Posts for category: Immunizations
Misinformation About the HPV Vaccine Keeps Vaccination Rates Low
The Overwhelming Safety of the HPV Vaccine
Paul A. Offit, MD
September 07, 2018
No vaccine has suffered more from misinformation and ill-founded concerns than the human papillomavirus (HPV) vaccine. Antivaccine activists have claimed that HPV vaccine causes chronic pain syndromes, chronic fatigue, sudden death, and a variety of autoimmune disorders. In addition, activists have gone so far as to claim that the HPV vaccine increases risky sexual behavior. These claims are often supported by the media as well as by substandard studies published in predatory journals. Indeed, on December 4, 2013, Katie Couric, in a segment titled "HPV Vaccine Controversy," interviewed two mothers: One claimed that the vaccine had caused her daughter to suffer chronic fatigue, the other that the vaccine had caused an otherwise unexplained death.
As a consequence of such fears, immunization rates for the HPV vaccine remain low. According to the Centers for Disease Control and Prevention (CDC), only 53% of girls and 44% of boys have received the recommended doses. As currently constructed, the HPV vaccine—which contains the L1 surface protein from nine different strains—will prevent about 29,000 cases of HPV-associated cancers and 5000 deaths a year. Unfortunately, because only about half of US adolescents have received this vaccine, every year about 15,000 people are destined to suffer and 2000 to die from a preventable cancer.
To the credit of the scientific and medical communities, millions of dollars have been spent on studies examining the safety of the HPV vaccine. Pre-licensure, about 30,000 people were studied for 7 years. Post-licensure, more than 1 million people have been formally studied, examining all manner of chronic pain and fatigue syndromes as well as more than a dozen different rheumatologic diseases.[3,4,5,6] Not surprisingly, the HPV vaccine has not been found to cause any chronic or debilitating condition. Indeed, the HPV vaccine is probably the world's best-studied, modern-day vaccine.
Another Unwarranted Concern Debunked: Primary Ovarian Insufficiency
One concern recently raised by antivaccine activists is that the HPV vaccine causes primary ovarian insufficiency. How this concern was born remains a mystery. HPV doesn't infect the ovaries. And the HPV L1 surface protein doesn't mimic proteins on ovarian cells, which would at least make an autoimmune disease biologically plausible. Nonetheless, the fear persists. To address this concern, researchers at Kaiser Permanente Northwest examined a cohort of 199,078 female patients, finding 120 with a diagnosis of primary ovarian insufficiency. The researchers found no statistically significant elevation of risk for ovarian failure following receipt of the HPV vaccine. They also didn't find an increased risk following receipt of the Tdap, MenACWY, or inactivated influenza vaccines.
The Kaiser Permanente study can now be added to the mountain of evidence that should reassure clinicians and parents that the HPV vaccine is safe. HPV, on the other hand, isn't safe. And until we dramatically increase immunization rates against this common, devastating infection, children will continue to suffer our ignorance.
Medscape Infectious Diseases © 2018 WebMD, LLC
Published on in Vaccine Update for Healthcare Professionals
In this period of “alternate facts,” a 24-hour news cycle, and an internet that can provide whatever answer a person seeks, it can be difficult to convince parents and patients using facts alone. Parents may respond using their own “facts” leaving you frustrated and unprepared to dive further into the conversation.
Without further conversation and as more parents become convinced by the counter-arguments, these “alternative facts” become widely held “truths.” Often the counter-arguments are based on fallacies, or errors of logic or reasoning. Different types of logical fallacies have been described in an article by David Ferrer, published on The Best Schools website. The article, which includes some short video examples, describes 15 types of fallacies:
- Ad hominem attacks — Criticizing the messenger in the absence of a counter-argument related to the fact being discussed.
- Straw man attacks — Attacking a position or fact that was not actually put forth. For example, oversimplification of a complex subject or statement to make it appear false.
- Appeal to ignorance — Taking advantage of what is not known. Using the notion that something has never been proven definitively is a common example of this type of fallacy.
- False dichotomy — Making a position appear to have only one of two possible options when the options are not mutually exclusive or when more than two options exist.
- Slippery slope — Arguing against a fact by suggesting unlikely, extreme outcomes.
- Circular argument — Using the preliminary assumption as the basis for arriving at the same conclusion.
- Hasty generalization — Jumping to conclusions without reviewing all available evidence.
- Red herring — Using a parallel or seemingly relevant argument to distract from the original point being discussed.
- Appeal to hypocrisy — Suggesting deception or insincerity of the messenger as a way to neutralize or distract from the issue.
- Causal fallacy — Incorrectly identifying two things as causally associated either without enough evidence to do so (false cause); solely based on one occurring before the other (post hoc); or because they were found together (correlational fallacy).
- Fallacy of sunk costs — Continuing with, or suggesting continuation of, a project based on the resources invested to date without consideration of future resources that will be incurred if the project continues.
- Appeal to authority — Considering something to be true simply because a perceived authority said it is so (without evidence) or because it was said to be true by citing authority figures who are not qualified in that field.
- Equivocation or ambiguity — Delivering a message that is intentionally deceitful or misleading.
- Appeal to pity — Evoking emotion to deter or replace the discussion of facts.
- Bandwagon approach — Suggesting something is true because it is a popular belief; it is accepted by authorities or large numbers of people; or because someone specific, based on their reputation, agrees.
Recognizing these fallacies, and helping your patients and families recognize them may be useful to approaching vaccine-related conversations as well as helping sort out fact from fiction in general. To that end, the VEC recently created a new Special Topics sheet, titled Logical Fallacies and Vaccines: What You Should Know. The new, four-page sheet includes a definition for each type of fallacy, a common example of how the fallacy is used to argue against vaccines, and a “reality check” statement about the related myth.
As with other Special Topics sheets, and most VEC materials, this information can be photocopied for distribution, linked from your website, or shared on social media.