Controversial HPV vaccine even protects unvaccinated women, study suggests
AP
(CBS News) A new study shows that the human papillomavirus (HPV) vaccine is so effective at reducing the number of infections young women are getting, it's even protecting people who haven't gotten vaccinated.
The protective effect is called "herd immunity," a concept that suggests when a critical portion of a community is immunized against a contagious disease, the rest of the community becomes protected because there's less chance for an outbreak.
For the new research, doctors at Cincinnati Children's Hospital Medical Center looked at 368 unvaccinated young women ages 13 to 16 from two local primary care clinics who had sexual contact and were recruited from 2006 to 2007. The researchers compared those rates to a different group of 409 young women recruited between 2009 and 2010, more than half of whom got at least one dose of the HPV vaccine. Girls in the study who were vaccinated were given the Gardasil vaccine, which protects against four strains of HPV.
The researchers found a 58 percent decrease in the prevalence of vaccine-targeting HPV strains, from 31 percent of young women to 13.4 percent. That amounted to a 69 percent decrease among vaccinated patients and a 49 percent decrease for unvaccinated young women. The findings were published July 9 in Pediatrics.
"Infection with the types of HPV targeted by the vaccine decreased in vaccinated young women by 69 percent," study author Dr. Jessica Kahn, a physician in the division of Adolescent Medicine at Cincinnati Children's Hospital, said in a press release. "Two of these HPV types, HPV-16 and HPV-18, cause about 70 percent of cervical cancer. Thus, the results are promising in that they suggest that vaccine introduction could substantially reduce rates of cervical cancer in this community in the future."
Kahn said the decrease among vaccinated young women was "especially remarkable" because many were sexually experienced and exposed to HPV before vaccination, and many only underwent one dose of the vaccine when three are recommended for the most protection.
Critics of the HPV vaccine have argued against states that require preteen girls to get the shot, including arguments from some claiming that vaccinating young girls may promote promiscuity. Other critics call such a requirement a violation of civil liberties, such as when Rep. Michele Bachmann targeted Governor Rick Perry's controversial 2007 executive order in Texas during a presidential debate last year. The Texas Legislature eventually passed a bill to block the order.
Another common complaint against the vaccine points to oft-debunked links that tie vaccines to causing development disabilities such as autism.
Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University told MyHealthNewsDaily that the study is "good news that comes surprisingly soon."
"It's impressive if other studies can confirm it," Schaffner said, adding research would also neeed to be done on a larger population - including boys - to show herd immunity. "Vaccination is not just about the individuals getting vaccinated...it's about everyone else in the community."
Disease protection for people who can't get vaccinated is one reason why doctors heavily urge parents to get their child immunized despite parents' vaccine fears over autism links.
Kahn however noted that while rates of HPV strains the vaccine targets decreased, the overall prevalence of HPV was "extremely high," she said, with about one in four unvaccinated study participants already positive for one high-risk type of the disease.
Besides Gardasil, which also protects against two strains of HPV that cause most genital warts, Cervarix is also approved to protect against the two HPV strains tied to cancer risk. Out of the two vaccines, only Gardasil is approved for boys (up until age 21) as well.
HPV is the main cause of cervical cancer in women. Each year there are about 12,200 new cervical cancer cases in the United States and more than 4,200 deaths in women each year. There are about 15000 HPV-associated cancers in the U.S. that may be prevented by vaccines each year in women, including cervical, anal, vaginal, mouth cancers.
About 1 in 100 sexually active adults in the U.S. have genital warts at any given time.
The CDC has more on HPV vaccines.
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http://www.sciencedirect.com/science/article/pii/S0264410X10013307
"The estimated weekly reporting rate of post-GardasilGBS within the first 6 weeks (6.6 per 10,000,000) was higher than that of the general population, and higher than post-Menactra and post-influenza vaccinations. Further prospective active surveillance for accurate ascertainment and identification of high-risk groups of GBS after Gardasil vaccination is warranted."
Anyway, as Dr. Shaffner said:
"It's impressive if other studies can confirm it."
There is nothing impressive about one study, is there? And reducing even higher risk infections of HPV proves nothing as far as reducing cervical cancer rates. The portion of the population of both vaccinated and unvaccinated girls who are still contracting the infection may contain those at risk of developing cancer. Only a tiny fraction of women who contract even high risk HPV in the U.S. go onto develop cancer.
Why can't some women clear those viruses and why do some actually get cancer? We still don't know, but smoking and drinking are risk factors for both throat and cervical cancer, along with some HPV strains.
