[HN Gopher] HPV vaccine study finds zero cases of cervical cance...
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HPV vaccine study finds zero cases of cervical cancer among women
vaccinated <14
Author : ellingsworth
Score : 168 points
Date : 2024-01-25 18:43 UTC (4 hours ago)
(HTM) web link (www.statnews.com)
(TXT) w3m dump (www.statnews.com)
| tick_tock_tick wrote:
| It's so crazy/impressive to me that some vaccines are actually
| "prefect".
| SomeoneFromCA wrote:
| Never seen vaccines employed as prefects. Well, I've hears
| about cat prefects in Japan, but not vaccines.
| tick_tock_tick wrote:
| Ahh you're really missing out then they let you get away
| without a hallpass.
| davrosthedalek wrote:
| Where is your towel?
| londons_explore wrote:
| Many vaccines become 'perfect' by causing the disease they
| treat to die out in the local community.
|
| It doesn't need to be perfect at the individual level to cause
| that - and in fact many vaccines at the individual level
| actually have pretty bad metrics - like for example only
| preventing half of cases.
| TylerE wrote:
| You're seeing this in vivo with polio - POLIO!! - starting to
| make a reappearance in some of the more extremist Hassidic
| communes in NYC. Those groups do not get vaccines.
| inasio wrote:
| Reminder that HPV in men has a similar association to oral/anal
| cancer, and this vaccine (ideally the quadrivalent version)
| prevents it too [0]. HPV vaccine campaigns often emphasize
| vaccinating only girls, but boys should be vaccinated too.
|
| [0] https://academic.oup.com/jnci/advance-article-
| abstract/doi/1...
| MrDresden wrote:
| Many European nations have started vaccination of boys too.
| jeffbee wrote:
| This is one of the many reasons that "parental rights" people are
| dead wrong. People as young as 12 should have the absolute right
| to seek and get, in confidence, this vaccine and other health
| care. Nobody should give any weight to whether their parents want
| them to not have this vaccine.
| NotGMan wrote:
| And you blindly trust these studies and everything else that
| big pharma puts out.
|
| It's because of people like you that parental rights must
| exist.
| kstrauser wrote:
| I always love the presumption that "big pharma" is the same
| worldwide, and therefore non-US countries' health
| organizations are in on the "big lie".
| rootusrootus wrote:
| > as young as 12
|
| Why the arbitrary line at 12?
| jmyeet wrote:
| Children have rights. Parents have responsibilities.
|
| Vaccines are a medical miracle. Never except that being an
| anti-vaxxer (or a "vaccine skeptic", which is the sanitized
| name for the same thing) as being on equal footing. Vaccines
| are evidence-based. Anti-vaxxers are vibes-based.
| iraqmtpizza wrote:
| People putting parental rights in scare quotes are why we need
| age of consent laws
| ceejayoz wrote:
| Age of consent laws have nothing to do with parents' rights;
| that's about the _child 's_ rights. I don't think any of us
| want a world where a parent can consent to sex on behalf of
| their child.
|
| (In fact, parents' rights to consent to underage _marriage_
| in some states is currently a loophole in this regard.
| https://www.mcgill.ca/newsroom/channels/news/child-
| marriages...)
|
| > In many U.S. states, children can legally marry at an
| earlier age than they can consent to sex, leading to
| situations where sex between spouses may be a criminal act.
| Some states exempt sex between married spouses from their
| definition of statutory rape, which may create perverse
| incentives for child marriage, according to researchers from
| McGill University.
| iraqmtpizza wrote:
| >I don't think any of us want a world where a parent can
| consent to sex on behalf of their child.
|
| You would think a leftist would understand intuitively that
| it's possible for multiple people to be required to approve
| something before it can be done. Isn't that why it's
| impossible to build a house in California?
| ceejayoz wrote:
| Child rape is a situation where it shouldn't _matter_ how
| many people approve.
|
| If your twelve year old wants to have sex, and you with
| your "parents' rights" endorse that choice, _you should
| go to jail_. Because your right as a parent to make
| decisions is in conflict with the right of the child not
| to be subject to statutory rape.
