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HPV Immunization: Mired In Controversy

Patients with pre-teens and teenagers have been asking my opinion on the HPV (human papilloma virus) immunization, sold as Gardasil by the Big Pharma giant Merck. Young daughters, and now sons, are bringing home handouts from school, being pressured by the family pediatrician, and, oh those TV commercials.

Families who go online discover arguments for and against immunization that sound like two dogs on opposite sides of a cyclone fence barking furiously at each other. Actually, that’s an unfair comparison. Most of the scientists on both sides are fairly reserved, but you can sense their dismay that the view of their side hasn’t been accepted as universal truth.

“Why in heaven’s name would you not want to use a safe vaccine to protect your children from certain cancers that could kill them,” says one group of well-meaning (and generally Big Pharma-funded) scientists. The other side responds “Because we aren’t positive that the vaccine is safe, that it really does protect against cancer, and that the long-term effects are harmless.”

As a parent, your most sane conclusion is confusion
Regular readers of these Health Tips know that I’m highly skeptical of virtually all clinical trials and research studies testing any industry-funded pharmaceutical product simply because there’s so much money involved in terms of Big Pharma profits. Look at the following Gardasil numbers and prepare for a throbbing head trying to get a handle on the math.

The three Gardasil injections come to about $600, generally funded through health insurance and various government subsidies. Current CDC recommendations call for Gardasil to be given to all girls and boys between 11 and 12. This is for the US, but Gardasil is marketed worldwide (or at least in those areas of the world that can afford it). My pocket calculator can’t handle this, but let’s agree that Merck, which manufactures Gardasil, stands to make a lot of money. Along the way, Merck can also afford to pay its researchers, especially those who bring in good results, a great deal of money.

Before you have your daughter or son thrice jabbed by the pediatrician, consider:

  • HPV is the most common sexually transmitted disease (STD). There are about 100 strains of HPV (some strains cause those harmless warts you had as a kid), but only a few, like #16 and #18, are linked to cervical cancer.
  • Most HPV infections go away by themselves. The higher-risk strains take years to develop into cervical cancer.
  • Gardasil does confer immunity against nine of the high-risk HPV types, but no one (not even Merck) knows exactly how long this immunity lasts. The best guess is that booster shots will be needed every four years.

There has been controversy about the phrasing used by Merck researchers. The ads say “Helps prevent HPV infection” and “expected to prevent cervical cancer” but this is not the same as “definitely prevents cervical cancer.” WebMD says that Merck now reports Gardasil does prevent cancer. In the same breath WebMD admits that Merck is a financial supporter of WebMD (get my drift?).

Deaths from cervical cancer are not all that common
This year there will be 12,000 new cases of cervical cancer (discovered by Pap smears) and most women will be completely cured. 4,000 American women will die from cervical cancer, compared to 40,000 women dying from breast cancer and 25,000 from colon cancer.

Deaths occur primarily in women who have never had a Pap smear and arrive at the doctor with advanced disease. In fact most cervical cancer deaths occur among medically underserved women of color. As the article at the link states, “NCI conducted a study of regions within the United States where cervical cancer incidence rates are high. They found that cervical cancer rates reflected a larger problem of unequal access to health care.” Death rates are even higher in underdeveloped countries.

Although most female patients at WholeHealth Chicago have their own gynecologists for Pap smears, we do quite a few ourselves and in 16 years we’ve never had a single Pap smear that revealed cervical cancer. A few patients have cervical dysplasia, some cases of which increase cancer risk, though most do not. This low incidence of cancer is the result of access to care, regular checkups, and healthy lifestyles.

Take-home message: get your annual Pap smear (and to protect against all STDs, HPV included, use a condom). You’ll be tested for HPV during your Pap smear and if you’re negative you can reduce the frequency of annual Pap smears to every three years for women between 21 and 30, and every five years between 31 and 65.

