There's A Vaccine To Prevent Several Cancers

I was pretty young, maybe 27 or 28 years old when I walked into an operating room for the first time. As a 3rd year medical student, I was starting my first clinical rotation, gynecologic oncology. I knew a little about gynecologic cancers from my textbooks and from gazing through a microscope at blue-stained cells, but this was my first encounter with a patient—a person—to whom those cells weren’t some just smear on a glass slide.

It was bad.

I don’t remember all the details, but the patient needed a procedure on her cervix—I don’t recall if it was for some abnormal cells or for a cancer; I don’t remember her name or anything about her as a person. What I do remember is that she had a serious heart condition and couldn’t safely have general anesthesia. The surgeon injected lidocaine at several points on the patient’s cervix and after a few minutes began to burn/cut/cauterize/whatever—whatever it was, it hurt—a lot.

I have no idea what eventually happened to the patient. Presumably she died of her heart disease decades ago.

About 20% of women have had an abnormal Pap smear, and it can be very scary. Pap smears look for cellular changes caused by infection with human papillomavirus (HPV). HPV is one of several viruses that can cause cancer. A Pap smear is the tool we have to detect abnormal cells on the uterine cervix and hopefully prevent cancer; or detect cancer cells at a stage when we can still cure the disease.

As I’ve touched on before, designing screening tests is tricky, but it’s usually easier if a disease is common, and HPV is common. About 80% of sexually active adults will have an HPV infection at some point. It often has no symptoms; but some strains cause genital warts, and some cause cancers, usually of the cervix but also of the vulva, vagina, penis, throat, and anus.

The amazing thing is, we’ve had a vaccine to prevent HPV infection—and therefore cervical cancer—for almost 20 years. The bad news is that it is needlessly controversial, and by “controversial” I really mean that there is a “manufactroversy”. No controversy exists among experts that the HPV vaccine is safe and effective and has done an enormous amount of good. What kind of good?

• Precancerous changes to the cervix have declined steeply with HPV vaccination.

• Cervical cancer deaths in young women declined steeply in the US since the introduction of the HPV vaccine.1

• Study after study has confirmed the safety of the HPV vaccination.

The supposed “deaths” from HPV vaccines cited by Kennedy is entirely made up2. There have been no deaths known to be due to HPV vaccines. Nor would we expect any deaths. And when he says no teens or preteens die of cervical cancer, even if that were true, that’s not what the shot does. It takes years after being infected to develop cancer. My girls got the shot not to prevent childhood cancer but to prevent cancer from developing when they become sexually active and might be exposed to the virus.

So we have a vaccine that has been around for a couple of decades, has been shown to be safe, and prevents several kinds of cancers. Why are we even talking about anything other than, “how do we get this shot into everyone who needs it?”

Why would Robert Kennedy keep touting clearly-false warnings about the HPV vaccine?

There are, in my opinion, two reasons. First, Kennedy is a true believer. He has been a fierce (and wrong) critic of all vaccines for decades and continues to be. The second is just slimy—Kennedy gets paid to attack the vaccine.3 He receives money from a law firm to which he refers people who think they’ve been injured by the HPV vaccine.

Our public health system is under attack—literally. It is being intentionally dismantled and Kennedy is targeting the HPV vaccine among others. Evidence has shown us that HPV vaccines save lives and prevent cancers. If Kennedy is successful at reducing vaccination rates, cancer deaths will rise.

Stay well.

-pal