|
| The poster upthread asserts a similar conflict between
| the rights of the parent to make decisions and the right
| of the child to lifesaving medical measures.
| iraqmtpizza wrote:
| Actually you make a good point. Nobody should be
| penetrating children, regardless of what the parents
| think -- kids can get irreversible medical procedures
| when they turn 18.
| ceejayoz wrote:
| Vaccination being irreversible, that's pretty clearly in
| conflict with the child's right not to die horribly of
| preventable diseases like polio.
|
| As a parent, you get to make all sorts of decisions. As
| with all other rights, it's still not unlimited. Certain
| decisions are not solely yours; certain decisions aren't
| _ever_ yours.
| iraqmtpizza wrote:
| The right not to die of disease (were it to exist) would
| be a statutory right and not a fundamental one. I'd
| rather discuss fundamental rights which are a very
| different thing than the shopping list that is the
| Universal Declaration of Human Rights.
|
| But I'll go one step further. Children have no
| fundamental right to even seek a vaccine independent of
| their mother and father. If they did, the tanks would be
| rolling into Lancaster County right now.
| ceejayoz wrote:
| > I'd rather discuss fundamental rights...
|
| You're in luck, then; SCOTUS has deemed even _compulsory_
| vaccination to pass muster here.
| https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts
|
| We've got plenty of precedent that parents can't always
| opt out of life-saving care for their children, too.
| https://www.nbcnews.com/health/cancer/connecticut-teen-
| curab...
|
| > Children have no fundamental right to even seek a
| vaccine independent of their mother and father. If they
| did, the tanks would be rolling into Lancaster County
| right now.
|
| Are the children of Lancaster County pushing to be
| vaccinated and being denied by their parents?
| iraqmtpizza wrote:
| Compulsory vaccination statutes don't imply anything
| about whether a toddler has the fundamental inherent
| right to wander the neighborhood looking for immunizing
| material. I don't know why you brought it up.
|
| Vaccines are not life-saving care by any definition. Not
| least of all because it does not cure or treat disease. I
| believe it's even illegal for a doctor to tell a patient
| otherwise. So this, too, is irrelevant.
|
| >Are the children of Lancaster County pushing to be
| vaccinated and being denied by their parents?
|
| Presumably they're pushing to do a whole lot of things.
| Not least of all staying up past bedtime.
| ceejayoz wrote:
| > Compulsory vaccination statutes don't imply anything
| about whether a toddler has the fundamental inherent
| right...
|
| They do demonstrate a pretty clear scenario where some
| rights is trumped by other things. We are discussing a
| potential such scenario; parents' rights versus a child's
| opting to get a vaccine that's most effective if
| administered as a minor.
|
| > Vaccines are not life-saving care by any definition.
| Not least of all because it does not cure or treat
| disease.
|
| Sure they can.
| https://en.wikipedia.org/wiki/Therapeutic_vaccines
|
| https://en.wikipedia.org/wiki/Rabies_vaccine is a good
| example of a vaccine frequently administered _while_
| infected to _treat_ a disease.
|
| Even without those, "not getting cancer" seems pretty
| clearly life-saving at a population level.
|
| > Presumably they're pushing to do a whole lot of things.
| Not least of all staying up past bedtime.
|
| A dodge. To be clear: if an Amish child wanted to get
| vaccinated, and their parents forbade it, I'd want our
| legal system to side with the child.
| Traubenfuchs wrote:
| The continuing focus on cervical cancer and women's sexual health
| in the context of HPV (vaccination) is my biggest pet peeve ever.
|
| HPV causes penile, anal, mouth-throat and cervical cancer.
|
| I'd argue that all of those cancers are much, much worse than
| cervical cancer. After all, they can cause permanent
| disfigurement, chronic pain, inability to ever speak again and
| loss of the penis. Infertility? Woe is me!
|
| Anyone who is not celibate should really get the HPV vaccines.
| Tell a teenager he's risking to lose his dick and he's gonna get
| vaccinated tomorrow.
| LiquidPolymer wrote:
| Many, many women have died from cervical cancer.
