HPV quadrivalent cancer preventing vaccine, known as Gardasil (or Silgard in Europe), can reduce the risk of several types of cancer by blocking sexually transmitted (along with a few other pathways) infection by human papillomavirus (HPV). 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. About one-quarter of those sub-types are implicated in a number of genital, anal and oral cancers.
In a broad review of all of the published clinical research involving HPV vaccines, there is a clear scientific and medical consensus that HPV vaccines are extraordinarily safe, they quickly reduce HPV infection rates in populations of adolescents and young adults, and by reducing HPV infection rate, we will eventually have a real and statistically significant reduction in the risks of many types of cancer.
Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the USA. There are more than 40 HPV sub-types that can infect the genital areas of males and females. These same HPV types can also infect the mouth and throat. They are transmitted from personal contact during vaginal, anal or oral sex.
Some HPV subtypes, such as HPV-6 and HPV-11, can cause warts around the genitals or anus, but have low (but not 0) risk of causing cancers. However, the higher risk subtypes, such as HPV 16 and 18, not only cause approximately 70% of cervical cancers, but they cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. HPV is estimated to be the cause of nearly 5% of all new cancers across the world.
Anecdotally, it has always seemed like the HPV quadrivalent vaccine, known as Gardasil or Silgard, was the most despised vaccine on the market. Although I write about almost every vaccine, I seem to write more about Gardasil, countering all kinds of silly claims. Despite several large case-controlled epidemiological studies, some of which I’ve discussedpreviously, there is some pervasive fear that the HPV vaccine is dangerous. You don’t know how many times I’ve read “I vaccinate my kids, but never that Gardasil stuff.”
Just for review, forget that Gardasil saves lives by preventing cancer. The HPV quadrivalent vaccine specifically targets human papillomavirus (HPV) subtypes 16 and 18, that cause not only approximately 70% of cervical cancers, but they also cause most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. It also targets HPV6 and HPV11, which account for approximately 90% of external genital warts. The viruses are generally passed through genital contact, almost always as a result of vaginal, oral and anal sex.
There is substantial clinical evidence that once a population is vaccinated against HPV, the rates of infection drop, which should lead to lower risk of various cancers. There is no other way to say this but Gardasil is very safe and very effective at preventing cancers.
Vaccine deniers, especially in the USA, use the 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 data is considered to be “passive” because the individual reports can be made online, by fax or by mail–real causal events may be underreported and hyped, imaginary issues with no causality, can be over-reported. However, without medical investigations of causality between the vaccination and the claimed adverse events that are reported to the VAERS database, the data have no real value.
Furthermore, there is a background rate for mortality (death) or morbidity (abnormal medical condition), 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 data that shows anything might cause any adverse medical event, like playing video games leads to prostate cancer, but we would have no evidence of any type of causality whatsoever. Continue reading “Reports of vaccine related effects can be useful”
Rotavirus is a virus that causes gastroenteritis, an inflammation of the stomach and intestines. Rotavirus causes severe watery diarrhea, often with vomiting, fever, and abdominal pain. In babies and young children, it can lead to dehydration (loss of body fluids). Globally, it causes more than a half a million deaths each year in children younger than 5 years of age.
But one of the more important scientific failures of the antivaccine gang is an unsophisticated lack of understanding of basic mathematics, specifically the measurement of risk. Using 2010 USA numbers only, let’s look at the top mortality risks for children aged 1-14:
Unintentional injury (motor vehicle accidents, bathroom falls, etc.): 53.75 (out of every 100,000 Americans between the ages of 1-14)
Malignant neoplasms: 22.33
Congenital anomalies (commonly called birth defects): 14.25
Firearms (number broken out from the numbers for all homicides): 3.68
Heart disease: 6.09
Chronic respiratory disease: 3.26
Influenza and influenza-related pneumonia: 2.87
Benign neoplasms: 2.50
Meningococcal infection: 0.25
The average risk for “serious” complications from vaccines range from 0.1 to 1 in 100,000, with the risk of death from vaccines found to be so small, it can be barely measured as a risk. By the way, those of you who think that VAERS (Vaccine Adverse Event Reporting System) should be used to estimate risk, the best I could say is that VAERS is pretty much useless, since it cannot establish causality, it is gamed by those with an antivaccine agenda, and the rate of adverse events is frequently below the background rate for these events in a typical populations of Americans. VAERS is an incredibly useful tool to spot potential new adverse events that might arise from vaccination, but the numbers themselves cannot be used to determine risk.
