Guard Against Gardasil: The Critical Mom's Research

PLEASE NOTE: I've reversed my position on Gardasil: my daughter has been vaccinated and has experienced NO ILL EFFECTS. But I'm leaving this post here for "historic interest."

If you are the mother of a nine-to-twelve year old girl, your pediatrician is sure to recommend the Gardasil or the Cervarix shot for HPV--human papillomavirus, otherwise known as the cause of genital warts, a condition that can (but does not usually) lead to deadly cervical cancers. The only surefire way to avoid HPV, which the vast majority of the population has, or will have, is never to touch another person's genitals. 
But the alternative to these infections--there are many types of HPV, and in most cases they clear up by themselves--is the shot.  Is the shot safe?

When I Googled the virus and the vaccines, the name Diane Medved Harper appeared repeatedly, because Dr. Harper, now at the University of Louisville, was one of the physicians employed by Merck to evaluate the vaccine and to run clinical trials. You can read about her here and here.

But I decided to write to her myself, and she very kindly wrote back, and since she had no objection to my sharing our correspondence of November 5, 2015 with my pediatrician, I am also sharing it with my readers.

The Critical Mom: How wise is it to give a vaccine for a condition that may never develop? (If I am correct in assuming that only 10% of infected people develop cancer, that is).

Dr. Harper: Only 5% of infections develop CIN 3 lesions (precancer).  Of the CIN 3 lesions, only 20% become cancer within 5 years, and only 40% become cancer within 30 years -- so less than 1% of HPV infections become cancer after a very long period of time.   How wise it is is a judgement that only you can make:  it weighs the knowledge that you have a screening system in place to detect the CIN 3 precancer and then treat it. Our treatments are nearly 100% effective (LLETZ, usually).  HPV4 or HPV9 only protect against about 47% of the CIN 3 lesions regardless of HPV type;  HPV2 protects against 93% of CIN 3 lesions regardless of HPV type.  Neither prevents all CIN 3, so screening is still necessary.  HPV2 lasts at least 9.4 years.  HPV4 lasts at least 5 years.  HPV9 lasts at least 3.5 years. ​Screening has few side effects -- the worst side effect is being told you were positive for HPV 16 and going to colposcopy and having a biopsy and having the results of the biopsy be normal. You can see the Gardasil Girls videos on the internet.​

The Critical Mom: Would you give your daughter this vaccine? (Side effects reported by parents on forums do seem worse than those reported for the standard childhood vaccinations).

Dr. Harper:  I would give her the option of choosing whether she wanted it -- but I would suggest that she wait until she was at least 16 years, and maybe even 18 years if she had not yet begun any interest in any sexual activity.​

The Critical Mom:  Isn't a yearly pap test enough after my daughter becomes sexually active? My kids know all about condoms and barrier protection and seem like responsible people. 

Dr. Harper: Yes, screening is enough.  And screening has moved to every 3-5 years depending on whether your doctor uses HPV genotyping as a screen.

The Critical Mom:  Is family history important? (We have no family history of uterine cancer--that is, my mother, my aunt, my grandmother, my husband's mother, never came down with it).

Dr. Harper:  No -- this is an infection that is transmitted by skin to skin contact -- not hereditary​.

The Critical Mom: Is it important, in making a decision, to note that more side effects for Gardasil appear to be reported on the Merck website than are listed for standard vaccines like those for polio and diphtheria?

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Dr. Harper: I would think that you would want to consider all possible side effects. I would also think that you should want to know whether one vaccine offered better protection and fewer side effects.  In my opinion I believe that HPV2 is superior.​

The Critical Mom: On a related subject: Anaïs Nin, the diarist, died of cancer of the vagina. As she detailed in her writings, she had sex four times a day with four different partners for a number of months.  A Gardasil vaccine might have been good for her--but when I read around on the net, and listen to some genuinely alarmist videos, like this and this, I wonder if the vaccine is predicated on the assumption that most girls will pursue sexual activity at the same rate that Nin did.

Dr. Harper: Yes, the adolescent pediatricians promoting the vaccine see only the segment of the adolescent population who indeed are having sex at Nin's frequency.  The vaccine may not have helped her as HPV infections causing vaginal cancer are not necessarily covered by HPV4 or HPV9.​

  
I am very glad to have Dr. Harper's opinions and for the time being have decided not have my daughter vaccinated. Folks with a history of cervical cancer in their families may well feel differently.  I have watched a number of videos of young women who claim that their health has been damaged by the vaccine--Gardasil girl videos referred to by Dr. Harper above; I've also read and seen video accounts that discredit the girls, or that claim no distinct pattern has emerged explaining the girls' idiosyncratic reactions: the implication is that the girls who got sick were already sick, or that their reactions are too rare and unusual to worry about.

So far, I don't agree.  I've decided to continue questioning experts--I've sent an email to Dr. Marcia Angell, the professor of medicine at Harvard who was the first woman editor of the New England Journal of Medicine. Haven't heard from her yet, but hey--how many experts are going to get around to writing some obscure mom?

That is why I appreciate Dr. Harper's response--and, should you read this, Dr. Harper, know that I did forward your remarks to my pediatrician, who thanked me, then insisted that the vaccine offered significant protections, that his thirteen-year-old daughter had already had the first shot, that his wife is a gynecologist who approved it. When I asked him why a pap smear wasn't enough, he rolled his eyes. When I asked if he'd seen any of the Gardasil girls videos, he smiled and said, "Not yet."  He told me his daughter had been vaccinated. But that's not what I need to know. I need to know what percent of women are afflicted by cervical cancer, what kinds of screenings exist, and how to assess the side effects when the mothers and the medical authorities appear to differ. So, Moms, do your own research.  Since the manufacturer of the vaccine, Merck, lists significant side effects on its website, I will wait.  Compare that Merck page to the ones for polio and other standard childhood vaccines.
Personally, I'd wait on a vaccine about which so many side effects including death, continue to be reported.