Sawbones: A Marital Tour of Misguided Medicine - Sawbones: The HPV Vaccine

Episode Date: August 30, 2019

A vaccine that can practically eliminate a type of human cancer should be cause for celebration across our species. Would it surprise it to learn that some people don't trust it? ... Probably not at this point, huh? This week on Sawbones: The HPV vaccine. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talkies about books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We were shot through the broken glass and had ourselves a look around.

Some medicines, some medicines, the escalant macaque for the mouth. Wow! Hello everybody and welcome to Saul Bones, Emerald Tour of Miss Guy at the Medicine. I'm your co-host Justin McRoy. And I'm Sydney McRoy. I'm Justin McRoy. Still. Still. Consistent. That's what people want in a podcast host consistency. To remain Justin McRoy throughout the entire podcast. Observe me or do not observe me, I am still Justin McRoy. Justin, I have a story for you. Are you ready?

Yes. You don't say, I mean, you didn't respond. Like you didn't say, great, or woohoo, or I love stories. The idea that I would hold a story from you is beyond comprehension. I just thought that was the same. Uh-huh. This story was from Riley, my sister.

She told me the other day that she was driving a van full of fellow college age students and they were discussing a vaccine and whether or not some of them who had not yet received the vaccine should get the vaccine. And she shared with me this disturbing story of one of the students telling everyone else that she knew this vaccine was secretly dangerous, and if they hadn't gotten it already don't, because there were all kinds of side effects that people didn't know about, and we're hidden, and you shouldn't get it. Now, if you're a long time listening to Sub-Ens at this point, you probably guess where we fall on this, but I'm eager to hear more.

Well, I mean, I suppose... No, there's just nothing. I always try to see the other side of things, but there's not here. There's not another side of this. They were discussing, as you may have guessed, the HPV vaccine. Now, I will say, today, in 2019, I could have been talking about any of the vaccines. Hard-breakingly, yes. Sadly, all vaccines have been called into question by people who don't know anything about

vaccines. They are still, by the way, safe and effective. Trust everyone who knows anything about vaccine. Trust us. Still great. Hey, listen, go by the t-shirt on McLeod Merch dot com. It says vaccine saving effective since I think 1796. We just actually donated, I mean, we didn't, you all did, but buying the shirt $2,000 towards vaccine awareness. Education and combating exactly this kind of

misinformation that threatens public health and safety. as well as the health and safety of the college students inside the van that my sister was driving. Yes. So I want to talk about human papillomavirus HPV and the vaccine because even though it doesn't have a, it's not a very old history that I want to go through. Like in our lifetime, right? I mean, I don't. The vaccine is in our lifetime.

The history of HPV is well, obviously. The four-hour lifetime. Right. But I feel like of all the vaccines, this one, and maybe the flu vaccine, these two are the ones that people want to debate the most. Everything else, it's kind of, it's like an all or nothing. They're either all in or all out. But these

are the two that I'll find even like the most staunch vaccine advocates will for some reason hesitate when it comes to the HPV vaccine. And there is no reason to do that. And so I thought it was worth talking about because the vaccine to prevent high risk types of human papilloma virus is really a landmark vaccine. Do you know what differentiates it from other vaccines, Justin? Uh, well, no. In a good way. This is in a good way.

Oh, okay. What it can do that most, that other vaccines really aren't aimed at doing, it can prevent cancer, which is, you know, a big deal. Seems awesome to me. Right, we live in a time where we still, while we do have some effective cancer treatments, we don't have a one-shot cure for cancer. We don't have a, you know, works every time, every cancer, every stage way. We still, there's a lot of unpredictability and a lot we have to learn.

And so something that could prevent cancer before it starts, I mean, when the HPV vaccine first came out, this should have been like a triumphant moment in human history, where we all came together and held hands. Cumaia. Brought our young people, because this vaccine is targeted, mainly in children, although we'll get into the more than children can get the vaccine brought all of our children to their doctors immediately to get their vaccines and then cracked open a bottle of like sparkling grape juice

because kids for the kids and celebrate but that didn't happen because of a lot of misinformation and probably some sex stuff Because of a lot of misinformation and probably some sex stuff. HPV is responsible for almost all cases of cervical cancer, which I think we most people have heard by now. Yes. Most people have heard that. I would hope you would know that at this point.

It is. It's also responsible, by the way, for 95% of anal cancers. Yeah, don't know that stat as much. You don't know that brought up as many times. People, when the vaccine was released, it was really targeted at preventing cervical cancer, even though it was, we'll talk about it, is not the only cancer that the vaccine can prevent. That was kind of the big marketing angle, I would say.

