Get vaccinated against HPV
Gardasil reduces mortality from cervical cancer
Ilya Yasny, XX2 century
"XX2 century" has repeatedly written about vaccines against human papillomavirus (HPV) and what they cause heated debates in society. The first such vaccine, Gardasil (Gardasil, Merck & Co), was registered in 2006, but the debate in social networks about whether it should be vaccinated has not subsided to this day. However, as it turned out, there is also no unity among specialists: in 2018, the then member of the Cochrane Collaboration (a non–profit organization engaged in the independent evaluation of medical interventions) Peter Goetzsche criticized the Cochrane report on the effectiveness and safety of HPV vaccines - he and his colleagues found an increased frequency of some neurological syndromes in groups of vaccinated. However, other researchers have found errors in this work itself, and a number of scientific communities have spoken in favor of the vaccine. Peter was subsequently expelled from Cochrane for "disruptive and inappropriate behavior" over a "number of years." Controversy over HPV vaccines played an important role in the incident.
Until now, the strong argument of anti-vaccinators was the lack of direct data on the effect of the vaccine on the development of cancer. Indeed, HPV vaccines have been registered on the basis of preventing infection with the virus and on the basis of preventing the development of precancerous conditions. Thus, the quadrivalent Gardasil vaccine, which protects against four strains of the virus, showed 100% effectiveness in preventing neoplasia of the cervix and genitals in women who are negative for these strains of the virus, compared with the control group. Infection with HPV strains 6, 11, 16, 18, and especially cervical neoplasia is a significant risk factor for cervical cancer. However, it took too long to wait for the development of cancer during prospective randomized clinical trials, which gave anti–vaccinators a reason to talk about the "unprovenness" of vaccine protection (as if protection against neoplasia is not in itself a valuable enough quality).
Another argument of anti-vaccinators against HPV vaccines is the lack of knowledge of its safety – allegedly they can cause autoimmune diseases and even infertility. However, the observations of the vaccinated continue, and the vaccines have not shown any differences from the control groups in terms of safety throughout the entire follow-up period, which is now almost 14 years.
Vaccines are also reproached for not being compared with saline in prospective randomized trials. And this is not true: here are examples of such studies: 1, 2.
On October 1, 2020, the New England Journal of Medicine published an article by Swedish scientists on the results of a retrospective study of the relationship between HPV vaccination (we are talking about Gardasil) and the risk of invasive cervical cancer. Data on 1,672,983 girls and women from Swedish registries from 2006 to 2017 were analyzed. The vaccine reduced the incidence of invasive cervical cancer by 49% after age adjustment (538 fell ill in the group of 1,145,112 unvaccinated, 19 in the group of 527,871 vaccinated). If we take into account other amendments, vaccination reduced the risk of getting cancer by 63%, and in vaccinated under 17 years of age – by 88%! This result is consistent with those obtained earlier, and suggests that it is better to vaccinate before a person has met with HPV infection (which is most often sexually transmitted).
Of course, the retrospective nature of the study makes it vulnerable to various kinds of distortions, which the authors tried to take into account by introducing various statistical corrections. The result obtained, according to the authors, may rather underestimate the degree of risk reduction after vaccination than overestimate it. Thus, the study convincingly shows a reduction in the risk of invasive cervical cancer after vaccination and knocks one of the last arguments out of the hands of anti-vaccinators.
Portal "Eternal youth" http://vechnayamolodost.ru