“Free” boys’ shots next?

After NACI’s recommendation of HPV vaccine for 9-26 yr old males we can expect another round of questionable hyperbole. Is Canada poised to emulate Australia, the first country to fund male HPV shots? The recommendation aims at genital warts, precancerous lesions and anal cancer in males but, “based on assumptions”, suggests it would also reduce HPV transmission to females and therefore, “prevent additional cases of genital warts and cervical cancer in females to varying degrees”. In April, the Canadian Cancer Advocacy Coalition endorsed the recommendation, urging “free” taxpayer funded HPV vaccine for boys as did the Federation of Medical Women of Canada in July. Five years ago, the latter endorsed “free” funding for Gardasil vaccine for schoolgirls after Merck had given them a donation which the Federation claimed had no bearing on their helpful decision to back Merck’s vaccine.

In 2007, federal government taxes were used to help kick-start the schoolgirls’ HPV vaccine program with funding of $300 million over three years. Now, with less-than-stellar uptake in that program (eg 55% uptake in Ontario, 66% in BC) despite its incessant promotion, only their own resources available, and ever-increasing demands for more “free” health provisions (including post vaccination medical treatment) in a slumped economy, provinces and territories may need much more encouragement to adopt a schoolboys’ HPV program. Ontario is conducting a retrospective five year appraisal of their schoolgirls’ program to help determine how beneficial a boys’ program might be. And BC’s PHO, Dr Perry Kendall, admitted to the Winnipeg Free Press: “It’s competing with a whole bunch of other vaccines that are either here or in the pipeline. And there’s limited, finite dollars in the health-care budget these days.”

A study by Jessica Kahn MD, MPH et al uploaded July 9th to the eFirst pages of Pediatrics and to be formally published in August appears to be fodder to help convince a gullible public that HPV vaccine is highly effective. But, a critique of the study by SANE VAX Inc maintains it’s proven no such thing and, in fact, shows evidence of the opposite. The study aimed to determine if HPV vaccination affected HPV infection rates in sexually experienced, mostly African American 13 to 26 yrs olds. It did so by comparing results of 2006-7 prevaccination HPV status with that of 2009-10 postvaccination status. The study concludes that “there was a substantial decrease in vaccine-type HPV prevalence and evidence of herd protection in this community.” However, it admits that the increase in non-vaccine HPV types found in vaccinated participants “warrants further study.”

There are numerous problems with the study’s methodology which should discourage us from enthusing over its positive conclusions. (a) Participants were counted as “vaccinated” after receiving just one of the usual three doses of the vaccine. (b) The method of testing used in the study to determine HPV types is known to be unreliable. Just one of many inaccuracies to which this could lead is the attribution of HPV prevention to vaccination rather than to natural immunity developed via prevaccination HPV exposure. (c) The vaccine strain, HPV-18 exists as three subtypes, population prevalence of which varies according to race. At least in USA, the subtype included in HPV vaccine is much more common in African American women than in white women, thus results from the vaccinated population should not be extrapolated to the population as a whole.

But to be even more heretical, let’s remember that it’s never been proven that HPV actually causes cancer or even genital warts. It’s known that poor lifestyle habits and the stresses of poverty can contribute to these; it’s possible that HPV simply thrives best in tissues compromised by these factors. (Our HPV vaccine page discusses this concept at greater length.) Furthermore, a December 2011 study in Annals of Medicine disputes the propaganda we’ve all heard; authors Tomljenovic and Shaw reveal that, “while the world’s leading medical authorities state that HPV vaccines are an important cervical cancer prevention tool, clinical trials show no evidence that HPV vaccine can protect against cervical cancer.”

According to medicalxpress.com, the Pediatrics study found: “The prevalence of vaccine-type HPV decreased 58 percent overall, from 31.7 percent to 13.4 percent. The decrease was high among vaccinated participants (69 percent), but also was substantial for those who were unvaccinated (49 percent).” But, “Dr Kahn emphasizes that despite the evidence of herd immunity demonstrated in her study, vaccination of all young women between the ages of 11 and 26 is important to maximize the health benefits of vaccination.” Does she herself doubt the validity of her study’s results; does she doubt the validity of ‘herd immunity’; or is it just that she’s so pro-vaccine that, in her mind, not one prospective female recipient should be allowed to escape? Considering her high opinion of “the health benefits of vaccination”, why is she apparently not eager to “maximize” them by advocating HPV vaccine for males? Could it be she has a son and/or grandson she wants to protect?