Offit made erroneous HPV claims, too

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In yesterday’s post on Dr. Paul Offit’s article in USA Today, Voices: Our children are at risk and here’s why, we saw how he overstated the number of measles deaths that existed in the pre-vaccine era by almost 100% and made a scientifically unsubstantiated claim about the efficacy of the vaccine.

Offit’s unsubstantiations didn’t end there — he also made erroneous and scientifically unsubstantiated claims about human papillomavirus, or HPV, which can lead to cervical cancer. Specifically, Offit claimed that “in about 20 years, thousands more will die from cancers caused by human papillomavirus” because “parents chose not to immunize [their children].”

Does Offit have any basis for his claim that the HPV vaccine will offer long-term protection, such that thousands will be spared over the next 20 years? He does not. According to Professor Diane Harper, the scientist who was the principal investigator for Merck, the pharmaceutical company that developed the Gardasil HPV vaccine, “we do not have evidence that Gardasil offers efficacy any longer than five years.” Harper did speculate on scenarios in which the duration of efficacy lasted as long as 15 years, saying in a 2010 email interview: “If duration is at least 15 years, then vaccinating 11-year-old girls will protect them until they are 26 and will prevent some pre-cancers, but postpone most cancers. If duration of efficacy is less than 15 years, then no cancers are prevented, only postponed.”

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It’s possible, of course, that Gardasil will provide long-term protection. But Offit’s quote would still have been wildly misleading because Gardasil doesn’t save lives in modern countries, where women obtain Pap smears.

As Harper explained it: “Pap smears alone prevent more cervical cancers than can the vaccines alone.” Even getting both — the vaccine plus Pap smear screening — does little good. “The combination of HPV vaccine and screening in the U.S. will not decrease the incidence of cervical cancer to any measurable degree at the population level.”

While a typical informed parent would have difficulty discerning the logic in vaccinating his daughters, the parent’s logic in avoiding Gardasil in favor of the Pap smear is crystal clear. “Pap smears have never killed anyone,” Harper stated. “Gardasil is associated with serious adverse events, including death.” Her unambiguous conclusion: “Pap smears are absolutely the way to go.”

Harper’s credentials in the HPV sphere are stellar — she’s one of the few recognized experts in this field in the world. In fact, she was also hired by Merck’s competitor, GlaxoSmithKline, to be the principal investigator for its competing HPV vaccine, Cervarix. Now the Chair of Family and Geriatric Medicine at University of Louisville, Harper has personally seen tens of thousands of women with abnormal Pap smears, women from all continents of the world having come to her referral clinic for her expertise, giving her a breadth of understanding few could match.

In giving parents advice, Offit needs to up his game, at a minimum acknowledging that his view runs counter to that of a preeminent expert in the field. But so does USA Today — good copy editors, if not good editors, should do a better job of protecting readers from potentially serious misinformation. USA Today might also consider revising Offit’s article.

Our rating

Offit’s article needs another four band-aids, or demerits in our rating system, to correct the errors in his article.

As with all journalists we rate, Offit has a standing invitation to respond here.

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Your comments are welcome, using the form below. You might also consider commenting on the USA Today site,  via Twitter to @DrPaulOffit and/or @USATODAY.

Comments

  1. The very questionable human papillomavirus (HPV) vaccine that Dr. Offit promotes is being pushed upon girls and boys around the world.

    Are these young people and their parents being properly informed that the co-inventor of the technology enabling the HPV vaccines, Professor Ian Frazer, has acknowledged that the risk of cancer associated with the HPV virus is very low?

    In an article on the university and CSIRO-funded The Conversation website, titled “Catch cancer? No thanks, I’d rather have a shot!”, Professor Frazer stated: “Through sexual activity, most of us will get infected with the genital papillomaviruses that can cause cancer. Fortunately, most of us get rid of them between 12 months to five years later without even knowing we’ve had the infection. Even if the infection persists, only a few individuals accumulate enough genetic mistakes in the virus-infected cell for these to acquire the properties of cancer cells”. [1]

    If only “a few individuals accumulate enough genetic mistakes in the virus-infected cell for these to acquire the properties of cancer cells”, is it really justifiable to coerce mass populations of children to have HPV vaccination, particularly as the long-term consequences of the HPV vaccine are unknown?

