HPV vaccine. Will you get it for your daughter? (diabetes, weight, 4 years old)
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IMO, the risk vs. gain assessment leaves this one lacking.
#1 There are neurological issues associated with the vaccine. Supposedly only temporary motor control issues but I know of one girl who was still in a wheel chair several months after getting the vaccine.
#2 The vaccine is expected to be effective for only 7 years so it will be wearing off at age 19 for girls who get it at 12 which is kind of silly to me.
#3 Cervical cancer is 100% detectable and curable if caught early. Mine was caught in the pre cancerous stage, removed and I have gone on to lead a healthy life.
#4 It only reduces the risk of cervical cancer and DOES NOT eliminate the need for pap smears. I predict that while we will see fewer cases of cervical cancer because of the vaccine, we could see more deaths due to cervical cancer because women could get a false sense of security and pass on the pap smear.
If it elminated the need for pap smears, I might think the issues with neurological issues was worth the risk but I'm thinking not. I will let my daughters make this decision themselves when they are 18.
Here's one I find interesting. My insurance will pay for the HPV vaccine but would not pay for the menningitis vaccine. Menningitis poses a greater risk (lower incidence but you're likely to die or be paralyzed for life if you get it) but I had to pay $100 for my girls to get that one.
IMO, the risk vs. gain assessment leaves this one lacking.
#1 There are neurological issues associated with the vaccine. Supposedly only temporary motor control issues but I know of one girl who was still in a wheel chair several months after getting the vaccine.
#2 The vaccine is expected to be effective for only 7 years so it will be wearing off at age 19 for girls who get it at 12 which is kind of silly to me.
#3 Cervical cancer is 100% detectable and curable if caught early. Mine was caught in the pre cancerous stage, removed and I have gone on to lead a healthy life.
#4 It only reduces the risk of cervical cancer and DOES NOT eliminate the need for pap smears. I predict that while we will see fewer cases of cervical cancer because of the vaccine, we could see more deaths due to cervical cancer because women could get a false sense of security and pass on the pap smear.
If it elminated the need for pap smears, I might think the issues with neurological issues was worth the risk but I'm thinking not. I will let my daughters make this decision themselves when they are 18.
Here's one I find interesting. My insurance will pay for the HPV vaccine but would not pay for the menningitis vaccine. Menningitis poses a greater risk (lower incidence but you're likely to die or be paralyzed for life if you get it) but I had to pay $100 for my girls to get that one.
1. I do not believe this, and would like to see a link. Here is what the CDC says:
As of September 30, 2010, there were 17,160 VAERS reports of adverse events following Gardasil vaccination in the United States. Of these reports, 92% were reports of events considered to be non-serious, and 8% were reports of events considered serious.
All serious reports (8%) for Gardasil have been carefully analyzed by medical experts. Experts have not found a common medical pattern to the reports of serious adverse events reported for Gardasil that would suggest that they were caused by the vaccine.
Will a booster shot be needed? The length of vaccine protection (immunity) is usually not known when a vaccine is first introduced. So far, studies have found that vaccinated persons are protected for five years. More research is being done to find out how long protection will last, and if a booster dose of vaccine will be needed.
A booster would be one shot, compared to the three shot series.
3. You were lucky. Not everyone is so fortunate. There are many stories, as valid as yours, about people who for some reason, despite regular paps, had more advanced cervical cancer.
4. Everything in the literature states that paps are still needed. Do you have a crystal ball to make this prediction with?
By the time your daughters are 18, they may be having sex and be infected.
I have no response to your insurance dilema; that is not the case for most policies that our patients in Colorado have. You could have gone to the health dept. and gotten the meningitis vax for much less than $100.
As of September 30, 2010, there were 17,160 VAERS reports of adverse events following Gardasil vaccination in the United States. Of these reports, 92% were reports of events considered to be non-serious, and 8% were reports of events considered serious.
All serious reports (8%) for Gardasil have been carefully analyzed by medical experts. Experts have not found a common medical pattern to the reports of serious adverse events reported for Gardasil that would suggest that they were caused by the vaccine.
