How Safe is the HPV Vaccine?

I was about to say that I'm just one of those people who understands things more fully once I see them in visual form, but I think that, when it comes to statistics, "one of those people" really just means "most of us".

Case in point, this great visualization of the facts about HPV vaccine safety and cervical cancer risk put together by the Information is Beautiful blog. For me, this really bridged the gap between knowing the facts and intuitively understanding them. Follow the link to check it out.


  1. This is really great, it really gets the point across. It would be awesome if they did this for all vaccines. I am glad I got the HPV vaccine

  2. It’s also important to keep in mind that many of those side effects have nothing to do with the content of the shots but are really a side effect to a nervous person receiving a shot.

    I’m also put off by the “lifetime risk” – it implies that the vaccine itself can cause a death which as far as I know is not the case. Is there a causative link that’s known? (As distinct from correlative?)

    Also, your image resizing could use some help.. I like to use Irfanview to resize pictures – go into the resize dialog and use “resample” with the Lanczos (slowest) filter. It’s still really fast, and the resultant images are really clean.

  3. The problem in these risk calculations is that the vaccine only works on four strains of HPV. There are tens of strains, and while those four are particularly dangerous and problematic- and good riddance to them- there is no change in behavior on the part of the host. As a result, those four strains that predominate will replaced. And then, of course, the company gets the patient’s insurance company to pay for three more shots once the new, improved vaccine comes out.

    All of this to prevent about 4,000 deaths a year (in the US) from a disorder that is routinely managed with regular PAP tests- the need for which is not obviated by the vaccine. How many individuals will skip their PAP test thinking they don’t need one is unknown.

    It is a useful vaccine, but- given individual behavior- it’s unlikely to make an appreciable change. The cost of the vaccine ($360 for 3 shots) times the number of girls who will receive the vaccine (over 23 million doses in the US alone, for ~7 million treated) to prevent 4,000 cases of cervical cancer = $630,000 per case of cancer prevented- and that’s a conservative estimate, assuming all 4,000 cases of cancer would be prevented with only 7 million children treated with Gardasil.

    Compared with other programs to prevent early death, that’s a very, very expensive program.

  4. I’ll second what dculberson said, the image is quite illegible here. Though maybe that is the point and we should all go read it on Information is Beautiful…

  5. Any idea if the HPV vaccine works on males? Some of my male friends have contracted genital warts and have complained how horrible it can be (albeit non-cancer-causing in males).

  6. Ian70, it was recently approved for use in males. There may be a cut off age for men as there is for women, though. Apparently after the age of 26 the chances are already so high that you already have one or more of the viruses that it’s not worth immunizing people.

    I got the vaccine just before I reached the cut off age, at the insistence of my NP mother. I had a HORRIBLE reaction to the second shot, with joint pain (starting in the arm where I got the shot and eventually spreading to all my major joints) for over 3 weeks. I consulted my doctor on that, and we decided that since I did eventually recover from the joint pain that I should have the third shot, and if the pain returned we would report it to the vaccine maker. Luckily the third didn’t have any side effects.

  7. re: Effectiveness of the HPV vaccine in boys (@Ian70)

    1) Gardasil has recently been approved for boys/men 9-26 years. WSJ blogs article here: .

    I assume the next update to these charts will include the 0% chance of cervical cancer among that population ;).

    2) Paraphrasing 3rd Paragraph of above article: ‘It has not been shown [though no negative results exist either, I would guess] that vaccinating boys reduces the risk of HPV badness in either gender’.

  8. It’s faintly possible that vaccinating guys would have an affect on rates of penile cancer. HPV’s cancer-causing properties (basically a wart gone out of control after some hefty changes to the viral genome) can occasionally cause cancer on the skin of the penis. It’s extremely rare though, so you’d need to treat an enormous number of guys to make a difference to the stats. It’s also very seldom lethal – because it’s on the surface it’s both easy to spot early and easy to remove threatening-looking growth – so even if the incidence was changed by vaccination, you probably wouldn’t save enough extra lives to notice.

    1. But men are part of the chain of infection; women aren’t being infected with HPV out of thin air. So even if it makes no difference to male mortality, vaccinating men could still save lives, especially if female coverage is much less than 100% thanks to vaccination scares.

  9. This type of graphical representation is excellent, but the previous comment has hit the nail on the head. The “risk of dying” from the vaccine is zero unless a causal relationship has been demonstrated. It would be more accurate to represent the “risk of dying from the vaccine” equal to the “risk of dying sitting on your a$$ in front of the television set doing nothing”… hold it, the latter is probably higher.

  10. I did a research paper on cervical cancer as part of my PhD work last spring. Interestingly, HPV has been implicated in some THROAT cancers (i suspect you can imagine how a papilloma virus could get from genitals to throat.) Most throat and neck cancers are, I believe, caused by smoking, but there is a possibility that the same mechanism that makes viral proteins oncogenic in the epithelial cells of the cervix would work on the epithelial cells of the throat.
    Particularly since these viruses can be passed from skin-to-skin contact (rather than just through bodily fluids), making condoms only somewhat useful, I say, “Hooray vaccine!”

  11. Good on getting it approved for men– I suspect that it’s an easier sell explaining to parents that you need to give their boy the vaccine because he’s a super-stud than you need to vaccinate their precious, angelic daughter whose knees are sealed tight as if by magnetism and the Word of God, never to be parted ’till marriage.

  12. 1. HPV causes penile cancer (in uncircumsed) and anal cancer (esp in G/B men). Ewwww – Vaccine please!

    2. The papillomaviridae are coming up in skin, head and neck cancers, and have been detected in melanoma (though we’re not sure if they are just bystanders or actually pathogenic).

    3. I LOVE intuitive graphics. Here’s websites for generating proportional Venn diagrams via the Godfather of data visualisation Edward Tufte –

  13. Another little niggler about this is the wee asterisks at the beginning had me wondering. Vaccines distributed by the company. Seemed distributed equates as taken in the stats. How convenient Heck maybe more should be given out in order to make the #’s even lower.

  14. Oral cancers will take almost 3 times more lives each year than cervical cancers in the US. The fastest growing segment of the oral cancer population is HPV16 positive, and that is their primary etiology that brings them to the disease. This is a factor independent from all other causes (primarily tobacco and alcohol). It is currently estimated that about 50% of all new oral cancer cases in the US today are HPV16+. These are predominantly posterior of the mouth cancers. oropharyngeal, tonsillar and base of tongue. There is a panel in the next few days at the CDC looking at this issue as it relates to the vaccines.

    So besides men being vectors of the virus to women, and being one of the reasons that the reservoir of the virus is so large, and the virus so ubiquitous in the US, it is the primary cause of oral and anal cancers, and penis cancers as well. When you tally up all these, (there are others now implicated such as naso-pharyngeal cancers) the costs issues of vaccinating vs. death and morbidity of the disease and treatments starts to be much more meaningful. As to the vaccine and cervical, where it will really make a difference is in other countries, particularly third world countries where they do not do a good job of opportunistic screening for the disease like women do here in the US. As to the other HPV’s that are out there, right now 9 out of the more than 120 out there are known to be oncogenic. Most do nothing that we are aware of, or only cause papillomas (usually benign warts)

    Check out this page from the Oral Cancer Foundation’s web site for additional information. Please note that this foundation has been one of the financial sponsors of the research work at Johns Hopkins that elucidated all this.

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