Wednesday, January 3, 2007

HPV vs. cervical cancer vs. Gardasil

Have you read the vaccine package insert?
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf

Gardasil contains only four strains of HPV: Types 6, 11, 16, 18 (note that there are over 120 strains of HPV)

"HPV also causes approximately 35-50% of vulvar and vaginal cancers.... HPV also causes genital warts (condyloma acuminata) which are growths of the cervicovaginal, vulvar, and the external genitalia that rarely progress to cancer. HPV 6, 11, 16, and 18 are common HPV types.
HPV 16 and 18 cause approximately:
• 70% of cervical cancer, AIS, CIN 3, VIN 2/3, and VaIN 2/3 cases; and
• 50% of CIN 2 cases.
HPV 6, 11, 16, and 18 cause approximately:
• 35 to 50% of all CIN 1, VIN 1, and VaIN 1 cases; and
• 90% of genital wart cases."

So, of the 35-50% (leaving 65-50% of the cervical cancers being caused by other things) of cervical cancers that are diagnosed as being caused by HPV, HPV 16 and 18 cause approximately 70% of the 35-50% of cervical cancers caused by HPV.

Say 100 women are diagnosed with cervical cancer:
--50-65 of them will have gotten cervical cancer from a different cause
--35-50 of them will have gotten cervical cancer from HPV
--of the 35-50 who have cervical cancer from HPV, only ~70% of them would have been protected from HPV causing cancer (strain 16 and 18 are the cancer causing strains in gardasil)--24.5-35 of the women (in a 100) "could" have been protected against cervical cancer--that's if the vaccine were effective in them--or if the vaccine didn't wear off...or that they could receive the vaccine at all (because most people have adverse events following vaccination due to allergies or an over-response from the immune system).

Vaccine package insert: "As for any vaccine, vaccination with GARDASIL may not result in protection in all vaccine recipients."

"This vaccine is not intended to be used for treatment of active genital warts; cervical cancer; CIN, VIN, or VaIN.
This vaccine will not protect against diseases that are not caused by HPV.
GARDASIL has not been shown to protect against diseases due to non-vaccine HPV types.
As with all injectable vaccines, appropriate medical treatment should always be readily available in case of rare anaphylactic reactions following the administration of the vaccine. The decision to administer or delay vaccination because of a current or recent febrile illness depends
largely on the severity of the symptoms and their etiology. Low-grade fever itself and mild upper respiratory infection are not generally contraindications to vaccination.
Individuals with impaired immune responsiveness, whether due to the use of immunosuppressive therapy, a genetic defect, Human Immunodeficiency Virus (HIV) infection, or other causes, may have reduced antibody response to active immunization (see PRECAUTIONS, Drug Interactions).
As with other intramuscular injections, GARDASIL should not be given to individuals with bleeding disorders such as hemophilia or thrombocytopenia, or to persons on anticoagulant therapy unless the potential benefits clearly outweigh the risk of administration. If the decision is made to administer
GARDASIL to such persons, it should be given with steps to avoid the risk of hematoma following the injection."

"GARDASIL is not recommended for use in pregnant women."

"GARDASIL has not been evaluated for the potential to cause carcinogenicity or genotoxicity."

"Because many drugs are excreted in human milk, caution should be exercised when GARDASIL is administered to a nursing woman."

"The safety and efficacy of GARDASIL have not been evaluated in children younger than 9 years....The safety and efficacy of GARDASIL have not been evaluated in adults above the age of 26 years."

See pages 11-13 in vaccine package insert for adverse events table.

Keep in mind HPV is a sexually transmitted disease--a preventable disease (without vaccination). Practice safe sex people...

This is one, of many, vaccine I would NEVER recommend.

2 comments:

Nancy said...

Bravo! HPV has been all over the news because of Guardisil (even the makers of the HPV test have jumped on the bandwagon), and the ads are everywhere.

However, for most people who get this virus, it's usually symptomless, and progression to cervical cancer is rare in the U.S. It's a serious problem in developing countries where women don't get regular Pap smears - and those most likely to afford this expensive vaccine.

Folks out there, please don't believe the hype. HPV is harmless and symptomless for most, and cervical cancer can be prevented and treated with existing technologies and common sense. Just be careful out there, and NEVER miss your yearly Pap smear!

HoneyBeap said...

It is nice to hear a differing opinion from people. My Doctor asked me to think about getting the vaccine and I'm trying to weigh the pros and cons, its hard to find people talking about the cons! So thanks! One thing I would like to point out though, I have read that it is not possible to protect against HPV by using condoms. So unless you mean abstinence when you say "practice safe sex people" your misleading people. See this article in The Nation
http://www.thenation.com/doc/20050530/pollitt