Tag: cancer vaccines

Are Rates of Cancer in Children Skyrocketing?

Why do some folks think that rates of cancer in children are skyrocketing?

If you want to do something during Childhood Cancer Awareness Month, encourage folks to get vaccinated and protected so that they don't put people with cancer, who are likely immunosuppressed at risk to get a vaccine-preventable disease.
If you want to do something during Childhood Cancer Awareness Month, encourage folks to get vaccinated and protected so that they don’t put people with cancer, who are likely immunosuppressed at risk to get a vaccine-preventable disease.

Oh, the usual suspects…

Are Rates of Cancer in Children Skyrocketing?

Cancer is actually one of the leading causes of death, but it is not the leading causes of death in children.

Childhood cancer is not the leading cause of death.

And cancer rates in children are not skyrocketing.

“We identified 120,137 childhood and adolescent cancer cases during 2001-2009 with an age-adjusted incidence rate of 171.01 per million. The overall rate of all cancers combined remained stable over time.”

Siegel et al on Cancer incidence rates and trends among children and adolescents in the United States, 2001-2009.

They have been very stable for many years.

So much for the anti-vax theory that vaccines can cause cancer

There’s more.

Not only are cancer rates in children not skyrocketing, fewer kids today are dying of cancer.

The death rate from childhood cancer has been decreasing.
The death rate from childhood cancer has been decreasing.

And now that they are actually getting vaccines that can prevent cancer, these children have an even lower risk of getting several cancers when they get older!

Even worse than pushing the idea that cancer rates are skyrocketing and that vaccines cause cancer, many of these same folks steer people with cancer away from life-saving medical treatments!

How can these folks publish advice that people with cancer should stop chemotherapy and radiation?!?
How can these folks publish advice that people with cancer should stop chemotherapy and radiation?!?

Surprised?

You shouldn’t be.

This is the modern anti-vaccine movement.

More on Cancer and Vaccines

Should You Get an Extra Dose of Gardasil9?

Believe it or not, the first human papillomavirus (HPV) vaccine was approved way back in 2006.

HPV Vaccine is Cancer Prevention.

And believe it or not, we are now on our third version of the vaccine, which provides protection against even more strains of HPV.

HPV Vaccine Timeline

So we have gone from:

  • Cervarix – HPV serotypes 16, 18 (2006)
  • Gardasil – HPV serotypes 6, 11, 16, 18 (2006)
  • Gardasil9 – HPV serotypes 6, 11, 16, 18, 31, 33, 45, 52, and 58 (2014)

And with each new vaccine, there comes more protection against anal and genital warts and anal, genital, head and neck, and cervical cancers.

Gardasil9, the only HPV vaccine available in the United States, increases the protection level against cervical cancer from 70 to 90%!

Should You Get an Extra Dose of Gardasil9?

Has your child already finished their HPV vaccine series?

With which HPV vaccine?

To be clear, if they have finished the series, then they are considered to be fully vaccinated and protected.

“Persons who have completed a valid series with any HPV vaccine do not need any additional doses.”

National Cancer Institute on Human Papillomavirus (HPV) Vaccines

Remember, the key, high-risk strains that cause most HPV-associated cancer are HPV-16 and 18, which are present in all of the HPV vaccines.

The extra coverage in Gardasil9 to HPV strains 31, 33, 45, 52, and 58 could prevent an additional 10% of invasive HPV associated cancers or about 3,800 cases each year though, mostly in women.

Should you get any extra doses of Gardasil9 for this extra coverage?

“Administration of a 3-dose regimen of 9vHPV vaccine to adolescent girls and young women 12-26 years of age who are prior qHPV vaccine recipients is highly immunogenic with respect to HPV types 31/33/45/52/58 and generally well tolerated.”

Garland et al on Safety and immunogenicity of a 9-valent HPV vaccine in females 12-26 years of age who previously received the quadrivalent HPV vaccine.

While safe to do and it works, there is no formal recommendation that anyone actually get any extra doses of Gardasil9 at this time.

It is something to consider if you want the extra protection though.

Will we get even more coverage in future HPV vaccines? The future might come in different types of vaccines or even in therapeutic vaccines. There doesn’t seem to be a new version of Gardasil with expanded strain coverage in the immediate pipeline though.

More on Getting an Extra Dose of HPV9

Did the FDA Approve a New HPV Vaccine for Adults?

What do you know about the HPV vaccine?

Hopefully you know that it can prevent cervical cancer and that lots of folks spread misinformation that is intended to confuse and scare you away from getting vaccinated and protected with it and other vaccines.

Did the FDA Approve a New HPV Vaccine for Adults?

News that the approved ages for Gardasil have been expanded will likely add to that confusion for a little while.

The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.
The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.

The first thing to understand is that the FDA did not approve a new Gardasil vaccine for older adults.

They very simply expanded the age recommendations for who should get the existing Gardasil 9 vaccine, which was approved back in 2014, replacing the original Gardasil vaccine, which was approved in 2006.

“The U.S. Food and Drug Administration today approved a supplemental application for Gardasil 9 (Human Papillomavirus (HPV) 9-valent Vaccine, Recombinant) expanding the approved use of the vaccine to include women and men aged 27 through 45 years.”