Gardasil is probably a good idea in those US regions (and other countries) where women don’t have access to Pap smears or don’t get them regularly for other reasons. However, until there’s better data on actual cancer prevention (like the results of tracking immunized vs. non-immunized girls), I recommend not rushing into this. One fear is that once immunized, women might not be as stringent about getting their annual exams—a definite mistake as the pelvic exam done with a Pap smear can diagnose a variety of conditions unrelated to cervical cancer (including ovarian cancer, fibroids, and endometriosis).

Then, of course, there’s always the question of safety. Is the Gardasil three-shot immunization series completely safe? Naturally, Merck says yes and that the most commonly reported side effects (lightheadedness, fainting, and pain at the injection site) are harmless events that occur with many young girls receiving any type of an injection. These complaints are being reported at a frequency no different from when the young girls are injected with a placebo.

But we should be skeptical
It often takes years for serious issues related to any new medication to appear. For example, the permanent tendon damage that can occur with quinolone antibiotics (like Cipro and Levaquin) wasn’t reported until the drug had been out for several years. No one ever connected an antibiotic with tendon inflammation. Now, 30 years later, tendon damage is such a risk that there’s a black box warning (high risk, dangerous) printed on the package insert.

What caught my eye about Gardasil was a series of reports from around the world that told of a syndrome appearing in young women who had received the Gardasil vaccination. The symptoms seemed indistinguishable from the fibromyalgia/chronic fatigue syndrome I’ve been working with for years.

“Oi veh!” I mumbled to myself. “We need this vi ein loch in kopf.” I will translate. “Oh woe! We need this like we need a hole in the head.”

As if teenagers didn’t have enough tsuris (troubles) with pimples, hormones, bullies, and getting into the college of their parents’ choice, now we’re going to give them fibromyalgia? Chronic fatigue?

Other reported symptoms include orthostatic hypotension (fainting when rising from a seated to a standing position, also called postural orthostatic tachycardia syndrome, or POTS), complex regional pain syndrome (CRPS, a horror show of constant and difficult-to-relieve pain in one specific limb), memory and cognitive problems, sleep disorders, and so forth.

Or you could simply watch one teenage girl describing her life after Gardasil, though I’ll be the first to acknowledge that it’s possible she could have developed these symptoms without Gardasil. Certainly most fibro-CFS patients have no history of using Gardasil. Warning: the video at the link is emotionally wrenching and I notice there are at least a dozen others.

Naturally, those involved in the promotion of Gardasil stand by their guns, saying basically that such symptoms can appear in anyone and that the frequency of fibromyalgia-chronic fatigue in those who have been vaccinated with Gardasil is no different than in the female population at large. The European Medical Agency (EMA) reassures EU patients and physicians not to worry, but the EMA has real issues with financial conflicts of interest.

Some countries are very concerned, not thrilled about trading protection from a low-risk virus for a lifetime of pain, fatigue, and disability. In 2013, Japan withdrew its Gardasil recommendations to the public and initiated a system for physicians to report on side effects. After a study was published in Denmark about the link between Gardasil, POTS and CRPS, the Danish government ordered its own independent study, separate from the bland reassurances of Merck and the EMA. Glaxo (a second vaccine manufacturer) vehemently denies everything and I’d link you to their article but it’ll cost you $35 to read it.

So there it is
You’ve got a kid at home who’s soon going to be flooded with sex hormones and you don’t want her or him to develop cancer related to sexual activity. (For men, BTW, it’s prevention of penis cancer, which is rare in North America. I saw it just once in my career at Cook County Hospital in an elderly, malnourished skid row alcoholic.)

You’ve got a pharmaceutical industry with one goal: shareholder profits. Their track record for manipulating clinical trials and withholding information about side effects is shameful.

If your health insurance covers regular Pap smears for your daughter and she is getting them, your son or daughter is clear that a condom must always be used to prevent STD transmission, and your daughter doesn’t smoke (yet another risk), well, make the best decision you can.

Be well,
David Edelberg, MD


Leave a Comment

  1. calle says:

    One of the women who helped develope this is totally against it now. No time to google her name but have read her comments.
    As well as some have died from this..no way would I ever give it to my dead dog much less my precious children.