Will a booster shot be needed? The length of vaccine protection (immunity) is usually not known when a vaccine is first introduced. So far, studies have found that vaccinated persons are protected for five years. More research is being done to find out how long protection will last, and if a booster dose of vaccine will be needed.
A booster would be one shot, compared to the three shot series.
3. You were lucky. Not everyone is so fortunate. There are many stories, as valid as yours, about people who for some reason, despite regular paps, had more advanced cervical cancer.
4. Everything in the literature states that paps are still needed. Do you have a crystal ball to make this prediction with?
By the time your daughters are 18, they may be having sex and be infected.
I have no response to your insurance dilema; that is not the case for most policies that our patients in Colorado have. You could have gone to the health dept. and gotten the meningitis vax for much less than $100.
You do realize that you are supporting my case. Except for #1 and both my physician and our pediatrician agree that the jury is still out on the neurological issues. They both agree they are there but, most, have proved to be minor and temporary. However, I don't see the point in taking the risk given the risk to benefit ratio. We don't know how long the vaccine will last, we don't know how effective it will be but we do know it does not eliminate risk and could lead to a false sense of security that results in young women not getting the test that could diagnose and cure cervical cancer. A pap smear can diagnose cervical cancer and it's curable if caught early. No, I'm not getting my girls a vaccine that, at best, only reduces their risk of getting cervical cancer, curable if caught early and if you're getting regular paps, you can catch it early, and could have adverse effects.
I don't have a link stats for the neurological issues but on our last visit to the pedicatirician he confirmed that there have been temporary major motor control issues (difficulty walking) after the vaccine is given. The girl I know who is wheel chair bound had had an issue earlier in her life that she had recovered from. Her parents didn't know about the motor control issues with the vaccine. Given her history, she should not have been given the vaccine. I'm not sure how she's doing as she was a student of mine at the high school I taught at last year.
I would rather my girls rely on regular pap smears than this vaccine. They will need them anyway even if they get the vaccine so what have we really accomplished if they get the vaccine? I know first hand that cervical cancer is 100% diagnosable with regular pap smears and easily curable if caught early. IMO, this vaccine is just a way for the manufacturer to make a lot of money. There are other things I will vaccinate against, like menningitis. Not that the rate of incidence is that high but if you get it, the consequences are dire and there's no early detection test for that one.
Next time I see the pediatrician, I'll ask what medical journal he got the information on motor control issues from. He does say that, so far, they have not confirmed any long term issues with the vaccine but there's a vested interest not to given the amount of money changing hands here. Everyone from the supplier on down is making money off of this one. And I do believe it will lead to fewer women getting regular pap smears. Since it only reduces getting HPV which only increases your risk of cervical cancer, I really don't see the point.
It doesn't reduce getting HPV. It -eliminates- getting specific strains of HPV. This, in turn, -eliminates- the risk of cervical cancer caused by those specific strains.
Those specific strains, eliminated by the vaccine, are those that most commonly cause cervical cancer. In other words, if a patient is diagnosed with cervical cancer caused by HPV, then it is *most likely* to have been caused by one of the strains that the vaccine would have eliminated, had the patient been vaccinated.
As for regular pap smears: women get a pap smear every year, if they're getting them "regularly."
You can contract HPV the week after your pap smear, and have cervical cancer the next month, and show NO symptoms of it at all - and 11 MONTHS later, have your next pap smear, only to be told that you've had cervical cancer for the past 11 months.
Is that a risk you are willing to take with your children?
Anytime a new drug is touted as "It MIGHT" help, or "It COULD" help, I stay away from it. Look at the number of lawsuits going on right now involving newer drugs. When a drug commercial comes on television and the first sentence is, "It is believed", or "It is thought that" such and such is caused by this or that, it's alarming. That means those drugs are created to alter something that might not have anything to do with the problem.
The ONLY drugs I trust are the ones that are tried and true and have been around for a long time.
What is the sense of having to jump through the same hoops as before the drug is administered? With Gardasil, you still need pap smears; you still could end up with cancer. By their own admission, it's useless.
The research to create Gardasil has existed since the 1980's, and the testing phase began in the 1990's. It was approved for distribution to patients in 2006; so it's been around for 5 years. I don't know what constitutes "a long time" for you, but for me, something that has been used for 5 years, that has been researched for 30 years, and tested for 20 years, is "a long time" for me.
