Tag: cancer 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

Can Vaccines Cause Cancer?

We know that several vaccines can prevent cancer, including the human papillomavirus (HPV) vaccines and hepatitis B vaccine.

A cancer treatment vaccine, Provenge, has also been approved by the FDA to treat metastatic prostate cancer. Others are in development.

What Causes Cancer?

It seems like everything causes cancer, doesn’t it?

Did you see the media reports about coffee?

“Cancer is a complex group of diseases with many possible causes.”

American Cancer Society on What Causes Cancer?

Some of the most common causes of cancer include:

  • genetic mutations
  • smoking and tobacco
  • heavy alcohol use
  • unprotected exposure to UV rays in sunlight
  • infections

Fortunately, we can protect ourselves from many of these common causes of cancer.

Can Vaccines Cause Cancer?

Vaccines don’t cause cancer, but that doesn’t stop anti-vaccine websites from saying that they do.

“Cancer is part of our new normal. One in two men and one in three women will receive a cancer diagnosis in their lifetimes. But it’s not just adults. If you can’t bring yourself to focus on this topic for you, please do it for your children.”

Louise Kuo Habakus (Fearless Parent) on Do Vaccines Cause Cancer?

Cancer can definitely become part of your “new normal” if you or a friend or family member gets diagnosed.

National Cancer Institute Surveillance, Epidemiology, and End Results Program cancer statistics.
National Cancer Institute’s Surveillance, Epidemiology, and End Results Program cancer statistics.

Fortunately, cancer rates have been stable, with declining mortality rates. In children, cancer rates have been rising, but only slightly, and nothing like the boom in rates that some folks describe.

Anti-vaccine folks promote the idea that more people are sick, more people have cancer, and in general, everyone is unhealthy, because it fits with their idea that vaccines are dangerous for everyone.

How do they link vaccines and cancer?

They often push the idea that vaccines cause cancer because the original polio vaccines were found to be contaminated with SV40, or simian virus 40. SV40 has not been linked to cancer though.

What about formaldehyde?

Some vaccines contain formaldehyde and formaldehyde is carcinogenic, so how can you say that vaccines don’t cause cancer?

While some vaccines do contain formaldehyde, remember that it is also naturally found in our bodies.

“Carcinogens do not cause cancer at all times, under all circumstances.”

American Cancer Society

It is the long-term exposure to high amounts of formaldehyde, usually inhaled formaldehyde, that is the big concern. Those most at risk would be workers who might be exposed to inhaled formaldehyde. The small amount of formaldehyde in vaccines is safe and does not cause cancer.

Another anti-vaccine talking point? Misusing vaccine package inserts to make you think that vaccines aren’t properly evaluated for mutagenicity and carcinogenicity.

“To ensure the safety of new vaccines, preclinical toxicology studies are conducted prior to the initiation of, and concurrently with, clinical studies. There are five different types of preclinical toxicology study in the evaluation of vaccine safety: single and/or repeat dose, reproductive and developmental, mutagenicity, carcinogenicity, and safety pharmacology. If any adverse effects are observed in the course of these studies, they should be fully evaluated and a final safety decision made accordingly. ”

M.D. Green on the Preclinical Toxicology of Vaccines

They are.

Vaccines are safe and necessary. They don’t cause cancer.

What to Know About Vaccines and Cancer

Several vaccines can prevent cancer and there is even a vaccine that can treat cancer. Vaccines don’t cause cancer though.

More on Vaccines and Cancer