• Healthcare Triage: The HPV Vaccine, and Why Your Kids Should Get It

    Healthcare Triage #4 is up. What’s Healthcare Triage? Glad you asked:

    Healthcare Triage is a series about healthcare. Dr. Aaron Carroll will explain healthcare policy, medical research, and answer a lot of other questions you may have about medicine, health, and healthcare. Not only that, the videos are going to be pretty fun. John Green will stop in regularly to have his hypochondria soothed by Aaron’s clear and engaging explanations. Healthcare Triage is made by the people who make Crash Course, mental_floss video, and The Art Assignment.

    This one is about the HPV Vaccine. Longtime readers of the blog know how I feel about this, and other vaccines:

    Human Papillomaviruses (HPV) are the cause of genital warts, and believed to lead to a number of cancers. But there’s a vaccine for HPV that can prevent you from getting infected. This week, Rosianna sends in some questions about the safety and efficacy of the vaccine, based on some emails she’s received. Aaron takes the opportunity to talk about HPV, how the vaccine works, how safe it is, and how misinformation is preventing us from saving lives.

    Please watch and share! We need support in terms of subscribers and viewers to keep this going!

    @aaronecarroll

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    • Need to check the slides. Your statements about deaths from cervical cancer are accompanied by slides showing incidence.

    • Hi Aaron,
      Big fan of the blog and your message on the importance of both this and other vaccines. As both a doctoral student in health services research and a young female, one important message which is not getting to girls, women, and preventive health advocates is that the HPV vaccines currently on market only cover a few strains of the HPV virus. While some of these covered strains are some of the most serious, the number of women who are still infected with HPV despite being properly administered Guardasil and similar products is large (don’t have a stat on hand about this and hate to not be able to cite, but have spoken to enough physicians, nurses, and caregivers as well as patients to see a cause for at least some concern with this).
      While I absolutely support the widespread use of HPV vaccines, I worry about the number of girls and women who believe, ‘I’m protected against HPV because I’ve had Guardasil!’ and don’t go in for regular screening and testing from their physician for HPV (this issue is exacerbated by even conscientious women who ask for STD tests from male partners since HPV is currently not tested in men). While women over 30 should be tested periodically for HPV (assuming they are going in for their regular women’s visits) and it could hopefully be caught this way, it can still be an upsetting experience for patients to discover they are at increased cancer risk despite ‘doing what they are supposed to do.’
      I understand that the marketing and messaging of HPV vaccine of ‘protects against SOME strains that cause cervical cancer’ is not the same as ‘protects against cervical cancer,’ but I think the more complete truth about these vaccines is an important one to get to patients. Perhaps I am naive, but hopefully this more complete message would still motivate similar numbers of girls and women to get this very important vaccine.

      • THE HPV VACCINE’S EFFICACY

        qHPV is a vaccine against the two most common causes of genital warts (types 6 and 11) and the two leading causes of cervical cancer (types 16 and 18). Its antigen is a virus-like particle with no genetic material, so it is not a live-virus vaccine and cannot cause infection. It has an excellent response rate, inducing an adequate antibody response to all four types of HPV in 99.5% of women after the third dose that has been shown to persist for at least five years.

        Regarding efficacy, most cervical cancer occurs decades after the infection, so it will be quite some time before we can demonstrate the effect qHPV should have on the incidence of cervical cancer. However, lesions identified on Pap smear and known to precede cervical cancer occur far earlier, and have served as a surrogate in pre and post-licensure studies. In trials to date, qHPV is 94-100% effective at preventing pre-cancerous changes from these four HPV types.

        http://www.sciencebasedmedicine.org/gardasil-safety-revisited/