So I've been watching all these ads on TV telling people to find out about GARDASIL. And then I read that Merck was lobbying for this vaccine to become mandatory. Then I saw that the Texas governor is making this vaccine mandatory in Texas for preteens. So I finally decided to look into it.

Here's the scoop:

1) GARDASIL is a vaccine for 4 strains of the human papillomavirus (HPV), two strains that are strongly associated (and probably cause) genital warts and two strains that are typically associated (and may cause) cervical cancer. About 90% of people with genital warts show exposure to one of the two HPV strains strongly suspected to cause genital warts. About 70% of women with cervical cancer show exposure to one of the other two HPV strains that the vaccine is designed to confer resistance to.

2) HPV is a sexually communicable (not an infectious) virus. When you consider all strains of HPV, over 70% of sexually active males and females have been exposed. A condom helps a lot (70% less likely to get it), but has not been shown to stop transmission in all cases (only one study of 82 college girls who self-reported about condom use has been done). For the vast majority of women, exposure to HPV strains (even the four "bad ones" protected for in GARDASIL) results in no known health complications of any kind.

3) Cervical cancer is not a deadly nor prevalent cancer in the US or any other first world nation. Cervical cancer rates have declined sharply over the last 30 years and are still declining. Cervical cancer accounts for less than 1% of of all female cancer cases and deaths in the US. Cervical cancer is typically very treatable and the prognosis for a healthy outcome is good. The typical exceptions to this case are old women, women who are already unhealthy and women who don't get pap smears until after the cancer has existed for many years.

4) Merck's clinical studies for GARDASIL were problematic in several ways. Only 20,541 women were used (half got the "placebo") and their health was followed up for only four years at maximum and typically 1-3 years only. More critically, only 1,121 of these subjects were less than 16. The younger subjects were only followed up for a maximum of 18 months. Furthermore, less than 10% of these subjects received true placebo injections. The others were given injections containing an aluminum salt adjuvant (vaccine enhancer) that is also a component of GARDASIL. This is scientifically preposterous, especially when you consider that similar alum adjuvants are suspected to be responsible for Gulf War disease and other possible vaccination related complications.

5) Both the "placebo" groups and the vaccination groups reported a myriad of short term and medium term health problems over the course of their evaluations. The majority of both groups reported minor health complications near the injection site or near the time of the injection. Among the vaccination group, reports of such complications were slightly higher. The small sample that was given a real placebo reported far fewer complications -- as in less than half. Furthermore, most if not all longer term complications were written off as not being potentially vaccine caused for all subjects.

6) Because the pool of subjects were so small and the rates of cervical cancer are so low, NOT A SINGLE CONTROL SUBJECT ACTUALLY CONTRACTED CERVICAL CANCER IN ANY WAY, SHAPE OR FORM -- MUCH LESS DIED OF IT. Instead, this vaccine's supposed efficacy is based on the fact that the vaccinated group ended up with far fewer cases (5 vs. about 200) of genital warts and "precancerous lesions" (dysplasias) than the alum injected "control" subjects.

7) Because the tests included just four years of follow up at most, the long term effects and efficacy of this vaccine are completely unknown for anyone. All but the shortest term effects are completely unknown for little girls. Considering the tiny size of youngster study, the data about the shortest terms side effects for girls are also dubious.

8) GARDASIL is the most expensive vaccine ever marketed. It requires three vaccinations at $120 a pop for a total price tag of $360. It is expected to be Merck's biggest cash cow of this and the next decade.

These are simply the facts of the situation as presented by Merck and the FDA. This vaccine was just approved in June, 2006. It was never tested on pre-teens except in a tiny trial run with at most 18 months of follow up. Even if we subscribe to the theory that HPV causes cervical cancer, there is ZERO hard data showing that this vaccine reduces cervical cancer rates or cervical cancer mortality rates, which are both already very low in the US and getting lower every year. Now Texas has already made this vaccine mandatory for middle school with all sorts of useful idiots and Big Pharma operatives clamoring for more states to make this vaccine COMPULSORY immediately.

Has everyone gotten the picture or should I continue?

So Kelly Jean Cogswell and "stickdog" have missed the point. Gardasil is not a substitute for good healthcare, which includes screening and preventative care for heart disease and lung cancer and all the things mentioned above as more important than cervical cancer. Gardasil is a vaccine that induces immunity to the most carcinogenic strains of the human papilloma virus, which causes cervical and anal cancer. While the trials are limited by the relatively low prevalence of cervical cancer and the long time it takes to develop after exposure to HPV, they do show that it effectively induces a robust immune response to the virus. For now, that's the best we have as a way to prevent a cancer that, when it occurs, often leads to major surgery and sterility (and extensive anal resections for the boys). That's worth the price of an iPod.

No, Worried Doc, what Cogswell was talking about was that women are constantly told to get Pap Smears. The second question women are asked (after when their last period started) is when they last got a pap smear. Even though women are much, much more likely to be killed by heart attacks, lung cancer, and strokes, doctors fixate on breasts and cervixes. Maybe, with a vaccine, doctors will realize that there are more to women's health than just reproductive organs.

Thanks, Queerty, for pointing up this column in GCN - although probably for opposite reasons you cited. I was shocked by how uninformed and narrow-minded she was. I mean, she's basically saying "I'm a dyke. I don't care about this disease that is devastating the female population. I only care about a narrow base of diseases that (and this is highly arguable) might affect me as a dyke."

Really stupid and self-defeating.

what a moron!!!

the reason that the rate of cervical cancer is so low is that it is possible to find precancerous lesions before they turn into full blown cancer! when a pap test is performed, precancerous cells are sampled and can be seen on the slide by someone who is looking for them and knows what to look for. the proper course of action can then be taken to PREVENT the cancer from developing!!!

cervical cancer used to be the LEADING cause of death among women up until the pap test came into widespread use!

Given that my mother died of cervical cancer, I think it's misguided at best to encourage women to avoid pelvic exams.

Aaaand, that's pretty much all I find myself capable of typing without going into an extreme rant. I doubt the author has spent a year in an oncology ward with someone dying of a preventable disease.