  2. Laurie Empen says:

    I have a friend from high school whose daughter became VERY sick because of this vaccine. She found a doctor in the region to do a series of treatments to reverse the damage, but it was VERY real, and very scary. And I have had cervical dysplasia and it cleared with using Vit A and Folic Acid. So WOMEN – stay on top of your Pap Smears!

  3. Susan says:

    I basically do not support this vaccine. However one thing that gives me pause, which DR. Edelberg does not address, is the exploding rates of oral squamous cell cancers (throat cancer, tongue cancer, etc). These are also frequently due to HPV and are due to oral sexual practices. Seeing as we are not yet screen for HPV (a “Pap” of the oral cavity) these are not being caught and results dire. Thoughts Dr. E?

  4. Dr E says:

    Hi Susan
    Despite the increases in oral cancer, fortunately the overall numbers remain small. This particular cancer appears mainly in people who drink a lot of alcohol and use tobacco products. Yes, carrying one of the cancer causing strains of HPV in your mouth increases your oral cancer risks but nowhere near so much as alcohol/tobacco use. There is a salivary test to determine if you are an HPV carrier
    Statistically, 8% of people are HPV carriers but only 1% carry the strain that is associated with oral cancer and the vast majority of these carriers don’t develop cancer. We do not know if HPV vaccination prevents/reduces oral cancer. The one reasonably positive benefit of the mandatory vaccination for HPV is that ultimately there will be fewer carriers of the virus and those not immunized will have some protection as well.

  5. Deb says:

    Dr. E. This article hits extremely close to home. My daughter’s best friend was diagnosed with autonomic dysfunction from her HPV vaccinations. She live in California, but came back to Chicago to get a final diagnosis after failing to get one there. It has taken months to get the right diagnosis. This young woman is 24 years old. I have known her since she was 5. She is an intelligent, talented up and coming fashion designer. In high school, a short time after her first HPV vaccination, she fainted. She missed months of school, had continual fainting and went in premature menopause. She got somewhat better, returned to school, went to college in LA and was married last November to the love of her life. In February of this year, she began fainting upon standing, having extreme headaches, fatigue, and many other symptoms. She went to her regular doctor her and then on to a specialist here affiliated with The Mayo Clinic. After rigorous testing, some of which could not even be completed due to her fragile state, he made the diagnosis of Autonomic Dysfunction. He put all the pieces together from her HS fainting to the present. There is no cure. She will never get better, the symptoms are cumulative.
    Her life these days consists of sleeping 20 hours a day. She wears compression leggings, a compression girdle and is on a timed released beta blocker among other things. She has to sit down after a brief walk to the corner, and has fallen asleep at the beach for hours after her husband carried her in the sand to the water for her to dip her feet. Let me me remind all of you who are reading this that she is only 24. She is at constant risk for a heart attack or stroke. All of this because of a needless HPV vaccination that is pushed down our throats by big pharma. If we don’t do it, we’re terrible mothers. Just google what happen to Katie Couric when she spoke out against it. The backlash she got was near epic, and she had to withdraw her comments even though her own daughters experienced some menopausal symptoms. China, India, to name a few have pulled the plug on this vaccine and a young girl in France sued the maker of the vaccine after she contracted MS.
    Like you mentioned in your article, this is a manageable virus. And if we teach our young daughters about safe sex, having condoms with them (don’t depend on the guy,) this can be avoided. I’m so sorry I made my own daughter get vaccinated, but the nurse practitioner pushed it.
    This young woman’s one year wedding anniversary is a few days away. Luckily she has an amazing, amazing husband, and a lot of support, but this is hardly compensation for being a prisoner in her own body.
    We love you Megan!

  6. William Lukander says:

    Please read about HPV vaccines

  7. calle says:

    Thanks Ladies for your posts, had not read them before.
    The adage,,,,,do no harm comes to mind.

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