10 HPV Vaccine Myths
#1: Young women are being used as "guinea pigs" for an unproven vaccine.
#2: There's been a rush to use this vaccine – we should wait until we have more answers.
#3: My daughter doesn't need this vaccine now because she isn't sexually active.
#4: There weren't any studies done in the group of girls (aged 9 - 15 years) that public health wants to vaccinate.
#5: We don’t know how long the vaccine protection will last.
#6: We don't need an HPV vaccine program when Pap testing catches cervical cancer early and it can be treated.
#7: Once you get the vaccine you won’t need to get Pap tests anymore.
#8: This vaccine is really expensive – it's not worth it.
#9:This vaccine will promote earlier sexual activity.
#10: There have been reports that the vaccine causes serious side effects.
FACT: Young women are benefiting from a safe and effective vaccine.
- The HPV vaccine has been thoroughly studied. In the combined analysis of studies with Gardasilä vaccine, 20,583 women were enrolled in the studies and eligible for analysis. Of these, 10,291 were randomized to the vaccine group and 10,292 were randomized to the placebo group. These studies took place in North America, Europe, Latin America and the Asia Pacific Region.
- For the women in the studies, the vaccine prevented almost 100% of pre-cancer lesions of the cervix caused by the HPV subtypes in the vaccine. The women in the studies received all the recommended doses of vaccine and had not yet been infected with any of the four strains of HPV contained in the vaccine.
- The HPV vaccine is safe. The majority of adverse events following immunization are transient fever and injection site reactions (i.e. pain, redness, and swelling).
- Vaccines are licensed for use in Canada only if they meet very strict standards for safety and effectiveness.
- Assuring the safety of vaccines and medications does not stop with licensing.
- Across Canada, there is a reporting network that enables Health Canada to monitor vaccine associated adverse events after vaccine licensure. Health Canada investigates potential problems and acts upon them as needed.
FACT: HPV vaccine has been very carefully studied.
- We know the vaccine is very effective and safe. Pre-licensure, HPV vaccine has been one of the most extensively studied vaccines.
- HPV vaccine is now being used in 93 countries around the world (e.g. Australia, New Zealand, the US, UK, most European and Scandinavian countries).
- Cervical cancer is the second most common cause of cancer in women between the ages of 20 - 44 years and the second leading cause of years of life lost in women internationally.
Young girls can be protected now. It’s always better to prevent disease than treat it.
FACT: We want to protect girls before they are sexually active.
- The majority of females become infected with at least one type of HPV within 2 to 5 years of becoming sexually active.
- A recent US study in college-aged women showed that infection with HPV happens very commonly with the first sexual partner.
- In BC, 3% of girls aged 12 or younger have already had sexual intercourse, and over 30% are sexually active by age 16.
- If a girl is already infected with one or more types of HPV prior to vaccination, the vaccine will not treat or clear those HPV types.
- The vaccine should be given to girls before they are exposed to HPV through sexual activity. This includes any oral or genital contact - intercourse isn’t necessary.
This is the same approach taken with any vaccine: it needs to be given prior to exposure to the infectious agent.
FACT: There were studies of the vaccine immune response in this age group. Health Canada reviewed the data and approved the use of the vaccine.
- In the studies with older women (aged 16 – 26 years), researchers were able to do both blood tests and pelvic exams.
- Blood tests show antibody protection and pelvic exams detect pre-cancer changes in the cervix. As it is not ethical to do pelvic exams on girls so young, only blood tests were done.
The studies showed that both age groups developed high antibody levels after vaccination. In fact, the younger girls developed higher antibody levels than the older females. In the older age group the vaccine prevented almost 100% of pre-cancer changes in the cervix. Therefore, the researchers concluded that the vaccine would also prevent pre-cancer cervical changes for the younger girls.
FACT: There is mathematical modeling data that predicts HPV vaccine protection will last for at least 15 years, and probably lifelong.
- We know from the vaccine studies that there is good protection 5 years after the first dose of vaccine and that the antibody level is much higher after vaccination than after natural infection with HPV. This is good news as a high antibody level usually means longer protection.
- When any new vaccine is approved for use there are unanswered questions such as the length of protection and the need for a booster dose. An example is the grade 6 hepatitis B vaccine program that was started in BC in 1992. The length of protection from hepatitis B vaccine is still being studied all these years later.
- The HPV vaccine will protect girls now. It’s far better to give the vaccine and then give a booster in the future, if needed, than not to give the vaccine at all.
FACT: Both HPV vaccine and Pap tests are needed to prevent and detect cervical cancer.
- The Pap test identifies lesions that may progress to cancer of the cervix and is not guaranteed to prevent and detect cervical cancer.
- In fact, over 30% of women with cervical cancer in BC have followed the provincial recommendations for Pap testing.
- Women who have an abnormal Pap test require further tests and treatments to prevent the progression to cancer (e.g. colposcopy, biopsy, or removal of portions of the cervix). In BC each year more than 10,000 women have these invasive procedures.
More than 60% of the abnormal, potentially pre-cancerous lesions could be eliminated with an HPV vaccine program. More importantly, about 70% of invasive cervical cancer could be prevented.
FACT: Sexually active females will still need to get Pap tests after they’ve been vaccinated.
The HPV vaccine provides protection against the two HPV types (16 and 18) that cause 70% of cervical cancer. There are at least 40 types of HPV that can infect the genital tract. There is still a need for Pap tests to screen for the cervical lesions caused by the remaining 30% of HPV types that contribute to cervical cancer.
FACT: An HPV vaccine program is worth the investment.
- Several cost-effectiveness analyses have been available for several years, including a BC - specific study. These studies all estimate a “cost per quality life year saved” approach (which can be used to compare the costs and benefits of different kinds of health care interventions).
Based on these studies, an HPV vaccine program is as cost-effective as other recently implemented vaccine programs and is competitive with other widely accepted medical and surgical interventions.
FACT: There is no evidence that being vaccinated against HPV will promote earlier sexual activity.
- There were similar concerns in 1992 when BC introduced the hepatitis B vaccine program for grade 6 students. Since then, the age in which teens engage in sexual activity has actually risen, with more teens also having fewer sexual partners (i.e. the McCreary study).
There is evidence that many factors can influence young peoples’ decisions about early sexual activity. These include peer pressure, self-image, sex education, and impact of the media.
FACT: While serious events have been reported following the receipt of HPV vaccine, none can be convincingly linked to the vaccine.
- During the HPV vaccine trials, the women who had the HPV vaccine were compared with women who received placebo (salt-water) injections. The rate of serious events was identical in both groups.
- In the vaccine trials, deaths were reported in both groups. Investigators have concluded that it is highly unlikely that the HPV vaccine caused the deaths. Deaths were caused by the usual reasons seen in the age groups studied (motor vehicle accidents, overdose and blood clots). Other causes were blood poisoning, pancreatic cancer, heart beat irregularities, and suffocation
- There have been reports of Guillian Barre Syndrome (GBS), a nervous system disorder, in vaccinated people in the US. So far, the number of cases of GBS is below the number that is usually reported for the US population. It is thought that these cases occurred by coincidence following vaccination.
- 95% of reported HPV vaccine side effects are very minor and similar to those following other vaccines (i.e. fever and injection site reactions).
- Health Canada monitors all adverse events following immunization (including HPV). All identified problems are investigated and acted upon as needed.
