The following is a Facebook response I crafted to a woman who was opposed to the HPV vaccine because she felt that the risks of the vaccine did not outweigh the benefit. Since it was lengthy, I share it on my own profile, and my friends asked that I make it public. Subsequently, I was asked to make it into a blog post. So here we are.
I find this argument interesting, but I wonder how much of it comes from a sense of complacency. It seems a little bit like a skewed risk assessment more than anything, borne out of complacency.
This isn’t an insult. Let me explain. If I don’t vaccinate my child against measles, that child could be exposed to measles tomorrow (hypothetically) and contract measles. The consequences of not vaccinating my child could be immediate, and I would have no control.
If I don’t vaccinate my child against HPV, he’s not coming down with cancer tomorrow. However, it is possible that through his own sexual activity (though not necessarily consensual and not necessarily intercourse), he could be exposed to HPV in the next few years and then, in 20 or so years, the HPV infection could lead to cancer.
So the risk of HPV-caused cancer seem distant, and there are plenty of rumors about the HPV vaccine (which, by the way, are false).
If I don’t vaccinate my child against measles, he could be one of the 60-600 people infected in the U.S. this year. (My own state saw 79 cases this spring/summer–so the threat was real.)
If I don’t vaccinate my child against HPV, he could be one of the 16,500 men (and 39,800 people) who gets cancer in the United States. There is no Pap smear-like test for oropharyngeal cancer, penile cancer, or anal cancer currently, so we wouldn’t know he had cancer until he became symptomatic.
But even with Pap smears, 4,000 women die in the United States right now from cervical cancer alone–almost all of which is caused by HPV. Before the vaccine, 450 children died every year from measles. So in reality, a girl is 10 times more likely to die from HPV-related cervical cancer than her grandparents were from measles. That alone seems to make it worth preventing, and doesn’t mention the damage done to a woman’s body if her cancer is caught early or in the pre-cancerous stage. The risks go beyond death into infertility, pain, suffering, etc.
The data we have, now, is that HPV infections have been reduced by 90% in places like Australia and they are way down, despite our low uptake rate with the HPV vaccine, in the United States. One study of more than a million girls in Scandinavia showed absolutely no serious side effects from this vaccine.
The other issue is how diseases are contracted. Tetanus is also a behavioral illness. Just don’t get a dirty puncture wound, and you will be fine, right? It isn’t infectious–yet every state requires this vaccine for school entry.
Of course we require this vaccine. You can’t really avoid tetanus by just being careful.
And you can’t really avoid HPV by being careful or abstinent before marriage. Unlike HIV, HPV is not passed along via secretions. It lives on the skin. If someone wears a condom, he can still pass on HPV. Deep kissing can pass on HPV. Non-consensual sexual contact can pass on HPV. A virgin can get HPV on her wedding night from a spouse who caught it before marriage. It is much more like contracting tetanus than we think, and for many people, they have absolutely no control over whether or not they contract it.
So I wonder–does it still seem worth the risk to pass on this vaccine?