One study even shows that exposure to carcinogens in woodsmoke is linked to the development of cervical HSIL.
http://www.ncbi.nlm.nih.gov/pubmed/16795085
Only one study, once again, but that is supported by others linking tobacco smoke to cervical cancer.
I'm not so sure that a rate of 69 cases of GBS is something I would suddenly change my practice views over, considering the millions who have received the vaccine. Out of 10 mil. patients, that would be 0.0000069% (the rate of car accidents and fatalities in the US exceed this every year). Does this suggest we should STOP giving the HPV vaccine? Stop driving cars?! NO!!
Fact is, Gardisil DOES decrease the rates of cervical cancer in those who are VACCINATED. But only of the types (4) it is intended for. There is nothing to suggest that getting the vaccine suddenly eliminates any/all forms of cervical cancer. That's just misinformation and silliness.
I will agree there are risk factors included that, in my opinion, potentiate the risk of cervical cancer. Noting the rates of actual CANCER in women with "high risk" HPV types is simply just a "known." This is nothing new. And yes...some women CLEAR the virus on their own. (Look up "HPV algorithms" on Google). We DO know why, however -- it is an immune response. This is why things/activities that decrease our immune response abilities (e.g. smoking, etc.), cause higher rates of confirmed cancers than those who don't. It's not that hard. This, in no way, is to suggest that cervical cancer is ALWAYS caused by smoking, or ALWAYS by HPV for that matter.
Thanks for your input. I love to read research that promotes nothing more than someone extracting useless elements of someone else's studies (Vaccine), and then forming some mega-analysis to pad the inside of their pocketbooks. The unfortunate thing is that even such publications that appear "research-based," don't have the ability to always circumvent when there's useless data out there. Oh well.
http://www.sciencedirect.com/science/article/pii/S0264410X10013307
"The estimated weekly reporting rate of post-GardasilGBS within the first 6 weeks (6.6 per 10,000,000) was higher than that of the general population, and higher than post-Menactra and post-influenza vaccinations. Further prospective active surveillance for accurate ascertainment and identification of high-risk groups of GBS after Gardasil vaccination is warranted."
Anyway, as Dr. Shaffner says:
"It's impressive if other studies can confirm it."
There is nothing impressive about one study, is there? And reducing even higher risk infections of HPV proves nothing as far as reducing cervical cancer rates. The portion of the population of both vaccinated and unvaccinated girls who are still contracting the infection may contain those at risk of developing cancer. Only a tiny fraction of women who contract even high risk HPV go onto develop cancer.
Why can't some women clear those viruses and why do some actually get cancer? We still don't know, but smoking and drinking are risk factors for both throat and cervical cancer, along with some HPV strains.
One study even shows that exposure to carcinogens in woodsmoke is linked to the development of cervical HSIL.
http://www.ncbi.nlm.nih.gov/pubmed/16795085
Only one study, once, again, but that is supported by others linking tobacco smoke to cervical cancer.
HPV is given to every 13 year old girl in the UK. It is even thought that boys should be vaccinated against HPV too. Anyway, there was one reported death of a young girl after she was given HPV. Boy, did the right wingers had a field day with that one. Turns out she had a underlining heart defect....nothing to do with the vaccine.
And like I wrote to kbrum1066,
Were you also against the MMR vaccine? Do you know that people like you have caused an increase in reported cases of mumps and measles. Patients who contracted those diseases should look you up and thank you..........a$$.
IF if causes cervical cancer, then 100% of the people exposed to the virus would develope the cancer and the elimination of the virus would result in a 100% elimination of cervical cancer... yet anyone with any intelligence knows that this is not the case.
The same is true with many other "cancer causing" agents. If you eliminated all cigarettes, there would be lung cancer, throat cancer, mouth cancer, etc.
In true science, there is not only a direct 100% link (i.e. - it not only occurs 100% of the time, but the elimination of it results in a 100% elimination of the cancer) but each testing will result in the same results 100% of the time, regardless of who performs the experiment.
Studies are nothing more than exercises in probability and statistics... NOT science. The simple truth is that NO ONE KNOWS WHAT CAUSES CANCER. If you were to eliminate every "known carcinogen", you would still have cancer. They (scientists) are just too arrogant to admit to this.
I think we can agree that cancer, itself, is idiopathic. Such is the same for hypertension. We don't know what causes it, but we know risk factors FOR it. As for cervical cancer, nobody in the medical community would subscribe to the idea that ALL HPV causes cancer (as you suggest). The HPV virus has many different strains (like types of potatoes), and the vaccines guard against the ones that have been cited as having the highest risk for development of cervical cancer.
