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Gardasil (HPV vaccine) coverage and safety in the United States

Gardasil-vaccine-virusGenital 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.

According to the CDC, roughly 79 million Americans are infected with HPV–approximately 14 million Americans contract HPV every year. Most individuals don’t even know they have the infection until the onset of cancer.Read More »Gardasil (HPV vaccine) coverage and safety in the United States

HPV vaccine is unrelated to venous blood clots in another huge study

gardasil-retro-advertAnecdotally, 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 discussed previously, 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.

But science is irrelevant, if you can spread fear. The antivaccination cult at GreenMedInfo, home of the vaccine denying lunatic Sayer Ji, cherry-picked a whole laundry list of “peer-reviewed”, many of marginal if not laughable quality, trying to “prove” that Gardasil is dangerous. One article, of slightly better quality, use a bit of dumpster diving into the fairly useless VAERS database that showed an overabundance of reporting of venous thromboembolic events, though, because of the quality of data, they authors were unable to establish any firm correlation between the HPV quadrivalent vaccine and those events.Read More »HPV vaccine is unrelated to venous blood clots in another huge study

Reports of vaccine related effects can be useful

 

©KenRockwell.com, 2007. Photographer's son actually receiving RotaTeq vaccine and giving a smile to Paul Offit for keeping him from ever getting a rotavirus infection.

©KenRockwell.com, 2007. Photographer’s son actually receiving RotaTeq vaccine and giving a smile to Paul Offit for keeping him from ever getting a rotavirus infection.

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.

Frankly, VAERS can be gamed by those with nefarious intentions. In reality, 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 being 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.

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.Read More »Reports of vaccine related effects can be useful

Why we vaccinate–protect kids from rotavirus induced seizures

 

H. Fred Clark and Paul Offit, the inventors of RotaTeq, a pentavalent rotavirus vaccine.

H. Fred Clark and Paul Offit, the inventors of RotaTeq, a pentavalent rotavirus vaccine.

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. 

Prior to the launch of the rotavirus vaccine (RotaTeq® or Rotarix®) in the United States in 2006, rotavirus was the leading cause of severe diarrhea in infants and young children. Before the vaccine became available, almost all children in the United States were infected with rotavirus before their 5th birthday. Each year, in the US, rotavirus lead to more than 400,000 doctor visits; more than 200,000 emergency room visits; 55,000 to 70,000 hospitalizations; and 20 to 60 deaths in children younger than 5 years of age. After the introduction and widespread use of the vaccine, a Cochrane systematic review concluded that the rotavirus vaccines may prevent up to 96% of severe diarrhea cases arising from rotavirus.Read More »Why we vaccinate–protect kids from rotavirus induced seizures

Save children from risks–vaccinate and keep them away from guns

Vaccine deniers are basically clueless about science. They invent stuff about the immune system, while missing how a vaccine induces a long-lasting immune response. They conflate correlation with causality, an important distinction if you’re going to understand epidemiology. They deny… Read More »Save children from risks–vaccinate and keep them away from guns

Anti-vaccine lunacy–more lies about Gardasil

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.Read More »Anti-vaccine lunacy–more lies about Gardasil

HPV vaccinations lagging despite strong safety and effectiveness

hpvThe 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 quadrivalent vaccine, also known as Gardasil (or Silgard in Europe), is marketed by Merck & Co., usually for vaccination of teenage girls (with an increasing number of boys). The vaccine prevents the transmission of certain types (pdf) of human papillomavirus (HPV), specifically types 6, 11, 16 and 18. 

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.Read More »HPV vaccinations lagging despite strong safety and effectiveness