Warning There’s A New Deadly Disease Worse Than HIV.


HPV – Human Papilloma Virus – Facts You MUST KNOW:

 First of all, you should know that this virus is mainly transmitted sexually (ETS), and it affect both women and men. According to the experts, this virus is responsible for cervical cancer, penis, mouth and anus cancer. The human papillomavirus (HPV) is actually a group of viruses that can affect the human skin, and there are over 100 different types of this virus. This is explained in the National Cervical Cancer Coalition of the United States – NCCC. In fact, certain types of HPV cause common warts on the hands and feet. Most types of HPV are harmless, do not cause any symptoms, and go away on their own.

You’ll be shocked when we tell you that almost 40 types of HPV are known as genital HPV as they affect the genital area. The experts warn that up to 80% of females and males will be infected with at least one type of genital HPV at some time. Genital HPV types may be high-risk types that can cause cervical pre-cancer and cancer, or low-risk types that can cause genital warts and usually benign changes in the cervix. This type of virus is easily spread through direct skin to skin contact. Anyone who has any kind of sexual activity involving genital contact could get genital HPV. That means it’s possible to get the virus without having intercourse. And, because many people who have HPV may not show any signs or symptoms, they can transmit the virus without even knowing it. A person can be infected with more than one type of HPV. The medical experts claim that many people get their first type of HPV infection within their first few years of becoming sexually active.

 According to the latest statistics, women who are infected with the virus HPV (high-risk), have high chances of developing cervical cancer in the next 10 – 20 years. This is why all women are advised (and women who are no longer sexually active), that they should continue performing their routine gynecologic exams. You should also know that infections in women older than 30 years are less likely to be cured by the body, in natural way. So, they should visit the gynecologist and get a proper treatment.

This is very important for you to remember – the male condoms help reduce the risk of contact. And the female condoms cover more than the male condoms, however, they just reduce the risk of infection. Neither of these two types of condoms eliminate the risk of infection completely. And, you’ll be shocked when we tell you that (according to the latest statistics) almost 30 % of oral carcinomas are HPV-related.

Bottom Line:

  • HPV is a common, prolific and highly contagious infection, which is sexually transmitted.
  • Condoms cannot provide 100% protection.
  • The statistics show that more than 80% of sexually active women will get infected at some time in their lives.
  • This virus is mainly transmitted through sexual contact and most people are infected with HPV shortly after the sexual activity.
  • This virus can be present, even when the infected individual has no signs or symptoms of the virus.
  • In some cases, the symptoms do not appear for years, and are even some cases when people never experience any symptoms during their life.
  • It can spread through skin-to-skin contact with infected areas of the skin not covered by the condom such as the male and female genitalia.
  • Women are more more “vulnerable” to the virus than men.
  • The most common HPV- related disease is cervical cancer. And, you should know that cervical cancer is one of the leading causes of death in women.

Lesbians ‘told they did not need cervical screening’


Women who have sex with women are often wrongly told they do not need a cervical screening test, say LGBT groups.

This results in half of all eligible lesbian and bisexual women never having had a smear test, they said.

The human papilloma virus (HPV), which causes most cervical cancers, can be transmitted through lesbian sex.

Cervical cancer charities say all women, no matter their orientation, should have regular cervical screening.

Lesbian, gay, bisexual and transgender (LGBT) groups say women regularly face barriers to accessing healthcare and can have poor experiences when they do.

For example, in a survey of lesbian, bisexual and other women who have sex with women, 36% said a doctor or nurse had assumed they were heterosexual.

The National LGBT Partnership says women also suffer in other ways – they are more likely to report a long-term mental health problem and more likely to binge drink than heterosexual women.

Preparing for a cervical screening test

‘Blanket statements’

Joanna, 30, was told that she did not require a cervical screen test because she was a lesbian.

Although she was eventually tested, Joanna says: “I just felt she [the doctor] needed to be more knowledgeable on the subject.”

Diane, also 30, said she received inaccurate information about whether or not she could benefit from cervical screenings.

She said: “My GP didn’t advise me of my risk level, she just made a number of blanket statements.”

But HPV is passed on through body fluids, like other sexually transmitted infections.

This means that oral sex, transferring vaginal fluids on hands and fingers, or sharing sex toys can all be ways of being exposed to HPV.

The charity Jo’s Cervical Cancer Trust says all women, regardless of their sexual orientation, should have regular cervical screening.

“As HPV can be transmitted through skin-to-skin contact in the genital area, gay women are equally at risk of contracting HPV and experiencing abnormal cervical changes and, thus, should always attend when invited for cervical screening.”

In a study of attitudes to cervical screening among gay and bisexual women in the north-west of England, carried out by the University of Salford in 2011, 37% of women questioned said they had been told they did not require a cervical screening test because of their sexual orientation.

line breakWhat is cervical screening?

It is a test to check the health of the cells of the cervix, not a test for cancer.

Around one in 20 women’s tests show some abnormal changes. Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own.

However, in some cases, the abnormal cells need to be removed so they cannot become cancerous.

All women who are registered with a GP in the UK are invited for cervical screening:

  • Aged 25 to 49 – every three years
  • Aged 50 to 64 – every five years
  • Over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests

Who gets cervical cancer?

It is possible for women of all ages to develop cervical cancer, although the condition mainly affects sexually active women aged 30 to 45.

The condition is much rarer in women under 25.

There are about 3,000 cases of cervical cancer diagnosed each year in the UK.

Do lesbian and bisexual women need cervical screening?

Yes – women should always be offered screening whether they are gay, straight or bisexual.

Sometimes, lesbian women have been advised by health workers that they do not need screening because they do not have sex with men.

But only women who have never had sex at all (with either men or women) may be advised that screening is not necessary.

HPV Down: Is This a Victory?


Prevalence of the four types of HPV in the 4-valent HPV vaccine declined by nearly two-thirds among teenage girls and fell by about a third among young women, according to data from the CDC’s NHANES survey.
Among female teenagers ages 14-19, 4vHPV-type prevalence was down 64% and declined 34% among women ages 20-24 compared to comparable NHANES data from the “pre-vaccine era” (2003-2006), reported Lauri E. Markowtiz, MD, of the CDC, and colleagues.

However, no statistically significant differences were observed among women ages 25-29 and ages 30-34 from the pre-vaccine era to the “vaccine era” (2009-2012), they wrote in Pediatrics.
The authors concluded the decline in vaccine type prevalence was greater than expected after introduction of HPV vaccination (based on current 3-dose coverage), and suggested possible reasons for this finding: “This outcome could be due to herd protection or effectiveness of less than a complete 3-dose series, for which there is accumulating evidence.”
There were also declines among the two younger age groups in prevalence of HPV 16 and 18 — the two types of HPV that are responsible for most types of cervical cancer. Among female teenagers, this prevaccine versus vaccine era difference was statistically significant (7.1% to 2.8%, P<0.01), and significant when adjusted for race/ethnicity and lifetime and past year sex partners, among women ages 20-24 (15.2% to 10.5%, respectively, P<0.05).
Diane Harper, MD, of the University of Louisville, explained via email that she was not surprised by these findings, considering the millions of dollars invested in the cervical cancer vaccine, Gardasil (Merck), but emphasized that preventing cervical cancer would have more to do with screening than the vaccine.
“Cervical cancer prevention in the U.S., though, relies on the routine participation in the screening program as neither Gardasil nor Gardasil9 [the HPV 9-valent vaccine] can prevent more than 50% of all CIN 2/3 disease which is one of the primary aims of our screening and early detection programs,” Harper, who was not involved with the research, wrote to MedPage Today.

