To not let dd have the HVP vaccination?

[DogGoneMad]

Dh and I really disagree on this.

Both scuttlebutter and brdgirl have shared really personal, painful stories on this thread (back on page 3) and I'm kind of amazed that they've barely been acknowledged except to be snidely dismissed as "emotional blackmail."

The OP asked whether it was unreasonable not to vaccinate her daughter. Two people, both of whom have personally suffered the dangerous effects of the virus prevented by the vaccine, replied to share their experiences as evidence of why they feel that it is unreasonable not to vaccinate. That's not "emotional blackmail", that's answering the question that was asked, from one of the best possible perspectives from which it can be answered.

scuttle and brdgirl - just wanted to say thank you for sharing your stories. They both really impacted me. I was not in any question as to whether I will vaccinate dd (I certainly will), but I can be quite lax about my own smears and check-ups, so your 'emotional blackmail' is a very welcome kick in the ass for me to make the appointment.

Before you read this, remember that all reported reactions are included and if serious investigated to ascertain if there is a causal relationship

This is for the gardasil vaccine only

from 2006 to 2008, after over 23 million doses had been administered in the United States. The following results were noted:

From June 1, 2006 to December 31, 2008, VAERS received 12,424 reports of adverse events following HPV immunization; a total of 772 reports (6 percent) were serious events, including 32 reports of death; following investigation, it was concluded that HPV vaccination was unlikely to be the cause (of any of the 32 reported deaths.)

Most of the adverse events rates were not greater than those reported with other vaccines, with the exception of syncope and venous thromboembolic events. Among the 1896 syncopal reports, 15 percent resulted in a fall or injury.

Among the 31 patients with thromboembolism, 28 (90 percent) had a known risk factor (ie, estrogen-containing birth control pills or a family history of clotting disorder).

There were 19 pulmonary embolism cases and 4 resulted in death. Venous thromboembolism (VTE) was the only adverse event reported for this vaccine to meet the CDC screening criteria for "signal detection" and will continue to be closely monitored. (This was reported in 2009 and there have been no continuing safety concerns that would lead to the withdrawal of the vaccine)

There was no increased risk of Guillain-Barré Syndrome

There were two documented reports of young females who presented with a rapidly progressing neurologic disorder occurring some months after receipt of HPV vaccine. Autopsy confirmed a diagnosis of amyotrophic lateral sclerosis (not caused by a vaccine) in one case; the other autopsy was reported as "pending".
(Although, not included in this report, to the best of my knowledge the other death confirmed a diagnosis not caused by the vaccine)

Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. lade BA, Leidel L, Vellozzi C, Woo EJ, Hua W, Sutherland A, Izurieta HS, Ball R, Miller N, Braun MM, Markowitz LE, Iskander J. 2009;302(7):750.

Hope this helps

well said cloudydays!!

Interesting - So PIMS, before they give the vaccine do they ask about family history of clotting disorders, just to be on the safe side?

That would worry me, no family history of C, but big problems with Thrombosis..

This is only a consideration for Gardasil.

It is a consideration but not a contraindication. That means they may ask but it doesn't mean you shouldn't get the jab, it means you should have a discussion with your GP about the risk/benefit.

When adverse data is collected it is compared to what would have been expected in a population of that size.
We can predict that and accept that a certain percentage of people will develop disease x,y and z. The number of people that developed clotting disorders was only slightly higher than expected and so for the mean time, this information is simply being monitored.
It was not conclusive. I have just done another search which has found evidence published this year that shows the risk of blood clots is no greater than in the general population and the risk was due to the pre existing blood condition rather than the vaccine. Therefor it is likely that this will no longer be monitored if the FDA and MHRA are satisfied that there is no risk.
After a meta analysis of 7 good quality studies it was concluded that 'Overall there was no statistically significant difference in the risk for vaccine-related serious Adverse Events between vaccine and control groups'

ref: Efficacy and Safety of Prophylactic Vaccines against Cervical HPV Infection and Diseases among Women: A Systematic Review & Meta-Analysis nfect Dis. 2011; 11: 13. Published online 2011 January 12
Beibei Lu,1 Ambuj Kumar,2 Xavier Castellsagué,3 and Anna R Giuliano1

Cevarix has never reported any increased risk of clotting and so could potentially be given as an alternative if you were worried (although it does not protect against the HPV strains that cause genital warts)
So if you were in any way worried, you could request the alternate vaccine

Hope this helps, I try to leave the text as untouched as possible so Im not accused of being biased, but I know that some research papers can just seem like gobbildy gook!!

I have three DCs at secondary school. They are far more clued up, informed, aware about sexual health matters than I ever was (or TBH am now). They dont get 'little chats' about sexual health. It is full on, informative and meaningful. The HPV immunisation is given in that context in my DCs school.

TBH I think it is offensive to say that sex education or HPV immunisation will make our DCs promiscuous. They are far more intelligent than that.

if they don't know what causes cancer and find a cure for cancer how can they prevent it

'They' (the medical profession) do know what causes cervical cancer, how to treat it and how to prevent it.
Cervical cancer is caused when the cells obtain abnormal DNA (in this case HPV) and start to reproduce inappropriately. The cells continue to replicate and grow and invade health tissue. The health tissue looses its ability to function normally and becomes a mass that can invade other vital organs.

