From the desk of Sarah Hawthorn, Dream Team Coach:
A common question that I have been hearing lately in my practice is “should my teenage daughter receive the HPV vaccine?” With the lack of information on the vaccine, the risk of side effects and lack of studies proving its efficacy the public is concerned and misinformed as this vaccine is being promoted as a ‘vaccine against cancer’. Teenage girls especially are being targeted to receive the HPV vaccine to prevent them from developing the Human Papilloma Virus (HPV), which has been linked to cervical cancer.
To answer this common question: Is this vaccine necessary? My answer: No, however regular pap exams are.
There are two types of HPV vaccines approved for use in Canada, Gardasil® and Cervarix ®. The Gardasil® vaccine was approved in Canada in July 2006 (Health Canada, 2010) for males and females age 9-26. The vaccine is effective in preventing HPV types 16 and 18, which are responsible for 70% of cervical cancer. The HPV vaccine only protects against the two most common types of HPV linked to cervical cancer, while there are multiple (over 200) strains of HPV left, leading to the other 30%. In a study by Stanley, he explained that the current HPV vaccines include only two of the 15 cancer causing HPVs, and these vaccines will not eliminate cervical cancer or the other HPV associated ano-genital diseases (Stanley, 2010). The Cervarix® vaccine was approved for use in Canada in February 2010 for females aged 10 to 25, and is also effective in preventing the HPV types 16 and 18 [responsible for 70% cervical cancer] (Health Canada, 2010). The goal of Health Canada is to mass vaccinate young women before they become sexually active to maximize protection before they become sexually active. However, the research has still not been able to prove how long the protection will last and there has been discussion concerning certain individuals needing vaccine boosters.
HPV is one of the most common sexually transmitted infections in Canada, and the majority of cervical cancers are caused by this infection. However, research has shown that most sexually active people will experience an HPV infection at some point in their lives and 80-90% of these will clear spontaneously within two years. Regular pap exams in sexually active females are an effective and useful tool to screen for abnormal cervical cells (HPV) (www.cwhn.ca). Since pap exams were introduced, the rate of cervical cancer dropped dramatically. Pap exams should be done annually in sexually active females as it is still the primary tool for discovering abnormal pre cancerous cervical cells. The fear is that women will have a false sense of security after receiving the HPV vaccine, which may lead to unprotected sex, not getting annual pap exams and a false feeling of being protected from cervical cancer. According to Health Canada, vaccinated females must continue to have regular cervical cancer screening (pap exams) and practice safe sex practices. Other causes of cervical cancer include smoking, nutritional deficiency especially folic acid and immunodeficiency (Health Canada, 2010).
Now let’s discuss the risks. According to Health Canada, 22 hospitalizations and one death following HPV immunization have been reported to date in Canada (Health Canada, 2010). A teenage girl died in December 2008 after receiving a dose of the Gardasil® vaccine in Montreal. She was found unconscious two days after receiving her second dose of the vaccine. After the first dose in October 2008 she experienced dizziness and memory loss; yet she still went through with the unnecessary second dose (www.torontosun.com). Furthermore, the National Vaccine Information Centre has linked 78 deaths to the Gardasil® vaccine in the US (Egan, 2007). Another teenage girl from the US was diagnosed with Guillain-Barre Syndrome (auto-immune disease causing paralysis), eight days after receiving the Gardasil® vaccine.
Due to all the unknowns and risks, a lot of women and parents are unsure if they or their children should receive the vaccine. In a study by Zemet et al., they discussed the issue with 185 women. 48% of them were declining the vaccine. 42.6% of them wanted more research, 35.4% thought the vaccine was too new, 31.7% thought there wasn’t enough information on the vaccine and 24.4% were concerned about the side effects (Zemet et al, 2010). In 2008, Horn et al., questioned 325 parents with children aged 9-17 to discover that 57% thought the HPV vaccine should NOT be included in vaccination programs as it infringes on their rights, has not been well studied and has too many adverse effects (Horn et al, 2010).
Merck, pharmaceutical company, is responsible for manufacturing this vaccine and is expected to net over $2 billion globally. It is a very expensive protocol as the three vaccines over a six month period cost $410 per person (Health Canada, 2010)
To finish, let’s use the tools we already have, such as the Pap test, to help eradicate cervical cancer. Vaccinating everyone is a shotgun approach. The money would be better spent ensuring that all women have access to regular pap exams. The media’s portrayal of the HPV vaccine must also be altered so young girls don’t think that they are 100% protected from contracting HPV or cervical cancer. Make an informed choice!
Yours in health,
Dr. Sarah Hawthorn, ND