Markowitz’s team examined the prevalence of HPV -31, -33, and -45 — which are part of the additional five strains in the 9-valent vaccine — specifically because there had been prior evidence of cross protection, but found no significant difference when comparing prevaccine versus vaccine time periods. In fact, there were no statistically significant differences in the prevalence of the five additional 9-valent HPV vaccine types.
Examining vaccination coverage, about half of female teens reported receiving ≥1 dose of HPV vaccine (51.4%) — the highest of any age group, followed by around a third of women ages 20-24 (32.6%). Markowitz and colleagues note these estimates are similar to estimates from the National Immunization Survey-Teen and the National Health Interview Survey.
But Harper points out that in these 10 years covered by this CDC study, the organization has also reported a significant decline in cervical cancer screening programs nationally.
“This is worrisome as to date the U.S. has yet to see improved health outcomes for the health dollars and energies spent with a clear signal that screening is declining,” she said.
The authors examined cervicovaginal specimens from females ages 14-34 years in NHANES for both time periods. Participants were also interviewed about their sexual history. In 2009-2012, a higher portion of women 20-24 reported having ≥2 sexual partners in the past year and ≥3 lifetime sexual partners than 2003-2006, but otherwise there were no significant changes in women reporting sexual activity in the past year or lifetime sexual partners among demographic groups.
Limitations to the study include potential vaccination overreporting or underreporting, that some analyses may be limited by small sample size, and that there may be residual confounding due to unadjusted changes or differences in sexual behavior not measured by NHANES.

Gardasil Researcher Speaks Out


Amid questions about the safety of the HPV vaccine Gardasil one of the lead researchers for the Merck drug is speaking out about its risks, benefits and aggressive marketing.
Dr. Diane Harper says young girls and their parents should receive more complete warnings before receiving the vaccine to prevent cervical cancer. Dr. Harper helped design and carry out the Phase II and Phase III safety and effectiveness studies to get Gardasil approved, and authored many of the published, scholarly papers about it. She has been a paid speaker and consultant to Merck. It’s highly unusual for a researcher to publicly criticize a medicine or vaccine she helped get approved.Dr. Harper joins a number of consumer watchdogs, vaccine safety advocates, and parents who question the vaccine’s risk-versus-benefit profile. She says data available for Gardasil shows that it lasts five years; there is no data showing that it remains effective beyond five years.

This raises questions about the CDC’s recommendation that the series of shots be given to girls as young as 11-years old. “If we vaccinate 11 year olds and the protection doesn’t last… we’ve put them at harm from side effects, small but real, for no benefit,” says Dr. Harper. “The benefit to public health is nothing, there is no reduction in cervical cancers, they are just postponed, unless the protection lasts for at least 15 years, and over 70% of all sexually active females of all ages are vaccinated.” She also says that enough serious side effects have been reported after Gardasil use that the vaccine could prove riskier than the cervical cancer it purports to prevent. Cervical cancer is usually entirely curable when detected early through normal Pap screenings.

Dr. Scott Ratner and his wife, who’s also a physician, expressed similar concerns as Dr. Harper in an interview with CBS News last year. One of their teenage daughters became severely ill after her first dose of Gardasil. Dr. Ratner says she’d have been better off getting cervical cancer than the vaccination. “My daughter went from a varsity lacrosse player at Choate to a chronically ill, steroid-dependent patient with autoimmune myofasciitis. I’ve had to ask myself why I let my eldest of three daughters get an unproven vaccine against a few strains of a nonlethal virus that can be dealt with in more effective ways.”

Merck and the Centers for Disease Control and Prevention maintain Gardasil is safe and effective, and that adequate warnings are provided, cautioning about soreness at the injection site and risk of fainting after vaccination. A new study in the Journal of the American Medical Association found while the overall risk of side effects appears to be comparable to other vaccines, Gardasil has a higher incidence of blood clots reported. Merck says it continues to have confidence in Gardasil’s safety profile. Merck also says it’s looking into cases of ALS, commonly known as Lou Gehrig’s Disease, reported after vaccination. ALS is a progressive neurodegenerative disease that attacks motor neurons in the brain and spinal cord. Merck and the CDC say there is currently no evidence that Gardasil caused ALS in the cases reported. Merck is also monitoring the number of deaths reported after Gardasil: at least 32. Merck and CDC says it’s unclear whether the deaths were related to the vaccine, and that just because patients died after the shots doesn’t mean the shots were necessarily to blame.

According to Dr. Harper, assessing the true adverse event risk of Gardasil, and comparing it to the risk of cervical cancer can be tricky and complex. “The number of women who die from cervical cancer in the US every year is small but real. It is small because of the success of the Pap screening program.”

“The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC’s Dr. Barbara Slade) were 3.4/100,000 doses distributed. The rate of serious adverse events on par with the death rate of cervical cancer. Gardasil has been associated with at least as many serious adverse events as there are deaths from cervical cancer developing each year. Indeed, the risks of vaccination are underreported in Slade’s article, as they are based on a denominator of doses distributed from Merck’s warehouse. Up to a third of those doses may be in refrigerators waiting to be dispensed as the autumn onslaught of vaccine messages is sent home to parents the first day of school. Should the denominator in Dr. Slade’s work be adjusted to account for this, and then divided by three for the number of women who would receive all three doses, the incidence rate of serious adverse events increases up to five fold. How does a parent value that information,” said Harper.

Dr. Harper agrees with Merck and the CDC that Gardasil is safe for most girls and women. But she says the side effects reported so far call for more complete disclosure to patients. She says they should be told that protection from the vaccination might not last long enough to provide a cancer protection benefit, and that its risks – “small but real” – could occur more often than the cervical cancer itself would.

“Parents and women must know that deaths occurred. Not all deaths that have been reported were represented in Dr. Slade’s work, one-third of the death reports were unavailable to the CDC, leaving the parents of the deceased teenagers in despair that the CDC is ignoring the very rare but real occurrences that need not have happened if parents were given information stating that there are real, but small risks of death surrounding the administration of Gardasil.”

She also worries that Merck’s aggressive marketing of the vaccine may have given women a false sense of security. “The future expectations women hold because they have received free doses of Gardasil purchased by philanthropic foundations, by public health agencies or covered by insurance is the true threat to cervical cancer in the future. Should women stop Pap screening after vaccination, the cervical cancer rate will actually increase per year. Should women believe this is preventive for all cancers – something never stated, but often inferred by many in the population– a reduction in all health care will compound our current health crisis. Should Gardasil not be effective for more than 15 years, the most costly public health experiment in cancer control will have failed miserably.”

