Taking the Politics out of the Cervical Cancer Vaccine (Gardasil)
The recent comments and media attention in the USA over the Cervical Cancer Vaccine (Gardasil, Merck), has resulted in a large amount of false statements and scaremongering. Its time to get back to the data and let that guide public opinion and legislature. So here is a very short over-view of what it is and what we currently know about the vaccine.
What is it ?
The vaccine most commonly given now is the Quadrivalent form (quad means 4 for the 4 types of HPV it targets). It targets the human papillomavirus (HPV), types 6, 11, 16 and 18. The vaccine is not a live, or dead virus, it is recombinant (lab/man-made) vaccine composed of virus-like particles (VLPs). These were developed by the CICR (now Diamantina Institute) in Brisbane Queensland during the 1990’s. These VLPs are not real virus’s, and are not capable of replicating, infecting, or causing any disease themselves. They simply mimic the look of a small part of the HPV virus so that the immune system can them make antibodies against HPV. This will enable the body to quickly react to any future infection with a real HPV virus particle, and destroy it, preventing the infection that causes genital warts, and cancer.
(Side note: I was fortunate enough to do my PhD at this institute during this time and saw first hand the hard work, dedication and amazing results produced by the researchers working on the vaccine).
Does it work ? Yes. But you need to have the vaccine before you get the virus for it to be effective. That is why it is being targeted at teenagers. HPV 16 and 18 account for around 70% of all cervical cancer cases. The vaccine has only be on the market since 2006, and thus long term effectiveness is still unknown. While 6, and 11 account for over 90% of genital warts.
“Studies have shown that both Gardasil and Cervarix prevent nearly 100 percent of the precancerous cervical cell changes caused by the types of HPV targeted by the vaccine for up to 4 years after vaccination among women who were not infected at the time of vaccination.”
Is it Safe ? Yes. It is as safe as any other vaccine, perhaps even more so. Chances of a local/minor adverse reaction are around 0.00008%, and the chance of serious or life threatening complications is significantly less (chances are at about 1 in a million or 0.0000001%). Its up to you if these odds are worth the benefits of dramatically reducing the risk of contracting cervical cancer, and or genital warts.
“The most common adverse events reported for Gardasil in the Vaccine Adverse Event Reporting System are syncope and local site reactions, which have an incidence of 8.2 and 7.5 per 100,000 doses, respectively” (Slade BA, Leidel L, Vellozzi C, Woo EJ, Hua W, Sutherland A, et al. Postlicen- sure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA 2009;302:750–7).
“It does not contain mercury, thiomersal or live virus or dead virus, only virus-like particles (VLPs), which cannot reproduce in the human body”.
Should I get it ? Speak to your doctor first, but if you are a teenager, or have not yet contracted the virus then it is not a bad idea to consider getting the vaccine. There are even benefits if you are a boy, so do a bit of reading. Wikipedia is a great place to start to get the facts (not hyperbole). If your feeling up to it then PubMed or Medline are great places to get the source data produced by the scientists, before it gets twisted by bias.
Ethics ? This is where the situation gets cloudy, and the politics and fear often overwhelm both the data and moral obligations of the real issue. What Gardasil is is the best preventive treatment for cervical cancer that scientists have developed so far. It has the potential to eliminate 70% of all cases. The morals of this situation demand that given is huge potential, that the vaccine must be available to everyone who wants it. If scientists/doctors/politicians, kept this vaccine from the public and refused to provide it, it would create justifiable and widespread outrage. Millions of taxpayers money are donated each year to finding cures for cancer. Here is one of the fruits of that investment. The public deserves access to it, and to deny or prevent people from taking it would be morally unjust. If you had the power to prevent the deaths of 10’s of thousands of people every year, what would you do ?
Having said that, I can also agree with not making this vaccine mandatory. It should be voluntary, and combined with a fact based campaign to help educate the public on the benefits of the vaccine. Forcing people to do things only creates anger, which is in this case being misplaced on the vaccine itself, which has the very real problems of people jumping on the conspiracy bandwagon and undermining the raw data and potential of this life saving vaccine.
UPDATE: Steven Colbert has done a nice piece on all this hoopla you can watch it here