Lookee there! Vaccines work!

Quelle surprise!

From the New York Times:

The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in recent years, a striking measure of success for a vaccine against the virus that was introduced only in 2006, federal health officials said on Wednesday.

This is, of course, marvelous news.  What’s even more striking about those efficacy rates is that teenagers in the United States are vaccinated well below optimal numbers, with only about one in three adolescent girls protected by the full complement of immunizations.  (Strong work, America.  You’re getting beaten by Rwanda in an important public health measure.)  One might reasonably expect an even greater drop in prevalence once more patients (both girls and boys) are fully vaccinated.

Because that’s certainly going to be the response to this news, right?  That people will see the benefit of vaccination for their children and will opt to offer them as much protection as possible from cancer?  (And not just cervical cancer.  Thank you for the reminder, Mr. Douglas.)

There are some signs that resistance to the vaccine may be growing. A study published in the journal Pediatrics in March found that 44 percent of parents in 2010 said they did not intend to vaccinate their daughters, up from 40 percent in 2008. Because it prevents a sexually transmitted infection, the vaccine comes with a stigma. Some parents worry it promotes promiscuity. And it has been controversial. During the Republican primary in 2011, Representative Michele Bachmann, Republican of Minnesota, said the vaccine could have “dangerous side effects,” a concern that health officials say is unfounded.

*sigh*

I haven’t had a chance to discuss HPV vaccination with any parents since this newest report came out.  Perhaps it will be persuasive to some of the fence-sitters.  The Michael Douglas coverage certainly seems to have changed a few minds, which is encouraging.  And, contra the Pediatrics  study, my own experience is that parents are growing gradually more comfortable with the vaccine.

But then I live and work in a part of the country where people are (thanks be to God) not particularly apt to pay attention to the likes of Michele Bachmann.  And even here, discussion of the HPV vaccine unearths how rife with suspicion and misconceptions people still are about it and vaccines in general.  Even in a practice that does not accept patients whose parents refuse to vaccinate them, many parents still treat them with mistrust.  Many evince reluctance to vaccinate their kids when they are too young to be sexually active, which is the entire point of a measure meant to prevent a sexually transmitted disease.

Absolutely nothing confounds me quite like the persistent resistance to one of the most unambiguously good things modern medicine has ever accomplished.  It is a theme I have returned to again and again.  Vaccinations work and they are safe.  They save lives, and the HPV vaccine will almost certainly save thousands upon thousands of people from cancers that would have otherwise killed them.

But still people refuse to get them.  Maybe this new report will help.  I have been grateful for the parents who have been persuaded by a clear, straightforward conversation with me.  There are many people who will listen to reason.  But for those who act in defiance of it, I doubt this wonderful new information will make any difference.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.

21 Comments

  1. The anti-vaccination crowd is really strange compared to other conspiracy thinkers or even compared to the anti-evolutionists, who at least have some understandable motivations. We have some pretty good evidence that vaccines work and really don’t cause any problems. Millions, maybe billions, of lives have been saved because of vaccinations. Yet, these people will have none of it. They want to return to a world where diseases like small pox or polio ravage us and harm survivors for life. I can’t really think of any reason why they think its a good thing.

    A lot of people on the extremes of both sides of the political equation have this fear of bigness and modernity. They want to return to a pass that never really existed and that was pretty horrible in the first place. They have these romantic images of the self-sufficient rural village and everybody being happy in the country. It wasn’t like that at all.

    • at least among the park slope types, it’s largely a fear of autism – if your kid can’t speak, he’s not smart, and then you’re not smart, and something something something stupid stuff. also the whole “toxins” thing.

  2. Well, of course the rate of sexually transmitted disease dropped. The vaccine turned all the girls autistic, so they couldn’t get intimate with the guys.

      • Being autistic doesnt make them unable to get intimate…

        • I didn’t mean the physical side, but making the personal and emotional connections. But if you want to dig into a throw-away joke and suck all the fun out of it, I’m sure there’s an app for that. 😉

  3. “There are some signs that resistance to the vaccine may be growing.”

    When I first read that, I thought you were going in a direction about the evolution of “superbugs” and whatnot. “Oh no!” I thought, “The vaccine is going to stop working!”

    Then I read on.

    Now my head hurts.

  4. They work at turning delicate young flowers into hardened porn stars, if that’s what you mean.

    • A company that managed to make a shot that does that would make money from millions of willing buyers of both genders and all sexualities.

      • As the social conservatives; they’ll tell you that company already exists. And also that the end-times are upon us, because fewer people getting certain types of cancer is a nightmare or something.

  5. I’ve been having this argument with one of my siblings. She has two pre-teens, and I’ve repeatedly asked her if she’s had them vaccinated for HPV yet. She keeps ignoring it. I get especially agitated because we have had two relatives with liver cancer, both were positive for hepatitis B – my take on it is that genetically we may be somewhat susceptible to virally-caused cancers. Which on top of the public health data for the vaccine, I really don’t get why she keeps blowing this off. It makes me want to bang my head against a wall.

    • All of my girls will be vaccinated. The two of them old enough have done so already. It was framed as just another shot for protecting their health. I don’t see any reason they needed to be informed that Gardisal is anything other than that. In fact although it isn’t mandatory, it is listed as part of the regular vaccination schedule at our pediatrician’s office.

  6. The AV crowd somehow thinks that the organic unicorn farts and rainbow drops they feed their children (together with probiotics, colloidal silver, garlic oil, coconut oil, camel’s milk, etc) will somehow miraculously prevent their special snowflake from contracting a vaccine preventable disease.

    They somehow think that their special snowflake will remain chaste (in all forms – no petting, no nothing) until the sanctity of marriage with a partner equally as pure as the snow.

    The reality is, they’re setting their children up for risking cancer and a host of other illnesses due to their own staggering ignorance and hubris. The “I’ve spent HUNDREDS of hours Googling vaccine injuries!” claim somehow, miraculously, gives them a greater knowledge and insight into the immune system, biology, epidemiology (and public health) than anyone who actually has spent HUNDREDS of hours on an actual education.

    But then again, many of them subscribe to the belief that, if a child dies from a vaccine preventable disease, that child couldn’t have been healthy to begin with.

      • You have my blessing.

        Use it in good health, or wind… or something.

    • The people described in your first paragraph and those described in your second paragraph are different groups of people with different motivations for not vaccinating. There’s some overlap, but those who are opposed to vaccines generally span the ideological spectrum, while those who are opposed to HPV vaccination specifically are mostly social conservatives.

  7. I really don’t care about the anti vaccine crowd. They can make their choice to not get their kids the shot or not. What I objected to, and still do, is the mandatory aspects of the vaccination programs, particularily in the schools.

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