CDC continues to recommend Gardasil for girls and young women. The agency says the vaccine’s benefits outweigh its risks and that it is an important tool in fighting a serious cancer.

Dr. Harper says the risk-benefit analysis for Gardasil in other countries may shape up differently than what she believes is true in the US. “Of course, in developing countries where there is no safety Pap screening for women repeatedly over their lifetimes, the risks of serious adverse events may be acceptable as the incidence rate of cervical cancer is five to 12 times higher than in the US, dwarfing the risk of death reported after Gardasil.”

HPV and Cancer


Human papillomavirus (HPV) is usually passed from person to person during direct skin-to-skin contact. HPV is the most common sexually transmitted disease in the United States. There are more than 150 different types of HPV. Most men and women do not know they have it because they do not have any symptoms or health problems. Sometimes, certain HPV types can cause warts in different parts of the body. Other HPV types can cause precancerous lesions or cancer.

Types of HPV and how HPV spreads

Most types of HPV can cause “common” warts. These warts grow on places such as the hands and feet. However, more than 40 of the viruses are called “genital type” HPVs. These viruses are spread from person to person when their genitals come into contact. This commonly occurs during vaginal, anal, and oral sex.

Genital HPV types can infect a woman’s genital area, including inside and outside the vagina. It can also affect a man’s genital area, including the penis. In both men and women, genital HPV can infect the anus and some areas of the head and neck. Sometimes “low-risk” types of genital HPVs can cause genital warts or lesions to form on or around these locations. These are most commonly HPV-6 or HPV-11. The growths vary in size, shape, and number, but they rarely lead to cancer.

HPV-related cancers

“High-risk” HPVs are types of genital HPV that are more likely to cause cancer. A person’s immune system is usually able to get rid of this type of infection. But some people develop a lasting infection. Slowly, often over many years, it changes normal cells to create precancerous lesions or cancer. The following cancers are associated with HPV:

  • Cervical cancer. HPV infection causes nearly all cervical cancers. Of the cervical cancers related to HPV, about 70% are caused by two strains: HPV-16 or HPV-18. Also, smoking may increase the risk of cervical cancer for women who have HPV. Although HPV causes almost all cervical cancers, it is important to remember that most genital HPV infections will not cause cancer.
  • Oral cancer. HPV can cause cancer of the mouth and tongue. It can also cause cancer of the oropharynx, which is the middle part of the throat, from the tonsils to the tip of the voice box. These HPV-related cancers are increasing in both men and women. Changes in sexual behavior, including an increase in oral sex, may be one reason for the rise.
  • Other cancers. HPV is also associated with less common cancers, including anal cancer, vulvar and vaginal cancers in women and penile cancer in men.

Managing health problems from HPV

There is no cure for HPV. But doctors can often treat the health problems caused by the infection. Warts and precancerous lesions can be removed in the following ways:

  • Freezing
  • A loop electrosurgical excision procedure, which uses electric current to remove abnormal tissue
  • Surgery
  • Medicated creams applied directly to your skin for genital warts

However, removing genital warts does not mean a person no longer has HPV. Warts may return later because the virus may remain in the cells. A person with HPV who does not have any visible warts can still infect a sexual partner with the virus. In addition, an inactive infection may become active when a person’s immune system is weakened due to illness or other reasons.

Vaccines

Receiving an HPV vaccine reduces your risk of infection. The U.S. Food and Drug Administration (FDA) approved 2 vaccines that help prevent HPV infection: Gardasil and Cervarix. It is important to note that the vaccines cannot cure an existing HPV infection.

  • Purpose of the vaccines. The vaccination’s goal is to prevent a lasting HPV infection after a person is exposed to the virus. Gardasil helps prevent infection from the two HPVs known to cause most cervical cancers and precancerous lesions in the cervix. The vaccine also protects people from the two low-risk HPVs known to cause 90% of genital warts. Gardasil is approved for the prevention of cervical, vaginal, and vulvar cancers in girls and women ages 9 to 26. It is also approved to prevent anal cancer in women and men and genital warts in men and boys in the same age range. Cervarix is approved for the prevention of cervical cancer in girls and women ages 10 to 25.
  • Effectiveness and safety of the vaccines. Data show the HPV vaccinations are safe and highly effective in preventing a lasting infection of the types they target. It takes many years before a precancerous lesion develops into an invasive cancer. So, it may take several years to find out if people who received the vaccine are developing fewer HPV-related cancers.
  • Immunization schedule. It is not known how long a single series of HPV vaccinations will last, if revaccination is required, and, if so, how often. The studies following vaccinated individuals have been going on for 6 years. So far, the level of protection after exposure to the virus has not decreased. More follow-up of people who received a vaccine in clinical trials will provide important information about whether they need the vaccine again.

Because a vaccine can only prevent infection, not cure an existing one, it is ideally given to people before they become sexually active. People who are already sexually active and who may already be infected with HPV should talk with their health care team. The vaccine may protect them from types of HPV that they do not have.

Other prevention strategies

In addition to vaccination, women should protect themselves by having Pap tests. This is the most common test to help detect cervical cancer. Pap tests can find precancerous cells that can be removed before they turn into cancer. Researchers have found that combining a Pap test with a test designed to detect HPV in women provides the most accurate results. A woman should talk with her health care team about having a Pap test and possibly an HPV test. There is no recommended HPV test for men.

Limiting your number of sex partners is another way to reduce your risk. Having many partners increases the risk of HPV infection. And, using a condom cannot fully protect you from HPV during sex.

Questions to ask your health care team

Learn more about HPV by asking your health care team these questions:

  • What is my risk of getting HPV?
  • How can I reduce my risk of getting HPV?
  • Can I get genital HPV without having sex?
  • What are some of the signs and symptoms of HPV?
  • How soon after sex do HPV symptoms appear?
  • Should I be tested to see if I have HPV?
  • Should I receive an HPV vaccine? Why or why not?
  • Which vaccine should I receive?
  • Are the HPV vaccines safe? What are the potential side effects?
  • How is an HPV vaccine given? Is more than one shot needed?
  • How long does an HPV vaccine last?
  • Does my health insurance cover the cost of an HPV vaccine?
  • I am pregnant and have HPV. Can it harm my baby?

