Monday, May 14, 2007

Doubts about the HPV Vaccine

Not that it comes as any suprise to me. The LA Times reports on a study in the New England Journal of Medicine raising questions about the effectiveness of the HPV vaccine. Dr. L Koutsky noted that the data hinted that blocking HPV strains 16 and 18 might have opened up a niche that other HPV strains previously consider minor players could take advantage of. In an editorial in the same issue Dr G Sawaya called the benefits of the highly publicized vaccine as "modest" and suggested that women take "a cautious approach" to vaccination.

So, as I had initially suspected when the Merck first rolled out the vaccine. Many in the Cytology community has suspected that the vaccine was being oversold. If you understood the biological nature of viruses its not surprising other viruses would take the opportunity to fill in the gap. My concern was patients receiving the vaccine thinking they no longer needed to get another pap smear because they were protected.
When doctors give the vaccine to patients, they think that " 'I am protected against everything,' and that's just not true," said Dr. Diane M. Harper of Dartmouth University, who helped design a related Merck-funded HPV study in the journal.
She is still in favor of giving Gardasil to girls because it is safe and it "protects against the main HPV bad actors," but she argued that neither doctors nor women should be lulled into a false sense of security by the shots.
"I don't think this is the gun that is going to take cervical cancer off the map," she said.

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