Should Your Daughter Receive the HPV Vaccine?

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“Herd immunity” is a very important concept in immunology, but its relevance in the HPV context is minimal. In my correspondence with CDC scientists I have learned that anywhere from 85% to 98% of all uninfected members of the population, both male and female, would need to be vaccinated for several generations before herd immunity against HPV had even a chance of kicking in. If a disease has a high mortality rate and is highly contagious, then vaccinating everyone to prevent a large portion of the population from dying makes sense, but otherwise, the costs of trying to achieve herd immunity might very well outweigh its potential benefits.

HPV does not meet any of the criteria that justify a public health policy of trying to achieve herd immunity. Consider a comparison with smallpox, the classic example of a type of disease where attempting to achieve herd immunity is warranted. Smallpox is a disease that even today has no curative treatment. A smallpox epidemic could wipe out a whole community, making an attempt at achieving herd immunity through vaccination an essential part of combating the disease. Unlike smallpox, the HPV viruses that cause cancer are not transmitted through casual contact. Unlike smallpox, before the advent of vaccines, there is no epidemic. While much of the U.S. population has some form of HPV, only 1% has HPV 16 or 18. And, most importantly, unlike smallpox, death is preventable through other means than vaccination. If a potentially dangerous form of HPV turns cancerous, which rarely happens, then it can be treated.

See the U.S. Supreme Courts decision in favor of mandatory smallpox vaccination in the 1905 case of Jacobson v. Massachusetts.   The cost benefit rationale is the same for any vaccination program, but particularly any one that advocates trying to attempt reaching “herd immunity.”

Also – Be careful to remember scientists believe there are as many as 200 different types of HPV, but only 5 or 6 forms of HPV have been linked to cancer.   When someone discusses the prevalence of HPV, always ask yourself “Which types of HPV is the author talking about – All types or only those that potentially cause cancer?”