Why the new age indication?

“In a study in approximately 3,200 women 27 through 45 years of age, followed for an average of 3.5 years, Gardasil was 88 percent effective in the prevention of a combined endpoint of persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions, and cervical cancer related to HPV types covered by the vaccine.”

But isn’t the whole point of giving the HPV vaccine to preteens that you want to get them vaccinated and protected before they are sexually active and exposed to and infected by HPV?

Sure, but if you didn’t, and unless you are sure that you have been exposed to and have been infected by all 9 types of HPV strains that Gardasil 9 protects you against, then the vaccine is still a good idea when you are older.

Except FDA approval doesn’t automatically mean that your insurance company will pay for it.

That usually comes once a vaccine is formally added to the immunization schedule by the ACIP.

“In a 2005 study, 92% of insurance plans reported following Advisory Committee on Immunization Practices recommendations to determine covered vaccines; of those, 60% could extend coverage within 3 months after issuance of recommendations and 13% in 1 month.”

Lindley et al on Financing the Delivery of Vaccines to Children and Adolescents: Challenges to the Current System

And Obamacare still requires insurance plans to provide ACIP-recommended vaccines at no charge.

Will Gardasil 9 be added to the immunization schedule for adults?

The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.
The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.

We should know sooner, rather than later. It is on the agenda for the next ACIP meeting on October 25…

More on Gardasil for Older Adults

Does HPV Vaccination Decrease the Chances You Will Get a Pap Test?

HPV vaccines, including Gardasil and Cervarix, can reduce your risk of developing cervical cancer.

That doesn’t mean that you can stop getting Pap tests to screen for cervical cancer though.

Why not?

Vaccines are not 100% effective and while the HPV vaccines protect against the strains of HPV that are most likely to cause cervical cancer, they don’t include every single strain.

Does HPV Vaccination Decrease the Chances You Will Get a Pap Test?

Again, HPV vaccines don’t replace pap tests.

Whether or not a woman is vaccinated, if they have no extra risk factors (can mean extra screening), they should have:

  • their first Pap test at age 21 years, to look for cell changes on the cervix that can be a sign of precancers (was previously at age 18 years if sexually active)
  • a Pap test every 3 years from age 21 through 29 years (was previously done every year)
  • a Pap test with HPV cotesting (actually tests for the presence of HPV in cervical cells) every 5 years or a Pap test alone every 3 years from age 30 through 65 years

This routine testing can help find precancers before they turn into cervical cancer.

Why would anyone stop getting a pap test after getting vaccinated?

They shouldn’t.

Some folks worry that they might though, because those who are vaccinated might think they are at lower risk to get HPV and cervical cancer.

#SaidNoDoctor, except Dr. Jay Gordon, who made this statement about the HPV vaccine on the Ricki Lake Show.
#SaidNoDoctor, except Dr. Jay Gordon, who made this statement about the HPV vaccine on the Ricki Lake Show.

Fortunately, most studies show that this doesn’t happen. Not surprisingly, studies have also confirmed that HPV vaccines are safe and they don’t encourage kids to have unprotected sex.

And data from the National Center of Health Statistics show that a steady number of women over age 18 years have been getting Pap tests since 1987. Numbers did drop a bit recently for young women between the ages of 18 to 24 years, but that coincides with the 2003 and 2012 changes for when to get Pap testing.

What makes this all a bit confusing is that there are actually some suggestions that women who have been vaccinated at an early age (before they are sexually active), with the newest HPV vaccines (cover more HPV types) might actually be able to get HPV testing instead of a Pap test, can start getting tested at a later age, and can get fewer tests.

None of those are formal recommendations though, so women should keep getting their Pap tests on schedule, whether or not they have been vaccinated.

What about reports of increased rates of cervical cancer in Sweden that are linked to an increase in HPV vaccination rates?

Lars Adersson became a pseudonym when he was outed as not being associated with Karolinska Institute.
Lars Andersson became a pseudonym when he was outed as not being associated with Karolinska Institute.

 

In addition to fake credentials, the author came to bogus conclusions, as although there has been an increase in rates of cervical cancer in some of the smaller counties in Sweden, it is thought to be due to differences in regional cancer prevention. To put it more simply, if it was due to getting vaccinated, then since immunization rates aren’t that different in those counties (just like immunization rates vs autism rates in the United States), then why didn’t rates of cervical cancer go up everywhere?

“Joakim Dillner, professor of infectious epidemiology at Karolinska Institute and register holder for the National Quality Register for Cervical Cancer Prevention and Analysis, says, however, to the Medical Journal that there is nothing in the allegations that the increase would be due to HPV vaccination.”

KI investigates suspected false scientist: “Extremely serious”

Of note, Sweden, recently had the highest participation in their cervical cancer screening program ever, at 82.4% of the population.

“HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women.”

Herweijer et al on The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study

So much for the idea that getting an HPV vaccine decreases your likelihood of getting a Pap test…

What to Know About HPV Vaccines and Pap Testing

Although HPV vaccines can decrease your risk of cervical cancer, that shouldn’t influence your decision to get a Pap test.

More on HPV Vaccines and Pap Testing