One of the enduring myths (there are so many) about the HPV vaccine is that it is linked to one or more autoimmune syndromes, an abnormal immune response to a healthy body part. These claims, pushed by an Israeli physician, Yehuda Shoenfeld, are called “autoimmune syndrome induced by adjuvants (ASIA)” and, sometimes, Shoenfeld’s Syndrome.
But we call it a myth, a lie, pseudoscience, and quackery. Despite the rejection of Shoenfeld’s bogosity by scientists worldwide, he was recently elected to the Israeli Academy of Sciences and Humanities. What were they thinking?
Furthermore, the European Medicines Agency, which is the primary regulatory body in the EU for pharmaceuticals, has rejected any link between the HPV vaccine and various autoimmune disorders. The science stands in direct opposition to autoimmune syndromes being caused by any vaccine.
Despite the lack of evidence supporting the existence of autoimmune syndromes induced by adjuvants, and even more powerful evidence that it doesn’t exist, the anti-vaccine religion still cherry-picks articles to support their preconceived conclusions that the HPV cancer-preventing vaccine is dangerous.
So, let’s take a look at Yehuda Shoenfeld and his ridiculous ASIA claims. Then we’ll criticize the Israeli Academy of Sciences and Humanities for seemingly endorsing his junk science.
Recently, Robert F Kennedy Jr has been making numerous false claims about the Gardasil vaccine, which is the cancer-preventing human papillomavirus vaccine. Of course, he has recently become a loudmouth anti-vaccine acolyte, who has been chastised by his own family for helping “to spread dangerous misinformation over social media and is complicit in sowing distrust of the science behind vaccines.”
Now, he has decided to go on the attack against the HPV vaccine, providing the world with “25 reasons to avoid the Gardasil vaccine.” For some unknown reason, he’d rather pass along “dangerous misinformation” about vaccines than actually focus on the health and lives of children. I don’t understand his motivation, but it sickens me.
Ten years after the introduction of the human papillomavirus (HPV) vaccine in the USA in 2006, HPV prevalence has dropped significantly in a new study from the Centers for Disease Control and Prevention (CDC). This is very encouraging research that further strengthens the evidence behind the effectiveness of the HPV vaccine.
One of the tropes pushed by the anti-vaccine religion is that we don’t know if the vaccine actually will prevent an HPV infection after 10 years. Well, now we know.
Other than stating that I objectively support Dr. Summers’ statements and conclusions, I don’t have much else to say. But you and I know that an op-ed piece by a real doctor will be noticed by someone in the vaccine denier world, and they will pull out every single trope, myth, and conspiracy theory to claim that Dr. Summers is wrong and that there really is a “vaccines cause autism debate.”
I came across an article by Jeremy R Hammond in the right wing alternative news website, Personal Liberty, which attacked Dr. Summers with those aforementioned tropes, myths, and conspiracy theories. The same ones you’d see from any of your standard, run-of-the-mill vaccine denier.
Let’s take a look at Hammond’s article. Generally, I can only get through about half of an anti-vaccine article when I have to stop because I’m banging my head against the desk too much. I need to protect the neurons in my brain from further damage. But I will try to persevere in the name of science.
If you have been paying attention to the pages about the Japanese HPV vaccine, you would know about some controversies there. The whole experience there is the basis of numerous vaccine denier memes and tropes that have always been inaccurate. Now we have some scientific data that makes some of those lies quite funny.
As the title suggests, the book concluded that the HPV vaccine (from the first vaccine, licensed in the U.S. in 2006) was a betrayal, because it was unjustified, harmful, and with no health benefits. As the authors’ first chapter lays out, their opinion is in tension with statements from health authorities and cancer authorities worldwide – and goes against a large amount of data.
It is no exaggeration to say that the book is ill-founded, misleading, and anti-vaccine to the core. HPV vaccines have been especially signaled out by anti-vaccine activists since their creation. This book draws on anti-vaccine claims made over the years, including most of the older anti-vaccine tropes (claims, by the way, that are not always consistent with each other – for example, is the problem aluminum in vaccines, or a novel and different adjuvant?) and offering new (and ill-founded – see the discussion of chapter 8 below) ones.
To explain the problems with it, three of us divided the subjects in the book, and are reviewing it as a team. A review by Dan Kegel, who has an undergraduate degree in biology from Caltech and maintains a comprehensive site with the data on HPV and HPV vaccines, is found here. A review of the chapters on autoimmunity, aluminum, and a few more by John Kelly, a career biochemist, and molecular biologist and a survivor of HPV+ cancer, will be added later.
On one hand, I am in a committed monogamous relationship. I am a married mother of two young children, I have no plans of changing partners, and I’ve already probably been exposed to anything my husband had. I have never had an abnormal pap smear. That means that I am likely pretty low risk for getting a new HPV infection and that I have cleared any I ever had (almost all sexually active people in the United States have had HPV). If you are in a relationship, including marriage, and if you had children, you likely had sex at some point.
