Last week we devoted several segments on my TV talk show to the issues surrounding the HPV (human papillomavirus) vaccine. Learning about this relatively recent preventive measure is tremendously important, and I felt it was a subject well worth exploring. Following the show, and in fact before it even aired, there was criticism that the program was too anti-vaccine and anti-science, and in retrospect, some of that criticism was valid. We simply spent too much time on the serious adverse events that have been reported in very rare cases following the vaccine. More emphasis should have been given to the safety and efficacy of the HPV vaccines. As someone who has spent the last 15 years relaying important medical information with the goal of improving public health, it is critical to me that people know the facts.
There's no doubt that HPV is a growing problem. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million people in the United States are infected with at least one of the many types of HPV. The immune system usually fights off the virus before any health problems can occur. But certain types of HPV are the leading cause of cervical, vaginal, and vulvar cancers in women. The virus can also cause anal cancers and in some cases even penile cancer in men. There is increasing concern about mouth and throat cancers resulting from direct contact with HPV-infected partners. The CDC estimates that each year in the United States alone, 26,000 people are diagnosed with a cancer caused by HPV.
After careful study, the U.S. Food & Drug Administration approved two vaccines for HPV, Gardasil and Cervarix. These protect against the two types of the virus that cause most, although not all, cases of cervical cancer, as well as other HPV-related cancers. The CDC recommends HPV vaccination for both boys and girls beginning at age 11 or 12.
There's no question that vaccination is highly effective. In large clinical trials, Gardasil has been shown to significantly reduce the chance that women will develop the cervical, vaginal, and vulvar abnormalities that precede cancer. Similarly, it has been shown to reduce the rates of the tissue abnormalities that precede anal cancer in men. More recent data showed that in the period between 2007, shortly after the vaccines were introduced, and 2010, the rate of infection with the HPV types that the vaccine protects against fell by 56 percent, as compared to the four-year period before the vaccines were available in the U.S. This improvement is remarkable, considering that in 2010, only one-third of girls between the ages of 13 and 17 had received the recommended three doses.
Nevertheless, concerns have been raised about reactions to the vaccination. Unfortunately, there's no question reactions can occur, as with all vaccines. The vast majority of these reactions to the HPV vaccine are not serious, consisting of pain at the injection site, fever, dizziness, and nausea. More severe reactions are sometimes reported, however. Some people say their children have suffered from a variety of medical problems after the vaccination, and there have even been a few reports of death.
As a journalist, I felt that we couldn't simply ignore these reports. That's why we had two mothers on the show who reported adverse reactions after their daughters had been vaccinated for HPV. One could hardly get out of bed for three years, and the other tragically died. There is no definitive proof that these two situations were related to the vaccine. Every life is important. However, the time spent telling these stories was disproportionate to the statistical risk attendant to the vaccines and greater perspective is needed.
The federal government has a system for reporting adverse reactions following immunization with any vaccine. For the 23 million doses of Gardasil distributed in the United States from 2006 to 2008, 12,424 adverse reactions were reported, a rate of 5.4 per 10,000 doses, and the vast majority of these were not serious. Furthermore, only 772 of the 12,424 adverse reactions were reported to be serious, a rate of 0.3 per 10,000 doses. These rates are extremely low.
Another concern expressed was the duration of protection the vaccines offer. An early study showed that they are effective for five years. But more recent research indicates the protection lasts for at least eight years, and potentially well beyond that. The longer the vaccine is available, the more research can be done on its long-term efficacy, and the public will need to be informed.
There is one aspect of the show that I felt was especially critical to communicate to viewers. It is also important for women to have regular Pap smears to detect cell abnormalities that can lead to cervical cancer. There's been troubling research out of Australia that indicates some women are skipping their Pap tests because they have been vaccinated. That's a terrible idea. While the vaccine protects against some of the HPV strains that cause cervical cancers, it doesn't protect against all of them, and regular Pap smears are essential for life-saving diagnoses.
The concern among many people is whether the benefits of vaccination outweigh the risks.
Our goal in doing this show was to help parents make an informed decision about the HPV vaccine, not cause irrational fear. Right now, science is telling us that the benefits far outweigh the risks and that adverse reactions are exceptionally rare events.
Having personally experienced the devastating impact that cancer has on people and their loved ones, I have been a passionate advocate for cancer research, education, and prevention. Through my work as a co-founder of both the National Colorectal Cancer Research Alliance and Stand Up To Cancer (SU2C), I have supported fundraising efforts that are helping finance the cutting-edge research we need to make progress in the fight against this disease. One of the most recent decisions we at SU2C made was to collaborate with the Farrah Fawcett Foundation on a $1 million grant for a team of researchers looking to make progress against HPV-related cancers, and The HPV and Anal Cancer Foundation recently pledged $200,000 to support that work.
I know there is a segment of the population that has expressed intense concern over vaccines in general and that this is an emotional issue for some. But based on the science, my personal view is that the benefits of the HPV vaccine far outweigh its risks. That is why, as I said on my show, I had my own two daughters vaccinated against HPV. I hope that other parents will look at the research and the facts, and make a reasoned decision on the HPV vaccine and what is best for their children.
Source : http://www.huffingtonpost.com/katie-couric/vaccine-hpv-furthering-conversation_b_4418568.html?ncid=txtlnkusaolp00000592
Email 