| tick_tock_tick wrote:
| They are offering the HPV vaccine for boy too. Hell my doctor
| suggested it, and I got it, a couple of years ago as a late 20s
| male.
| mac-mc wrote:
| 10 to 20 years ago, you got a lot of pushback if you wanted
| this vaccine as a male, with some insinuations about gayness,
| or it being "too late" if you wanted it in your early 20s
| when you heard about this benefit. To this day I don't have
| it as a result.
|
| Maybe today that has been fixed.
| ceejayoz wrote:
| > Infertility? Woe is me!
|
| Well, and a couple hundred thousand deaths annually worldwide.
| https://www.who.int/news-room/fact-sheets/detail/cervical-ca...
| acdha wrote:
| I agree it should be more broadly recognized as not being only
| for women but cervical cancer causes something like 340k deaths
| vs. the other ones being 1-2 orders of magnitude lower so it's
| not surprising that attention has been focused there.
|
| https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...
| cmrdporcupine wrote:
| Here in Ontario the vaccine is given by default to everyone,
| male or female.
| bregma wrote:
| When my kids were in school that was certainly not the case.
| It must have changed recently.
| ziddoap wrote:
| > _Infertility? Woe is me!_
|
| Even if this was the only issue cervical cancer potentially
| caused (it's not, you forgot death, among others), this is a
| really insensitive comment.
|
| Awareness of other cancers doesn't need to come at the cost of
| reducing cervical cancer awareness. Seems like a really
| immature thing to have a pet peeve about.
| ksenzee wrote:
| Cervical cancer kills. I don't think you mean "it's worse for a
| man to lose his penis than for a woman to die" but that's how
| it's coming across. And that's unfortunate because your point
| is entirely valid: men are not nearly terrified enough of HPV.
| Benanov wrote:
| I saw it as more along the lines of "this is why _men_ should
| get it " - the context is already established that HPV should
| scare men and here's why...
| bregma wrote:
| 100% of all cervical cancer patients already don't have a
| penis. There are about 10 times the number of deaths each year
| from cervical cancer as there are from penile cancer, and
| scooping out parts of your innards is not just infertility but
| is far more invasive and liable to complications than just
| slicing off your dangly bits. Sounds a bit like an argument
| from misogyny.
| tasty_freeze wrote:
| > Woe is me!
|
| Do you think infertility is the only consequence of cervical
| cancer? Do you mock children with with leukemia saying, "Oh,
| you feel a little tired? Get over yourself?"
|
| For many people treatment goes smoothly and the can get on with
| their lives. For some they get treatment, it comes back, they
| get more treatment, it comes back, and they die, and there is a
| range of options in between. Maybe they don't die but they can
| no longer have intercourse. Maybe the financial strain of many
| rounds of treatment puts them in life-changing debt.
|
| Don't be so glib with the misfortune of other people.
| tasuki wrote:
| My partner died of cervical cancer at 30 years old. I'm now
| raising a toddler by myself.
|
| Is this the place where I can tell you to fuck off?
| lancebeet wrote:
| It seems a little strange to me that the people interviewed in
| this article find this is so remarkable. Only 40,000 people
| belonged to the group that got the vaccine before 14. If the
| incidence rate were the same as for the unvaccinated (8.4 per
| 100k) you would have expected roughly 4 in the group to have
| gotten cancer. If the incidence rate were the same as for those
| vaccinated after 14 (3.2 per 100k), you would have expected only
| ~1 to have gotten cancer. Maybe I'm missing something here?
| nerdponx wrote:
| > Maybe I'm missing something here?
|
| Statistical literacy is difficult to develop, statistical
| _intuition_ even moreso, even among well-intentioned and very
| intelligent people.
| logicchains wrote:
| That's why papers get away with making big claims that are
| unsupported by the data.
| dekhn wrote:
| As demonstrated by the original comment we're all replying to
| (see the other replies).
| NoZebra120vClip wrote:
| The article says that all participants were eligible for
| screening, but it doesn't say how many were screened or tested.
|
| Also, this cohort would be age 28-36 years currently. The
| _lowest_ median age for HPV cancer diagnosis is 50.
