Thursday, March 28, 2013

is the HPV vaccine fundamentally different?

A few weeks ago BabyCenter News posted an article from HealthDay News, Parents' worries about the safety of HPV vaccine on the rise, study says (March 15, 2013).  Years ago I spent a semester studying HPV and its relationship to oral cancer, so I'm naturally a bit interested in the HPV vaccine discussions.

Before I say too much, I want you to know that I am not an expert on vaccines, and am not either recommending, or not recommending that you or your children get the HPV vaccine.  I do think it's interesting to critically think through this article and the recommendations that accompany it. 

According to this article, the safety concerns of parents in regards to the HPV vaccine nearly quadrupled between 2008 and 2010.  HealthDay News doesn't tell us which study actually found this out, merely using using the catch words of "experts" and "study."  I'd be curious to know how the study actually measured these concerns, since there could certainly be room for error here.  Did the concerns really quadruple?

The article also states that, "There are more than 100 strains of HPV....".  It's true that there are many different strains of HPV, but to emphasize this when focusing on the  HPV vaccine seems a little over dramatic since the HPV vaccine is only effective against 4 strains of HPV(1).

But what really jumps out the most to me is that the article states that,
"...the worries [about safety] seem specific to the HPV vaccine. Parents in the study were also asked about two other vaccines recommended for teenagers: the "Tdap" vaccine against tetanus, diphtheria and whooping cough; and the "MCV4" vaccine against bacterial meningitis -- a potentially fatal inflammation around the brain and spinal cord.  Across the study period, less than 1 percent of parents cited safety concerns over those two vaccines."
This makes sense to me-- think about the different modes of transmission.  Tetanus, diphtheria, whooping cough, and meningitis are all highly contagious and can be transmitted in an everyday
setting.  HPV is different.  HPV is a sexually transmitted disease.  I believe that's at least part of the reason why it was reported that just over 17% of parents said that the HPV vaccine was "not necessary." 

The ways of acquiring HPV are directly related to a specific lifestyle, whereas the other diseases can be acquired simply by going to the grocery store or stepping on a rusty nail.  And that is a difference that ought to be considered when thinking about  this vaccine.

No matter how safe a medical intervention is, there will always be associated risks and costs (at least to someone).  In critically thinking about this, we must weigh these risks and benefits.  The article may be right that there are very few risks associated with the vaccine, but we should also be careful to think about the potential benefits since this disease is a result of a lifestyle that is chosen. 

But anyways, just some musing on how the HPV vaccine is a little different ideologically than other vaccines.

What do you think though? Is a different mode of transmission for the disease a big enough difference to put this vaccine in a different sort of category?  Or, does it all just seem the same to you?

(1) CDC. (2012). Human Papillomavirus (HPV) Vaccine. Accessed 3/27/2013


Pinon Coffee said...

That _is_ an interesting article.

On a gut level, the different mode of transmission does make a major difference to me. Maybe it shouldn't. When it comes time we may decide it's worth getting the vaccine for her after all -- but I don't want to.

I do find it strange that the medical community refuses to speak out about the health risks of having sex with numerous partners, period, when it's so willing to condemn things like tobacco use. I mean, there's this whole category of diseases that are nearly 100% preventable. I wonder if that's part of the hesitation of those 17% of parents: they feel their concerns about a promiscuous lifestyle are being ignored by medical professionals.

Rebecca said...

When it comes time, we might very well decide it's worth it too, but like you, on the gut level, I just don't want to. I feel like there could be a whole other philosophical/theological level here too (one I haven't really thought through)-- do we assume our kids might "mess up" and therefore protect them with the vaccine, or do we train them and trust that they will follow the Lord and His ways? Obviously this too would require great wisdom.

You bring up a great point about how surprisingly quite the medical community is about the risks associated with promiscuous sex. It does seem strange that they'll tell people to change their unhealthy habits when it comes to eating, exercising and smoking, but not when it comes to sex and numerous partners. Do you think this is just a result of our culture's view of sex?