Gardasil

[Seraphim]

The vaccine is also for up to age 26 so it says in the literature. Do they test women for HPV or look for displasia before giving the vaccine? By 26 looking on this forum even, many women have been through quite a few partners.The could have contracted it already. What are the paramaters for a 26 year old to get the vaccination? Did it have a 20 year trial to prove it helped save lives?

[karvala]

karvala... i want to see actual evidence that this vaccine is protecting the female body from HPV.

 

so far the # of lives saved from this vaccine is also: 0

 

because it hasnt had enough time to show that its defending these women.

In the trials the women were checked and vaccinated, but there is no way of knowing if the partners they slept with even had the strains of HPV that cause those 90% of cervical cancer cases.

 

Ah good, now we're really getting somewhere. This is an excellent point that you raise, because in my view, there is one significant weakness in the evidence for the vaccine which has not yet been mentioned, and which could, and I stress the word could since we don't yet know, undermine it's usefulness. This is in relation to the incubation period for HPV-caused cervical cancer.

 

Table 1: Trial data from four phase 3 clinical trials of HPV vaccines (data available in the public domain; table adapted from the citation given in my previous post)

Trial 1 2 3 4

HPV VLP type 16 16,18 6,11,16,18,18 16

Subject age 16–23 15–25 16–23 16–23

No. subjects 1,533 721 468 1,505

Follow up (yrs) 1.5 1.5 2.5 3.5

Persistent infections 42/0 7/0 36/4 111/7 (vaccine/placebo group)

 

In the clinical trials, we do know that the women in the vaccination group were extremely likely to have been infected with HPV on the grounds that the control groups (matched accross a number of factors) given a placebo at the same time DID get the infection. I've shown the trial data above, and from that you can calculate the odds that it was just by chance that the infections occurred predominantly in the placebo group in the way that they did, and they are astronomically low. So we can safely rule that out as an explanation.

 

BUT, and here is where the fun starts, you can also see something else rather interesting in the trials, which is that the those trials that covered the longest period (i.e. had the longest delay between vaccination and final subsequent test), were also the ones that showed the vaccine to be less than 100% effective against the targeted HPV strains. There are two possible interpretations of that, and the data doesn't allow us to easily distinguish between them. One is that the the vaccine was never 100% effective from the start, but it was only when the number of infections increased over time (as they obviously do in the population at large as well, simply because you have increased exposure over a longer time period) that this lack of total protection became apparent. The other is that the effectiveness of the vaccine decreases over time. There isn't yet enough data to conclusively say which of those explanation is true, though it leans marginally towards the latter, and we know from other vaccinations that boosters are generally required, so vaccination isn't always protection forever.

 

If it turns out that the second explanation is the correct one, then this raises a serious question about the vaccine, because it would then require a booster every two or three years to retain a useful degree of protection. While that's not impossible, it both increases the cost significantly, and it also raises the question of how safe it is to do so (probably quite safe, but it's not something we should really be guessing about), and that hasn't received major trials to my knowledge.

 

So yes: it is entirely possible that it has not saved any lives yet, because it is too early to do so, and that it may not turn out to be very useful in the longer term if it's efficacy decreases over time and it's not safe to keep topping up. There are a lot of assumptions there, and personally I suspect it that the efficacy will decrease over time, but it will be safe to give boosters every couple of years, and many lives will be saved in the long-run, but it would be wrong to say that this is certain to happen. That is something else that should certainly be factored in ToV's cost-benefit ratio.

[EQD]

Thank you karvala. *bows*

[Seraphim]

I am SO happy I have a son. Having a girl looks too complicated.

[EQD]

its like saying "i'm going to try this out because i believe it will save me like it says in the commercial from the horrible 'c-word' and then everything will be ok"

 

when really its experimental, its not guaranteed, its not being supported by much evidence, it hasnt saved anyone, and the results and long and short term health benefits or side-effects are not really fully known or understood.

 

Its like RISKING your health for a vaccine that may or may not keep you from contracting a form of disease that may lead to a statistically rare cancer thats frequency is being steadily abolished by simply going to regular checkups.