Oncology Dietitian Exposes Fraud in CDC’s HPV Vaccine Effectiveness Study


HPV Vaccine

Story at-a-glance

  • An oncology dietitian has pointed out significant discrepancies in a new HPV vaccine effectiveness study that claims the vaccine’s effectiveness is “high”
  • Recent reductions in HPV infection prevalence among young women in the US cannot be said to be due to introduction of Gardasil vaccine in 2006 and use of HPV vaccines by pre-teen and teenage girls since then; the data clearly shows that unvaccinated girls had the best outcome
  • In 2007-2010, HPV prevalence dropped 27.3 percent in the unvaccinated girls, but only declined by 5.8 percent in the vaccinated group. In four out of five different measures, the unvaccinated girls had a lower incidence of HPV
  • According to Merck’s own research before Gardasil was licensed, if you’ve been exposed to HPV strains 16 or 18 prior to receiving Gardasil vaccine, you could increase your risk of precancerous lesions by 44.6 percent.
  • Judicial Watch has received previously withheld documents from the DDHS, which reveal that the National Vaccine Injury Compensation Program has awarded $5,877,710 to 49 victims for harm resulting from the HPV vaccine

There are currently two HPV vaccines on the market, but if there was any regard for sound scientific evidence, neither would be promoted as heavily as they are. The first, Gardasil, was licensed by the US Food and Drug Administration (FDA) in 2006. It is now recommended as a routine vaccination for girls and women between the ages of 9-26 in the US.

On October 25, 2011, the CDC’s Advisory Committee on Immunization Practices also voted to recommend giving the HPV vaccine to males between the ages of 11 and 21. The second HPV vaccine, Cervarix, was licensed in 2009.

Most recently, an oncology dietitian pointed out significant discrepancies2 in a new HPV vaccine effectiveness study published in the Journal of Infectious Diseases3, which evaluated data from the National Health and Nutrition Examination Surveys (NHANES), 2003-2006 and 2007-2010.

The study pointed out that HPV vaccine uptake among young girls in the US has been low but concluded that:

“Within four years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14–19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.”

Assessing the Overall Impact of the HPV Vaccine

In her article4, Sharlene Bidini, RD, CSO, points out that the study’s conclusion was based on 740 girls, of which only 358 were sexually active, and of those, only 111 had received at least one dose of the HPV vaccine. In essence, the vast majority was unvaccinated, and nearly half were not at risk of HPV since they weren’t sexually active.

“If the study authors were trying to determine vaccine effectiveness, why did they include the girls who had not received a single HPV shot or did not report having sex?” she writes.

“Table 1 from the journal article compares 1,363 girls, aged 14-19, in the pre-vaccine era (2003-2006) to all 740 girls in the post-vaccine era (2007-2010) regardless of sexual history or immunization status.”

In the pre-vaccine era, an estimated 53 percent of sexually active girls between the ages of 14-19 had HPV. Between 2007 and 2010, the overall prevalence of HPV in the same demographic declined by just over 19 percent to an overall prevalence of nearly 43 percent.

As Bidini points out, this reduction in HPV prevalence can NOT be claimed to be due to the effectiveness of HPV vaccinations. On the contrary, the data clearly shows that it was the unvaccinated girls in this group that had the best outcome!

“In 2007-2010, the overall prevalence of HPV was 50 percent in the vaccinated girls (14-19 years), but only 38.6 percent in the unvaccinated girls of the same age.

Therefore, HPV prevalence dropped 27.3 percent in the unvaccinated girls, but only declined by 5.8 percent in the vaccinated group. In four out of five different measures, the unvaccinated girls had a lower incidence of HPV,” she writes.

Furthermore, in the single instance where unvaccinated girls had a 9.5 percent higher prevalence of HPV, a note stated that the relative standard error was greater than 30 percent, leading Bidini to suspect that “the confidence interval values must have been extremely wide. Therefore, this particular value is subject to too much variance and doesn’t have much value.”

Another fact hidden among the reported data was that among the 740 girls included in the post-vaccine era (2007-2010), the prevalence of high-risk, non-vaccine types of HPV also significantly declined, from just under 21 percent to just over 16 percent.

So, across the board, HPV of all types, whether included in the vaccine or not, declined. This points to a reduction in HPV prevalence that has nothing to do with vaccine coverage. Besides, vaccine uptake was very LOW to begin with.

All in all, one can conclude that there were serious design flaws involved in this study—whether intentional or not—leading the researchers to erroneously conclude that the vaccine effectiveness was “high.” Clearly the effectiveness of the vaccine was anything but high, since the unvaccinated group fared far better across the board.

Case Report of a Gardasil Death Confirms Presence of HPV DNA Fragments

Earlier this year, a lab scientist, who discovered HPV DNA fragments in the blood of a teenage girl who died after receiving the Gardasil vaccine, published a case report in the peer reviewed journal Advances in Bioscience and Biotechnology5. The otherwise healthy girl died in her sleep six months after receiving her third and final dose of the HPV vaccine. A full autopsy revealed no cause of death.

Sin Hang Lee with the Milford Molecular Laboratory in Connecticut confirmed the presence of HPV-16 L1 gene DNA in the girl’s postmortem blood and spleen tissue. These DNA fragments are also found in the vaccine. The fragments were protected from degradation by binding firmly to the particulate aluminum adjuvant used in the vaccine.

“The significance of these HPV DNA fragments of a vaccine origin found in post-mortem materials is not clear and warrants further investigation,”he wrote.

Lee suggests the presence of HPV DNA fragments of vaccine origin might offer a plausible explanation for the high immunogenicity of Gardasil, meaning that the vaccine has the ability to provoke an exaggerated immune response. He points out that the rate of anaphylaxis in girls receiving Gardasil is far higher than normal—reportedly five to 20 times higher than any other school-based vaccination program!

HPV Vaccine Is Associated with Serious Health Risks, Including Sudden Death

Many women are not aware that the HPV vaccine Gardasil might actuallyincrease your risk of cervical cancer. Initially, that information came straight from Merck and was presented to the FDA prior to approval6. According to Merck’s own research, if you have been exposed to HPV strains 16 or 18 prior to receipt of Gardasil vaccine, you could increase your risk of precancerous lesions, or worse, by 44.6 percent.

Other health problems associated with Gardasil vaccine include immune-based inflammatory neurodegenerative disorders, suggesting that something is causing the immune system to overreact in a detrimental way—sometimes fatally.

  • Between June 1, 2006 and December 31, 2008, there were 12,424 reported adverse events following Gardasil vaccination, including 32 deaths. The girls, who were on average 18 years old, died within two to 405 days after their last Gardasil injection
  • Between May 2009 and September 2010, 16 additional deaths after Gardasil vaccination were reported. For that timeframe, there were also 789 reports of “serious” Gardasil adverse reactions, including 213 cases of permanent disability and 25 diagnosed cases of Guillain-Barre Syndrome
  • Between September 1, 2010 and September 15, 2011, another 26 deaths were reported following HPV vaccination
  • As of May 13, 2013, VAERS had received 29,686 reports of adverse events following HPV vaccinations, including 136 reports of death,7, as well as 922 reports of disability, and 550 life-threatening adverse events

Lawsuit Reveals Payouts of Nearly $6 Million to HPV Vaccine-Damaged Victims

On February 28, 2013 the government watchdog group Judicial Watch announced it had filed a Freedom of Information Act (FOIA) lawsuit against the Department of Health and Human Services (DHHS) to obtain records from the Vaccine Injury Compensation Program (VICP) related to the HPV vaccine8. The lawsuit was filed in order to force the DHHS to comply with an earlier FOIA request, filed in November 2012, which had been ignored. As reported by WND.com9:

“Judicial Watch wants all records relating to the VICP, any documented injuries or deaths associated with HPV vaccines and all records of compensation paid to the claimants following injury or death allegedly associated with the HPV vaccines… The number of successful claims made under the VICP to victims of HPV will provide further information about any dangers of the vaccine, including the number of well-substantiated cases of adverse reactions.”

