My doctor was recommending the 13 yo ds receive the Gardasil vaccine...

[Sputterduck]

:iagree:

 

 

As far as I know, the only reason they say the Vacc can only be given until the early 20s is, they believe it's a waste if you've already had sex. It doesn't really have anything to do with age, but experience. If you're a 30 year old woman, you can have the vaccine, but they don't recommend it if you've already had sex. It's a vaccine that I'll wait until my girls are 18, and then leave the decision up to them.

 

Good discussion! I'm learning some things I didn't know (Thanks Asta ;))

Blessings!

Dorinda

 

 

I'm nearly 30. I was married, but was a virgin and so was he, so no exposure to HPV. Now I'm single and it was recommended for me. It is very unlikely that I'll find someone my age who has never had sex, so the vaccine was very very appropriate for me at my old age. :p

[angela in ohio]

I think there is a difference between 'did not happen' and 'have not been found to occur more than expected.' It sounds like they knew it would cause blood clots before they released it, and they are finding that it hasn't caused any more than what they expected.

 

There are risks to every vaccine, just as there are risks to any other medical procedure. I'm sure there's probably a risk to getting blood drawn or a tooth filled. We weigh the risk versus the benefit for our particular child. Denying the risk even exists just leaves us making blind decisions.

[Perry]

Okay, I have my brain back on line.

 

 

 

As my son says: "Science fail."

 

This is what drives me absolutely BATTY when I'm reading medical journals and abstracts.

 

The JAMA article... oh, ok, I'll bite. Which JAMA article?

 

describes 56 cases, 31 of which were confirmed blood clot reports. (period) Confirmed by whom? What kind of blood clots? How many people died? Were they in the legs, the lungs, the brain? How did they manifest? Sitting watching TV? Running around a track? What ages were the people?

 

Twenty eight reports (90%) AIIIEEEE!!!! Twenty eight of WHAT? Ninety percent of WHAT? Are we discussing 28 of 56 or 28 of 31? Well, of course it must be 28 of 31, because that is 90%, but how many readers thought we were talking about the original 56? Don't fib, now...

 

had underlying known risk factors such as hormonal birth control, genetic clotting abnormalities, obesity, smoking, and immobility Hmmm. Now we have a quandry. Because we started with 56 cases. And 28 of them somehow all had one of these terrible nasties that either incapacitated or killed them. Even though they were all under the age of 25. Ages at which terrible nasties such as these normally just aren't really seen.

 

And 28 + 28 = 56. So half of this JAMA group did swimmingly, and the other did poorly or died. Due to blood clots.

 

So, yes. I'd have to say that Gardasil has a problem with blood clots.

 

But then again, I'm not a doctor. I'm a mommy.

 

 

a

The FDA link provided the source article reference. The entire article is online.

 

Venous Thromboembolic Events

Based on MedDRA search terms of venous thrombosis, thrombosis, embolism, pulmonary embolism, deep vein thrombosis, pulmonary thrombosis, and embolic stroke, there were 56 reports of VTEs after qHPV, for an RR of 0.2 case per 100 000 doses. Ten cases were hearsay reports that could not be confirmed or clinically evaluated, 9 reports were related to "clots with menses" and were not VTEs, 5 were manufacturer reports with no identifying information for follow-up, 1 report had insufficient information available for adequate evaluation, and 31 reports had sufficient information for clinical review. There were 5 reports of deep vein thrombosis alone, 7 reports of deep vein thrombosis with pulmonary embolism, 12 reports of pulmonary embolism without deep vein thrombosis, 4 reports of cerebrovascular accidents, 1 report of superior mesenteric vein thrombosis, and 2 reports of superior sagittal venous thrombosis. There were 4 deaths reported among the 19 pulmonary embolism cases (21%).

Thirty of 31 reports (97%) were associated with qHPV immunization alone. The mean age of individuals reported to have VTEs after qHPV immunization was 21 years (median, 20 years; range, 15-39 years). The number of doses preceding the diagnosis of a VTE included 9 cases after dose 1, 11 cases after dose 2, and 10 cases after dose 3; dose number was unknown for 1 case. The mean time between qHPV immunization and diagnosis was 41.5 days (median, 23 days; range, 0-306 days).