 

 

There have been in the past vaccines, medications, and treatments that have been accepted by the general public only to find out later that it is something that does much more harm than good.

This is because of the allowance for the market to accept treatments, medications, and vaccines that arent fully tested or proven.

 

But it can and will go either way. Sadly around 25 million people jumped out of their seat over something like this and got it.. gave it to their children, so hopefully it ends up being a great vaccine.. but mistakes have been made before.

 

And thats a big potential for tragedy to me. Considering if it is a bad deal then its going to be absolutely devestating because this vaccine wasnt given time to be properly tested over a persons lifetime. i understand money goes into research, but why not wait another 6-10 years to see if those few thousand women who took it in trials actually come up with problems, or an idea at likely immunity before sticking a good percentage of the american population with this stuff?

[EQD]

and to go on, phen phen, the first h1n1 vaccine, depo provera, lead in paint, asbestos, hydroxycut.. what else can we add to the list?.. all of these at one time or another were fully supported and consumed by americans.. only to later find out that 'oh, we didnt look into this enough and now its hurting us.. alot of us.'

 

so when does it stop? when do we stop making the same mistakes?

[Seraphim]

and to go on, phen phen, the first h1n1 vaccine, depo provera, lead in paint, asbestos, hydroxycut.. what else can we add to the list?.. all of these at one time or another were fully supported and consumed by americans.. only to later find out that 'oh, we didnt look into this enough and now its hurting us.. alot of us.'

 

so when does it stop? when do we stop making the same mistakes?

 

the plastic used to make baby bottles and iv lines....etc etc

[karvala]

The vaccine is also for up to age 26 so it says in the literature. Do they test women for HPV or look for displasia before giving the vaccine? By 26 looking on this forum even, many women have been through quite a few partners.The could have contracted it already. What are the paramaters for a 26 year old to get the vaccination? Did it have a 20 year trial to prove it helped save lives?

 

In the trials, all women were tested and verified clear before being given the vaccine. In good clinical practice that will also be the case. It's given to women under 26 simply because this is what has been trialled. I would imagine an application to extend that to older women after more trials will happen at some point in the future. Other than the age requirement, a clean bill of health, and no other contraindications (i.e. not taking other medications which might interact, though I don't know of any off-hand), there aren't any other parameters that I'm aware of.

 

In regard to the trial: no it didn't have a full 20-year trial (no medication ever does), it had a number of full trials which lasted up to abour 4 years. This is a significant weakness in the case of a vaccine for something that has such a long incubation period, and especially in light of the trial results, as I discuss in my previous post. This, I believe, is the one strong argument against early adoption of this vaccine.

[Seraphim]

So then what it comes down to is no one really knows what it is going to do, the efficacy is also undetermined and may require boosters which could cost too much money and could or could not cause health issues.Yet millions are linning up "just in case". No one finds this scary? You, yourself said the average joe does not get to see all the scientific materials. That is my case and point. We are treated like dodos and we are supposed to just "accept" what we are given. We all know science is so good at apologsing for it's mistakes.

[karvala]

And thats a big potential for tragedy to me. Considering if it is a bad deal then its going to be absolutely devestating because this vaccine wasnt given time to be properly tested over a persons lifetime. i understand money goes into research, but why not wait another 6-10 years to see if those few thousand women who took it in trials actually come up with problems, or an idea at likely immunity before sticking a good percentage of the american population with this stuff?

 

If it were up to me, that's probably what would happen, or what I would do, to be honest, but that's just me being characteristically cautious.

 

The argument for vaccinating now is that every potential cancer victims are being saved from this year (albeit with a 15-20yr latency), and every year you delay, you're condemning another 3000+ women to die of cervical cancer. Of course, it is is a risk to take the vaccine now when the long-term effects are unknown, and the long-term efficacy is unclear, but we know the danger of not taking it. It's obviously rather hard to make the cost-benefit judgment when we don't actually know what will happen in the long-term, but one way or the other we have the make the judgment, because not offering the vaccine is also a specific choice.

