The Overwhelming Safety of the HPV Vaccine

Misinformation Keeps Vaccination Rates Low

No vaccine has suffered more from misinformation and ill-founded concerns than the human papillomavirus (HPV) vaccine. Antivaccine activists have claimed that HPV vaccine causes chronic pain syndromes, chronic fatigue, sudden death, and a variety of autoimmune disorders. In addition, activists have gone so far as to claim that the HPV vaccine increases risky sexual behavior. These claims are often supported by the media as well as by substandard studies published in predatory journals. Indeed, on December 4, 2013, Katie Couric, in a segment titled "HPV Vaccine Controversy," interviewed two mothers: One claimed that the vaccine had caused her daughter to suffer chronic fatigue, the other that the vaccine had caused an otherwise unexplained death.

As a consequence of such fears, immunization rates for the HPV vaccine remain low. According to the Centers for Disease Control and Prevention (CDC), only 53% of girls and 44% of boys have received the recommended doses.^[1] As currently constructed, the HPV vaccine—which contains the L1 surface protein from nine different strains—will prevent about 29,000 cases of HPV-associated cancers and 5000 deaths a year.^[2] Unfortunately, because only about half of US adolescents have received this vaccine, every year about 15,000 people are destined to suffer and 2000 to die from a preventable cancer.

To the credit of the scientific and medical communities, millions of dollars have been spent on studies examining the safety of the HPV vaccine. Pre-licensure, about 30,000 people were studied for 7 years.^[2] Post-licensure, more than 1 million people have been formally studied, examining all manner of chronic pain and fatigue syndromes as well as more than a dozen different rheumatologic diseases.^[3,4,5,6] Not surprisingly, the HPV vaccine has not been found to cause any chronic or debilitating condition. Indeed, the HPV vaccine is probably the world's best-studied, modern-day vaccine.

Another Unwarranted Concern Debunked: Primary Ovarian Insufficiency

One concern recently raised by antivaccine activists is that the HPV vaccine causes primary ovarian insufficiency. How this concern was born remains a mystery. HPV doesn't infect the ovaries. And the HPV L1 surface protein doesn't mimic proteins on ovarian cells, which would at least make an autoimmune disease biologically plausible. Nonetheless, the fear persists. To address this concern, researchers at Kaiser Permanente Northwest examined a cohort of 199,078 female patients, finding 120 with a diagnosis of primary ovarian insufficiency.^[7] The researchers found no statistically significant elevation of risk for ovarian failure following receipt of the HPV vaccine. They also didn't find an increased risk following receipt of the Tdap, MenACWY, or inactivated influenza vaccines.

The Kaiser Permanente study can now be added to the mountain of evidence that should reassure clinicians and parents that the HPV vaccine is safe. HPV, on the other hand, isn't safe. And until we dramatically increase immunization rates against this common, devastating infection, children will continue to suffer our ignorance.