of optic neuritisneuromyelitis opticatransverse myelitis, and acute disseminated encephalomyelitis, which are other, non-multiple sclerosis demyelinating diseases
  • Because the first symptoms of some of these diseases may take up to 24 months to manifest, the researchers examined the medical records for a full two years after the last HPV vaccine dose (in the vaccinated group), comparing it to the rates in unvaccinated subjects.
  • The researchers found no increased risk of multiple sclerosis or any other demyelinating disease in the HPV vaccinated group.
  • Ironically, the researchers actually found that the vaccinated group had a risk of 6 multiple sclerosis cases per 100,000 per year, while the unvaccinated group had a risk of 21.5 MS cases per 100,000 per year. No, it is not likely that the HPV vaccine prevents or lowers the risk of MS (or other demyelinating diseases), we can only conclude that the the vaccine does not increase the risk.

Let’s be incredibly clear–in a huge study of a relatively homogenous population (which reduces many confounding factors), there was no difference in risk of multiple sclerosis and other demyelinating diseases between HPV vaccinated and unvaccinated groups. This should put this myth about this particular risk out to pasture. This adds to the strong quality evidence that Gardasil is a very safe vaccine.

Conclusions

Let me keep beating the drums here. HPV vaccine prevents HPV infections in large populations, even at the low vaccine uptake we’re observing. HPV vaccine prevents a large number of serious and dangerous cancers, one of the very few tools we have to prevent real cancers. And the vaccine is safe.

There are no justifications for not preventing cancer by getting this vaccine. Get Gardasil for your kids. Get it for yourself if you’re a young adult. It’ll save your life.

Editor’s note: This article was originally published in January 2015. It has been completely revised and updated to include more comprehensive information, to improve readability and to add current research.

Key citations:

The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!