The cancer can be treated by removing the harmful cells with surgery or killing them with chemotherapy or radiation (the later are unable to distinguish between healthy and cancerous cells.) Treatment surgical or medical may not be curative because it can be difficult to tell the difference between health tissue and cells that has abnormal DNA in it.

We know we can prevent people from catching HPV by giving them the antibodies that will stop the virus from entering healthy cells.
70-80% of cervical cancer is caused by HPV that can be prevented by the vaccine.

According to the CDC as of June 2011:

"VAERS received a total of 18,727 reports of adverse events following Gardasil® vaccination...8% were considered serious....Any VAERS report that indicated hospitalization, permanent disability, life-threatening illness, congenital anomaly or death is classified as serious."

Fewer adverse events were reported for Cevarix (it isn't widely used in the US)of those reported, 3% fell into the 'serious' category. I'm pretty sure they don't hospitalise people for a 'slight sniffle' or whatever other dismissive comment someone made earlier about reactions.

The two additional strains that Gardisal may protect against (types 6 and 11) may cause genital warts but are rarely linked to cancer. Types 16 and 18 are responsible for 70% of cervical cancer cases. Cervarix may protect against those.

OP, YANBU to question this and try to get as much information as possible about HPV, cervical cancer and the vaccine itself. From this thread it is quite clear that many people do not do that so I don't think they are in any position to criticise you.

I have been accused (Wrongly) on the other thread of only giving information from hysterical newspaper reports so I shall quote directly to attempt to avoid future allegations. Information about HPV and cervical cancer from Cancer Research UK /NHS/Macmillan:

"Most women who have had sex will have the virus at some time in their life. However, in many women their immune system will get rid of the virus and they won?t know they ever had it. "

"Some types of the virus can cause genital warts, and other types can cause CIN in the cells of the cervix. CIN usually clears up once the immune system has got rid of the virus. In some women the virus stays for a number of years, and in a few of these women the CIN will develop into cancer if it is not treated. "

"Having regular cervical screening is the most effective way to prevent cervical cancer."

"Cancer of the cervix is a relatively rare type of cancer. In the UK, around 2,800 women are diagnosed with it each year."

"Only about 7% of cervical cancer deaths occur in women under 35."

Other factors which increase the risk of developing cervical cancer :

• The oral contraceptive pill (40% increase in risk if you use it for 5 years+)

• Weakened Immune system from Smoking, Poor Diet, Infection eg HIV/AIDS

• Age at which you have your first child/number of children that you have.(Women who have their first baby before the age of 17 have double the risk of developing cervical cancer compared with women who have their first baby at 25 or older. Research has also found that women with three or more children have an increased risk compared to women with no children.)

The HPV vaccine provides no guarantees and it is important to have regular smear tests regardless of whether or not you have the vaccine. Personally I think screening starts much too late (current age is 25) and is not regular enough (currently every 3 years). As a result many people may develop cancer between smear tests and while cervical cancer is usually slow growing (source: NHS), several people have shared their experiences which show that it can develop faster which does strengthen the argument for more frequent smear tests. I was lucky enough to have been offered a smear test in my early 20s and they picked up cell changes that required treatment. I had to have two Lletz procedures within 12 months. I, personally, did not find them very traumatic. They were quick day procedures performed under local anaesthetic and I had no complications from them. Even with my experience I would not choose to have the HPV vaccine. I think it is too soon to know what the long term effects are and the effectiveness can only really be estimated at this stage. Only 7% of cervical cancer cases occur in the under 35s so I think it will be a while before we know if the 12 year old girls who were vaccinated a few years ago will go on to develop any cell changes that may lead to cancer. There is also continuing research into whether or not other types of HPV may take over as causes of cancer (source: NHS)

PIMS, you have another thread already where you can have a go at me. It's very bad form to drag it over here as well particularly when I wasn't even here to defend myself. Do you have a medical qualification? Are you in a better position to say that more frequent smear tests wouldn't reduce the number of cases of cervical cancer? I have posted several sources that state quite clearly that screening does prevent cancer because it detects the early changes and enables treatment to be carried out before it develops into cancer. The more frequent the smears, the more opportunities there are to detect changes before they get to the cancer stage . There are many of us who have had cell changes detected early enough to have successful treatment. It does work.

BM, thanks for posting the same info as me

Its good to make sure people have all the info
No one is claiming any guarantees, but a vaccine that can give 95-100% protection to prevent 70-80% of cervical cancer is a very close second

only 7% of cases of cervical cancer are in the under 35s???? That is not just a statistic, it is peoples daughters mothers sister and friends and that statistic can be reduced even further by this vaccine. And those people that make that statistic have posted on this thread. Are you suggesting this is reasonable 'collateral damage'

I have not dragged anything over here. I posted on here long before you arrived.

And yes, I have a medical qualification, 3 in fact :)
but I dont do internet diagnosis on other peoples situations like you do

There is NO evidence from any research and the most recent meta analysis to show that there are ANY long term effects from the vaccine

PIMS, by pointing out a statistic I am not belittling the people who are affected - it is a direct quote from Cancer Research UK take it up with them. Should I accuse you of suggesting that those who were affected by the vaccine are 'collateral damage' ?

