Burlington VT opportunity to express your views about HPV vaccine

[audiomama]

Hey Mamas,
I'm looking for speakers to come help a small class of future medical researchers understand concerns about vaccination, specifically HPV vaccination. It's not a hostile group-- they want to understand other viewpoints-- but they're definitely mostly mainstream medical people.

This topic is scheduled for Feb 26 at 3:30 on campus. If you have a viewpoint you're willing to share, pls let me know!

[mamakay]

What type of medical researchers are they?

[audiomama]

The course is called Cell to Society and is part of the curriculum in Clinical and Translational Sciences. Many of the students are physicians engaged in or planning research, others are in public health. I think there are about a dozen of us. I'm an audiologist and doctoral student interested in clinical research across disciplines.

Last semester we covered cervical cancer, HPV, and the development of the vaccine. This semester is more about the ethics, politics, economics, etc. of vaccination with HPV vaccine.

For Feb 26 I have one mama willing to talk about how she evaluates vaccines for her kids (completely non-vaxed thus far). I am going to talk about the information available on the internet (I'm on the fence-- self label as "vaccine cautious"). Interested in adding your voice?

[mamakay]

I don't live anywhere near there, but I have a collection of links regarding of some of the issues we've been discussing here.

Scroll down to page 169, table 111 here:

http://www.fda.gov/cber/review/hpvmer060806r.pdf

Negative 181% effective (increase in cancer) if you're PCR positive yet seronegative when you get the shot.

You see a similar (tho smaller), bad effect on page 362, table 279.

Obviously, the vaccine shouldn't be expected to prevent vaccine strain cancer in those already infected, but the increase is disturbing.

Especially in light of this:

http://www3.interscience.wiley.com/j...TRY=1&SRETRY=0

We previously showed that vertical transmission frequently results in persistent infection, and now present data on the prevalence of HPV-16 DNA (the most prevalent high-risk HPV type) in healthy children. Buccal samples from 267 healthy children aged 3-11 years were tested for HPV DNA by generic PCR (MY09/MY11), and a HPV-16 specific nested PCR.

HPV-16 DNA was detected by nested PCR in 138 of 267 (51.7%) samples,

And:

http://www.journals.uchicago.edu/doi...10.1086/498114

The current study shows that high-risk HPV DNA can be detected both in the oral and genital mucosa of infants during the first 3 years of life and that some HPV infections are persistent.

The results of the present study showed that 36%–42% of infants acquired high-risk HPV DNA in oral or genital mucosa, and 11%–14% of HPV DNA–positive infants cleared virus during the 3-year follow-up period. Both cumulative incidence and clearance rates ran in parallel for oral and genital mucosa.

So I'd like to see long term follow up on all cancers that might be related to HPVs in the vaccinated. (head, neck, respiratory, etc) But with mass immunization, there's really no "control group" to address this question, is there?

Other issues:

http://www.americanprogress.org/kf/h...transcript.pdf

(I'm going to try to stay within the quote word limit, but this isn't copyrighted material, anyway)

The speaker here is an HPV epidemiologist...

We don’t know, but I frankly do strongly suspect that when we do eradicate or minimize the HPV 16 and 18, that their very, very close relatives will fill in. Nature abhors the vacuum and these ecological niches are going to be vacant when HPV 16 and 18 and 6 and 11 are minimized, and I’m deeply concerned that there’ll be backfill of those ecologic niches by these very, very similar types.

and...(not too relevant, but interesting, nevertheless)...about merck:

From a purely business point of view, they’ve been facing some real interesting challenges over the Vioxx issue and they are looking at this as the foundation and the savior of the company. Believe me, they have a huge stake in this, just as we all do.

Also, onto it's actual effectiveness:

This is an editorial about the large FUTURE II trial...

http://content.nejm.org/cgi/content/full/356/19/1991

In analyses by lesion type, the efficacy appears to be significant only for grade 2 cervical intraepithelial neoplasia; no efficacy was demonstrable for grade 3 cervical intraepithelial neoplasia or adenocarcinoma in situ.

Findings from the FUTURE II trial showed that the contribution of nonvaccine HPV types to overall grade 2 or 3 cervical intraepithelial neoplasia or adenocarcinoma in situ was sizable. In contrast to a plateau in the incidence of disease related to HPV types 16 and 18 among vaccinated women, the overall disease incidence regardless of HPV type continued to increase, raising the possibility that other oncogenic HPV types eventually filled the biologic niche left behind after the elimination of HPV types 16 and 18.

Then the FDA responded to that editorial:

http://content.nejm.org/cgi/content/full/357/11/1154

The FDA-approved label clearly informs health care providers of the other concerns: Gardasil "does not prevent infection with the HPV types not contained in the vaccine"; it "reduced the overall rate of CIN 2/3 or AIS [adenocarcinoma in situ] caused by vaccine or non-vaccine HPV types by 12.2%

And...

http://www.cfp.ca/cgi/content/full/53/12/2157

The vaccine will likely be most beneficial when administered before sexual activity. In the intention-to-treat population, most of whom were sexually active, the vaccine was only efficacious for preventing lesions associated with HPV types 16 and 18, but it was not efficacious for preventing high-grade cervical disease when considering all HPV types.

So, it's not as effective as it's being made out to be, and we're messing with things we don't really understand. I feel more comfortable at this point planning on teaching my daughter about the importance of regular paps.