| https://www.cdc.gov/cancer/hpv/statistics/age.htm
| bigbillheck wrote:
| I believe that's "8.4 per 100k PER YEAR".
| NoZebra120vClip wrote:
| The paper uses the term "person-year". So, the intersection
| of both.
| dyslexit wrote:
| The incidence rate is per year and the study was over an
| average of 32 years per patient. At that rate you'd expect
| around 105 incidents instead of 4, although there are other
| considerations like age to take into account.
| Moldoteck wrote:
| Does it make sense to get a vaccine for older ppl, like 30y, does
| this still apply for men?
| ceejayoz wrote:
| The CDC doesn't recommend it. By that age, you've probably been
| exposed already.
|
| https://www.cdc.gov/hpv/parents/vaccine-for-hpv.html
|
| > HPV vaccination is not recommended for everyone older than
| age 26 years. Some adults ages 27 through 45 years who were not
| already vaccinated might choose to get HPV vaccine after
| speaking with their doctor about their risk for new HPV
| infections and possible benefits of vaccination for them. HPV
| vaccination of adults provides less benefit, because more
| people in this age range have been exposed to HPV already.
| chimeracoder wrote:
| > The CDC recommends against it.
|
| The CDC does _not_ recommend _against_ getting vaccinated for
| people in their 30s. They don 't issue a general
| recommendation for vaccinating people in their 30s.
|
| That's an extremely important distinction.
| ceejayoz wrote:
| I'll update that to "The CDC doesn't recommend it", in that
| case.
| echelon wrote:
| > I'll update that to "The CDC doesn't recommend it", in
| that case.
|
| As a native speaker, even that language feels as though
| the CDC discourages vaccination despite the literal
| meaning not implying that. This is a case where it's
| probably best to be more verbose and explain in full
| details.
|
| I don't know why the CDC themselves choose to use this
| language. It's confusing.
| ceejayoz wrote:
| There's a reason I cited the entire paragraph, yes.
| ksenzee wrote:
| Agreed. I'd rather see "doesn't actively recommend" or
| "is neutral" or something.
| pazimzadeh wrote:
| I don't understand why they recommend against it. I guess the
| monetary costs don't outweigh the benefits, but that's only
| if you care more about saving money than potentially
| preventing cancer. It's not like the vaccine going to hurt
| you. But the HPV vaccine is not particularly cheap, so it
| sounds like the insurance companies have lobbied against it
| or something. In my opinion men should also be vaccinated for
| it since they are often carriers and can be affected too.
| londons_explore wrote:
| Since nearly everyone is infected with HPV, if you've had
| sex with a few people you're almost certainly already
| infected and therefore the vaccine will be of no benefit.
|
| I guess if you were 50 and still a virgin, and planning to
| change that, it might be worth it.
| ksenzee wrote:
| Or you've been monogamous but are now getting divorced,
| or whatever. Not that uncommon.
| pazimzadeh wrote:
| How can you be sure there would be no benefit? When my
| mom was diagnosed with stage four HPV-positive cancer,
| they still gave her the vaccine on the off chance that it
| would induce an immune response.
| volkl48 wrote:
| Yes, but being infected with one strain isn't the same as
| being infected with all of them in terms of the risks.
| You are unlikely to have _all_ the strains known to cause
| problems already.
|
| -------
|
| Additionally (something I only became aware of from
| knowing a person dealing with it) - there's a modest body
| of clinical research suggesting that vaccinating for HPV
| in someone who already _has_ it and is symptomatic
| (warts) can significantly lessen or eliminate their
| symptoms.
|
| It was recommended for the person I know on that basis by
| their doctor as a thing to try, and they've noticed
| significant improvement. Anectdata, but mentioning
| anyway.
|
| These are very small studies and I won't claim that this
| is definitive (nor that I've put that much effort into a
| review of all literature), but to provide some support
| for my claims that this is a thing being
| suggested/investigated in research:
|
| - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541142/
|
| - https://pubmed.ncbi.nlm.nih.gov/38068369/
|
| ---------
|
| I believe that it's too early in the research for that to
| be factoring into the analysis going into current CDC
| recommendations, but it's an additional possible upside
| of vaccination (reducing symptoms/likelihood of symptoms,
| even if already infected) if the research continues to
| pan out.
