The CDC and HPV Vaccines – Science or Shameless Promotion?

By Norma Erickson

During the last two weeks, it seems every time you turn around you find a news article singing the praises of HPV vaccines. It all started with a paper entitled “Prevalence of HPV After Introduction of the Vaccination Program in the United States” co-authored by Markowitz, Liu, Hariri, Steinau, Dunne and Unger of the CDC ^[1] that has been widely quoted to promote HPV vaccination among the teens, claiming “HPV vaccine more effective than expected”. ^[2]

It’s all well and good to quote the newest CDC publication, but one would expect any journalist worthy of their title to at least read and perhaps even analyze the original before making such bold statements as the one above.

You see, careful reading of the article revealed the following misrepresentations:

The authors claimed the “HPV DNA prevalence was analyzed in cervicovaginal specimens…”  In fact, in the Methods section they disclosed that the women who were examined in a mobile examination center (a van) were asked to self-collect a cervicovaginal sample.

However, in real life the average American woman cannot collect any uterine cervicovaginal epithelial cells at the transformation zone where the “cancer causing” viruses are known to infect. Think about it ladies, when was the last time anyone (other than the CDC) asked you to collect your own Pap smear sample? Therefore, this is false claim 1.

The authors claimed “The surveys are designed to be nationally representative of the civilian, noninstitutionalized US population.”

However, average American women are usually examined in a board-certified gynecologist’s office, not in a van; the cervicovaginal specimens are collected with a Pap smear brush through a speculum, not a Q-tip. This is false claim 2.

In the Methods section, the authors stated “In 1999 to 2006, Mexican-Americans, non-Hispanic blacks, low-income non-Hispanic whites and others, as well as adolescents aged 12 to 19 years, were oversampled.” “In 2009 to 2012, all Hispanics were also oversampled and in 2011 to 2012, Asians were also oversampled.”

It is well known that prevalence rates of individual HPV genotypes or subtypes among different ethnic groups of a population are different. Therefore, to compare the data obtained in the groups of women in 1999 to 2006 with those obtained in the groups of women in 2009 to 2012 is meaningless. It amounts to “comparing apples and oranges”.

The paper states, “Dr. Unger assisted with study design, supervised laboratory testing, and reviewed and revised the manuscript”; and the “extracted DNA was tested by using the Research Use Only Linear Array HPV Genotyping Test (Roche Molecular Diagnostics, Indianapolis, IN)…”.

LINEAR ARRAY® is a trade name of Roche’ Line-blot assay.^[3] In a WHO-conducted HPV genotype detection proficiency survey, only 8 of 17 sets of data based on Roche’s Linear Array were found to be 100% correct and 6 were considered not proficient. ^[4] Dr. Unger was a coauthor in an article published in 2000 which found “the concordance of the detection of HPV types between cycle sequencing and the line blot assay was moderate (kappa value, 0.51; 95% CI 5 0.46 to 0.58). ^[5]

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Therefore, the authors knew or should have known that their genotyping results were not reliable, and the difference in any two sets of data could have been due to faulty methodology.

So, did the CDC authors of this publication write it as a genuine contribution to the medical and scientific community; or was the article ^[1]simply written to promote the sale of a publicly rejected vaccine with an unproven ability to prevent cancer and a demonstrated ability to cause serious adverse reactions?

References:

[1] Markowitz LE, Liu G, Hariri S, Steinau M, Dunne EF, Unger ER. Prevalence of HPV After Introduction of the Vaccination Program in the United States. Pediatrics. 2016 Mar;137(3):1-9. doi: 10.1542/peds.2015-1968. Epub 2016 Feb 22.

[2] CDC: HPV vaccine more effective than expected http://www.upi.com/Health_News/2013/06/20/CDC-HPV-vaccine-more-effective-than-expected/20531371775926/

[3] LINEAR ARRAY® is a Line-blot assay.  http://molecular.roche.com/assays/Pages/LINEARARRAYHPVGenotypingTest.aspx

[4] Eklund C, Forslund O, Wallin KL, Zhou T, Dillner J; WHO Human Papillomavirus Laboratory Network. The 2010 global proficiency study of human papillomavirus genotyping in vaccinology. J Clin Microbiol. 2012; 50:2289-98.

[5] Vernon SD, Unger ER, Williams D (2000). Comparison of human papillomavirus detection and typing by cycle sequencing, line blotting, and hybrid capture. J Clin Microbiol 38:651–655

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