Why vaccinate for HPV?

A reader emails me this article pointing to a relatively high rate of allergic reactions to the HPV vaccines:

But some experts remain unconvinced, saying policy makers rushed into a pricey immunization program when there is no epidemic of cervical cancer, which can already be screened through regular Pap smears.

In a Canadian Medical Association Journal article last year, four researchers led by epidemiologist Abby Lippman of McGill University urged a more prudent course.

The New England Journal of Medicine echoed similar feelings in an editorial two weeks ago. "With so many essential questions still unanswered, there is good reason to be cautious about introducing large-scale vaccination programs," it said.

Says the reader:

This study on its own won't change your mind, but maybe the drip, drip of these findings will eventually give you pause.

Let's think about this.  Effect of allergic reactions:

The allergic reactions included nausea, itchy red rash, difficulty breathing and other symptoms.

Now let's talk about what happens when you get an abnormal pap.  First, they test for HPV.  If that comes back positive, they microscopically examine your cervix for cancer.  If they decide you're in danger, here are your treatment options:

• Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
• Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
• Radical hysterectomy: Surgery to remove the uterus, cervix, and part of the vagina. The ovaries, fallopian tubes, or nearby lymph nodes may also be removed.
• Pelvic exenteration: Surgery to remove the lower colon, rectum, and bladder. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag. Plastic surgery may be needed to make an artificial vagina after this operation.
• Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy.
• Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
• Loop electrosurgical excision procedure (LEEP): A treatment that uses electrical current passed through a thin wire loop as a knife to remove abnormal tissue or cancer.

The LEEP procedure is the nicest of your options.  It impairs your fertility, is painful, and prevents you from having sex for six weeks or so.  Its used only on early stage cancer.  All the others are worse.

If they don't do any of these procedures, what they do is watch you, with an eye to doing one of them in the future if there are any changes.

Nausea and/or a rash, or hysterectomy?  We report, you decide.