On March 20, Judicial Watch announced it had received the FOIA documents from the DDHS, which revealed that the National Vaccine Injury Compensation Program has awarded $5,877,710 to 49 victims for harm resulting from the HPV vaccine. According to the press release10: “On March 12, 2013, The Health Resources and Services Administration (HRSA), an agency of HHS, provided Judicial Watch with documents revealing the following information:

  • Only 49 of the 200 claims filed have been compensated for injury or death caused from the (HPV) vaccine. Of the 49 compensated claims, 47 were for injury caused from the (HPV) vaccine. The additional 2 claims were for death caused due to the vaccine.
  • 92 (nearly half) of the total 200 claims filed are still pending. Of those pending claims, 87 of the claims against the (HPV) vaccine were filed for injury. The remaining 5 claims were filed for death.
  • 59 claims have been dismissed outright by VICP. The alleged victims were not compensated for their claims against the HPV vaccine. Of the claims dismissed, 57 were for injuries, 2 were for deaths allegedly caused by the HPV vaccine.
  • The amount awarded to the 49 claims compensated totaled 5,877,710.87 dollars. This amounts to approximately $120,000 per claim.

This new information from the government shows that the serious safety concerns about the use of Gardasil have been well-founded,” said Judicial Watch President Tom Fitton. “Public health officials should stop pushing Gardasil on children.”

Review of HPV Vaccine Trials Conclude Effectiveness Is Still Unproven

Last year, a systematic review11 of pre- and post-licensure trials of the HPV vaccine by researchers at University of British Columbia showed that the vaccine’s effectiveness is not only overstated (through the use of selective reporting or “cherry picking” data) but also unproven. In the summary of the clinical trial review, the authors state it quite clearly:

“We carried out a systematic review of HPV vaccine pre- and post-licensure trials to assess the evidence of their effectiveness and safety. We found that HPV vaccine clinical trials design, and data interpretation of both efficacy and safety outcomes, were largely inadequate. Additionally, we note evidence of selective reporting of results from clinical trials (i.e., exclusion of vaccine efficacy figures related to study subgroups in which efficacy might be lower or even negative from peer-reviewed publications).

Given this, the widespread optimism regarding HPV vaccines long-term benefits appears to rest on a number of unproven assumptions (or such which are at odds with factual evidence) and significant misinterpretation of available data.

For example, the claim that HPV vaccination will result in approximately 70% reduction of cervical cancers is made despite the fact that the clinical trials data have not demonstrated to date that the vaccines have actually prevented a single case of cervical cancer (let alone cervical cancer death), nor that the current overly optimistic surrogate marker-based extrapolations are justified.

Likewise, the notion that HPV vaccines have an impressive safety profile is only supported by highly flawed design of safety trials and is contrary to accumulating evidence from vaccine safety surveillance databases and case reports which continue to link HPV vaccination to serious adverse outcomes (including death and permanent disabilities).

We thus conclude that further reduction of cervical cancers might be best achieved by optimizing cervical screening (which carries no such risks) and targeting other factors of the disease rather than by the reliance on vaccines with questionable efficacy and safety profiles.” [Emphasis mine]

Talk to Your Kids about HPV and Gardasil

There are better ways to protect yourself or your young daughters against cancer than getting Gardasil or Cervarix vaccinations, and it’s important you let your children know this. In more than 90 percent of HPV infections, HPV infection is cleared within two years on its own, so keeping your immune system strong is far more important than getting vaccinated.

In addition, HPV infection is spread through sexual contact and research12 has demonstrated that using condoms can reduce your risk of HPV infection by 70 percent, which is far more effective than the HPV vaccine. Because this infection is sexually transmitted, the risk of infection can be greatly reduced by lifestyle choices, including abstinence. In addition, there are high risk factors for chronic HPV infection including smoking, co-infection with herpes, Chlamydia or HIV and long-term birth control use. Women chronically infected with HPV for many years, who don’t get pre-cancerous cervical lesions promptly identified and treated, can develop cervical cancer and die.

So it is important to remember that, even if they get vaccinated, girls and women should get Pap test screening every few years for cervical changes that may indicate pre-cancerous lesions because there is little guarantee that either Gardasil or Cervarix vaccinations will prevent cervical cancer. After Pap test screening became a routine part of health care for American women in the 1960’s, cervical cancer cases in the U.S. dropped 74 percent and continued Pap testing is recommended for women who receive HPV vaccines.

Why We Must Protect Vaccine Exemptions

There can be no doubt that we are in urgent need of a serious vaccine safety review in the US. Quality science is simply not being done. And very few vaccine recommendations, which prop up state vaccine mandates, stand on firm scientific ground. Your right to vaccine exemptions is also increasingly under threat.

I urge you to get involved in the monumentally important task of defending YOUR right to know and freedom to choose which vaccines you and your child will use. The non-profit charity, the National Vaccine Information Center (NVIC), has been preventing vaccine injuries and deaths through public education for more than 30 years and is leading the advocacy effort in the states to protect vaccine exemptions. Supporting NVIC is one way you can help, in addition to signing up for the free online NVIC Advocacy Portal so you stay informed about threats to vaccine exemptions in your state and contact your state legislators to make your voice heard.

All across the United States, people are fighting for their right not to be injected with vaccines against their will. These threats come in a variety of guises like California bill AB49913, which permits minor children as young as 12 years old to be vaccinated with sexually transmitted disease vaccines like Gardasil without parental knowledge or parental consent! In light of the evidence that HPV vaccines have not been proven safe or effective, how wise is it to allow doctors to give a minor child Gardasil or Cervarix vaccinations without informing and getting the consent of parents? How are parents supposed to monitor their children for signs of a vaccine reaction if they don’t even know their children have been given a vaccine? It’s nothing short of reprehensible.

I cannot stress enough how critical it is to get involved and stand up for your human right to exercise informed consent to vaccination and protect your legal right to obtain medical and non-medical vaccine exemptions. This does not mean you have to opt out of all vaccinations if you decide that you want to give one or more vaccines to your child. The point is, EVERYONE should have the right to evaluate the potential benefits and real risks of any pharmaceutical product, including vaccines, and opt out of any vaccine they decide is unnecessary or not in the best interest of their child’s health. Every child is different and has a unique personal and family medical history, which may include severe allergies or autoimmune and neurological disorders, that could increase the risks of vaccination.