So the benefits of the adult HPV vaccine for me are low – but not non-existent. You never know what will happen, and while I hope to stay with my partner forever, bad things can happen – like death or sexual assault. One hopes for the best, but it’s reasonable to also plan for the worst (for example, while we do not plan to die, we have a will written out with provisions for caring for our kids if we do) – and the vaccine is age-limited. There are nine cancer-causing HPV strains in the vaccine, and I am fairly certain that I have not been exposed to all of them.
The risks of the adult HPV vaccine are extremely minor. I’m likely to get a sore arm, may get other mild reaction like fever, and have a theoretical reaction of an allergic reaction (or fainting, though not being a teen, I think that’s unlikely). Studies pretty much rule out other risks.
So the adult HPV vaccine has low benefits but minuscule risks, at least for me. Still, it seemed to me to make sense to go for it, if possible. Especially because I speak up about HPV vaccines and encourage others to go for them, I thought it’s fair to get them myself, too. Show I mean it when I say that they are safe.
To be sure, I emailed Dr. Paul Offit, who I trust completely on vaccines. He recommended going for it.
I did not know, however, if my provider will give me the vaccine or if my healthcare insurance will cover it at my age (most health insurance in the USA does cover all vaccines, including the HPV vaccine, for children). In spite of what anti-vaccine people believe, I do not have secret ties to pharma or special access to vaccines.
So I emailed my doctor:
Dear Dr. X,
Since the FDA approved HPV vaccines for people up to 45, I would like to get the vaccine, if possible.
I emailed Dr. Paul Offit, a vaccine expert,for his opinion, and he recommended getting it.
Can you help me do that?
My doctor said: “Sure, let me see what our protocol is here and get back to you.”
After I did not hear back for over a week, I emailed again. My doctor answered:
Sorry that I could not repond in a timely manner. I had forwarded your request to Dr. Y [details omitted to preserve my providers’ – and my own – privacy] but did not hear from them. I have ordered the shots. You can call your … health plan to see if it will be covered just to be sure.
You can go to ### injection clinic Mon-Fri 9am-12pm, 1:30-4:30 pm for the shot (ordered already).
Okay. All that was left was to actually get the vaccine. I wanted a picture – so I asked my eight-year-old son if he will act as photographer and come with me. He agreed. We went together, waited, and went in. I told him to take a lot of pictures all through, and he did.
The nurse asked if I was feeling okay, if I ever had a reaction to a vaccine, if I was allergic to latex or anything else I knew of (yes, no, no). She explained what the shot was, and gave me the Vaccine Information Statement. We also wrote out the schedule for the next two doses. Then she cleaned the area, told me to take a deep breath and let it out, and done. I barely felt the needle.
She told me my arm will hurt for a day or two. It didn’t, actually. Not complaining. I’m okay with less pain. But I would have been okay (not happy, but okay) with a sore arm for a few days, too.
My son did a great job taking a lot of pictures. I posted several of those pictures on Facebook and Twitter, because, again, I think it’s important to make it clear I stand behind what I say on HPV vaccines specifically, and vaccines generally.
So that’s my adult HPV vaccine story. One dose down, two to go. Maybe my arm will hurt next time.
I always thought that the age cutoff, 26 years, was rather arbitrary and that the vaccine would be safe and effective for a 27-year-old as much as it is for a 26-year-old. The FDA can be very conservative with indications for all medications, including vaccines, so they probably awaited more data before moving the approved age for the vaccine up to 45 years. But it’s better late than never that the FDA approved Gardasil for “older” individuals.
The importance of the vaccine is because genital, anal, 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.
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.
Merck manufactures Gardasil, along with Gardasil 9, approved by the FDA in 2014, which 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.
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.
In the press release, Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research, said:
Today’s approval represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range.
The Centers for Disease Control and Prevention [CDC] has stated that HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90% of these cancers from ever developing.
Also, the FDA stated:
Effectiveness of Gardasil 9 in men 27 through 45 years of age is inferred from the data described above in women 27 through 45 years of age, as well as efficacy data from Gardasil in younger men (16 through 26 years of age) and immunogenicity data from a clinical trial in which 150 men, 27 through 45 years of age, received a 3-dose regimen of Gardasil over 6 months.
I know that some may claim that anyone who is 45 years old may have already contracted an infection from one or two HPV types. However, since the current Gardasil9 protects against 9 different HPV types, it’s very possible that the vaccine can provide protection against other HPV types.
Why shouldn’t anyone up to the age of 45 get this vaccine? Of course, I think that 45 is still arbitrary, and if you can convince your healthcare plan (most will agree) or can afford the vaccine, I don’t think it matters if you’re 50, 55 or 60, especially if you’re sexually active, to get the HPV vaccine.
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