| gnicholas wrote:
| > _Since nearly everyone is infected with HPV_
|
| Not quite, though the messaging on this is muddy. The CDC
| simultaneously says:
|
| > _HPV is so common that nearly all sexually active men
| and women get the virus at some point in their lives._
| [1]
|
| and
|
| > _During 2013-2014, any genital HPV prevalence among
| adults aged 18-59, was 42.5% in the total population,
| 45.2% among men and 39.9% among women; high-risk genital
| HPV prevalence was 22.7% in the total population, 25.1%
| among men and 20.4% among women._ [2]
|
| 1: https://www.cdc.gov/std/hpv/stats.htm
|
| 2: https://www.cdc.gov/nchs/products/databriefs/db280.htm
| jliptzin wrote:
| I don't understand either. My doctor recommended I get it
| despite being older, because it's possible there are
| strains of HPV it protects against that I have not yet been
| exposed to. He also said it could theoretically help clear
| an existing infection faster.
| chimeracoder wrote:
| > I don't understand why they recommend against it. I guess
| the monetary costs don't outweigh the benefits, but that's
| only if you care more about saving money than potentially
| preventing cancer. It's not like the vaccine going to hurt
| you.
|
| All vaccines have a nonzero risk of adverse outcomes. That
| can be as simple as the risk of physical injury due to
| incorrect administration of the needle. That's weighed
| against the risk of nonvaccination.
|
| In almost all cases, the balance is so extremely skewed
| that it's safe to issue general recommendations in favor of
| vaccination. For HPV, the issue is that there's literally
| zero benefit after exposure, and it's difficult/infeasible
| to test for exposure, but from epidemiological data we know
| that most people over the age of 25 have already been
| exposed.
|
| > In my opinion men should also be vaccinated for it
|
| The recommendation is for all genders, and has been for
| well over a decade.
| logicchains wrote:
| >In almost all cases, the balance is so extremely skewed
| that it's safe to issue general recommendations in favor
| of vaccination
|
| It's still the riskiest pharmaceutical product the
| average young person will take. That's why vaccine
| manufacturers were originally given liability immunity:
| they claimed they'd go bankrupt otherwise. No other
| pharmaceutical product has been deemed so risky that it
| couldn't exist unless people were prevented from suing
| its manufacturers.
| ceejayoz wrote:
| > It's still the riskiest pharmaceutical product the
| average young person will take.
|
| That'll almost certainly be Tylenol.
|
| > No other pharmaceutical product has been deemed so
| risky that it couldn't exist unless people were prevented
| from suing its manufacturers.
|
| That's not why the program exists. It was deemed risky
| _for the national security of the United States_ to lose
| its ability to manufacture vaccines because twelve lay
| people in a jury room decide to bankrupt a drug company.
|
| https://en.wikipedia.org/wiki/National_Vaccine_Injury_Com
| pen...
|
| "The National Vaccine Injury Compensation Program (VICP
| or NVICP) was established by the 1986 National Childhood
| Vaccine Injury Act (NCVIA), passed by the United States
| Congress in response to a threat to the vaccine supply
| due to a 1980s scare over the DPT vaccine. Despite the
| belief of most public health officials that claims of
| side effects were unfounded, large jury awards had been
| given to some plaintiffs, most DPT vaccine makers had
| ceased production, and officials feared the loss of herd
| immunity."
| volkl48 wrote:
| Noted in my other comment, but mentioned here as well:
|
| - Exposure to a strain is not the same as exposure to all
| strains. Few are likely to have been infected with _all_
| of the strains that the vaccine protects against, and
| infection by multiple strains is not a rare event.
|
| - There's research being done on if the vaccine can
| reduce symptoms to people who already have HPV. Early
| results seem promising. Certainly nothing large enough
| for the CDC to be making recommendations on yet (that I
| know of/could find from a quick search), but worth noting
| - there may well turn out to be a significant benefit to
| the vaccine even after exposure, we just seem to be
| relatively early in that research.