Many many drugs that were believed to be appropriate and safe, were taken off the market because the people who believed this, were wrong. Laudanum is a great example.
You do realize that you are supporting my case. :think: Except for #1 and both my physician and our pediatrician agree that the jury is still out on the neurological issues. They both agree they are there but, most, have proved to be minor and temporary. However, I don't see the point in taking the risk given the risk to benefit ratio. We don't know how long the vaccine will last, we don't know how effective it will be but we do know it does not eliminate risk and could lead to a false sense of security that results in young women not getting the test that could diagnose and cure cervical cancer. A pap smear can diagnose cervical cancer and it's curable if caught early. No, I'm not getting my girls a vaccine that, at best, only reduces their risk of getting cervical cancer, curable if caught early and if you're getting regular paps, you can catch it early, and could have adverse effects.
I don't have a link stats for the neurological issues but on our last visit to the pedicatirician he confirmed that there have been temporary major motor control issues (difficulty walking) after the vaccine is given. The girl I know who is wheel chair bound had had an issue earlier in her life that she had recovered from. Her parents didn't know about the motor control issues with the vaccine. Given her history, she should not have been given the vaccine. I'm not sure how she's doing as she was a student of mine at the high school I taught at last year.
I would rather my girls rely on regular pap smears than this vaccine. They will need them anyway even if they get the vaccine so what have we really accomplished if they get the vaccine? I know first hand that cervical cancer is 100% diagnosable with regular pap smears and easily curable if caught early. IMO, this vaccine is just a way for the manufacturer to make a lot of money. There are other things I will vaccinate against, like menningitis. Not that the rate of incidence is that high but if you get it, the consequences are dire and there's no early detection test for that one.
Next time I see the pediatrician, I'll ask what medical journal he got the information on motor control issues from. He does say that, so far, they have not confirmed any long term issues with the vaccine but there's a vested interest not to given the amount of money changing hands here. Everyone from the supplier on down is making money off of this one. And I do believe it will lead to fewer women getting regular pap smears. Since it only reduces getting HPV which only increases your risk of cervical cancer, I really don't see the point.
How am I supporting your case?
Yes, you should ask him. I'll bet he won't be able to tell you, or even give you a hint of where he read that. It probably came from Oprah. Most pediatricians in pediatric practice do not read the vaccine literature; they are as vulnerable to some of the media hype as anyone else. In addition, some have issues with the sexuality implications of this vaccine and think it's only for "bad" girls. I have heard some say that.
I'll repeat, just because your cervical cancer was 100% cured, thankfully, that doesn't mean that everyone's is or ever will be.
As for the meningitis, you should argue with your insurance company if they wouldn't pay for it. Your daughters are young, IIRC. Meningitis vaccine (Menactra) is recommended at 11-12 years with (gasp!) a booster at 16-17 because immunity starts to wane after 5 years. Also, this is a thead about the HPV vaccine, not meningitis.
Other vaccines requiring boosters:
Diptheria, tetanus, pertussis: every 10 years, one time with a vaccine for all three, the rest with TD for life
MMR: one booster
Chickenpox: one booster
Polio: if traveling to a country with endemic polio
In fact, DTP, Polio, Hib, and Prevanr all require a series of shots and one or two reinforcing boosters.
Last edited by Katarina Witt; 01-16-2011 at 08:57 AM..
Yes, you should ask him. I'll bet he won't be able to tell you, or even give you a hint of where he read that. It probably came from Oprah. Most pediatricians in pediatric practice do not read the vaccine literature; they are as vulnerable to some of the media hype as anyone else. In addition, some have issues with the sexuality implications of this vaccine and think it's only for "bad" girls. I have heard some say that.
I'll repeat, just because your cervical cancer was 100% cured, thankfully, that doesn't mean that everyone's is or ever will be.
As for the meningitis, you should argue with your insurance company if they wouldn't pay for it. Your daughters are young, IIRC. Meningitis vaccine (Menactra) is recommended at 11-12 years with (gasp!) a booster at 16-17 because immunity starts to wane after 5 years. Also, this is a thead about the HPV vaccine, not meningitis.