Risk factors included estrogen-containing birth control (n = 20), family history (n = 10), history of smoking (n = 2), immobility (n = 7), overweight (n = 6), increased triglycerides (n = 1), history of surgery (n = 1), pregnancy (n = 2), trauma from surfing (n = 1), and hyperviscosity from diabetic ketoacidosis (n = 1). Twenty-eight of 31 cases (90%) had a known risk factor for VTEs. Twenty-two of 31 cases (71%) were tested for hypercoagulability; 10 were positive, including 2 cases with factor V Leiden deficiency, 2 cases with methylenetetrahydrofolate reductase deficiency, 1 case with methylenetetrahydrofolate reductase deficiency with increased homocysteine levels, 1 case with the prothrombin gene mutation with methylenetetrahydrofolate reductase deficiency, 1 case with a prothrombin mutation and increased homocysteine levels, and 2 cases of antiphospholipid syndrome. All 10 cases with hypercoagulability had a known risk factor for VTEs, including 7 with a history of taking estrogen-containing birth control medications.

The PRR for 6- to 17-year-olds was 4.8 (2 = 4.16, P = .04). The PRR for 18- to 29-year-olds was 6.7 (2 = 7.48, P = .006). Both of these age groups met the screening criteria for signal detection.

ETA: This is why one has to be very careful with VAERS information. VAERS takes all reports, whether there is any real association to the vaccine or not. Edited May 3, 2010 by Perry

[PiCO]

Well, if you go up to the laryngeal links, you'll see that it doesn't have to be transmitted vaginally at all, as this abstract mentions also:

 

Sexual and non-sexual transmission of human papillomavirus

 

 

a

 

I cannot open anything but an abstract on any of the links that mention non-sexual transmission of the virus. I'm wondering what the non-sexual methods of spreading the virus are- kissing, oral sex, exchange of bodily fluids, mother-to-baby (like HIV?) Or can it be spread by using a toilet seat like someone else said earlier. (And what would one have to do with a toilet seat to get the virus?) How long does the virus live outside a body?

 

Thanks for your help!

[Perry]

I cannot open anything but an abstract on any of the links that mention non-sexual transmission of the virus. I'm wondering what the non-sexual methods of spreading the virus are- kissing, oral sex, exchange of bodily fluids, mother-to-baby (like HIV?) Or can it be spread by using a toilet seat like someone else said earlier. (And what would one have to do with a toilet seat to get the virus?) How long does the virus live outside a body?

 

Thanks for your help!

I don't think non-sexual transmission of HPV is really much to be concerned about (excepting vertical transmission, which isn't common but certainly happens). Here's an excerpt from a CDC report:

 

For example, a recent study of college-aged women in Seattle reported a two-year genital HPV incidence rate of 39% among sexually active women and 8% among women who had not engaged in penetrative vaginal intercourse. Almost all of the infections in women who had not engaged in sexual intercourse appeared to be related to genital contact other than penetrative intercourse (21). This study also found minimal evidence of HPV transmission through oral sex (either transmitted from the genital area to the mouth or the mouth to the genital area) (21). Genital HPV infection also may be transmitted by non-sexual routes, but this is extremely uncommon. Non-sexual routes of genital HPV transmission include transmission from a mother to a newborn baby, which is rare (91;92), and transmission by inanimate objects such as environmental surfaces and clothing, which has been hypothesized but has never been documented (93-96).

 

The virus can't live long outside the body. There are other things on toilet seats I'd worry about, but not HPV.

[asta]

I'd like to just say this:

 

How many people here know how to translate this from this form into something they can use?

 

 

JAMA. 2009;302(7):750-757

 

 

 

a

[Perry]

I'd like to just say this:

 

How many people here know how to translate this from this form into something they can use?

 

 

JAMA. 2009;302(7):750-757

 

 

 

a

If you copy it and paste it into the Google search bar, it's the first hit.