|
| - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541142/
|
| - https://pubmed.ncbi.nlm.nih.gov/38068369/
| 98codes wrote:
| Talk to your doctor, be honest about your sexual history and
| current situation. It made sense for me to get the vaccine, but
| may not make sense for all, or at least not make sense enough
| to be approved by your insurance.
| smeej wrote:
| A note about current sexual situation too: This first came
| out when I was in college. My (female) roommate wanted to get
| it immediately, even though she was very open about only
| having been with the man she was seeing at the time.
|
| When I asked her about it, since it seemed like her risk of
| contracting HPV would be very low, she mentioned she was
| doing it to mitigate the risks she faced as a woman who was
| barely 5 feet tall and didn't weigh 100 pounds soaking wet.
| She said she already has to keep her head on a swivel against
| the possibility of assault, and she'd really rather not have
| to worry about a virus that could cause cancer in addition to
| that risk.
|
| I had the privilege of not ever having had to pay much
| attention to the risk that my current sexual situation might
| change _without_ my consent, but it was sobering to be
| reminded that was something that she had a reason to have on
| her radar.
| AnimalMuppet wrote:
| She could also get HPV if the man she was "seeing" at the
| time was seeing more people than just her (or had seen,
| ever).
| jseliger wrote:
| Yes: https://cbuck.substack.com/p/the-freedom-to-choose-
| medicine-...
|
| Also, HPV causes head and neck cancers in men and women. These
| are very unpleasant and not recommended:
| https://jakeseliger.com/2023/09/09/life-swallowing-tasting-a...
| f38zf5vdt wrote:
| Yes, please, even if you've had HPV before, get this vaccine.
| The medical literature says there are benefits in almost
| every person, even if your insurer does not.
|
| > In a retrospective analysis of data from two qHPV vaccine
| efficacy studies in young women who underwent cervical
| surgery or were diagnosed with genital warts or
| vulvar/vaginal disease related to infection present before
| vaccination (Figure 1), prior qHPV vaccination was associated
| with a significant reduction (46.2-64.9% for those who
| underwent cervical surgery; 35.2% for those diagnosed with
| infection-related disease) in any subsequent HPV-related
| disease, including high-grade disease.6 Other studies
| demonstrated that HPV vaccination before and after surgical
| treatment for cervical lesions reduced the risk of subsequent
| cervical intraepithelial neoplasia (CIN) grade 2 or higher,
| related to HPV16/18 (88.2% efficacy 60 days or more post-
| surgery),8 and the risk of recurrent CIN 2-3 post-surgery was
| higher in qHPV vaccine non-recipients compared with
| recipients (hazard ratio [HR] 2.840).
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038021/
| Gibbon1 wrote:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580486/
|
| Seems to say that for a subset of people HPV infection is
| latent. But current vaccines aren't useful against latent
| infections. Quick skimming says therapeutic vaccines are an
| area of research. "Numerous DNA-based vaccines have been
| developed to target persistent HPV infection and are currently
| in various stages of clinical study"
|
| My thought is watch this space.
| fgimenez wrote:
| Yes absolutely. Even if you have already been exposed, the
| vaccine has been shown to prevent manifestations and/or
| recurrence of HPV-induced pathologies. It's not necessarily in
| standard of care, but the literature is pretty overwhelming
| here.
| gnicholas wrote:
| I recently heard a doctor mention that cervical cancer typically
| crops up around age 40. As a result, a study like this is a bit
| premature. It's not bad news, of course, but it's also not
| exactly good news.
| alfor wrote:
| Study like this are very good to push government to pay
| vaccination to all kids as early as possible.
|
| In Quebec they did the vaccination to all the kids at 12yo,
| boys and girls.
| mensetmanusman wrote:
| $300 per dose * 100,000:1, so about $30 million per cancer
| cure that has a 70% survival rate.
|
| Up to the voters I guess.
| ahazred8ta wrote:
| The lifetime risk of ever getting cervical cancer is about
| 1%. So, $30,000 per prevention if you just count the girls,
| or $60k if you vaccinate the boys as well.
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