Other vaccines requiring boosters:
Diptheria, tetanus, pertussis: every 10 years, one time with a vaccine for all three, the rest with TD for life
MMR: one booster
Chickenpox: one booster
Polio: if traveling to a country with endemic polio
In fact, DTP, Polio, Hib, and Prevanr all require a series of shots and one or two reinforcing boosters.
Cervical cancer is easily detectable on a pap smear. It's also easily treatable when caught early.
You said yourself the vaccine only works for 5 years (initial projections were 7). If you look at the numbers of adults who get boosters for other vaccines, the rate of recieving the booster will be low. Most adults never get their boosters. So we're talking about protecting our daughters during the years where they are actually least likely to be sexually active. I'm supposed to take a risk of neurological issues for that????
If I were inclined to get this vaccine, at all, for my daughters, and I am not ( my doctor, ob/gyn and pedicatrician agree with my decision as they have no counter argument for my arguments), I wouldn't get it until they were 17. Even the manufacturer admits that the effectiveness is nearly the same when administered at 17 as 12. That would offer my daughter, minimal protection (remember this vaccine does not prevent cervical cancer just the spread of HPV which is believed to be a precurser to cervical cancer in a signficant number of cerfical cancer cases) from 17 to 22. That makes far more sense than 12 to 17.
I really don't see the benefit for the risk on this one. Unlike the chicken pox vaccine, it doesn't prevent cervical cancer. It doesn't even eliminate the need for paps and regular paps can detect cervical cancer early enough to make it curable. I find it funny that you are arguing against this logic when my OB/GYN doesn't. He just shrugged when I gave him my argument. He had no counter arugment. Neither did our pediatrician.
I think we'd do better to make sure girls are getting pap smears from early ages than to give them shots that are going to give them a false sense of security. This shot only reduces the risk of contracting HPV. It does not immunize against cervical cancer. Seriously, if I weren't in the habit of getting them, I'd be dead. I was 19 when they found pre-cancerous cells on a routine pap smear.
You do realize that you are supporting my case. Except for #1 and both my physician and our pediatrician agree that the jury is still out on the neurological issues. They both agree they are there but, most, have proved to be minor and temporary. However, I don't see the point in taking the risk given the risk to benefit ratio. We don't know how long the vaccine will last, we don't know how effective it will be but we do know it does not eliminate risk and could lead to a false sense of security that results in young women not getting the test that could diagnose and cure cervical cancer. A pap smear can diagnose cervical cancer and it's curable if caught early. No, I'm not getting my girls a vaccine that, at best, only reduces their risk of getting cervical cancer, curable if caught early and if you're getting regular paps, you can catch it early, and could have adverse effects.
To date, the data do not support a cause and effect relationship between HPV vaccine and "neurological issues." There is no pattern to the reported adverse events occurring after receiving the vaccine to suggest that it increases the risk of Guillain Barre syndrome. There are numbers of reports of girls fainting, and that can be prevented by careful observation. Simple hyperventilation can even cause what looks like a seizure. And that is about the extent of the "neurological issues."
The vaccine has had extensive testing. We do know it is effective. As with any vaccine, it requires time to know if a booster will be needed. Would you not take a tetanus vaccine because you need periodic boosters?
Wearing a seat belt does not eliminate the risk of dying in an automoble accident, but it certainly decreases it. Do you not wear a seat belt because it does not guarantee you will not die?
Your Pap smear argument also fails, because Pap smears are not 100% effective in diagnosing cervical cancer.
The solution to the "false sense of security" is education of the patient, not skipping the vaccine.
Quote:
I don't have a link stats for the neurological issues but on our last visit to the pedicatirician he confirmed that there have been temporary major motor control issues (difficulty walking) after the vaccine is given. The girl I know who is wheel chair bound had had an issue earlier in her life that she had recovered from. Her parents didn't know about the motor control issues with the vaccine. Given her history, she should not have been given the vaccine. I'm not sure how she's doing as she was a student of mine at the high school I taught at last year.
What "issue" are you talking about, and how do we know the vaccine had anything to do with your student being in the wheelchair? Could it not be that whatever caused her to be in the wheelchair was related only to whatever her pre-existing issue was?
