On the HPV vaccine

And why my daughter is going to get it

I get asked about the HPV vaccine a lot these days. Not just online, in the real world.

Partly this is because people know my older daughter is now 13. At her last checkup, her pediatrician asked if she’d be getting it. We said we’d think about it.

Okay. I’ve thought about it. I’ve read the original randomized trials for both the first Gardasil and the updated version, which protects against more HPV strains. And I’ve looked at the big epidemiological studies from Scotland, Sweden, and elsewhere.

And she’s going to get it, sooner rather than later.

I realize many of you won’t like this decision. But if people respect me enough to ask my opinion, I’m going to be honest. I said before I will not accept audience capture.

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(But I will accept capturing audiences!)

And — new feature — one-time donations!

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Let me explain why and face the major objections head-on.

1: HPV is a sexually transmitted disease, in inoculating your daughter against it you are encouraging her to have sex.

I am not encouraging her, merely accepting she might. Besides, I don’t have a religious or moral objection to premarital sex. If you do, and it is so strong that you cannot bear doing anything to raise the chances your child might have sex, that’s your choice. I won’t argue. But that’s not a scientific discussion.

2: But she is only 13!

Obviously, I do not want her to have sex now, or for quite some time.

However, the data are unequivocal. The vaccine is significantly more effective when it is administered well before a person already has HPV — that is, well before she has begun having sex, since almost everyone who has sex eventually gets HPV. So it’s best to get it between 11 and 13. The Scottish national study is particularly telling. Not one girl who was vaccinated at 12 or 13 has gotten cervical cancer in the years since.

The public health messaging is unclear on this point, probably because — as usual — the public health people think everyone is too stupid to understand any nuance. They don’t want to say that the vaccine might not work if it’s administered too late. But, as usual, in hiding the truth they have caused more problems, by implying they expect girls to start having sex in eighth grade.

I don’t expect that. But, to be honest, I don’t really want to have to predict when my daughter or anyone else’s daughter will lose her virginity. The shot will protect her against HPV indefinitely (there is no evidence it loses its effectiveness over time) whenever she gets it.

So she might as well get it now and be done with it.

3: The shot does not protect against all strains of HPV.

True. But it does protect against the nine strains that are known to be the most likely to cause cancer. And, crucially, we now have strong epidemiologic evidence that when it is administered to girls 13 and under — that is, girls who probably weren’t sexually active and didn’t have HPV at the time they received it — it sharply reduces the risk of cervical cancer.

4: Cervical cancer is pretty uncommon and Pap smears usually catch it.

That’s true. I’d still rather not have my daughter get it, if she can avoid doing so. It’s a terrible cancer, not one of the fun ones.

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(From the company that brought you ivermectin!)

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5: But people still get cervical cancer even in countries where HPV vaccination is common.

Most of those people are unvaccinated or were vaccinated when they had already been infected with a strain of HPV known to cause cancer. Again, the vaccine is not magic, it works best if it is given before infection. Going back to point 2, this is an argument for early vaccination.

6: But some girls have had terrible side effects from Gardasil!

The clinical trials did not show those. VAERS (the federal side effect reporting system) shows a relative handful. My basis of comparison is the mRNA Covid jabs. The side effects of the mRNAs were (and are) clear and obvious in the trials for anyone who cared to look, and VAERS confirmed them.

No signal like that for Gardasil exists. And I do not count anecdotal stories in the absence of hard data collected in clinical trials or at a minimum many physician-written case reports — especially since people who dislike all vaccines are highly motivated to spread them.

Going back to point 4, cervical and other HPV-caused cancers are rare, so the absolute benefit of Gardasil is small. We shouldn’t tolerate a big risk for it. I wouldn’t tolerate that risk for my daughter.

I do not see that risk.

7: Merck makes a lot of money from Gardasil.

Sigh. It sure does. Welcome to American healthcare.

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(Giving it to you straight… and chasing subscribers!)

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I’ve said it before, and I’m sure I’ll say it again:

Blaming vaccines for everything equals blaming vaccines for nothing.

Pretending all vaccines are equally terrible is the same as pretending they’re all equally great.

HPV isn’t HIV. It’s not lethal most of the time. But it’s a risk. An avoidable risk.

Why not avoid it?