HPV is the most common, sexually transmitted disease, and more than 79 million Americans have human papilloma virus, and most people have no idea, because it's one of those viruses that can just be there and not necessarily do anything to you. There's not a reliable test that we do for HPV. It's not like I can just go like give you a quick HPV screen and tell you whether or not you have it. There are a lot of different types. There are a hundred types of HPV. And when we're talking about human papilloma virus and HPV, most people think I'm trying to use those terms, I'm trying to use them interchangeably

enough that I can just say HPV for the rest of the, is that okay to do? I think that's fine. Is that fine at this point? I was trying to reiterate that enough so I can just say HPV for the rest of the, is that okay to do? I think that's fine. Is that fine at this point? I was trying to reiterate that enough so I can just say HPV. There are about 60 that just cause warts on non-genital places. So if you have a wart on your finger, that's caused by an HPV, a human papilloma virus. But I had warts on my finger before I was, if I may, sexually active. Well, that is because Justin, not all types of HPV are sexually transmitted.

The types that cause a word on your finger are just from touching things. War. With the virus. Frogs, right? I know that much. No. No. Not frogs.

Darn it. Other warts. Or other people who have the virus. It's spread by contact that isn't necessarily sexual. Now, there are 40 that are sexually transmitted and can cause various manifestations in the genitals. The lower risk things, like specifically, strain 6 and 11, and these numbers aren't super important until we really get to the vaccine, which is why I mentioned them, but the lower risk strains cause about 90% of general warts.

So general warts are not, they don't develop into cancer, almost ever, almost ever any kind of war like growth is gonna develop into cancer. So that's what we call them low risk. It's important to establish that because so many people have HPV. I don't know if people think it's like a death sentence.

No, no, no. And certainly not if you have genital warts. Genital warts, they often, like they're the little wart light growths that often look like cauliflower, which a lot of warts can, you know, outside of the genitals, they can start to get that appearance. They show up weeks or months after you've had sex with somebody who was also infected if you, then if it was transmitted. And they're usually treatable through other either mechanical methods like removing them

or their medications and that kind of thing. These were not the reason I would say for the development of the vaccine. While they are, I mean, most people don't want to have them. They're not life threatening. Right. They're certainly must much worse things, you know, like the high-risk strains. Most. What's your genital model in which case they could be livelihood-threatening? Well, that's fair.

You know? That's fair. And I mean, I shouldn't downplay that. There's a lot of personal, like, there's a lot of stigma associated with any kind of sexually transmitted infection. And so there can be a lot of self-esteem issues and body image issues related to them, even if they're not necessarily painful or causing you to have a genital war. Sal buns has been very clear about this from the beginning.

I don't want to downplay the impact that can have on your quality. The high risk strains are what we're concerned about when it comes to cancer. So mainly 16 and 18, there are some other high risk strains that are less common and less likely to cause cancer but are out there. And they cause about 70 percent, that 16 and 18 alone cause 70 percent of cervical cancers. And then when you add in all the other ones, the majority of cervical cancers come from this. Cervical cancer is the second most common and fifth leading cause of death of people who have cervixes worldwide. That's terrible.

It's a big deal. It's a big problem, and not just cervical cancer can be caused by human papilloma viruses. P-niocancer, anal cancer, vaginal cancer, vulvar cancer. And then one that is often not mentioned, a lot of people associate it with different, like with the genitals, you know, with everything below the waist, but they're aurofrangial cancer. So cancers in the back of the mouth, like the base of the tongue or tonsular cancers, there are cancers that you can get there from human papilloma viruses. So you don't have to have a cervix to be

concerned about this. Right. Fair. Now, the this idea that a cancer could be caused by a virus first originates in the 1950s and 60s. We, prior to that, you wouldn't necessarily assume that, right? Like, we didn't know what caused cancer. But it's a big jump. Because you would think the idea that a certain thing could do two things that seemed unrelated, I think, would be a complex idea for us now, even today.

Let alone way back in the anus of history. It really, I think when you read stories like this, it's a testament to how, while you need, I talk so much about evidence in fact, and like the scientific method, but I think that all science is aided by having some creativity, some imagination, ability to, yeah, lateral thinking.

And then apply the scientific method to those ideas to get to the truth. But I think that is how that led people to begin researchers in the 50s and 60s to begin to notice a strange observation that if you looked at the age at which people started having sex, their first, you know, sexual encounter, cervical cancer seemed to be more common among people who had their first sexual experience at a younger age and had a higher number of sexual partners, which started to connect the dots where is this some sort of, you know, contagious thing? And that was weird, the idea, I mean, cancer isn't contagious. Why, I mean, why would we be seeing this?

