Monday, September 19, 2011

The HPV Vaccine Controversy

Ever since the FDA approved the HPV vaccine in 2006, its introduction has been embroiled in a medical, social, cultural, and political controversy. This controversy has once again been rekindled in the recent Republican Primary debates between Texas governor, Rick Perry and Congresswoman, Michelle Bachmann from Minnesota, where she emphatically stated that Merck’s HPV vaccine, Gardasil, causes mental retardation.

As a as a physician, a parent, and the author of the award-winning book The HPV Vaccine Controversy: Sex, Cancer, God and Politics (Praeger, 2008), I feel compelled to comment on this issue:

A report presented by four different sources to the Advisory Committee on Immunization Practices (ACIP), an independent panel of experts that advises the CDC, on vaccine policies, found no signals to link Gardasil directly to any of the serious adverse effects that have been publicized in the media.

In order to clarify this and help consumers make the best-informed decision before vaccinating, it is helpful to understand the difference between a side effect (caused directly by the vaccine), and an adverse effect (which usually occurs within six weeks after the administration of a vaccine but may or may not be related to the vaccine).

  1. The two most common side effects reported are pain at the site of injection, followed by swelling and redness. These are temporary symptoms and resolve within a few days, as is the case with most other vaccines.
  2. The number of adverse effects that link the HPV vaccines to the nervous system disorder are around 1-2/100,000 cases—about the same that occur in the general population as a sheer coincidence or chance, and have the same statistical occurrence as the population at large that has not been vaccinated.
It is obvious that the more number of shots administered, (as of June 22, 2011, 35 million doses of Gardasil had been distributed), the more likely the chance for these rare and unexpected events to occur. It should be noted that there is no report from the CDC of Gardasil resulting in mental retardation.

The HPV vaccine has established a decent track record at five years post-licensure. Based upon these current findings, the FDA strongly recommends vaccinating the target population: 9-26 year-old females and males. The CDC will continue to be vigilant and monitor safety data on an ongoing basis. Nevertheless, it is helpful to remind ourselves that regardless of how well studies are conducted, gray zones of risk exist. The history of medicine has shown us that such unfortunate events do occur for unknown reasons, and research is underway to study if genetics and environmental factors have a role to play in such rare and serious events.

One should always balance the greater good with these potentially minimal risks when evaluating the advantages offered by new and emerging medicines. ‘Scare mongering’ for personal political gain does not bode well for the education and welfare of the citizens at large. In the case of the HPV vaccine, it would be a shame if negative attention created by a few rare effects hampers the efforts to reach millions of women and men who risk losing their lives to HPV related diseases including cancers, particularly cervical cancer, both in our country and around the world.

Shobha S. Krishnan, MD is the Founder and President of the Global Initiative Against HPV and Cervical Cancer (GIAHC) A family physician and gynecologist, she serves on the STD research-working group at the Columbia College of Physicians and Surgeons. She is on the Medical Advisory Board of the National Cervical Cancer Coalition, and on the experts’ panel of the American Social Health Association. Dr. Krishnan has also worked as a surveillance physician for the Centers for Disease Control and Prevention and is the author of the independently written, national and international award-winning book, The HPV Vaccine Controversy: Sex, Cancer, God and Politics.

1 comment:

  1. Hi,

    A new study which published in The Journal of the American Medical Association (JAMA) is stated that oral human papillomavirus (HPV) infection is more common among men than women and it can leading to an increased risk for men of head and neck cancers (Source: JAMA 2012 [doi: 10.1001/jama.2012.117]).

    Vaccine efficacy against oral HPV infection is unknown but it may be more important in men than women for prevention of head and neck cancer.