Understanding the HPV vaccine “Table of Doom”
Hi Reader. I know you’ve seen it, but have you ever wondered about the story behind it? It’s seen about four times a year and results in great terror, howling and hand-wringing. No, it’s not the chupacabra. It’s the HPV vaccine Vaccine Adverse Event Reporting System (VAERS) table. It looks something like this, and is allegedly a list of the adverse events attributable to HPV vaccine.
So, a pop quiz on this table.
Q. Why is this table useless?
A. Well, for one thing, it’s because it includes no denominator. This table is composed of counts; it is not an “analysis” by any stretch of the definition. I’m not theoretically opposed to counting, nor to powerpoint tables. However, no victim looking at this table is provided with adequate information for considering whether or not the proportion of these events is less than, equal to, or greater than the rate of the events in the general population. It’s a good thing that the CDC has done so, and reports that there is no unusual clustering of any adverse events after HPV vaccination, with the exception of syncope (fainting). Despite that fact, the Table of Doom is most often interpreted, Henny Penny-like, as proving that HPV vaccine caused these events. It doesn’t. These are reports of events that occurred at any time after administration of HPV vaccine, and as the CDC page clearly states,
“The report of an adverse event to VAERS is not documentation that a vaccine caused the event“.
The CDC also asks that you acknowledge your understanding of this statement before commencing your rampant VAERS abuse. And yet, anti-vaxxers continue to misuse the database daily. But you may be wondering, what is the denominator? How many doses of HPV vaccine have been administered? I aim to please, so here it is: as of July 2012, 46 million doses of HPV vaccine had been given in the United States. As mentioned above, the CDC has calculated rates of the events listed in the Table of Doom for those who are vaccinated vs. the general population, and there are no differences. If we look at deaths, for example, there have been 121 reported after at least 46,000,000 doses of HPV vaccine. The annual death rate for U.S. teens aged 12-19 is 49.5 deaths per 100,000 population. It would take some serious contortions of mathematics to imply that the rate of deaths occurring after HPV vaccine are somehow higher than what is observed in the general population, though a thorough analysis would obviously be much more complicated than what I present here. Thankfully, as mentioned above, the CDC is constantly conducting such analyses and has concluded that HPV does not cause any serious adverse events.
As it happens, I know a person who is involved in evaluating these adverse events. He’s not a horned devil out to slay your daughters. He’s a physician and scientist who cares deeply about his role in ensuring the safety of the vaccine, for both professional and personal reasons. So if your next instinct is to “attack the source”, please remember that there are actual people reviewing these adverse events, and these are people who care greatly about ensuring the health of their own children and their community. If you’d like more information on the limitations of VAERS, Karen Ernst over at Moms Who Vax wrote a terrific summary of the problems.
Q. Who prepares this table?
A. The originator of the Table of Doom is allegedly Janny Stokvis, who refers to herself as an ”HPV Vaccine VAERS researcher and analyst”. I was not familiar with Stokvis’ body of work so I first headed over to PubMed to investigate her scientific publications. Unfortunately this was not very fruitful as the only pub by any “J. Stokvis” was a single 1987 article that appears to have nothing whatsoever to do with vaccination. So I employed the more prosaic technique of Googling and discovered that Stokvis describes herself and her partner in misunderstanding HPV vaccine as follows:
“…we’re not scientists, medical specialists or journalists. We consider ourselves professors in everyday life and even more, we’re mothers”.
Well. Okay then. I respect mothers. Really, I have one myself, and she’s just great (she also happens to be a medical specialist, but that’s beside the point). What I don’t respect is mothers who either deliberately or through a massive misunderstanding of the data are consistently misleading others about the safety of HPV vaccine. I can’t help but wonder if Ms. Stokvis really and truly does not grasp what is wrong with the Table of Doom, and if perhaps it is simply being misused by others for their own agenda. Either way, the Table of Doom is at best useless and at worst a danger to public health. The next time someone presents you with it, ask them how the rates of any of the events compare to those in the general population, and listen for the crickets.