• This is why we vaccinate, HPV edition

    File this under “holy crap”. “Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010“:

    Background. Human papillomavirus (HPV) vaccination was introduced into the routine immunization schedule in the United States in late 2006 for females aged 11 or 12 years, with catch-up vaccination recommended for those aged 13–26 years. In 2010, 3-dose vaccine coverage was only 32% among 13–17 year-olds. Reduction in the prevalence of HPV types targeted by the quadrivalent vaccine (HPV-6, -11, -16, and -18) will be one of the first measures of vaccine impact.

    Methods. We analyzed HPV prevalence data from the vaccine era (2007–2010) and the prevaccine era (2003–2006) that were collected during National Health and Nutrition Examination Surveys. HPV prevalence was determined by the Linear Array HPV Assay in cervicovaginal swab samples from females aged 14–59 years; 4150 provided samples in 2003–2006, and 4253 provided samples in 2007–2010.

    I’ve written about HPV, and the vaccine that prevents it here and here and here and here. Still, I get email about how it’s a government plot, or how it’s unnecessary, or how vaccination won’t do any good.

    This study looked at the prevalence of HPV among women and girls in the three years before the HPV vaccine was introduced (2003-2006) and the three years after it was introduced (2007-2010). The results are shocking. Just looking at adolescent girls age 14-19 years old, the prevalence of HPV covered by the vaccine fell from 11.5% before 2006 to 5.1% after. That’s a drop of more than 50%. And before any skeptics weigh in, there was no difference in the racial/ethnicity of the samples before and after the vaccine, nor any differences in sexual activity.

    These results (which were amazing even to me) came about even though only about a third of girls age 13-17 had received all three doses of the vaccine in 2010. Imagine what we could accomplish if we got that number closer to 100%. Cue Tom Frieden, director of the CDC:

    “Our low vaccination rates represent 50,000 preventable tragedies: 50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we reach 80% vaccination rates,” he said. “For every year we delay in doing so, another 4400 girls will develop cervical cancer in their lifetimes.”

    Vaccinate your girls against HPV. Vaccinate your boys, too.


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    • Glad you added the bit about “vaccinate your boys too.” It’s pretty silly how female-centric the HPV campaign has been when you consider that 1) HPV is also a serious problem for men, and 2) vaccinating men also protects women.

    • To personalize this, my sister died 16 years ago of cervical cancer caused by HPV. For her, the vaccination that could have avoided her disease and early death wasn’t available. Don’t let your wives, your sisters, or your daughters suffer my sister’s fate, get the vaccination today.

    • The main reason to vaccinate against HPV is not to lower the rate of the prevalence of the virus, but to reduce cervical cancer.

      • And? What’s your point?

        • I was not commenting on the use of the vaccine only that as proof you said: “the prevalence of HPV covered by the vaccine fell from 11.5% before 2006 to 5.1% after. That’s a drop of more than 50%.”. But that is not the reason for the vaccine to be given. The real reason is to prevent cervical cancer something quite desirable. Thus the real proof has to be a fall in cervical cancer not a reduction in the number of people with the virus.

          The reason for making that distinction is that women might feel totally protected by the virus (not true) long term (not true) and reduce the number of pap smears that are performed. This vaccine might very well turn out to save lives, though detection through regular pap smears can prevent the vast majority of deaths duplicating that effort.

          I am not against the vaccine.

    • To supplement Mark’s comment, I will repeat another comment I made previously about my sister. When she was diagnosed, I contacted an oncologist in the South I had met several times on fishing trips (to a truly great place in western NC). I told him that my sister resided in the low country and asked if he knew any oncologists who were particularly well-known in the treatment of cervical cancer. To my surprise, he told me that one of the nation’s best was located in the low country. Why, I asked, would he be located in the low country? Because that’s where the patients are: the low country has a very high incidence of cervical cancer. I guessed that it must be related to all those chemical plants in the low country – if you aren’t familiar, chemical plants are ubiquitous. That’s one theory my oncologist friend told me, but the medical explanation was that it was attributable to the high level of poverty and the absence of health care, including, for women, regular pap smears.

    • Great and vital post. We as a nation need to get the word out even more on this vital topic. Thanks for the post.