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So, I may have only five days left to get stuck with that needle, if I want my health plan to cover the maximum they will cover(80%).
PROS:
1) in women with no previous sexual experience, the vaccine was effective in preventing 100% of cases of the strains of HPV against which the vaccine innoculates
2) in women with sexual experience, that number drops, but only to 98%
3) the two cancer-causing strains the vaccine innoculates against are normally responsible for 70% of cervical cancers, they are the only strains that have been implicated in rectal cancers and one of them is the only strain currently implicated in throat cancers.
CON:
1) "looking at all women who got the vaccine with all types of HPV exposure, efficacy in reducing precancer was modest -- 17% fewer cases of precancer in vaccinated women vs. the placebo group. And if you look at the most significant precancer, grade 3, there is no significant reduction among vaccinated women."
http://www.webmd.com/sexual-conditions/HPV-Genital-Warts/news/20070509/hpv-vaccine-good-news-bad-news?page=1
In other words, although it was 98-100% effective at reducing HPV caused by the strains it innoculates against, it only reduced the incidences of precancer (CIN 2 or higher) due to other causes by 17%. The more serious form of precancer (CIN 3 and actual cancer) were apparently barely effected.
2) It's been, oh, about 3ish years since the first cohort received this vaccine. We don't know what if any long term health effects there will be, nor how long it will remain effective. However, a quick glance at the Prescribing Info (which you can download in PDF format here: http://www.gardasil.com/prescribing-information-about-gardasil.html) does not alarm me. It seems that deaths were unlikely to be caused by the vaccine. The rate of autoimmune diseases which could be attributed to it was so small as to be insignificant, although if there IS an effect, we'd need a much larger sample set to see it, and the risk would be, like the smallpox virus, with a rate based on hundreds of thousands, or millions. Data from the VAERS database indicate that there have been 9 deaths reported within 15 days of administration of the vaccine; however, note that these numbers include ALL deaths, even those which could not possibly be related to the vaccine, such as car accidents.
FYI:
For those who were wondering about the time it takes for an HPV infection to progress to the end point these studies used (CIN 2/3 or worse according to some resources, but other places I've looked at said ASCUS or CIN 1)... although prior 'wisdom' was that the progression from HPV infection to CIN 2/3 could take a decade or more, more recent research has shown that CIN 2/3 is reached in about 3 years, and CIN 3/cancer is reached in about 10 years. Since CIN 2/3 was the end point of the Gardasil study, the current length for which the vaccine's cohort has been studied is satisfactory for drawing conclusions.
CONCLUSION:
Even though the efficacy of this vaccine in preventing cervical cancer is in question, if it prevents infection with strains 16 and 18, it seems likely that it will protect me from HPV-caused throat and rectal cancers, since no other strains of HPV are implicated in those types of cancer. This is good, since they don't give regular paps to girls in the throat or rectum.
So, if I can arrange to get it covered by Ryerson's health plan, even at just the 80% mark, I think I will go ahead with it.
***
I'd just like to say that this took way too long when I was already busy. But I feel good -- I had so many remaining questions about this, it feels really great to have at least the vaccine-related ones sorted out in my head.
Now to bed -- I should be asleep, like, at least an hour if not two hours ago.
PROS:
1) in women with no previous sexual experience, the vaccine was effective in preventing 100% of cases of the strains of HPV against which the vaccine innoculates
2) in women with sexual experience, that number drops, but only to 98%
3) the two cancer-causing strains the vaccine innoculates against are normally responsible for 70% of cervical cancers, they are the only strains that have been implicated in rectal cancers and one of them is the only strain currently implicated in throat cancers.
CON:
1) "looking at all women who got the vaccine with all types of HPV exposure, efficacy in reducing precancer was modest -- 17% fewer cases of precancer in vaccinated women vs. the placebo group. And if you look at the most significant precancer, grade 3, there is no significant reduction among vaccinated women."
http://www.webmd.com/sexual-conditions/HPV-Genital-Warts/news/20070509/hpv-vaccine-good-news-bad-news?page=1
In other words, although it was 98-100% effective at reducing HPV caused by the strains it innoculates against, it only reduced the incidences of precancer (CIN 2 or higher) due to other causes by 17%. The more serious form of precancer (CIN 3 and actual cancer) were apparently barely effected.
2) It's been, oh, about 3ish years since the first cohort received this vaccine. We don't know what if any long term health effects there will be, nor how long it will remain effective. However, a quick glance at the Prescribing Info (which you can download in PDF format here: http://www.gardasil.com/prescribing-information-about-gardasil.html) does not alarm me. It seems that deaths were unlikely to be caused by the vaccine. The rate of autoimmune diseases which could be attributed to it was so small as to be insignificant, although if there IS an effect, we'd need a much larger sample set to see it, and the risk would be, like the smallpox virus, with a rate based on hundreds of thousands, or millions. Data from the VAERS database indicate that there have been 9 deaths reported within 15 days of administration of the vaccine; however, note that these numbers include ALL deaths, even those which could not possibly be related to the vaccine, such as car accidents.
FYI:
For those who were wondering about the time it takes for an HPV infection to progress to the end point these studies used (CIN 2/3 or worse according to some resources, but other places I've looked at said ASCUS or CIN 1)... although prior 'wisdom' was that the progression from HPV infection to CIN 2/3 could take a decade or more, more recent research has shown that CIN 2/3 is reached in about 3 years, and CIN 3/cancer is reached in about 10 years. Since CIN 2/3 was the end point of the Gardasil study, the current length for which the vaccine's cohort has been studied is satisfactory for drawing conclusions.
CONCLUSION:
Even though the efficacy of this vaccine in preventing cervical cancer is in question, if it prevents infection with strains 16 and 18, it seems likely that it will protect me from HPV-caused throat and rectal cancers, since no other strains of HPV are implicated in those types of cancer. This is good, since they don't give regular paps to girls in the throat or rectum.
So, if I can arrange to get it covered by Ryerson's health plan, even at just the 80% mark, I think I will go ahead with it.
***
I'd just like to say that this took way too long when I was already busy. But I feel good -- I had so many remaining questions about this, it feels really great to have at least the vaccine-related ones sorted out in my head.
Now to bed -- I should be asleep, like, at least an hour if not two hours ago.
