Human Papilloma Virus Vaccine

I was at a Sea World a little while back and overheard two moms talking about the HPV vaccine. The first mother related that she had taken her daughter to the pediatrician and the pediatrician told her that she needed to get her daughter the HPV vaccine ASAP. The mother asked if perhaps her daughter was a little young for the HPV vaccine, and was met with a tirade from the pediatrician who asked if the mother had ever seen what genital warts looked like and told her that if she waited longer the vaccine wouldn’t be as effective. I can see why this mother would have been taken aback since the HPV vaccine is now being recommended to 9 year olds.

What is the goal of the HPV vaccine? The HPV vaccine is intended to prevent teens and young adults from contracting the human papillomavirus which can cause 

  • cancers of the cervix, vagina, and vulva in women;
  • cancers of the penis in men; and
  • cancers of the anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men.

According to the CDC, The virus is very common, though 9 out of 10 infections will clear without any treatment and many infected individuals are asymptomatic. They further state that,

“Every year in the United States, HPV causes 30,700 cancers in men and women. HPV vaccination can prevent most of the cancers (about 28,000) from occurring.”

Further glowing praise from “The Guardian” reads: “The HPV vaccine works extremely well. In the four years after the vaccine was recommended in 2006 in the United States, quadrivalent type HPV infections in teen girls decreased by 56% and decreases in prevalence have also been observed in women in their early 20s. Research has also shown that fewer teens are getting genital warts since HPV vaccines have been in use in the United States. Decreases in vaccine-type prevalence, genital warts, and cervical dysplasia have also been observed in other countries with HPV vaccination programs.”

This is despite the fact that “CDC researchers said this is also the first time a study has shown evidence of the effect of the vaccination on women in their 20s, where prevalence decreased 34%, even though vaccination rates for HPV are relatively low in the US.” And that “‘Overall, the fact that we are seeing a larger decrease overall than what we expect given our coverage rates does suggest there may be some herd protection and there also may be effectiveness from less than a complete three dose series,’ Markowitz said.”

But there’s actually a problem with this glowing praise over the HPV vaccine.

If coverage rates for HPV are relatively low, then herd immunity can’t be responsible for the decline.

(For all you vaccine proponents who seem to forget, herd immunity is the idea that when rates of vaccination are very high, the pathogen causing the disease leaves the community, thus conferring protection to the unvaccinated.)

In fact this vastly oversimplifies the decrease in genital warts, attributing it to the vaccine with absolute certainty when other factors could be at play- like the fact that comprehensive sex education gained federal support around the same time that HPV vaccine was introduced. Cervical cancer used to be a major cause of death in women, but since the advent of regular screening, mortality has dropped drastically over the last 40 years. The decline in cervical cancer predates the vaccine, so the HPV vaccine can’t be responsible for the overall decline in cervical cancer mortality either… Though I wouldn’t put it past vaccine proponents to claim that it has.

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