HPV of the Cervix and Vaccines

Human papilloma virus, HPV, is the most common cause of both sexually transmitted infections and of cervical cancer worldwide. This virus is a particularly tricky one, sometimes evading the immune system for years. In addition to hiding from the immune system, it can cause changes to cells of the cervix, called cervical dysplasia.  Left unchecked, this dysplasia can lead to cancer. In fact, over 99% of cervical cancer cases can be directly linked to specific high-risk strains of this virus.  Annually, approximately 12,000 women in this country are be diagnosed with cervical cancer.

In 2006, the United States began offering a vaccine for HPV called Gardasil.   This vaccine immunized against strains 6, 11, 16, and 18.  At first this vaccine was only recommended to girls and women although now it is offered to both sexes starting at age 9.   In the last year, the recommendations were changed to allow women up to age 45 years to get the HPV vaccine.  Now, the US offers Gardasil 9, which immunizes against nine strains of HPV.

The HPV vaccine, like all vaccines, works by priming your immune system to mount a response to an infection, in this case to multiple strains of a virus.  Once vaccinated, the spread of HPV will decrease and thus the rates of cervical cancer are predicted to decrease.  The word “predicted” is chosen deliberately, as no studies were conducted long enough to conclude that the HPV vaccination prevents cervical cancer.  Cervical cancer is a slow growing cancer, and typically HPV needs to be present for a decade or more before the cells turn cancerous. The HPV vaccine was studied long enough to deem that it was effective at decreasing dysplastic cells, but it was not studied long enough to determine that it prevents cervical cancer.

Fortunately, even before the advent of these vaccinations, we had a way to screen and test for HPV and the cellular changes it can cause: HPV and pap tests.

As many of you know, guidelines have changed in the last few years to recommend getting pap and HPV tests less often.  This is because the screening was so frequent, it was causing many women to have unnecessary procedures done for a virus their body might have cleared on its own.  Some estimates are that 90% of HPV infections are transient and will resolve in one to two years.

Routine gynecologic exams, testing for HPV and/or pap tests are still an important part in preventing cervical cancer, regardless if you have had the HPV vaccine series or not.  Co-testing with both HPV and the Pap test are considered the most thorough and informative evaluation.

Some people are wary of this vaccination because of its association with ASIA, autoimmune/inflammatory syndrome induced by adjuvants.  There are published reports detailing new cases of autoimmune diseases after the HPV vaccine.  Some diseases that have been associated with the HPV vaccine include myasthenia gravis, Guillain Barre syndrome, autoimmune hepatitis, and Lupus.  There are also numerous case studies linking the HPV vaccine to premature ovarian insufficiency (POI).  None of these associations have been proven.

As a licensed physician, I recommend the CDC schedule in my practice and I also practice informed consent.  I will answer all your questions as well as discuss the risks of the infections we immunize against, and the risks and benefits of the vaccinations themselves.

If you are HPV positive and/or have an abnormal pap, we can help guide you as to testing and follow-up that is needed, in addition to treatment options including natural medicine, conventional medicine, or a combination.  Natural medicine offers treatments for the virus as well as the abnormal cells.  Conventional medicine offers treatment for the abnormal cells.

If you would like a vaccination consultation, please call the clinic and schedule with Dr. Rachel Surprenant, N.D.  503-222-2322

 

 

References

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Franco EL, Villa LL, Sobrinho JP, et al. Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis 1999;180(5):1415–23. doi: 10.1086/315086.

Ho GY, Burk RD, Klein S, et al. Persistent genital human papillomavirus infection as a risk factor for persistent cervical dysplasia. J Natl Cancer Inst 1995;87(18):1365–71. doi: 10.1093/jnci/87.18.1365.

Colafrancesco S, Perricone C, Tomljenovic L, Shoenfeld Y. Human papilloma virus vaccine and primary ovarian failure: another facet of the autoimmune/inflammatory syndrome induced by adjuvants. Am J Reprod Immunol N Y N 1989. 2013;70(4):309-316. doi:10.1111/aji.12151

New Concerns about the Human Papillomavirus Vaccine. Am Coll Pediatr. January 2016. https://www.acpeds.org/the-college-speaks/position-statements/health-issues/new-concerns-about-the-human-papillomavirus-vaccine.

Little DT, Ward HRG. Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination. J Investig Med High Impact Case Rep. 2014;2(4). doi:10.1177/2324709614556129

Khalifa YM, Monahan PM, Acharya NR. Ampiginous choroiditis following quadrivalent human papilloma virus vaccine. Br J Ophthalmol. 2010;94(1):137-139. doi:10.1136/bjo.2009.159293

Yonee C, Toyoshima M, Maegaki Y, et al. Association of acute cerebellar ataxia and human papilloma virus vaccination: A case report. Neuropediatrics. 2013;44(5):265-267. doi:10.1055/s-0033-1333873

Corte CD, Carlucci A, Francalanci P, Alisi A, Nobili V. Autoimmune hepatitis type 2 following anti-papillomavirus vaccination in a 11-year-old girl. Vaccine. 2011;29(29):4654-4656. doi:10.1016/j.vaccine.2011.05.002

Inbar R, Weiss R, Tomljenovic L, et al. Behavioral abnormalities in female mice following administration of aluminum adjuvants and the human papillomavirus (HPV) vaccine Gardasil. Immunol Res. 2017;65(1):136-149. doi:10.1007/s12026-016-8826-6

Debeer Ph, De Munter P, Bruyninckx F, Devlieger R. Brachial plexus neuritis following HPV vaccination. Vaccine. 2008;26(35):4417-4419. doi:10.1016/j.vaccine.2008.06.074

Chung JY, Lee SJ, Shin B-S, Kang HG. Myasthenia gravis following human papillomavirus vaccination: a case report. BMC Neurol. 2018;18(1):222-222. doi:10.1186/s12883-018-1233-y

Poddighe D, Castelli L, Marseglia GL, Bruni P. A sudden onset of a pseudo-neurological syndrome after HPV-16/18 AS04-adjuvated vaccine: might it be an autoimmune/inflammatory syndrome induced by adjuvants (ASIA) presenting as a somatoform disorder?. Immunol.Res. 2014 Dec;60(2-3):236-246

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