Wart’s that you say? A smidgen of good HPV news

Colby Cosh on new study of Australian visitors to sexual health clinics

Goodbye, genital warts! Can’t say you’ll be missed! A new study of Australian visitors to sexual health clinics reveals that vaccines against the most dangerous forms of the human papilloma virus (HPV) are turning out to be very effective at eliminating genital warts—so much so that it is actually a bit mysterious. In 2007 Australia introduced a program of free(-as-in-beer) HPV vaccination for schoolgirls aged 12-13, with optional free “catch-up” programs available to older girls and women. This effectively created the conditions for a controlled experiment: Australia now has an under-21 age cohort in which there was near-total vaccine coverage in the populace, a 21-30 cohort that is somewhere around 50% covered, and a 30-plus group among which almost nobody has had the jab.

The clinics, which are all over Australia, were instructed to record incidence rates of genital warts among patients visiting for the first time. As you can see if you peek at the tables, the rates have stayed the same amongst the unvaccinated oldies and have plunged in the younger populations. It’s not just the women who benefit in this regard (while receiving hypothetical protection from future cervical cancer); the incidence rates dropped among younger men, thanks to herd immunity, and even declined significantly among gay men. It is not as though Australians have stopped having sex, as the matching incidence figures for chlamydia suggest. In fact, they suggest that they’re probably at it a bit more. (And why wouldn’t they be, what with everybody having much tidier genitalia and all?)

Most remarkable is the finding (see Figure 2) that genital warts have disappeared altogether among those in the youngest group of women, those almost universally vaccinated in early or pre-adolescence. For the year 2011 there were 235 patients; 235 were wart-free. In the words of the authors, “We were surprised by this finding, as some of these women probably had only one or two doses of vaccine, and false positive diagnoses are always possible.” The vaccine is designed to suppress only strains of HPV thought to cause most genital warts; the docs speculate that either “most” was actually “all” all along, or that the vaccine is knocking out other strains it wasn’t engineered to fight. Either way, this is probably an auspicious leading indicator when it comes to the ongoing cancer-prevention powers of these “quadrivalent” HPV vaccines.

If you check the footnotes of the study, you can see that these researchers are probably quite delighted to have arrived at these conclusions, since some of them are cozy with Merck, makers of the Gardasil HPV vaccine. No doubt this study has been spun to create the greatest possible sensation, but there are plenty of urogenital specialists in Australia; an “absolutely no young people anywhere are turning up with warts anymore” finding is the sort of thing that wouldn’t be accepted if it weren’t close to the truth. Big Pharma is obnoxious in many ways, but we must give the monster its due when warranted.