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Peggy O'Mara

A Quiet Place

HPV Vaccines for Boys?

October 31st, 2011

On October 25, 2011, the Advisory Committee on Immunization Practices of the Center for Disease Control and Prevention recommended that all 11 to 12-year-old boys get vaccinated against the human papillomavirus (HPV). According to the CDC press release, “The HPV vaccine will afford protection against certain HPV-related conditions and cancers in males, and vaccination of males with HPV may also provide indirect protection of women by reducing transmission of HPV.”

First licensed in 2006, the HPV vaccination, branded as Gardasil or Cervarix, has previously been recommended only for girls. With this new recommendation, private insurers will be able to pay for the vaccine for boys. The vaccine is expensive, costing more than $300 for the three-shot series.

The HPV vaccine has been controversial for reasons other than its cost. Parents have been reluctant to give their pre-adolescent children a vaccine to protect them from sexually transmitted disease (STD).

The HPV vaccine for boys is also controversial because its benefits are not consistent. For example, Gardisil has been shown to prevent genital warts, but only in heterosexual men. There’s no evidence that Gardisil protects homosexual men from genital warts. Similarly, Gardasil has been shown to prevent anal cancer precursors in homosexual men, however these precursors rarely progress to anal cancer in heterosexual men.

A further rationale for the male vaccine is that preventing genital warts in heterosexual men will help reduce infection in women. However, this is only so if the vaccine is efficacious for a very long time. Every vaccine has a duration of efficacy. According to the Immunization Action Coalition(IAC), the HPV vaccine lasts five years.

Diane Harper, MD

However, Diane Harper, MD, the leading international expert on HPV, says that HPV antibody titers in the blood are detectable for only two years after HPV vaccination. Regardless of whether HPV is efficacious for two or five years, a child will need an HPV booster before he or she becomes sexually active.

Even with a booster, the efficacy of the HPV vaccine is questionable. According to Harper, “The cost modeling data indicate that with 50% female vaccination, vaccinating up to 50% of boys will provide some protection for females if and only if Gardasil lasts for a lifetime of duration. This modeled prevention of disease in females by vaccinating males does not exist if Gardasil loses efficacy earlier than 20 years.” Currently less than 50% of girls have had one shot and each shot lasts just two to five years.

It will take decades for the US population to be protected by the HPV vaccine alone and we will not see a substantial decrease in cervical cancer from vaccines until 70% are fully vaccinated. Until we reach that level of HPV vaccine saturation, STD screening alone is at least as effective as STD screening with vaccines in preventing HPV infection.

Controversy over the HPV vaccine erupted in the press earlier this year when Michelle Bachmann claimed that someone had become mentally retarded in one week from the HPV vaccine. While her statement has been widely discredited, more than 18,000 reports of adverse events associated with the HPV vaccine have been made to the Vaccine Adverse Events Reporting System (VAERS) since 2006, including 72 deaths.  In fact, the risk of adverse events associated with the HPV vaccine is 7 events per 100,000 vaccinated, while the risk of cervical cancer in the developed world is 3 cases per 100,000.The story of Gabby Swank, who reportedly died from complications of the HPV vaccine, is documented in the new film The Greater Goodstreaming live on mercola.com until November 5th.

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HPV Vaccine

October 12th, 2009

For those of you who want to know more about the HPV vaccine, you may want to order the audio of the NVIC presentation, “Gardasil Vaccine: Informed Consent?” by Diane Harper, MD, MPH, MS. Harper has worked in all aspects of HPV associated diseases, specifically cervical cancer prevention. She is the leading international expert on HPV vaccines and has worked with both Merck and GSK to develop Gardasil and Cervarix.

Before Harald zur Hausen identified HPV as the cause of cervical cancer in 1976, it was the most common cancer in the world, with a rate of 50 cases per 100,000 women. Today, cervical cancer is the fifth cause of death among women in developed countries with a rate of three cases per 100,000 women, but it is still epidemic in developing countries.

Seventy percent of HPV infections resolve within one year; 90 percent resolve within two years. Only 10 percent of infections will persist and 50 percent of these will be cancer precursors.

Of those who get cervical cancer, 50 percent never got a pap smear and ten percent had a pap more than five years before. Mass screening programs for HPV infection have had dramatic effects. Finland saw a 75 percent drop in cervical cancer when women participated in mass screening. When 70 percent of women in a society participate the rate of cervical cancer drops.

There are risks associated with a pap smear, however, including the stress and anxiety of screening, of abnormal results, of false positive results and of the treatments. There are also possible relationship traumas from the diagnosis of sexually transmitted disease (STD). The treatments, colposcopy and biopsy of the cervix, increase the risk of preterm delivery, low birth weight, premature rupture of the membranes and cesarean birth.

The vaccines, Cervarix and Gardasil, are highly effective against most types of HPV viruses, but not all of them; Merck is working on a supplemental vaccine. Coverage requires three doses of the vaccine and is costly⎯$375 for the series. No efficacy trials in girls under fifteen years of age have been done. The duration of efficacy is unknown for all recipients. On the package inserts, Gardisal publishes efficacy of five years and Cervarix publishes 7.5 years. According to Harper, “If HPV vaccines are not effective for at least 15 years, then no cervical cancer is prevented, only postponed.”

In general, the vaccine has proven safe for most women, but results from the Vaccine Adverse Events Reporting System (VAERS) indicate that 29 percent of vaccine recipients feel dizzy and faint. Thirteen cases of Guillain Barre’ have been reported to VAERS, and thirty-two deaths. The risk of adverse events to HPV vaccine is 7 events per 100,000 vaccinated.

At this time, the HPV vaccine may reduce the incidence of HPV, but not cervical cancer. There will be no substantial decrease in cervical cancer until 70 percent are vaccinated. Screening alone is as effective as screening with vaccines in preventing HPV infection. Screening is still essential.

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