The risk of a serious reaction, like an allergic one, from getting the flu vaccine is less than 0.1 in 100,000, far far less than the actual death rate from influenza at around 2.87 per 100,000. Moreover, meningitis (and meningococcal infection) have risks of death far higher than the risks of vaccines.
The saddest thing about these numbers is that I’m spending so much time defending vaccines, which are as safe as drinking a glass of filtered water and clearly save lives from preventable diseases. The antivaccine activists, who claim to be worried about children, don’t focus on the things that actually kill children. Motor vehicle accidents, some portion of which are probably a result of drunk drivers. Or firearm homicides? Where is the outrage, that young children are dying from gunshots? Or that the risk of a child dying of suicide is thousands of times higher than the infinitely tiny risk of death from vaccines (if it even exists)?
Why is it that these vaccine deniers show incredible outrage over an indefensible belief that vaccines are dangerous, yet not try to stop homicides, especially with guns? Or safer cars? Or something that actually will help kids live longer.?
Actual guns kill more actual kids than the antivaccine myth that vaccines harm actual children. You see, vaccine deniers don’t actually care about children, or they would be yelling and screaming about guns. And drunk drivers. And the lack of mental health care for teenagers.
One of the hallmarks of pseudoscience is an over-reliance on confirmation rather than refutation of a hypothesis. The antivaccine crowd are well-known for this particular violation of the scientific method. As discussed previously, science works on refutation–creating experiments that might actually disprove a hypothesis as a method to develop evidence in support of it. The anti-vaccination crowd actually hypothesizes (but not in a scientific sense) that a vaccine or set of vaccines was the causal factor in some side effect (autism, death, or whatever else), then they should establish an experiment (double-blinded of course) that would refute that hypothesis. If at some point, the data cannot refute it, then the anti-vaccinationists would have supporting data for their particular supposition.
But instead of actually performing experiments (which cost money, which may show that they are wrong, or which might not be ethical), they resort to mining data to prove their point. Data mining is dangerous, because confirmation bias, that is, finding information or data that supports a belief while ignoring all other data that does not, makes the data suspect or even useless.
So, in that vein, the anti-vaccinationists often mine data from any database they can find, such as the Vaccine Adverse Event Reporting System (VAERS), which is a program for vaccine safety, managed by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS functions as a post-marketing safety surveillance program (similar to other programs for almost every regulated medical device and pharmaceutical) which collects information about adverse events (whether related or unrelated to the vaccine) that occur after administration of vaccines.
VAERS has numerous limitations, including lack of scientifically designed questions, unverified reports, underreporting, inconsistent data quality, and absence of an unvaccinated control group. VAERS is basically a collector of information, but has limited value in making conclusions since it does not provide information that is obtained in a controlled manner. However, it does have some usefulness, in that certain trends may be spotted given enough time and data points. Continue reading “Anti-vaccine lunacy–more lies about Gardasil”
The CDC recently reported that only about half of US teenager girls have received the safe and effective quadrivalent HPV vaccine (HPV4), a disappointing level of vaccine uptake. Moreover, this rate hasn’t changed over the past three years, despite significant efforts to increase the awareness and effectiveness of the vaccine amongst teenagers. Even worse news in this report is that only about one-third of teenage girls have been fully immunized with all three doses.
HPV types 16 and 18 cause approximately 70% of cervical cancers, and caused most HPV-induced anal (95% linked to HPV), vulvar (50% linked), vaginal (65% linked), oropharyngeal (60% linked) and penile (35% linked) cancers. These cancers, mostly related to HPV, can be prevented as long as you can prevent the HPV infection from ever happening, which usually happens through genital contact, most often during vaginal and anal sex.
HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms. Approximately 79 million Americans, most in their late teens and early 20′s, are infected with HPV, and about 14 million people become infected each year in the USA. Continue reading “HPV vaccinations lagging despite strong safety and effectiveness”