 

Personally, I'm not that comfortable with the data as it stands, and I would prefer a bit of a delay while more data is acquired before mass vaccination, but I can see it both ways. I should add that vaccinations are not high risk in general terms; for the number of vaccinations that are given every year, the number of complications arising from them is minimal (I realise that's no consolation to those who have been affected, but we have to talk about the overall large-scale effect here), and there have been no widespread disasters due to a lack of long-term knowledge of vaccines that have been given to date, and I wouldn't expect this to be any different. If I had to bet the mortgage on whether or not more lives would be saved by vaccinating from tomorrow, or not vaccinating from tomorrow, I would definitely bet in favour of the vaccine, but I can't say I would feel entirely comfortable doing so.

[EQD]

this is the first vaccine against a 'cancer causing/related disease' though am i right?

the components are slightly different. albiet it is an infectious disease i'm shocked to have to restate what another site said "the cause is unknown"

thats a pretty potent statement there about cervical cancer. they know that HPV is linked to it, but so is smoking *shrug*

so...

 

take into consideration how FEW women die from cervical cancer. I understand the 'lets save people now' but its considered rare. the mortality rate is low. the death toll is comparitively low considering the death toll for other diseases that people are regularly vaccinated for. And the stats are shrinking every year after a huge 75% jolt of decline thanks to the PAP test and awareness of its importance.

Why does this now need a vaccine after all that?

 

once again i quote:

"Although the cause is unknown, several predisposing factors have been related to the development of cervical cancer: frequent intercourse at a young age (younger than age 16), multiple sexual partners, multiple pregnancies, exposure to sexually transmitted diseases (particularly genital human papillomavirus), and smoking. "

 

so... this fact is somewhat expressing that smoking, multiple pregnancies, and exposure to STD's particularly HPV are related to cervical cancer.

 

but of those people who are developing cervical cancer what are the odds that more than one of these factors are already present, thereby making them just as much of a possibility of causing it?

 

if 90% of women who have cervical cancer have 'this' type of HPV then what portion of those women have had multiple pregnancies? how many smoke also? how many have contracted STDs before? detailed studies should reflect how relevant or irrelevant these other predisposing factors are since after all they are on the same list as HPV. right?

[annie24]

i wouldn't say that the cause is unknown. HPV belongs to a family of cancer-causing viruses. Cancer is a pretty complex disease, and it often requires more than one thing to go wrong in a body. I won't go into the huge details here, but for sure, getting HPV is going to be a significant risk factor for getting cervical cancer, and smoking in general, causes all sorts of cancers. just as not everyone who smokes will get cancer, not everyone with HPV will get cancer either.

 

trust me, people are studying this all over the world, the data is coming in, it's just a complicated disease.

[annie24]

link removed

 

here is a very interesting article on HPV and cancer development.

[EQD]

i wouldn't say that the cause is unknown. HPV belongs to a family of cancer-causing viruses. Cancer is a pretty complex disease, and it often requires more than one thing to go wrong in a body. I won't go into the huge details here, but for sure, getting HPV is going to be a significant risk factor for getting cervical cancer, and smoking in general, causes all sorts of cancers. just as not everyone who smokes will get cancer, not everyone with HPV will get cancer either.

 

trust me, people are studying this all over the world, the data is coming in, it's just a complicated disease.

 

 

hey, i *didnt* say the cause is unknown. That was quoted. *nods*

[EQD]

link removed

 

here is a very interesting article on HPV and cancer development.

 

and i cant log into that.

[annie24]

here is the first page:

[EQD]

So... that makes me fear cervical cancer less now.

[IphigeniaSaysHi]

I get the sense that you think it's stupid to be afraid of getting cervical cancer. With anything in life, fear and paranoia gets you nowhere. Still, I think awareness and vigilance are important because the info about the link between hpv and cc has been a big breakthrough for women's health.

 

Some chose to panic and that's on them but it's good to know the reality.

[EQD]

good lord no. not all all. people should be afraid of getting all kinds of cancer.

cancer is bad.

 

i think its a little odd to worry and fret this much over a cancer that is so rare and treatable. and to automatically run to a vaccine that isnt proven to prevent it.