    Information provided by the Australian National Cervical Screening Program notes: “Anyone who has ever had sex can have HPV – it’s so common that four out of five people will have had HPV at some time in their lives. In most cases, it clears up by itself in one to two years. In rare cases, if the virus persists and is left undetected, it can lead to cervical cancer. This usually takes about 10 years. A pap smear every two years can detect any abnormal cell changes caused by HPV, which can then be monitored and/or treated to prevent cancer.” It is highlighted that: “It is important to remember that most women who have HPV clear the virus naturally and do NOT go on to develop cervical cancer.” [2]

    It’s interesting to note that the Gardasil HPV vaccine was originally rejected by the Australian Pharmaceutical Benefits Advisory Committee (PBAC) in 2006. In her report “Government response to PBAC recommendations”, Marion Haas provides some commentary on the Australian government’s interference with the PBAC’s initial rejection of Gardasil, noting the then Prime Minister, John Howard, “intervened personally by announcing that the drug would be subsidised (ie listed) as soon as the manufacturer offered the right price. The PBAC subsequently convened a special meeting and recommended that Gardasil be listed on the PBS”[3] (Pharmaceutical Benefits Scheme).

    Haas notes that “the developer of the Cervical Cancer vaccine [i.e. Ian Frazer] was prominent in the media during the debate about listing. His influence was enhanced by his position as Australian of the Year.” [4]

    Haas argues the main objectives “of the PBAC are to consider the effectiveness and cost-effectiveness of medicines in making recommendations to government regarding the listing of drugs for public subsidy. A perceived willingness to interfere in this process may undermine these objectives…” Government reaction which results in reversal of PBAC decisions has “the potential to send signals to manufacturers and lobby groups that a decision made by the PBAC may be reversed if sufficient public and/or political pressure is able to be brought to bear on the PBAC…this may undermine the processes used by the PBAC to determine its recommendations and hence the perceived independence of the PBAC.”[5]

    Getting a vaccine on the Australian Pharmaceutical Benefits Scheme must be the ‘golden goose’ for vaccine manufacturers as this assures a mass market for their vaccine product. Other countries have also adopted HPV vaccination, impacting on millions of children around the world and resulting in multi millions of dollars’ worth of sales for Merck (Gardasil) and GlaxoSmithKline (Cervarix)[6], and royalties for entrepreneurial scientist Ian Frazer from sales of HPV vaccines in developed countries[7], and for CSL which receives royalties from sales of Gardasil.[8].

    No wonder Ian Frazer was willing to forego royalties from developing countries [9] – how much profit will he reap from sales of the vaccine to governments in developed countries?

    The case for universal HPV vaccination is unconvincing, and the motives for its promotion are suspect. It’s time there was an investigation into the government lobbying and aggressive global marketing of the HPV vaccine.

    For more information, read my detailed letter forwarded to Chris Mitchell, Editor-in-Chief of The Australian newspaper, on this topic: “Is universal HPV vaccination necessary?” http://users.on.net/~peter.hart/Is_universal_HPV_vaccination_necessary.pdf

    1. “Catch cancer? No thanks, I’d rather have a shot!”. The Conversation, 10 July 2012: https://theconversation.com/catch-cancer-no-thanks-id-rather-have-a-shot-7568
    2. The link between cervical cancer and HPV (human papillomavirus): http://www.health.gov.au/internet/screening/publishing.nsf/Content/A4DD46018ECF8540CA257D5D007E132E/$File/hpv.pdf
    3. Haas, Marion. “Government response to PBAC recommendations”. Health Policy Monitor, March 2007: http://hpm.org/en/Surveys/CHERE_-_Australia/09/Government_response_to_PBAC_recommendations.html
    4. Ibid.
    5. Ibid.
    6. FierceVaccines special report on the 20 Top-selling Vaccines – H1 2012 states that H1 2012 sales for Gardasil (Merck) were $608 million, and sales for Cervarix (GlaxoSmithKline) were $285 million: http://www.fiercevaccines.com/special-report/20-top-selling-vaccines/2012-09-25
    7. “Catch cancer? No thanks, I’d rather have a shot!”. The Conversation, 10 July 2012: https://theconversation.com/catch-cancer-no-thanks-id-rather-have-a-shot-7568 The disclosure statement on this article by Ian Frazer states: “Ian Frazer as co-inventor of the technology enabling the HPV vaccines receives royalties from their sale in the developed world.”
    8. CSL ups profit guidance on Gardasil sales. The Australian, 27 November 2012.
    9. “Catch cancer? No thanks, I’d rather have a shot!”. The Conversation, 10 July 2012: https://theconversation.com/catch-cancer-no-thanks-id-rather-have-a-shot-7568 The disclosure statement on this article by Ian Frazer states: “Ian Frazer as co-inventor of the technology enabling the HPV vaccines receives royalties from their sale in the developed world.”

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