You can't catch cancer. The only alternative is that too much sex gives you cancer. Right, which it does not. We did not go that route, thank goodness. No, no, and I am not saying that. I am not saying too much sex causes cancer. I would never say that. But it began to, this is, you know, it's funny because you've got to look at like,

as our microscopes got better, and we started to understand first germs were a thing, and bacteria were a thing, and then we could see smaller things because viruses are smaller and so then eventually we saw viruses. And so then in that, like that's already in the cultural kind of concept among all the scientists and all the sudden, wait, cancer being contagious, no, but you know what is contagious, a virus would be contagious. And this is where we get to German virolog, Harold Zerhausen, who had already noticed an association between a different virus, Epstein-Barr virus, EBV, which can cause certain kinds of cancer.

And I want to be very clear, this does not mean that if you had mono or have mono or have ever been diagnosed with mono or EBV that you were a risk for cancer. Much like HPV, there are many with mono or EBV that you are a risk for cancer. Much like HPV, there are many different types of EBV. So I just want to, a lot of people have heard of EBV, and I don't want you to freak out when you hear that. But he had noticed these associations, and so he started thinking, I wonder if there's something here with the cervical cancer cases. I wonder if there's some similar kind of... There's a correlation there, maybe it's the same thing.

Yeah, maybe there's connection. And the thing that got him interested in specifically papaloma viruses, because we already at this point knew of the existence of these wart viruses, the viruses that cause war on your hands and the viruses that were causing war on the genitals, he had heard through some different researchers that perhaps there was a higher rate of

this cervical cancer among people who also had genital warts. If this correlation existed, it's interesting because I guess if it did, it would just be that they would be infected with two different strains. Oh, because it doesn't cause. The strains that cause genital warts are different from the strains that cause cervical cancer. I don't think we clarified that. That's good to know. But there was this correlation. And I mean, maybe we're talking about people who are exposed to multiple sexual partners or something, you know, who knows what this group of this cohort was. However,

they got this idea, it turned his interest to papaloma viruses. And there was some research from the 30s that suggested that there was a certain type of papaloma virus that caused both warts and cancers in rabbits. And so this led him to investigate papaloma viruses. And so he started out first with HPV6, which is one of the ones I've already mentioned can cause warts and he came up with nothing there, right, because as we already covered, it caused the warts, but it didn't cause cervical cancer. So he started there and that led him to check other strains of HPV. And he

finally was able to, in 1983, connect HPV 11, string 11, with some cases of cervical cancer. But that wasn't enough. That was good. It was, it was intriguing evidence. Researchers all began to turn their interest to HPV, but it wasn't enough to, you know, say that this was causation. So he went on next to study different types of HPV, specifically HPV 16 and then 18. And that was really when he, you know, struck gold from a research perspective. Because now he had stumbled upon the two types of HPV

that are linked with the majority of cervical cancers. I have a question to ask you, and you may not know the answer, but why is it called the human papilloma virus? Doesn't that go that saying? Usually when you see a human whatever virus, it's because there is also a similar type of virus that can only infect some other species other than humans. In this case, bo, papilloma virus is a thing. So that's cows.

I know. Yeah, I know that. I don't know medical stuff, but like I know about that. You look, you had a blank look that you knew. Well, in my head I was thinking about, well, we should just call RIS papilloma virus and call RIS bovine papilloma virus because we get to name everything.

Seems weird to put, but I see how that's a bit, that might be confusing for people because then if you don't say human then if you're at like a dinner party with a bunch of nerds if you say Pavolomavirus then they'll ask you excuse me are you speaking of the human Pavolomavirus or different strength of the bovine? Yeah well funny joke and here's a funny 15 minute anecdote about both on papaloma virus. I am going to get into both on papaloma virus before this is all over but no I would say that that's probably more related to the fact that at least from

my perspective the more you study science the less convinced you are of the superiority of the human race to all other species on Earth. Okay. And so I think that just taking papaloma virus and assuming human is a level of ego, I don't know that we're worthy of. Is that fair? Fair enough. Okay. So anyway, he once he turned everybody on to this idea that linked HPV to cancer.

There were people all over the world started doing the same studies. And first, there were studies from 22 different countries that linked 93% of cervical cancer to HPV. And then in 99, they did a bigger study and eventually came up with 99.7% of cervical cancer samples that they checked in this study Contained HPV. That's why almost every single case of cervical cancer came from HPV So this was this was a mom. This was when we finally said this is definitely yes Yes, we have we have done the research, we've proved it, there are lots of different kinds of HPV, they they zeroed in on the ones that were responsible for

most cancers and were most dangerous to get. And then we begin to understand other other things about this that even if you have a high risk HPV, you might like you might test positive for it, but not everybody gets cancer from it. That's an important thing to know, right? Because I've already said so many people have HPV. You'd think, well, everybody would be getting cancer from it. Well, no, because even if you get 16 or 18, one of the high restraints, sometimes your body clears it.

