Somewhere along the line, it became acceptable for parents who happily vaccinate their children against pertussis and measles and diphtheria and rotavirus to fear the HPV vaccine. Parents who shun the notion that the MMR causes autism or the the Tdap causes SIDS gobble up willingly blog posts about beautiful teenage girls who developed neurological problems or ovarian issues after the vaccine. That the websites they read are connected to the most notorious in the anti-vaccine world doesn’t register with these otherwise pro-vaccine parents. They are certain that this vaccine is not safe and that, while they can trust the CDC on every other vaccine, the HPV vaccine information has been obscured and sullied.
Parents fear vaccines for lots of reasons, and I’ve always held that fear of the HPV vaccine is one gateway into the anti-vaccine world. (Another prominent gateway is our birth culture, but that’s a different post.) Those pretty teenage girls had so much to hope for. And now their dreams are dashed–even if all evidence points away from the HPV vaccine.
I could go on about how safe this vaccine truly is, but I’ve done that before.
Instead, I’m going to insist today that parents who readily fall prey to misinformation about this vaccine do not understand what is at stake. I was fortunate enough to host a conference call last week featuring Dr. Nathan Boonstra on the topic of HPV vaccine uptake. While you should listen to the whole thing, I was most struck by what he said about the burden of HPV disease:
When we talk about the burden of this disease, I think it is underestimated by a lot of people…We are looking at 80 million Americans currently infected with HPV, 14 million new infections a year in the United States. And it’s most common in people in their teens and their early twenties…We are talking about 4,000 deaths from cervical cancer alone every year. We are talking about 12,000 cases of cervical cancer a year. And when we start looking beyond that, we are looking at something on the order of 25-26,000 cases of cancer in the United States from these [HPV] viruses. And then we can go even bigger and talk about the hundreds of thousands of cases of genital warts and hundreds of thousands of cases of precancerous lesions that have to be removed and that have their own set of complications and their own burden by bleeding or infection or even cervical incompetence…When we talk about males and females, a lot of people think we are trying to protect females. But when you really break down the numbers out of all of these 25,000 cases of cancer that are happening in the United States, a good third of them are in males…Most of these are your oropharyngeal cancers, which can be reduced by widespread use of the vaccine.
What Dr. Boonstra pointed out is that the burden of HPV disease actually outpaces some of the other diseases we vaccinate against. If we consider only cervical cancer deaths (even though HPV causes a number of cancers) and compare those to the deaths of other diseases, the harm caused by HPV disease is obvious:
- 4,000 HPV-related cervical cancer deaths in the U.S. today.
- 1,904 polio deaths in the U.S. in 1950 (near the height of the epidemic).
- 450 measles deaths every year in the U.S. before the vaccine.
- ~500 tetanus deaths each year before widespread use of the vaccine in the U.S.
- 100 chickenpox deaths every year in the U.S. before the vaccine.
And so on. You’ll notice that with the diseases we most fear for our children, we readily accept vaccinations. Except that HPV-related cancers kill more people every year than polio, measles, tetanus, and chickenpox combined did before we had vaccines for those diseases.
Parents who feel that they can let this vaccine hang or opt out of it because it doesn’t seem important are playing a dangerous game with their children’s health. HPV is a real threat, and preventing cancer when we can is an obligation. I would never say that one vaccine is more important than another, but the HPV vaccine is certainly crucial, even when it has the reputation of being optional.
While the burden of the disease may not hit their children until they are adults, the chance to protect their children happens when they are still children and parents have the obligations to make the choice to protect.