[asta]

If you copy it and paste it into the Google search bar, it's the first hit.

 

That's not what I mean, and you know it.

 

That citation was in the middle of an FDA report. To someone who didn't know what it was to begin with, it would mean absolutely nothing. If, on a lark, they happened to put it into google and get the JAMA report, then what? Welcome to statistical hell and medical gobbledegook.

 

If they make it through the entire report to what you posted, no matter how smart they are (and let's face it - the people here are smart) most of them are going to drop off when they see the word MedDRA. MedDRA? What is that? Medusa? Hydra? It's all about context, and normal people looking for information about what will or will not hurt their kid are going to click away and look for something that is much easier to understand. And, unfortunately, that thing may not be correct.

 

This is the entire reason medical writers have jobs and WebMD is in business - they take away all of the scary numbers and make things user friendly. But user friendly picks and chooses statistics just like anyone else.

 

I don't have the answer. I wish I did. I wish I hadn't taken stats in summer school at 7 am. But I try. And I never assume that because I can worm my way through a labyrinth of a particular kind of crap that someone else can. I value the fact that others treat me with the same kindness for other fields in which I have little to no expertise. The important thing is for parents to know the risk for THEIR families. And that only happens with complete, understandable, accessible information.

 

 

a

[Orthodox6]

I'd like to just say this:

 

How many people here know how to translate this from this form into something they can use?

 

 

JAMA. 2009;302(7):750-757

 

 

 

a

 

I do ! (I also used to be the head of the serials department at a university library.) :)

 

P.S. OK. Here you go: Journal of the American Medical Association. 2009. volume 302, issue #7, pp. 750-757.

Edited May 3, 2010 by Orthodox6

[kmacnchs]

He said that HPV could be spread in various ways... not just sexual. I had never heard of that. When I look it up it looks like there is some controversy about using it for boys and the only benefit listed as a possibility is for prevention of genital warts. I turned it down. Anyone know more than this?

 

maybe what the dr. means is not just sex (as in vag.) but can be transmitted through oral s*x. Many drs (sadly and I guess rightly so) assume parents don't really know what their kids are doing and that it's better to be safe rather than sorry...

[asta]

I do ! (I also used to be the head of the serials department at a university library.) :)

 

P.S. OK. Here you go: Journal of the American Medical Association. 2009. volume 302, issue #7, pp. 750-757.

 

What a dream job!

 

 

a

[Perry]

That's not what I mean, and you know it.

 

No, actually I'm not sure what you mean. I assumed you meant how would someone find the actual article with that information. It would have been nice if they had a bibliography, but it isn't necessary since they are giving sources. I really still don't understand what the problem is.

 

That citation was in the middle of an FDA report. To someone who didn't know what it was to begin with, it would mean absolutely nothing. If, on a lark, they happened to put it into google and get the JAMA report, then what? Welcome to statistical hell and medical gobbledegook.

 

There are plenty of summaries. Since you are linking articles, I assumed you wanted scholarly references. First, I posted a summary, and you criticized it. Then I gave you the original study information, and you didn't like that either. I'm not sure what it is you're looking for.

 

 

a

.

[Terabith]

Okay, major TMI warning here........

 

 

 

 

 

 

 

 

When I was in college, I was dx with HPV. I was very confused about this, since I had never had s*x. No oral s*x. I was dating my now husband, but he was the first man I had ever dated. I was the first girl he had dated. And we had never done anything more than kiss. The doctors didn't believe me about not being se*ually active. BUT, it was true. I went to a couple drs to confirm the dx. They said, "Well, maybe you got it from your mother when you were born. Or maybe from a toilet seat." I couldn't find information on the toilet seat transmission theory, and my mother was shocked and denied (and I believe her) when I asked her about it.......