[annie24]

i've never lost any sleep over HPV or the vaccine. in the grand scheme of things, i agree, there are scarier diseases and microbes out there. i don't think that it is that rare - i mean, i know several women who have developed cancerous lesions or pre-cancerous lesions by the age of 24. I got the vaccine at the age of 26, i was right at the cutoff, but i had also tested negative for the virus upon my request.

 

but just because a disease is relatively rare doesn't mean that people shouldn't pay attention to it. there are a host of rare disorders that 'only' cause 500 or less deaths a year, and very few doctors know about them. it's obviously extremely frustrating to someone who has mystery symptoms for decades, to not know what they have and if they finally find out, to find out that there's no cure. there is a show on TLC 'mystery diagnosis.' one lady had a host of strange problems for 17 years, before she finally found one doctor who knew what she had. of course, there was no cure, as no one knew much about the disease. she did get on some medication to manage it, and felt much much better.

[EQD]

thats part of why i cant seem to take it seriously. the lesions and cells dont always lead to cancer.

 

so while its scary that they are there to begin with the research suggests that even when you have the causing factors.. it doesnt always lead to cancer. which would explain the low body count.

which makes me wonder how many other types of cancer the body overrides and bypasses without us ever knowing.

 

and this whole latency period with HPV is quite interesting to note as well.

 

 

of course... you are talking to someone who has stopped going for my yearly pap smears... which i freely admit is absolutely stupid considering i carry excellent insurance that covers the whole visit practically.

-->this is me asking for trouble

 

i *should* schedule an appointment sometime though.... might find out i'm about to die *ghost fingers*

[IphigeniaSaysHi]

I say people advocate for more easily accessible paps. I don't have health insurance, I could go years without another pap. THAT scares me.

[annie24]

have you considered being a bio major?

 

oncogenesis (development of cancer) is not a simple thing, like i have mentioned. X doesn't necessarily lead to cancer. i'm sure you know some people who have smoked and ate red meat their entire lives and die of old age at 97, while others die at a relatively young age.

 

A lot of viruses have long latency periods. Many lie dormant in the cells until something happens and triggers the viruses to start proliferating. It wasn't until i was in college that it became a really accepted idea that some viruses can even cause cancer.

 

long story short, yes, your cells have all sorts of repair mechanisms to repair damage caused by carcinogens, radiation, reactive oxygen species, etc... and most of the time, your cells are pretty good at that. if there is a problem that is so bad in the cell that your enzymes can't fix it, your cells are supposed to go through 'programmed cell death.' a chain of events starts to happen where the cell is supposed to shut down and kill itself if it cannot fix the problems in a given amount of time.

 

in cancerous cells, there have been a significant number of mutations, in several genes (anywhere from just a few to a couple dozen) that the cell cannot fix errors, the cell is doing harmful things, is replicating out of control, and the "cell-suicide" system has been disengaged. obviously, this is a really complex process and it's pretty rare that one mistake in a genome will cause all of this.

 

chances are, while you are reading this, there are hundreds of cells in your body repairing themselves and going through the programmed cell death if they can't.

 

cancer is just so complicated and really varies from person to person - plus some people have already inherited sets of genes that make them more predisposed to certain kinds of cancers.

 

half the people in my family have either had or died of cancer, so for me, i try to stack the deck in my favor as much as possible - including eating lots of fruits and vegetables, not smoking, sleeping, managing stress levels, and taking the vaccine.

[EQD]

what bothers me is the high incidence of cancer and other diseases, defects, disorders, and general health problems in the general population.

of course i suppose that happens when we get out of the survival and procreation of the fittest, combined with our highly artificial lifestyles, and healthcare that keeps us alive much much longer so that we can live to see even more of these issues crop up.

 

thats what bothers me.

[annie24]

what bothers me is the high incidence of cancer and other diseases, defects, disorders, and general health problems in the general population.

of course i suppose that happens when we get out of the survival and procreation of the fittest, combined with our highly artificial lifestyles, and healthcare that keeps us alive much much longer so that we can live to see even more of these issues crop up.

 

thats what bothers me.

 

so you're saying people should stop going to the doctor and go back to living 35 years like our ancestors did and die in childbirth?