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GOP debates HPV vaccine, but medical community gives it OK [Update]

BOOSTER SHOTS: Oddities, musings and news from the
health world

September 13, 2011|By Jeannine Stein, Los Angeles Times / For the Booster Shots blog
  • The GOP may be debating the HPV vaccine, but medical and health groups routinely recommend it.
The GOP may be debating the HPV vaccine, but medical and health groups routinely… (Charles Rex Arbogast / Associated…)

The HPV vaccine, which protects women against the human papilloma virus, is in the news once again, thanks to the recent GOP debate in which presidential candidate Michele Bachmann criticized Texas Gov. Rick Perry's proposed mandate of the vaccine and called it "...what potentially could be a very dangerous drug."

But that's not how most mainstream medical organizations in the U.S. see the HPV vaccine, approved in 2006 to prevent the spread of the virus, which can cause genital warts and may lead to cervical cancer. "Every organization I know of, from the American Cancer Society to the American Academy of Pediatrics recommend routine vaccinations for girls, particularly those age 9 to 11," says Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

With safety surveillance systems in several countries around the world, including the U.S., there have been reports of side effects ranging from mild to serious, the latter being rare. The efficacy of the drug weighed against those few acute reactions has caused the medical and health community to give a nod to the vaccine.

"We do have six or seven years of data now--no, it's not 20 or 30 years," Saslow says, "but it is significant. As time passes we have not seen anything to detract from the original safety data."

The vast majority of side effects are mild and temporary, such as soreness at the injection site, redness,  fever, headache, nausea and fainting. The Centers for Disease Control and Prevention report that more rare and serious side effects include Guillain-Barre syndrome (which can cause muscle weakness), blood clots and death. Among those who got blood clots, most had a history of the condition, and among 32 confirmed deaths no pattern or clustering of the deaths indicate they were caused by the vaccine. Also, according to some reports, another cause brought about death that was not related to the vaccine.

Several health and medical organizations have released position statements or recommendations for the HPV vaccine. The American Academy of Pediatrics' 2011 policy statement on childhood and adolescent immunization schedules recommends both the quadrivalent vaccine (otherwise known as Gardasil, which acts on four types of HPV) and the bivalent vaccine (also known as Cervarix, which protects against two HPV types) to guard against cervical cancer and genital warts. The AAP adds that the quadrivalent vaccine may be given to boys age 9 to 18 to help prevent genital warts.

Both Gardasil and Cervarix are also recommended for girls by the CDC in its 2011 interim Vaccine Information Statement. It says that the vaccine is important because "it can prevent most cases of cervical cancer in females" if given before exposure to the virus.

The American Cancer Society recommends the HPV vaccine for girls 11 to 12 years old, adding that girls as young as age 9 can get the vaccination as well. It holds off on suggesting women age 19 to 26 get the vaccine, citing a lack of evidence on its effectiveness in that group.

Despite these recommendations there still may be a reluctance to get the vaccine; a 2010 study presented at the American Assn. for Cancer Research Frontiers in Cancer Prevention conference found that most young women who are eligible for the vaccine may not be getting it, or aren't getting all three shots necessary for full immunization.

Among 9,658 teenagers and young women surveyed, less than one-third had begun getting the series of shots.

A study released last week in the Journal of the National Cancer Institute found that two doses of the vaccine may work as well as all three. Researchers compared data on about 6,000 women in Costa Rica who got all three vaccine doses of Cervarix to 802 who received two doses, and 384 who got just one. After four years, all three groups had the same levels of protection against two common HPV strains known to cause cancer.

"It's such an emotional issue," Saslow said, "and I think there is a very vocal group of people who are anti-vaccine, and it makes me doubt whether more studies will help that group or not. But for people who are open to what the evidence shows, the evidence we have is sufficient for them to feel safe."

Update: 2:26 p.m. Sept. 13: [The AAP issued this statement today in response to Bachmann's recent recounting of a woman's statement that the HPV vaccine caused her daughter's mental retardation: "The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific  validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record."]

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