HPV vaccination (vaccination against cervical cancer)
Assessment of the HPV vaccination
During the observation period invasive cancer occurred neither in women who had been vaccinated with Gardasil nor in women who had been vaccinated with placebo. There is no scientific proof yet for the assumption that “Gardasil prevents cancer”.
The HPV vaccination does not offer protection against HPV vaccinations that are not contained in the vaccination. As with pneumococci or Hib the question remains whether there is not a shift in the pathogens in the course of time, potentially with serotypes which are much more dangerous. In the vaccination trials within two years a relevant replacement was already observed in the women who had been vaccinated.
The question has not been solved yet whether an infection with types 6 and 11, which are considered to be less dangerous, which is prevented by a vaccination with Gardasil, potentially has a protective effect against cancer of high risk types.
The duration of the trials does not make it possible to draw conclusion on how long the protective effect of the vaccinations last. Due to the fact that young women are capable of eliminating HPV viruses much easier than older women the protective effect of the vaccination would shift into an older age and thus the probability of chronification and degeneration would become greater.
As the distribution of HPV types differs widely worldwide the question whether the vaccination also covers the relevant pathogen types and thus an effect could be expected would have to be clarified before the vaccination was introduced.
The prevalence of the subtypes contained in the vaccination is only 3.4% of the women according to an American trial.
The vaccination can cause motivation to undergo cancer screening to drop, as women who have been vaccinated feel safe. This could potentially negate the positive effect of the vaccination. The focus of cancer screening would have to continue to be directed at being motivated to participate in cancer screening.
According to the interim results of the FUTURE trials the HPV vaccination GARDASIL lowers the total number of higher grade cervix dysplasia (CIN 2 and higher) in women between 16 and 26 years of age, the majority of which have already had sexual contact only by 17% and thus much less than expected. For higher grade dysplasia an effect cannot be shown at all anymore.
Cervix dysplasia caused by the serotypes contained in the vaccination occur much less frequently than expected.
Even though the data should be known the question remains unanswered what the effect of the HPV vaccination will be on the total number of higher grade cervix dysplasia in the target group, i.e. young women who have not had sexual contact yet.
In other words the database does not provide information on how to evaluate the benefit of the vaccination and the role other oncogenic HPV types play and thus a recommendation for Gardasil cannot be expressed. (a r z n e i - t e l e g r a m m 2007; Jg. 38, Nr. 6)
The Society of Anthroposophical Doctors has created an excellent leaflet for patients on HPV vaccinations which you should be sure to read.