Thoughts on the HPV vaccine

A friend of mine recently asked me about the safety of the Human Papilloma Virus (HPV) vaccine. She had heard some scary stories about the vaccine and did not want to subject her children to something that could be dangerous. As a mom, I completely understand the desire to protect your children and make the best decisions for their health and safety. This is why we use car seats, put our babies to sleep on their backs and fuss about eating enough vegetables. This is also why I vaccinate.

There is a lot of misinformation about vaccines in general and Gardasil especially. Just last week the Toronto Star – the biggest newspaper in Canada – published an “investigation” about side effects rumored to be associated with Gardasil. For this article, the author failed to interview anyone in the medical community or cite any of the studies formally evaluating the safety of the vaccine. The article has since been retracted and while it was embarrassing for the newspaper, I think it is also a reflection of how pervasive vaccine rumors are in our society.

The HPV vaccine (available in the US as Gardasil or Cervarix) has a lot of the same side effects as other vaccines – pain, local reaction, allergic reaction in some people, etc. Its unique side effect is syncope, or fainting. I think every pediatrician I know has seen at least one kid get the Gardasil shot and get a little light headed afterwards. This is in part because it is a painful shot. The other part of it is that teenagers faint more frequently than little kids and adults (for all kinds of reasons).

The other stories about bad things happening after receiving the vaccine are just stories with no data to support causality. There is a database called the Vaccine Adverse Event Reporting System where anything bad that could possibly be related to a vaccine is reported. Anyone can contribute. If you search the database, you will see there are three children under the age of 12 who were in car accidents some time after receiving vaccines. The vaccines probably did not cause the accidents. There are 40 reported cases of acne after receiving Gardasil. Did Gardasil cause the acne or did acne develop because the teenaged patients were already predisposed to developing acne, with or without the vaccine? The purpose of VAERS is to continue to monitor the vaccines for safety. It is good to have this system in place. It is not reasonable to do a scientific study for every story but if enough accumulate (there are over 3,000 reports of syncope after Gardasil injection) then it is reasonable to structure a formal evaluation to determine if there is a true association or just coincidence. One side effect of this effort is that it seems to give some credibility to stories that probably are not related to the vaccine.

Everything we do has risk. Gardasil does have an increased risk of fainting immediately after injection. There is no scientific evidence substantiating other scary rumors. There is good, solid evidence that it protects against the two strains of HPV that cause 70% of cervical cancer. And HPV infection is incredibly common. 50% of sexually active adults carry HPV. In 2008 there were 20 million new HPV infections in the United States. Cervical cancer is the only cancer we test for in healthy people under the age of 40. I never want my daughters or anyone I care about to have to worry about a positive pap smear. I absolutely will vaccinate my kids against HPV.