I haven't internet diagnosed anyone - more false accusations?

"There is NO evidence from any research and the most recent meta analysis to show that there are ANY long term effects from the vaccine"

How exactly can you show a long term effect when something has only been in use for a few years? It's going to be a while before we know how long the vaccine actually does offer protection for and how effective it is.

How exactly can you show a long term effect when something has only been in use for a few years

few is misleading, please be specific. The meta-analysis looked at studies that gathered evidence over 11 years. That was only the post licence studies

PIMS, by pointing out a statistic I am not belittling the people who are affected - it is a direct quote from Cancer Research UK take it up with them

Cancer research UK support the use of vaccination and screening and think it will have an effect on reducing the number of cases of cervical cancer. They did not use that statistic to identify an acceptable level of disease as you did

I most certainly was not trying to identify an acceptable level of disease - don't be so ridiculous. I was pointing out that there are few cases in the under 35 group so saying that those who were vaccinated have not developed cancer does not prove much yet. They are unlikely to develop cancer anyway.
I don't consider 11 years 'long term' and the vaccine program only started in 2008 so I think it is too soon to tell what impact it will have on the number of cases in the UK.

Bubbley, have been out but just want to support your assessment. It's extremely rational.

Sorry I can't offer more right now but I found your assessments on the previous thread (or is it this one? I'm muddled now) to be helpful.

The first research published was a in 2006 and it was a study that spanned 6,4 years. read the evidence

I was pointing out that there are few cases in the under 35 group so saying that those who were vaccinated have not developed cancer does not prove much yet. They are unlikely to develop cancer anyway.

from the future 1 trial (16-24year olds): 5455 women were radomised to the vaccine or placebo group. Vaccine efficacy was 100 percent in preventing CIN grades 1 to 3 or adenocarcinoma in situ caused by the vaccine-type HPVs in those women who were "HPV-naive" (ie, no cases were diagnosed in the vaccine group, whereas 65 cases were diagnosed in placebo group).

Please stop using words like 'unlikely' read the evidence. My friend was in that age group. Was screened according the the ACOG (every 2 years) and still managed to develop fatal cancer from HPV

I rest my case

I support the use of frequent and regular smear tests earlier than 25.

I'd also like to see the evidence which supercedes the 2006 University of Washington study which showed that correct use of condoms reduce the risk of HPV infection by 70pc.

Have tried not to comment thus far but bumbleymummy I think you are getting your stats mixed up. 7% of cervical ca deaths in the under 35 age group does not equate to a small number of cases. Cervical ca is the second most common cancer is women of that age group, after breast. Any impact that the vaccine has on incidence rates will be significant.

As PIMSoclcok said 11 years is only post licensing studies. The vaccines have been around for a bit longer than that.

Wrt one exchange on this thread - I do think it's rather odd that the arrival of the HPV vaccine is expected to bring with it a sudden acquisition of sexual health wisdom among teenagers.

BB it is rational, but that doesn't make it true.

You both accept that there is some risk of cancer (I have provided convincing evidence to say that this risk would be significantly reduced by a vaccine) but you are willing to accept the current level of risk is ok? and cant see the need for it to be reduced.

On the other hand I say to you that the risk of severe adverse event from vaccination is hugely 'unlikely' to coin your phrase, but this is an unacceptable risk. I dont get it. (and I've not just said its unlikely, I have given frank statistical scientific evidence to state what the risk is, not just that its unlikely)

Women are suffering and loosing their lives to this disease unnecessarily, they dont care that it was unlikely cause it has happened to them!!
Without the vaccine, the risk of developing HPV and cancer is higher that is undeniable.

in not is. That iPad.

bb, your ability to reference is shocking. How am I meant to find your study with such little information.

PIMSoclock thanks for fighting the good fight (and I am sorry about your friend). Sadly, I think some people will not listen and possibly are not able or willing to understand the evidence or the arguments. It's disturbing.

cloudydays: -"your 'emotional blackmail' is a very welcome kick in the ass for me to make the appointment. thank you so much. your post has made my day.

as for vaccines versus smears - that's a straw man. the whole point is that vaccines and smears are tools we have at our disposal to help every woman avoid a bad diagnosis or an invasive treatment.

New England Journal of Medicine

Posted because I don't want young people not to use condoms because they think there's no point.

I'm not sure why you think bubbly or I would deny that the risk of cervical cancer exists. If you've been trying to convince us of that, then I think you might have been wasting your energy rather. It's not something either of us have ever denied.

Smears are not really a straw man. Well, not at all.

They are extremely salient.

The age at which smears are offered is being pushed back and it's possible it may be pushed back further because of the vaccination. I think this is dangerous.

Regular and frequent smears will still be required if you vaccinate. Combine that with condom use (see above study) and a robust attitude to sexual choice and proactivity - that's what I'll recommend to my daughter. The risks and benefits are too unstable.

I don't think you need to insult me because of it: I don't feel the need to insult you for your choice.