The HPV Vaccine, POTS and ME/CFS and FM – Is There An Issue?, by Cort Johnson, Health Rising, July 1, 2015

Through their ability to virtually eradicate infectious diseases such as polio, smallpox and measles, vaccines have produced incalculable good over time. Measles is a case in point. In 1958, 763,094 cases of measles were reported in the U.S.:  in 2008 less than seventy were.  Recent research suggests that damage to the immune system following the measles infection probably resulted in many health issues later as well.  It’s almost impossible to calculate how much disease and suffering vaccinations have prevented.

That’s why it’s been difficult to write a blog suggesting that a specific vaccine may have problems. Put the studies indicating that it’s as safe as any vaccine against anecdotal reports that it’s causing harm, and you don’t have much.  Parents of autistic children were sure that the mercury in the vaccinations their children were taking was causing autism. It took millions of dollars to prove it wasn’t. Meanwhile many unvaccinated children were left in harms way.

The state of California is concerned enough about dropping rates of vaccinations that a  bill that would bar children who are not vaccinated from attending public schools, is on the brink of passing. I do not in any way wish to be a part of any general anti-vaccination promotion.

Designed to prevent infections associated with the development of cervical cancer, genital warts, and other cancers, the human papillomavirus vaccine is the latest vaccine to come to market.

The Upside

HPV vaccines have received widespread approval from major health organizations. The World Health Organization (WHO) and public health officials in Australia, Canada, Europe, and the United States have recommended vaccination of young women against HPV. ( The U.S. also recommends vaccination in young males).

The two vaccines approved in the U.S., Gardasil and Cervarix, protect against two types of human papilloma virus responsible for  70% of cervical cancers, 80% of anal cancers, 60% of  vaginal cancers, 40% of vulvar cancers, and 90% of genital warts.

The efficacy of the vaccine is not clear yet but it may be able to significantly reduce the rates of cervical cancer. It is the fourth most common cause of death from cancer. (The introduction of the pap smear has reduced number of deaths, they have dropped significantly over time.) The National Cancer Institute has stated that

“Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds, if all women were to take the vaccine and if protection turns out to be long-term. In addition, the vaccines can reduce the need for medical care, biopsies, and invasive procedures associated with the follow-up from abnormal Pap tests, thus helping to reduce health care costs and anxieties related to abnormal Pap tests and follow-up procedures.”

By 2014 almost 40% of teenage females in the U.S. had received at least one shot of the three shot protocols. In Australia the percentage is almost 70%. Statistics suggested the vaccine was working. The prevalence of HPV infections among teenagers aged 14–19 had been cut in half with an 88% reduction among vaccinated women in the U.S.. The infections were down threefold in Australia.

The National Cancer Institute reported that tens of thousands of vaccinations were done prior to licensing and that a recent CDC and FDA safety review found adverse events were no higher than in other vaccines.  (It did note that a higher proportion of syncope (fainting) was seen in Gardasil.)  While studies have found that the incidence of serious adverse effects is  low (<1 in a 1,000) anecdotal reports have emerged of the vaccine triggering autonomic nervous system dysfunction including postural orthstatic tachycardia syndrome (POTS).

A Downside?

The case against the HPV vaccine having an  unusual number of side-effects is quite strong. Some dissenting reports have emerged, however. A small Japanese study recently reported increased rates of orthostatic intolerance and an complex regional syndrome-like disease in young women, who associated their symptoms with HPV  vaccination. The young girls, some of whom were unable to attend school, tended to be diagnosed as having a psychosomatic disorder.  The study suggested abnormal peripheral sympathetic responses were present.

A media outlet recently published a report from a U.K. agency indicating that many more adverse side-effects have been reported for the HPV vaccine than for other vaccines. Since the vaccine was not given until three years in the reporting period the report understates the incidence of negative side effects of the HPV  vaccine relative to other vaccines.  It should be noted that this report stands at odds with reports from other countries.

The media report followed the case of a young girl experiencing a very ME/CFS like illness progression.

Two weeks after her first HPV injection, a previously healthy and active 13-year old teenager experienced dizziness and nausea.  She eventually ended up in the emergency room with severe chest and abdominal pains and difficulty breathing. Suggestions that the vaccinations were responsible were met with hostility and ridicule and predictably she was told to push herself to get back to normal. Two years later, now able to attend school only 3-4 hours a week, she was finally diagnosed with postural orthostatic tachycardia syndrome (POTS).

When people come down with POTS and ME/CFS and FM they often do so suddenly; there’s no way to tell that her POTS was caused by it or by another factor.

In the HPV category alone, however, ADRs numbered 8,228, of which 2,587 were classified as “serious”; i.e. resulting in hospitalization or deemed life threatening.

It should be noted that adverse effects “associated with” or occurring around the time of vaccination are to be expected. For instance the thirty-two deaths and 12,424 adverse reactions ranging from dizziness to autoimmune disorders reported with HPV vaccinations in a CDC study came after 23 million doses.  Those numbers are in line with safety studies of other vaccines.

In 2013 the Japanese government, pending an analysis of reports of long-term pain associated with the vaccine, withdrew its recommendation that young girls receive the vaccine.  It noted that while still very low (12.8 serious cases of adverse events per 1 million inoculation) the reports of adverse events were higher than for some other vaccines.

Hypothesis: Human papillomavirus vaccination syndrome—small fiber neuropathy and dysautonomia could be its underlying pathogenesis. Manuel Martínez-Lavín. Clin Rheumatol, July 2015, Volume 34, Issue 7, pp 1165-1169

Dr. Martinez-Lavin has produced a hypothesis paper proposing that HPV vaccines may cause sympathetic nervous system dysfunction in very small proportion of those being vaccinated.  Calling these issues “rare” Martinez-Lavin speculated the aluminium adjuvant in combination with the inactivated virus may play a role.

Martinez-Lavin believes the multi-symptom nature of the complaints may have made it difficult to determine causality and lead to under-reporting of harms. He started worrying about the vaccine after several girls now under his treatment developed fibromyalgia shortly after being vaccinated.

Conclusions

On the balance the evidence suggests HPV vaccinations are safe. They may help reduce the incidence of cervical cancer and genital warts.  Pending further analysis – and counter to other nations – the Japanese government, however, withdrew it’s recommendations that young girls be vaccinated. One recent report suggests rates of adverse effects, while still rare, may be higher than in other vaccines.