It is your parental right to make potentially life-altering health decisions for your own children. Why wouldn’t you want to keep that right—even if you want your child to receive most or all vaccinations currently available? Tomorrow there might be a vaccine you don’t want your child to receive, but if you’ve failed to support strong informed consent protections in public health laws, which includes the legal right for all Americans to take medical and non-medical vaccine exemptions, you’ve given away your own freedom to choose in the future…

Internet Resources Where You Can Learn More

I encourage you to visit the following web pages on the National Vaccine Information Center (NVIC) website atwww.NVIC.org:

  • NVIC Memorial for Vaccine Victims: View descriptions and photos of children and adults, who have suffered vaccine reactions, injuries and deaths. If you or your child experiences an adverse vaccine event, please consider posting and sharing your story here.
  • If You Vaccinate, Ask 8 Questions: Learn how to recognize vaccine reaction symptoms and prevent vaccine injuries.
  • Vaccine Freedom Wall: View or post descriptions of harassment by doctors, employers or school officials for making independent vaccine choices.
  • NVIC Advocacy Portal: Sign up today to be a user of this free online privacy-protected network of concerned citizens all working to educate legislators to protect vaccine exemptions in public health policies and laws.

Connect with Your Doctor or Find a New One That Will Listen and Care

If your pediatrician or doctor refuses to provide medical care to you or your child unless you agree to get vaccines you don’t want, I strongly encourage you to have the courage to find another doctor. Harassment, intimidation, and refusal of medical care is becoming the modus operandi of the medical establishment in an effort to stop the change in attitude of many parents about vaccinations after they become truly educated about health and vaccination.

However, there is hope.

At least 15 percent of young doctors polled in the past few years admit that they’re starting to adopt a more individualized approach to vaccinations in direct response to the vaccine safety concerns of parents. It is good news that there is a growing number of smart young doctors, who prefer to work as partners with parents in making personalized vaccine decisions for children, including delaying vaccinations or giving children fewer vaccines on the same day or continuing to provide medical care for those families, who decline use of one or more vaccines.

So take the time to locate a doctor, who treats you with compassion and respect and is willing to work with you to do what is right for your child.

Protect Your Right to Informed Consent and Defend Vaccine Exemptions

With all the uncertainty surrounding the safety and efficacy of vaccines, it’s critical to protect your right to make independent health choices and exercise voluntary informed consent to vaccination. It is urgent that everyone in America stand up and fight to protect and expand vaccine informed consent protections in state public health and employment laws. The best way to do this is to get personally involved with your state legislators and educating the leaders in your community.

THINK GLOBALLY, ACT LOCALLY.

National vaccine policy recommendations are made at the federal level but vaccine laws are made at the state level. It is at the state level where your action to protect your vaccine choice rights can have the greatest impact. It is critical for EVERYONE to get involved now in standing up for the legal right to make voluntary vaccine choices in America because those choices are being threatened by lobbyists representing drug companies, medical trade associations, and public health officials, who are trying to persuade legislators to strip all vaccine exemptions from public health laws.

Signing up for NVIC’s free Advocacy Portal at http://www.NVICAdvocacy.org gives you immediate, easy access to your own state legislators on your Smart Phone or computer so you can make your voice heard. You will be kept up-to-date on the latest state bills threatening your vaccine choice rights and get practical, useful information to help you become an effective vaccine choice advocate in your own community. Also, when national vaccine issues come up, you will have the up-to-date information and call to action items you need at your fingertips.

So please, as your first step, sign up for the NVIC Advocacy Portal.

Share Your Story with the Media and People You Know

If you or a family member has suffered a serious vaccine reaction, injury, or death, please talk about it. If we don’t share information and experiences with one another, everybody feels alone and afraid to speak up. Write a letter to the editor if you have a different perspective on a vaccine story that appears in your local newspaper. Make a call in to a radio talk show that is only presenting one side of the vaccine story.

I must be frank with you; you have to be brave because you might be strongly criticized for daring to talk about the “other side” of the vaccine story. Be prepared for it and have the courage to not back down. Only by sharing our perspective and what we know to be true about vaccination will the public conversation about vaccination open up so people are not afraid to talk about it.

We cannot allow the drug companies and medical trade associations funded by drug companies or public health officials promoting forced use of a growing list of vaccines to dominate the conversation about vaccination. The vaccine injured cannot be swept under the carpet and treated like nothing more than “statistically acceptable collateral damage” of national one-size-fits-all mandatory vaccination policies that put way too many people at risk for injury and death. We shouldn’t be treating people like guinea pigs instead of human beings.

Internet Resources Where You Can Learn More

I encourage you to visit the website of the non-profit charity, the National Vaccine Information Center (NVIC), atwww.NVIC.org:

  • NVIC Memorial for Vaccine Victims: View descriptions and photos of children and adults, who have suffered vaccine reactions, injuries, and deaths. If you or your child experiences an adverse vaccine event, please consider posting and sharing your story here.
  • If You Vaccinate, Ask 8 Questions: Learn how to recognize vaccine reaction symptoms and prevent vaccine injuries.
  • Vaccine Freedom Wall: View or post descriptions of harassment and sanctions by doctors, employers, and school and health officials for making independent vaccine choices.

Connect with Your Doctor or Find a New One That Will Listen and Care

If your pediatrician or doctor refuses to provide medical care to you or your child unless you agree to get vaccines you don’t want, I strongly encourage you to have the courage to find another doctor. Harassment, intimidation, and refusal of medical care is becoming the modus operandi of the medical establishment in an effort to stop the change in attitude of many parents about vaccinations after they become truly educated about health and vaccination.

However, there is hope.

At least 15 percent of young doctors recently polled admit that they’re starting to adopt a more individualized approach to vaccinations in direct response to the vaccine safety concerns of parents. It is good news that there is a growing number of smart young doctors, who prefer to work as partners with parents in making personalized vaccine decisions for children, including delaying vaccinations or giving children fewer vaccines on the same day or continuing to provide medical care for those families, who decline use of one or more vaccines.

So take the time to locate a doctor, who treats you with compassion and respect and is willing to work with you to do what is right for your child.

[+] Sources and Referen

Japanese Mushroom Extract Could Help Treat HPV Infections


A Japanese mushroom extract, active hexose correlated compound (AHCC), appears to be effective in eradicating persistent human papillomavirus (HPV) infection, according to results of a small pilot study.

Ten women with persistent HPV infection received a once-daily oral dose (3 g) of AHCC for up to 6 months, and half of the participants achieved a negative result for HPV infection.

Three of these women with a confirmed eradication have stopped using AHCC, and the remaining two responders are continuing on the study.

The results were presented at the 11th International Conference of the Society for Integrative Oncology.

Lead investigator Judith A. Smith, PharmD, pointed out that the five women who didn’t respond did not receive a full 6 months of treatment.

“We were initially optimistic that we were going to clear the infection in a month, and at first we were testing the women weekly,” said Dr Smith, associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Texas Health Sciences Center at Houston Medical School. “When our first patient didn’t respond at 5 weeks, we assumed that it wasn’t effective and we took her off treatment.”

