One of the numerous tropes about the HPV vaccine was that it causes primary ovarian insufficiency, also known as premature ovarian failure, which happens when a woman’s ovaries stop working normally before she is 40.
Of course, there has been little affirmative evidence of primary ovarian insufficiency being related to the HPV vaccine, aside from anecdotes, but that never stops anti-vaxxers from pushing that false narrative.
Now, we have another large epidemiological study that shows, once again, that there is no link between the HPV vaccine and primary ovarian insufficiency. And, of course, the ancient feathered dinosaur is here to review that article so that you can debunk these claims whenever they show up.
All about HPV and HPV vaccines
I know I cut and paste this section to every article I write about HPV vaccines, but it’s the first step to HPV vaccine myth debunking. Some readers may be coming here for the first time, and they ought to know just how the HPV vaccine prevents cancer.
However, I try to update this section when necessary with new information about either the disease or the vaccine. If you’ve read this section 47 times, just skip down to the next section where I discuss the key point of this article.
Genital and oral human papillomavirus (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. Of those 40 strains, most are fairly rare.
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:
In addition, there is some evidence that HPV infections are causally linked to skin and prostate cancers. The link to skin cancer is still preliminary, but there is much stronger evidence that HPV is linked to many prostate cancers.
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 43,000 HPV-related cancers are diagnosed in the USA every year. It may be several times that amount worldwide.
There were two HPV vaccines on the world market before 2014. GSK, also known as GlaxoSmithKline, produced 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 dangerous and, to abuse the definition slightly, common cancers that afflict men and women. Without a doubt, the HPV vaccine prevents cancer.
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.
Let me sum this all up so that if you come away from this section with nothing else, you get this summary. HPV is a sexually transmitted disease. HPV causes 43,000 cancers a year in the USA alone. The HPV vaccine prevents becoming infected by HPV, which means you are protected from these cancers.
HPV vaccine and primary ovarian insufficiency paper
The paper, by Anders Hviid and Emilia Myrup Thiesson, was published in JAMA Network Open in August 2021. The authors asked the question, “is human papillomavirus vaccination associated with primary ovarian insufficiency among Danish girls and women?”
This cohort study used nationwide data for 996 300 Danish-born girls and women aged 11 to 34 years. The study population included 505,829 individuals vaccinated against HPV (50.8%) and 490,471 unvaccinated individuals (49.2%). By any parameter, this is a large cohort study.
The results were:
- 144 individuals were diagnosed with primary ovarian insufficiency, including 54 individuals diagnosed after receiving the HPV vaccine.
- The median age of primary ovarian insufficiency diagnosis was 26.94 years.
- The adjusted hazard ratio (HR) of primary ovarian insufficiency comparing HPV vaccine group to no vaccination group was 0.96. An HR = 1.0 would indicate that there is no difference in risk between the two groups; thus, the observed HR = 0.96 means that there was no difference in risk of POI between the two groups.
The authors concluded:
This study found no association between HPV vaccination and primary ovarian insufficiency.
To be fair, this study has a few limitations:
- It included just Danish-born women and girls, so there may be some socioeconomic confounder that may change the results. On the other hand, it may also reduce confounding data.
- The number of individuals diagnosed with primary ovarian insufficiency, either with or without the HPV vaccine, is very small. The presence of a clinically relevant increase in rate of diagnosis cannot be excluded after vaccination cannot be absolutely excluded.
- Although cohort studies such as this one is very high on the hierarchy of biomedical research, it is still an observational study. A clinical trial would be required to definitively exclude primary ovarian insufficiency being linked to the HPV vaccine, but such a study would need to include 1 million participants and would cost tens of billions of dollars.
Nevertheless, this study meets the standards of a high-quality observational study that can provide powerful results. It was large, designed properly, and run by one of the leading researchers into the HPV vaccine.
This, along with dozens of other HPV vaccine studies, has shown that there is probably no link between it and primary ovarian insufficiency.
Get the HPV vaccine. It might save you from dying of cancer.
- Hviid A, Myrup Thiesson E. Association Between Human Papillomavirus Vaccination and Primary Ovarian Insufficiency in a Nationwide Cohort. JAMA Netw Open. 2021 Aug 2;4(8):e2120391. doi: 10.1001/jamanetworkopen.2021.20391. PMID: 34436612.
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