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So many scary reports out there about vaccines. As a Mom, it can be terrifying hearing about vaccines not being safe. As a physician I know that data supports the safety of vaccines and the incredible prevention of life threatening diseases. I still have some unanswered questions about the scheduling and number of vaccines given at one time since we have so many more vaccines today.
One of the latest questions is about Gardasil. It is a vaccine introduced in May of 2006 to help prevent cervical cancer and genital warts. It helps the body produce an antibody to 4 types of Human Papilloma Virus or HPV.
HPV is really easy to catch and it is passed through sexual contact. It doesn’t have to be intercourse; just skin-to-skin contact and condoms are not very effective. 80% of women will contract HPV in their life making it the number one sexually transmitted disease (STD).
The good news is that most women will clear the HPV on their own. The bad news is that many women will still get conditions caused from HPV. This includes genital warts, cervical cancer and cancer of genital skin including the penis, anus and vulva.
12,000 women in the US will get cervical cancer in 2008 and almost 4,000 will die from it. The reason why relatively few women get cancer compared to the women with HPV is 1) Many will clear it on there own and 2) Our health system does a pretty good job with Pap smear screening. Pap smears will find changes before it becomes cancer. A doctor will do a colposcopy and can treat the dysplasia or precancerous lesions on the cervix so it never becomes cancer.
In developing countries it is a much bigger problem because they don’t have access to pap smears and treatment making it the second leading cause of cancer in women worldwide. There will be 470,000 new cases and 233,000 deaths this year from cervical cancer.
Gardasil targets 4 types of HPV 6, 11, 16, and 18. There are over one hundred types of HPV but 16 and 18 account for most of the cervical cancer. The vaccine has been very effective so far at preventing infection.
http://www.cdc.gov/std/hpv/common-questions.htm
I saw a lot of HPV in my practice and had to put many girls through painful procedures to treat the precancerous lesions so I think it is a wonderful idea. It should be given before a girl is sexually active and that is why it is recommended for ages 9-26. I personally do not believe that giving the vaccine to a girl is giving her permission to have sex. They are still recommending that girls get the vaccine even if they are sexually active to prevent HPV infection.
The big hesitation that I have is the limited time that it has been studied. We only have a few years of experience using the vaccine. As of June 30, 2008 there have been 16 million doses distributed and only 9749 adverse reactions reported to VAERS (Vaccine Adverse Events Reporting System).
http://www.cdc.gov/vaccinesafety/vaers/gardasil.htm
Only 6 % of these have been serious. For most vaccines the average serious reaction reported is around twice that amount or 12%. There have been 20 reported deaths but no cause with the vaccine has been established.
Overall, I think that it is a good idea. Like anything, I wish we had more data but the data we do have is not alarming and that is why it is still recommended by the CDC and FDA.
http://www.nlm.nih.gov/medlineplus/news/fullstory_67216.html
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