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The most current numbers for the Center for Disease Control and Prevention (CDC) indicate that out of the nearly 10,000 US women diagnosed with cervical cancer every year, 30 to 45 are Alaskans.
Most medical professionals agree the sexually transmitted disease, Human Papilloma Virus (HPV), is the main cause of cervical cancer. The National Cancer Institute reports there are more than 100 HPV types, 15 of which can cause cervical cancer.
In 2006, after five years of clinical trials, Food and Drugs Administration officials approved Gardasil. Today, it remains the FDA's only approved HPV vaccine.
Since 2007, CDC officials have recommended all 9-year-old girls up to 26-year-old women receive Gardasil. It was during the same time period Merck, Gardasil's maker, launched a multi-million dollar ad campaign still airing today.
"Gardasil's the only cervical cancer vaccine that helps protect against 4 types of HPV," the commercial opens. "I chose to get vaccinated after my doctor told me cervical cancer isn't the only HPV disease Gardasil helps prevent," a woman says later in the ad.
By October the vaccine had been on the market for two-and-a-half years, and more than 16 million doses had been distributed. That's when CDC and
That same report also talks about Gardasil's more than 10,000 reported side effects. CDC and FDA officials consider 94% of them "non-serious."
The Gardasil ad even mentions these, "Side effects include pain, swelling, itching and swelling at the injection site, fever, dizziness, nausea and fainting."
The other 6% "serious events," translate into side effects like: the rare muscle weakness disorder Guillain-Barré Syndrome (GBS); blood clots in the heart, lungs, and legs; and even 27 deaths after the vaccination.
According to the CDC report, "There was no common pattern to the deaths that would suggest they were caused by the vaccine."
In a July 2008 Merck statement, the vaccine's maker added, "These types of events are events that could also be seen in the general population, even in the absence of vaccination. An adverse experience report describes an event that occurred after vaccination and does not necessarily mean that the vaccine caused or contributed to the event."
"I think if a person doesn't want to get the vaccine or want their child to get the vaccine they can arm themselves with that data. The medical data is it's a very safe vaccination and it prevents a lot of pathology," says Nurse Practitioner Heidi Hurliman.
Most of the Gardasil concerns expressed to Providence Women's Clinic medical workers, like Hurliman, do not revolve around the vaccine's side effects. Hurliman says the common concern has to do with the sexual stigma surrounding the recommendation that young girls receive the vaccine.
"The caveat is to be most effective, the vaccination has to be given before any sexual intercourse, before any exposure to the HPV virus," Harliman says. "That's why it starts so early, yes, is because their immune response is brisk at that point and time."
"Early detection saves lives. I mean I'm living proof of that," says 20-year cervical cancer survivor Susan Merrick.
Long before a HPV vaccine was even a reality, the now Providence Cancer Center social worker says her yearly pap test, where doctors look for cervical changes that might lead to cancer, saved her life.
"I'd always been very good about preventative care," Merrick said. "And an annual exam, and an annual pap smear certainly since I graduated from college. And so it was just time to go. I had absolutely no symptoms."
Most cervical cancer cases, like Merrick's, never have symptoms. Even if condoms are used during sex, women can still be infected and never know it. While most HPV infections go away, those that do not can lead to cervical cancer. That's why the annual pap test is so important.
"And the reason I'm alive is because I had an annual pap smear," Merrick says. "Regardless of being symptomatic, no woman needs to die of cervical cancer. It's one of the, you know, most easily detectable at an early stage."
Doctors say the pap test should start 3 years after a woman has sex, or when she turns 21, and continue every year after that. Both CDC and Merck officials encourage women to get regular pap tests, even if they have been vaccinated.
One of Gardasil's clinical trial investigators has suggested the FDA rushed the vaccine to market, saying it did not undergo a typical 7 to 13 year study. Right now no one really knows how long the vaccine lasts. It appears Merck officials are counting on time to answer that question.
The CDC has posted their complete report online and Merck has responded to reports of adverse effects.
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