“HPV: Sorting Through the Facts”

Life Matters —The Newsletter of the Respect Life Office of the Diocese of Rockford
March 2007

By Patricia Pitkus Bainbridge
Director, Respect Life Office

While waiting last summer for Food and Drug Administration (FDA) approval of its new vaccine, Gardasil, pharmaceutical giant, Merck, launched a multi-million dollar marketing campaign to create awareness and acceptance of the vaccine. The campaign, “Tell Someone,” encourages women to “Learn about cervical cancer and other consequences of human papillomavirus (HPV) and then tell someone.”

After Gardasil was granted FDA approval on June 8, 2006, the “One Less” campaign was launched to empower women to get vaccinations for themselves and their daughters—so as to ensure “one less life [will be] affected by cervical cancer.” According to Bev Lybrand, vice president & general manager, HPV Franchise, Gardasil, “Merck is committed to educating and providing access to women and girls who may benefit from this critical vaccine.”

In its “educational” efforts, Merck repeatedly asks the question, “Did you know that cervical cancer is caused by certain types of a common virus?”

It’s a virus we should all be concerned about—it’s called human papillomavirus (HPV). And even though HPV is really common, many people don’t know they have it because there often are no signs or symptoms. For most women, HPV clears on its own. But for some, cervical cancer and other consequences can develop.

The implication is this common virus is one that “all” of us could “catch.” But, is that true?

Curiously omitted from Merck’s advertising campaigns is any mention of the fact that genital HPV is a sexually transmitted disease (STD).

Searching Merck’s website, you will find the facts:

Women and men who have any kind of sexual activity involving genital contact with an infected person can get human papillomavirus (HPV). That means it’s possible to get genital HPV without having intercourse. And, because many people who have the virus may not show any signs or symptoms, they can transmit the virus without even knowing it.

HPV and Cancer
The Center for Disease Control (CDC) reports that “Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women.”

According to a study reported in Journal of Pathology, J.M Walbommers, et. al., found “The presence of HPV in virtually all [99.7%] cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer.” HPV can also cause other genital cancers in both males and females.

Gardasil protects against only 4 strains of HPV that account for about for 70% of cervical cancers. The CDC reports, “Because the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancer or genital warts. About 30% of cervical cancers will not be prevented by the vaccine, so it will be important for women to continue getting screened for cervical cancer (regular Pap tests).”

Eliminating or reducing risk
Information from the CDC on preventing genital HPV and cancer includes this:

The surest way to eliminate risk for genital HPV infection is to refrain from any genital contact with another individual. For those who choose to be sexually active, a long-term, mutually monogamous relationship with an uninfected partner is the strategy most likely to prevent future genital HPV infections. However, it is difficult to determine whether a partner who has been sexually active in the past is currently infected.

Regular Pap tests and follow-up can prevent most but not all, cases of cervical cancer . . . Pap tests can also detect most, but not all, cervical cancers at an early, curable stage. Most women diagnosed with cervical cancer in the U.S. have either never had a Pap test, or have not had a Pap test in the last 5 years.

Cervical cancer once claimed the lives of more American women than any other type of cancer. But over the last 40 years, widespread cervical cancer screening using the Pap test and treatment of pre-cancerous cervical abnormalities have resulted in a marked reduction in cervical cancer incidence and mortality in the U.S.

Merck pushes for mandating the vaccine
After the CDC Advisory Committee on Immunization Practices (ACIP) voted last June to recommend the use of Gardasil in females from ages 9 to 26, Merck has been engaging in huge lobbying efforts and—as former Congressman Bob Barr writes—“is pulling out all stops in an effort to secure legislation mandating vaccination with its product.”

There are two proposed bills in the Illinois state legislature that will require girls entering the sixth grade (in public, private or parochial school) to receive the HPV vaccination. While there is an opt-out provision, the pressure to vaccinate young girls for a sexually transmitted disease is a concern for many parents.

Oppose mandating
The American College of Pediatricians (ACP) and the Catholic Medical Association (CMA) have issued position papers on HPV Immunization in which both organizations strongly oppose state mandated HPV vaccinations for young girls.

The ACP’s position includes the following:

Until further research is completed, HPV vaccine recipients should be fully informed as to the current limits of knowledge regarding the vaccine’s potency and duration of protection.

They should be counseled, however, that HPV vaccination is not completely protective against cervical cancer. . .The most medically safe sexual conduct for adolescents is abstinence until marriage, and they should be counseled accordingly.

The American College of Pediatricians is opposed to any legislation which would require HPV vaccination for school attendance. Excluding children from school for refusal to be vaccinated for a disease spread only by penetrating vaginal intercourse is a serious, precedent-setting action that trespasses on the right of parents to make medical decisions for their children as well as on the rights of the children to attend school. In addition, this vaccine prevents a disease which is exclusively sexually transmitted; mandating it as early as 9 years of age places the medical provider in an ethical dilemma.

Excerpts from the CMA position paper include the following:

There is no ethical objection to the HPV vaccine either as a strategy against disease or in its production. Patients and parents must have the opportunity to give informed consent to its
administration . . .

The CMA opposes mandating the use of HPV vaccine, as well as direct or indirect efforts to pressure parents or minors to accept it.

HPV vaccine is a medical treatment, and under natural and civil law, it is parents who have the primary authority and responsibility to raise their children and to approve medical treatments for them. Addressing the issue of sexually transmitted infections (STIs) is a part of parents’ indispensable task of teaching their children about sex and forming them in chastity. Using mandates or other pressure (such as threatening to exclude children from attending school) violates parental rights and undermines parents authority . . .

An explosion in the number and severity of STIs has been one result of the breakdown in sexual morality over the last 40 years. Gardasil® can help to address one consequence of the spread of HPV, i.e., cervical cancer. At the same time, to best promote the health and happiness of adolescents, physicians, parents and social institutions should redouble their efforts to promote chastity. Consistent messages about and support for this virtue will not only help to reduce disease, but will help individuals, couples, and marriages to flourish.

HPV is transmitted through sexual activity and not by casual contact in the school setting. For this and other valid reasons, the decision to vaccinate minor girls must be made by informed parents, not the government.

For more information:
www.cdc.gov/nip/vaccine/hpv/hpv-faqs.htm
www.acpeds.org/index.cgi?CONTEXT=art&cat=10006&art=140&BISKIT=2570524575
www.cathmed.org/pressreleases/CMA_Statement_HPV_Vaccine.pdf

Copyright, 2007