 

This piece of info, along with some other circumstantial evidence (I was a cutter; I tend to dissociate under stress and I have little memory of much of my life; when I got married I was flat out unable to have s*x. Had panic attacks and a lot of pain. Was married three years before we managed to do it. Have never had an o**asm, nor experienced any real desire, either before or after marriage. No longer have panic attacks with it, and enjoy making my husband happy, but no personal pleasure from such things, including do-it-yourself.) This circumstantial evidence has made me think perhaps I was abused as a child and just don't remember it. Am VERY hesitant on the repressed memory thing, and I would never accuse anyone. But it's the theory that seems to make the most sense. Given the HPV being transmitted that way.

 

So, I guess I'm sort of eager to know about non-s*xual ways of transmission. It would be nice for that not to be my working supposition, although it's the theory that seems to make the most sense of my life.

[Penelope]

 

 

As to whether or not the vaccine has been tested in adolescents:

 

Safety and Persistent Immunogenicity of a Quadrivalent Human Papillomavirus Types 6, 11, 16, 18 L1 Virus-Like Particle Vaccine in Preadolescents and Adolescents: A Randomized Controlled Trial (no deaths, by the way)

 

Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial

 

 

I couldn't access the first trial.

 

In the second one, they found that after a series of three shots, the 9-15 year olds were still immune after 12 months.

 

One year. Is there any data looking at it up to 10 or 20 years? I could not find any.

 

Where is the long term data showing that this vaccine actually prevents complications and death from cervical cancer?

 

There isn't any, is there?

[Blessedfamily]

I couldn't access the first trial.

 

In the second one, they found that after a series of three shots, the 9-15 year olds were still immune after 12 months.

 

One year. Is there any data looking at it up to 10 or 20 years? I could not find any.

 

Where is the long term data showing that this vaccine actually prevents complications and death from cervical cancer?

 

There isn't any, is there?

 

I'm really not trying to be contentious to any posters here, or question any parents' choices (we all try to make the best informed decisions, don't we?), but... I think the long-term studies will come from watching what happens to the girls who've gotten the vaccine.

[elizabeth]

My great fear is regarding the young women who developed Guillain Barre shortly after receiving the vax. I know that correlation is not causation but that scares the heck out of me. The more important issue is the same one I dealt with when working at the health clinic-the pill led many, many people to forget about the importance of barrier birth control. I fear greatly that many young people who are not scientifically savvy will either misunderstand that herpes, HIV, Trich, bacterial vaginosis, syphillis etc are all still very high risk diseases that are only preventable by barrier methods. I saw this all the time , daily .I cannot tell you how many young people came in daily with horrible, disfiguring diseases(especially those who had G.warts treated with podophyllin causing burns, from not using barrier methods to protect themselves from STD's. They can and do kill. I am worried that the HPV vax will make young people deluded into thinking that they are protected from most STD's . Yes, many, many people are that dumb. There is no other word. Naive in some cases but usually just scientifically ignorant in ways you cannot begin to fathom unless you have worked in the field.

Edited May 3, 2010 by elizabeth
typo

[Blessedfamily]

My great fear is regarding the young women who developed Guillain Barre shortly after receiving the vax. I know that correlation is not causation but that scares the heck out of me. The more important issue is the same one I dealt with when working at the health clinic-the pill led many, many people to forget about the importance of barrier birth control. I fear greatly that many young people who are not scientifically savvy will either misunderstand that herpes, HIV, Trich, bacterial vaginosis, syphillis etc are all still very high risk diseases that are only preventable by barrier methods. I saw this all the time , daily .I cannot tell you how many young people came in daily with horrible, disfiguring diseases(especially those who had G.warts treated with podophyllin causing burns, from not using barrier methods to protect themselves from STD's. They can and do kill. I am worried that the HPV vax will make young people deluded into thinking that they are protected from most STD's . Yes, many, many people are that dumb. There is no other word. Naive in some cases but usually just scientifically ignorant in ways you cannot begin to fathom unless you have worked in the field.

 

I keep wondering why, at the end of birth control ads, they say "This will not protect you from STDs, etc....." Who assumes it will??????

[lionfamily1999]

I keep wondering why, at the end of birth control ads, they say "This will not protect you from STDs, etc....." Who assumes it will??????