The link I gave you does have the statistics. The vaccine is not being associated with a large number of serious side effects.
Quote:
I would rather my girls rely on regular pap smears than this vaccine. They will need them anyway even if they get the vaccine so what have we really accomplished if they get the vaccine? I know first hand that cervical cancer is 100% diagnosable with regular pap smears and easily curable if caught early. IMO, this vaccine is just a way for the manufacturer to make a lot of money. There are other things I will vaccinate against, like menningitis. Not that the rate of incidence is that high but if you get it, the consequences are dire and there's no early detection test for that one.
Next time I see the pediatrician, I'll ask what medical journal he got the information on motor control issues from. He does say that, so far, they have not confirmed any long term issues with the vaccine but there's a vested interest not to given the amount of money changing hands here. Everyone from the supplier on down is making money off of this one. And I do believe it will lead to fewer women getting regular pap smears. Since it only reduces getting HPV which only increases your risk of cervical cancer, I really don't see the point.
No, cervical cancer is not 100% diagnosable with regular Pap smears. See the link to the Italian study above. And I assure you that the women who are treated for it would not consider that treatment "easy'".
The treatment for simple warts is no walk in the park, either. Diagnosing precancerous cervical conditions involves painful biopsies and increased surveillance, which is expensive, time consuming, stressful, and sometimes leads to treatments which can result in fertility problems.
I am a bit tired of the argument that vaccines only exist to make money. I assure you that the medical system would make a lot more money off the misery caused by not having vaccines than it does off the vaccines themselves.
Anytime a new drug is touted as "It MIGHT" help, or "It COULD" help, I stay away from it. Look at the number of lawsuits going on right now involving newer drugs. When a drug commercial comes on television and the first sentence is, "It is believed", or "It is thought that" such and such is caused by this or that, it's alarming. That means those drugs are created to alter something that might not have anything to do with the problem.
The ONLY drugs I trust are the ones that are tried and true and have been around for a long time.
What is the sense of having to jump through the same hoops as before the drug is administered? With Gardasil, you still need pap smears; you still could end up with cancer. By their own admission, it's useless.
ITA. IMO this is unproven. Even if it does what they hope it does, it will only reduce cervical cancer rates not eliminate cervical cancer. One of the issues I have is that people think of immunizations as preventative...as in they won't get something if they have the shot. This one only reduces risk. You still need routine pap smears because there is still significant risk. My fear is women will pass on the pap smear because they had the shot. Even if it works to the levels they hope it does, that could mean that 30% of the cervical cancer cases we see now go undetected. We may see less rates of cervical cancer but higher numbers of women dying from cervical cancer because they didn't get the pap smear.
I am very fortunate that my mother and my doctor always pushed preventative medicine. If I hadn't had my pap smear when I turned 19, I might not be here today. I'm glad no one gave me a shot that led to a false sense of security. And then there's the simple fact that adults tend not to get immunization boosters. They don't think about them.
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Except for #1 and both my physician and our pediatrician agree that the jury is still out on the neurological issues. They both agree they are there but, most, have proved to be minor and temporary. However, I don't see the point in taking the risk given the risk to benefit ratio. We don't know how long the vaccine will last, we don't know how effective it will be but we do know it does not eliminate risk and could lead to a false sense of security that results in young women not getting the test that could diagnose and cure cervical cancer. A pap smear can diagnose cervical cancer and it's curable if caught early. No, I'm not getting my girls a vaccine that, at best, only reduces their risk of getting cervical cancer, curable if caught early and if you're getting regular paps, you can catch it early, and could have adverse effects. 
ITA. IMO this is unproven. Even if it does what they hope it does, it will only reduce cervical cancer rates not eliminate cervical cancer. One of the issues I have is that people think of immunizations as preventative...as in they won't get something if they have the shot. This one only reduces risk. You still need routine pap smears because there is still significant risk. My fear is women will pass on the pap smear because they had the shot. Even if it works to the levels they hope it does, that could mean that 30% of the cervical cancer cases we see now go undetected. We may see less rates of cervical cancer but higher numbers of women dying from cervical cancer because they didn't get the pap smear. 