The researchers then realized that more time was needed, so after waiting 8 weeks, another nonresponder was removed from therapy. Two more participants were also taken off treatment at 3 months, after they did not clear the virus. “Now we know that we need to give it at least 6 months to realize the full effect,” she told Medscape Medical News. “These patients will be eligible to go back on treatment.”

While most HPV infections are self-limiting and resolve without causing any symptoms, there is currently no effective treatment for those that persist and that the body’s innate immune system cannot clear.

“That is why this is so encouraging,” said Dr Smith. “We test women for HPV, and if they have a persistent infection, there is nothing we can do for them except watch and wait.”

Phase 2 in the Works

AHCC is an extract prepared from co-cultured mycelia of several species of Basidiomycete mushrooms. Preclinical studies have shown it to have anticancer properties, and both in vitro and in vivo studies have confirmed that it can eradicate HPV. Its ability to eradicate oncogenic HPV types 16/18 is attributed to modulation of the expression and signaling of interferon-α, β, and γ.

“We’ve been evaluating the efficacy of AHCC with chemotherapy for over a decade,” said Dr Smith. “It is a nutritional supplement with no known side effects, and it modulated the immune system to fight off infections and inhibit tumor growth.”

It is commercially available over the counter, and no adverse effects were associated with its use, Dr Smith noted. “This study confirms our preclinical findings, that it can eradicate HPV.”

Dr Smith emphasized that these are preliminary data, and the pilot study’s purpose was to define the appropriate dose and duration of therapy. A phase 2 randomized, double-blind trial is getting underway, and they will begin enrollment in about 2 weeks. “We would also like to investigate at some point if AHCC can actually prevent infection, or prevent re-infection,” she explained. “We’d like to see if it can help build up the immune system to the point of resisting infection with HPV.”

Treating Warts?

Anecdotally, she has had inquiries from both men and women about using AHCC to treat genital warts caused by HPV. “Since it’s a commercially available product sold without a prescription, and AHCC has had no reported side effects when taken appropriately, I told them they could try it,” she said, “Even though we have no information on that.”

Several people have reported that their lesions cleared up after using AHCC and have not returned. “One woman told me that a plantar wart disappeared, which was very interesting,” Dr Smith continued. “We don’t have any details on these cases with warts, but I have told them to keep me in the loop, because this may be something we can study later on in future trials.”

Because about 75% of adults in the United States have been exposed to HPV, the researchers were very careful to make sure that the study participants had a persistent infection, one that was not likely to clear on its own.

To minimize potential confounders, all of the participants were older than age 30 years and had a positive HPV test result within 3 months of entry into the study. To establish persistent infection, they had to have another positive test result no less than 6 months and no more than 18 months before enrollment.

“While a provocative study outcome, it must be emphasized that this is a very small sample size, and it is quite unclear if these infections would have resolved without any treatment,” said Maurie Markman, MD, from the Cancer Treatment Centers of America in Philadelphia. “Alternatively, there may have been issues with the HPV testing itself.”

“The plans for a well-designed randomized study are appropriate,” said Dr. Markman, who was not involved in the study. “The results of this larger trial will be awaited with keen interest.”

Two doses of HPV vaccine may suffice for genital warts prevention.


Just two of the recommended three doses of human papillomavirus virus (HPV) vaccine may be enough to reduce the risk of condyloma (genital warts) infections and potentially the risk of cervical cancer, a Swedish study has shown.

Completing the three-dose HPV vaccine series still conferred the most protection, but an examination of data from national Swedish population-based health data registers showed that the difference in risk reduction between the second and third doses was small, especially among girls who received their first dose before age 17. [JAMA 2014;311:597-603]

“The number of condyloma cases prevented by three doses versus two doses was 59 cases per 100,000 person years, which is a small difference,” said researchers from the Karolinska Institutet in Stockholm, Sweden.

The researchers identified 20,383 new cases of condyloma among a population of 1,045,165 females in Sweden aged 10 to 24 years, followed up between 2006 and 2010. Of these new cases, 322 occurred after at least one dose of HPV vaccine.

Risk reduction was highest among females who completed their vaccine course. However, two doses of vaccine also conferred significant protection.

For example, among girls aged 10-16, the incidence rate ratio (IRR) for condyloma was 0.18 for those who completed the vaccine course, 0.29 for those who received two doses, and 0.31 for those who had only one dose (p<0.001 for all), compared with those who did not receive the vaccine.

These corresponded to an incidence rate difference (IRD) of 459 cases of condyloma per 100,000 person years for three doses, 400 cases per 100,000 person years for two doses, and 384 cases per 100,000 person years for a single dose (p<0.001 for all) compared with no vaccine.

The IRR and IRD was consistently the least different between two and three doses among girls of any age, suggesting significant, if not the most, risk reduction.

Accounting for the impact of varying vaccine dose levels is important because “actual vaccination programs include substantial numbers of women who do not complete the full vaccination schedules,” the researchers said.

HPV serotypes 6 and 11 cause about 90 percent of condylomas, which are the first measurable endpoint for HPV infection and have an incubation period between 1 and 6 months. The females included in the study received the quadrivalent HPV vaccine, which also protects against serotypes 16 and 18, which are related to cancer outcomes, including cervical cancer.

The researchers said further investigations need to be done to determine if there is any reduced risk of cervical cancer with fewer than three doses of HPV vaccine. The current data may have also underestimated the number of condyloma cases since some patients can’t or won’t seek medical care, nor did it account for disease outcomes other than condyloma.

Vaccines Do Not Cover Most Common HPV Types in Black Women.


The HPV subtypes that are most common in black women in the United States are not targeted by the currently available vaccinesGardasil and Cervarix, according to new research.

The findings suggest that current HPV vaccination will be less beneficial for black women in the US than for their white counterparts, said study coauthor Catherine Hoyo, PhD, MPH, of Duke University, in Durham, North Carolina.

She spoke at a press briefing today at the annual International Conference on Frontiers in Cancer Prevention Research, in National Harbor, Maryland. The meeting is sponsored by the American Association for Cancer Research.

“The approved cervical cancer vaccines are effective but may not be effective for everyone,” said Paul Limburg, MD, from the Mayo Clinic, in Rochester, Minnesota, who moderated the press briefing. He was not involved with the study.

Persistent infection with HPV 16 and/or HPV 18 accounts for about 70% of all cervical cancers, said Dr. Hoyo. These are the subtypes targeted by Gardasil and Cervarix. Gardasil also targets HPV 6 and HPV 11.

Some black women in the new study did, in fact, have infections with HPV 16 and/or HPV 18. But much less often — their rate was about half of that of white women.

“Since African-American women don’t seem to be getting the same subtypes of HPV with the same frequency, the vaccines aren’t helping all women equally,” said study coauthor Adriana Vidal, PhD, in a press statement. She is also from Duke University.

The investigators prospectively looked at 572 women at 10 Duke-affiliated clinics with abnormal Pap tests who then underwent colposcopy; the group was about evenly divided among blacks (n = 280) and whites (n = 292). And just about even numbers of the respective racial groups subsequently had evidence of cervical intraepithelial neoplasia 1 (CIN1; 112 vs 118).