At not ONE point in the article (or the studies) has anyone suggested that it eliminates ALL forms of cervical cancer. That is simply not true, and one that is likely derived from an uneducated and skewed point of view. Sorry, but it is.
Where you derive that medical science (or "true science") is 100% absolute is incredibly silly. [What is "true science" anyhow? I've never heard that term being used. Is it like a "true television" verses a "not-so-true" one?] Nobody who has gone through the education involved in being able to treat patients and prescribe medication would bet that it is infallible by any degree, but it is convenient of certain people who live in the delusion that it somehow is for their own uneducated agendas.
If you truly believe that studies are nothing more than "probability and statistics," then you are likely someone who believes that anecdotal evidence, opinions, and personal testimonies have as much value. (e.g. like the kind they used to sell people crap in the herb shops). However, studies ARE the basis of all practical science, and the reason that we have extended the quality and quantity of life today.
No, I'm not too arrogant to admit to the fact that I don't know what [always] causes cancer. Neither are my peers. What IS abundantly true is that people who have convictions based on deliberate ignorance are the ones who can't admit when they're wrong.
Were you also against the MMR vaccine? Do you know that people like you have caused an increase in reported cases of mumps and measles. Patients who contracted those diseases should look you up and thank you..........a$$.
From Vanity Fair: The F.D.A. has consistently said that the milk produced by cows that receive rBGH is the same as milk from cows that aren't injected: "The public can be confident that milk and meat from BST-treated cows is safe to consume." Nevertheless, some scientists are concerned by the lack of long-term studies to test the additive's impact, especially on children. A Wisconsin geneticist, William von Meyer, observed that when rBGH was approved the longest study on which the F.D.A.'s approval was based covered only a 90-day laboratory test with small animals. "But people drink milk for a lifetime," he noted. Canada and the European Union have never approved the commercial sale of the artificial hormone. Today, nearly 15 years after the F.D.A. approved rBGH, there have still been no long-term studies "to determine the safety of milk from cows that receive artificial growth hormone," says Michael Hansen, senior staff scientist for Consumers Union. Not only have there been no studies, he adds, but the data that does exist all comes from Monsanto. "There is no scientific consensus about the safety," he says.
This is crap.
If the Costa Rican version of the HPV vaccine,(Cervarix®), is being touted to test groups as proposing they will NEVER get cervical cancer as a result, it is not the fault of the FDA. This is why I have problems with ANY medication on the market that utilizes data from other countries that do not have the more stringent guidelines that the USA has. Take it at face value.
You're also talking about a country that has socialized health care, and doctors make extra money by getting test subjects into such programs. As long as there is incentive to make money (and lots of it) for such studies, rest assured there is going to be some level of ethical corruption involved.
Now, to suggest there is no "long term" study, or "enough participants" simply confirms my suspicion that you have not read any of the study material. If you had, you would realize that Cervarix was brought with a double-blind placebo controlled study of over 23,000 participants (12,772 in control, and 10,730 in placebo group). The subjects in these groups were followed for an additional 6.4 years. Most people with any researched-based background will submit that this is enough time to evaluate efficacy in most any drug.
True, there is definite history that doctors used to prescribe smoking to lose weight. Well, considering they did not have the studies to realize the adverse physical reactions as a result (e.g. lung cancer, COPD, etc.), they didn't know what else to do in many cases. This doesn't make it RIGHT, but there is clearly a difference in approach to this today. It makes me think of all the patients who come to me and are worried about quitting smoking because they'll "gain weight."
Vioxx is a laughable example of how the public has pushed to eradicate a drug solely based on fears, and little on fact (this is why a mega-analysis is not guaged as a "pure study,"). Do you realize that Ibuprofen (Advil), and Naproxen Sodium (Aleve) carry the EXACT same risk factors? Or that THOUSANDS of people DIE every year from the overuse of Tylenol?
In parting, heed the same advice I give patients/families when discussing getting the HPV vaccine for their child..."Your daughter may have NO intention of having sex with anyone until she's married, but that doesn't mean that someone won't find a way to have sex with her." Get the point?
The stuff works well, and with minimal side effects for the most part. I have yet to bear witness to anyone (male or female) who have been vaccinated and had any more reaction to it other than tenderness at the site. At least I can believe that I'm doing the right thing by suggesting it. And no, I don't get any sort of kick-back when I prescribe it. Herd immunity is the basis for most pharmaphobes in the world today. Thank God others are getting vaccinated so that others don't carry as much risk.
Take the zombie, for instance.