They say the same thing with the ED commercials. We know Bob's practicing, but is he safe?

[TravelingChris]

Oh and the statistics how they had underlying conditions- two died who did have Antiphospholipid Antibodies. I have this. The only problem I ever had was with a broken leg. NOw, if I break my leg, I get blood thinners. But I definitely never had any problems with vaccines nor have I ever heard or read anything that suggested that I not get any other vaccine because of the APA. That is a big difference between this vaccine and others. As I said, I have no idea if my dds have inherited the same issue that I have. Since they have no problems at this time that makes anyone think they did, no one would be testing them just for the H. of it. Therefore, I will be strongly recommending that they not get this vaccine and will not be letting them have it while they are under my control (under 18). My girls don't smoke, use BC pills (yet another thing I will strongly recommend they keep away from), and one is very thin while the other is normal size-none are obese or even overweight.

[TravelingChris]

Oh, and I am not sure this will really help that much in saving not only lives but unnecessary procedures. I don't have any HPV. I have twice had to undergo further tests because of abnormal pap. The second time I asked how come I have to have further tests even though I am negative on HPV since we keep hearing how that is the only cause of cervical cancer. Apparantly not.

[Annabel Lee]

whoops NM

Edited May 4, 2010 by Annabel Lee

[KidsHappen]

Giving this to your daughter can prevent her from contracting cervical cancer, one of the deadliest types of cancer.

 

This is incorrect. Cervical cancer is one of the slowest growing cancers with one of the highest survival rates. I am a 20 year cervical cancer survivor so I am quite familiar with the stats on this.

 

http://en.wikipedia.org/wiki/Cervical_cancer

[Mergath]

This is incorrect. Cervical cancer is one of the slowest growing cancers with one of the highest survival rates. I am a 20 year cervical cancer survivor so I am quite familiar with the stats on this.

 

http://en.wikipedia.org/wiki/Cervical_cancer

 

I think that cervical cancer can be treated fairly easily, but because it's so widespread, it causes a lot of deaths worldwide. So it is very deadly, and it isn't, if that makes sense.

[Joker]

From what I've read, HPV can be spread orally, though it's rarer than with sexual contact. Also, an infected mother can also spread it to her baby during delivery.

 

http://www.health-science-report.com/research/how-is-hpv-transmitted-.shtml

 

 

I had two abnormal paps when pregnant with dd1. That led to a copolscopy (sp?). I was told it was HPV but they didn't want to do anything until after delivery. I was told that if I had a vaginal delivery it could "clean" out the bad cells. I had a vag. delivery and have never had an abnormal pap since. As far as I know my dd is perfectly healthy. Would I have known yet if I spread something like that to her? The drs never showed any concern that it could harm my child. Where did you get that info. Thanks!

 

ETA: I see the link posted about passing it during childbirth - it this the only link?

[Mergath]

I had two abnormal paps when pregnant with dd1. That led to a copolscopy (sp?). I was told it was HPV but they didn't want to do anything until after delivery. I was told that if I had a vaginal delivery it could "clean" out the bad cells. I had a vag. delivery and have never had an abnormal pap since. As far as I know my dd is perfectly healthy. Would I have known yet if I spread something like that to her? The drs never showed any concern that it could harm my child. Where did you get that info. Thanks!

 

ETA: I see the link posted about passing it during childbirth - it this the only link?

 

If you google "transmitting HPV during childbirth," you'll get a ton of links that agree that HPV can be spread during childbirth. The risk isn't high, but it does happen. In rare cases, the newborn can end up with warts growing on his or her vocal cords, which can be very serious. Something like that would show up right away, though.

 

I had an abnormal pap when I was pregnant, too. I found out I had HPV seven or eight years ago. My doc actually told me when I was pg that I could have a c-section to avoid transmission of the HPV, if I wanted. I ended up needing an emergency c-section anyway, so it wasn't an issue.

 

Your dd will probably be fine. Just be sure she gets regular paps when she's old enough and is tested before she become sexually active.