For whites with CIN1, the most frequent HPV subtypes were 16, 18, 56, 39, and 66.

But for blacks with CIN1, the most frequent HPV subtypes were 33, 35, 58, and 68.

Thus, in blacks, the most common genotypes were not HPV 16 and 18, which defies conventional wisdom about HPV infection.

There were no data on Hispanics in the new presentation because their numbers were too small at this point to be included, said Dr. Hoyo.

Without HPV 16/18, Are Some Black Women “Getting Dropped”?

The study findings may help explain why black women in the US are harder hit by cervical cancer than white women, said Dr. Hoyo.

She pointed out that both the incidence of invasive cervical cancer and related mortality rates are higher in blacks than in whites.

“We don’t know what is causing the disparity,” Dr. Hoyo told Medscape Medical News in a phone interview after the press conference.

“The problem is not likely detection,” she said, explaining that screening rates for precancerous lesions are comparable for black and white women.

The new data, however, suggest that, if clinicians are strongly focusing on HPV 16 and 18 for more careful follow-up in their black patients, then they may be missing some eventual cervical cancers, Dr. Hoyo said.

“Somewhere along the line, some black women may be getting dropped because they don’t have the HPV subtypes that are considered to be most aggressive,” she summarized.

Her advice to clinicians with black females who HPV infection and CIN is: “Broaden the subtypes that you look at.”

Currently, there is a vaccine in phase 3 clinical trials that targets 9 HPV subtypes (6, 11, 16, 18, 31, 45, 52, and 58). That means that 2 of the 4 most common subtypes in blacks are targeted by the experimental vaccine. “We need more African American women to enroll in trials like this to see how beneficial this new vaccine will be for them,” Dr. Hoyo said.

The new study is not the first to indicate that black women have lower rates of HPV 16 and 18.

A recent report found that black race was a predictor of lower HPV 16 and 18 positivity among women with high-grade cervical lesions (Cancer. 2013;119(16):3052-3058).

However, the new study from the Duke team is the first to indicate that this race-influenced distribution of HPV subtypes also occurs in lower-grade cervical lesions.

The Duke investigators also looked at high-grade lesions (CIN2/3).

In CIN2/3, HPV 16, 18, 33, 39, and 59 were the most common genotypes detected in white women, whereas HPV 31, 35, 45, 56, 58, 66, and 68 were the most prevalent in African American women.

Safety of the quadrivalent human papillomavirus vaccine.


The prophylactic human papillomavirus (HPV) vaccines are remarkable both for their efficacy against HPV infection and related diseases,1 and for their potential to prevent cervical cancer. Cervical cancer, which is caused by persistent infection with oncogenic HPV types, remains a cause of premature death in women around the world, most of whom have no access to secondary prevention through organised cervical screening programmes.2 The linked study by Arnheim-Dahlström and colleagues (doi:10.1136/bmj.f5906) provides a timely and important contribution to the evidence base on the safety of the quadrivalent HPV vaccine,3 which prevents HPV infection and disease due to the oncogenic types HPV-16 and HPV-18 and types HPV-6 and HPV-11, which cause genital warts.

This population based cohort analysis provides strong evidence that autoimmune conditions, neurological diseases, and thromboembolic disease are not triggered by quadrivalent HPV vaccination. Serious sudden onset conditions such as these, which are largely of undetermined cause, are sometimes falsely attributed to vaccination when population based vaccination programmes are implemented.4 It is crucial that surveillance systems can rule out false associations and identify rare but real adverse effects in the post-vaccine licensure period.5

Although vaccines are subject to rigorous pre-licensure evaluations, with many thousands of subjects in clinical trials, these trials are never powerful enough to detect rare adverse events, such as those that occur in less than one in several thousand vaccinated people. Systematic whole of population analyses, such as the current one, overcome the inherent limitations of passive surveillance systems for assessing adverse events after immunisation. In a passive surveillance system, it is up to individuals or their healthcare providers to report details of adverse health events that occur in the period after vaccination. Reporting can be haphazard and evaluable information is not guaranteed. Such reporting forms the basis for evaluating cases with similar diagnoses and assessing whether there is any indication that such cases are occurring at higher than background rates. Formal epidemiological assessment then follows using a rigorous systematic approach.

Instead, Arnheim-Dahlström and colleagues took a systematic approach from the outset, which removes reporting bias (both under-reporting and over-reporting) from the initial assessment of risk. They used the enviable registry systems available in Sweden and Denmark to identify girls aged 10-17 years who were vaccinated in both countries between 2006 and 2010 (nearly 700 000 doses). Once vaccination status and timing were defined for each girl, the authors calculated the rates of 53 outcomes of interest over the 180 days after vaccination using international classification of diseases codes in hospital records (inpatient and outpatient).

Among the 29 outcomes of interest with five or more vaccinated cases, only three conditions had a significantly increased relative risk—Behçet’s syndrome, type 1 diabetes, and Raynaud’s disease. However, they each fulfilled only one of three criteria examining the strength, consistency, and reliability of the association. Particularly reassuring is the lack of any consistency in the timing of disease onset after vaccination, as visually summarised in the accompanying figures. It is reasonable to assume that these associations were chance findings, given the multiple comparisons made and lack of consistency with risk estimates for these conditions from previous studies.6

The paper lays to rest earlier concerns about an association between vaccination and venous thromboembolism that emerged from a previous analysis of US data from passive surveillance.7 With more than 116 million doses distributed globally, our experience with HPV vaccines is now considerable. The World Health Organization global advisory committee on vaccine safety has reviewed HPV vaccines four times, most recently in June 2013, and each time agreed that the available data suggest these vaccines are safe.8 Although there are published case reports of rare illnesses coincident with HPV vaccination,9 this is the weakest form of evidence, and it is only through more sophisticated studies that such hypotheses can be tested.

The major strength of Arnheim-Dahlström and colleagues’ study is its size and the assessment of a whole population. Its main weakness is that vaccination coverage in the countries under study was still relatively low during the study period and early adopters may be different from non-vaccinees. The authors adjusted for potential confounders, such as socioeconomic status and ethnicity, to control for these differences as far as possible. But ongoing monitoring remains important to provide cumulative evidence of safety, particularly as vaccines are rolled out to new population groups such as boys.

The type of evidence reported by Arnheim-Dahlström and colleagues will help secure continuing confidence in both HPV vaccination and immunisation programmes more generally. The global immunisation environment is now one in which anti-vaccination misinformation about coincidental temporal associations can readily be promulgated through websites and social media. Clear and honest communication about vaccine safety, and rapid high level response and reassurance when the safety of a vaccine comes into question, are the best ways to prevent the erosion of public confidence in immunisation. This new evidence about the quadrivalent HPV vaccine firmly indicates that concern about vaccine related adverse events is not a rational reason to forgo this potentially lifesaving vaccine. This reassurance is particularly important as the vaccine is rapidly being made available to those girls in developing countries who need it most.

Source:BMJ