Sometimes you will develop some pre-cancer lesions, and then that will clear up on its own. And we know all of these different things, the way we learned all of the kind of the stages, how does it go from, I got the virus in my body to cancer, what all is involved in that transition. We learned a lot about that because of Dr. Papinacola and his famous smear. We've already talked about him. We did a whole episode about the rap smear. We're not pivoting into a long section about Dr. Peppinacola. No, but then this led to once we once we had the development of

the pap smear we could take all this information where we connected HPV to cervical cancer and learn a lot more about you know this transition from one to the other. And it's worth noting that in 2008, Zerhausen won a Nobel Prize for this connection. So this is great. Now we know that the majority of cervical cancers and some other cancers are caused by HPV. We know it.

We know which strains. And we've got a pap smear. And if we use pap smeers, well, as a screening tool, if people get their pap smeers, everyone who should get one, if they get them when they should, we can detect early changes that indicate a cancer could be brewing, and we can prevent deaths from cervical cancer. And that is exactly what happened with the pap smear. We prevented, we caught a lot more pre-cancerous lesions than we prevented deaths. And this was all excellent.

But what's better than catching cancer early and preventing it from progressing? Stopping it in the first place. That's right, Justin. And I'm gonna tell you how we did that. But first, let's go to the billing department. Let's go. The medicines, the medicines that ask you

let my cards pour the mouth. Cindy, you were going to tell me about our battle against HPV. So as I already mentioned, bovine papilloma virus was kind of the early, one of the early keys to our success and in creating a vaccine against human papillomavirus because we had been in the veterinary world, our veterinary colleagues were looking for a vaccine to protect cows from getting, I guess, BPV because it can cause

tumors since like the 50s. And all of this kind of body of research that already existed to try to create this cow vaccine was helpful when they started working on a vaccine for humans. The first, they noticed that there was a molecule that was very similar to a corresponding molecule in the human pebble-in-their-16 that could protect cows from getting the bovine form, and that was kind of an early breakthrough.

So they use this cow science and they applied it to humans. Cow science doesn't get enough credit, just because they're too big to wear lab codes. It doesn't mean that cow science should be neglected by us humans. It's egotistical. I like how much you people ever seen the far side. That's true. Those cows are doctors, scientists and all kinds of different things. I like this science because it was altruistic on both counts.

We wanted to protect cows and we wanted to protect humans and we get vaccines for both. If we're going to give credit to some scientists for the vaccine, there were some, there were two docs, two scientists in Queensland, Australia, who, and I mean, this is, it's one of those things, anything, anything, any big discover you can probably find a little bit of controversy over. So the two scientists that are usually credited are Professor Ian Frazier and Dr. Jean-Joh. These two Australian scientists made this great vaccine

and basically after that companies started. This is one of those where I like the stories where we talk about how nobody patented it. They just gave it out to everybody for free. In this case, yes, people patented it and started producing it. But somebody had to make the vaccine. So they started rolling out the vaccine in 2006. The first one came out. That was Gartisill. Okay. I've heard about that. And that protected against strain 6 and 11 that caused the warts and 16 and 18 that can cause cancer.

In 2007, another vaccine, kind of a competitor came out from a different company called Cerberix that only protected against the cancer causing strain, 16 and 18. And the reason is it was more just like, they thought, one, at first they thought it was a little more effective than Gardasil. And two, they were targeting the real what they kind of considered through a problem.

I think in most places, Gardasil has overtaken cervix due to cost effectiveness issues. They're both very effective, I should say. And then most recently in 2014, Gardasil 9 came out, which protects against, it's the same vaccine in that it protects against the original four strains, but it added five more strains of potentially cancer causing HPVs to it. So it's same idea just covers against more strains. Not unusual for vaccines. The flu vaccine you get every year covers against multiple

strains of influenza and it changes every year. So they started vaccine programs in a lot of different places. Australia is one of the early places that they started them. Scotland, Denmark, eventually of course in the US. We started not mandatory vaccination programs, but like routine recommending them, I should say, as routine parts of childhood immunizations. Initially, this vaccine was only recommended for people age nine to 27 who have service, who have a service. Services, right? Services. Okay.

That is confusing to me. Yes. Because everybody, almost pretty much everybody has an anus. And it causes 95% of anal cancers. Yes. Well. It's a great point. Yeah.

And I, I mean, part of it is that the early studies were only aimed at people with a cervix. And there's this kind of, I've talked about it before I think on the show. Even if we know that the vaccine would work in somebody who doesn't have a cervix, if we haven't done the study, we can't just say it. We have to do the study. And the early programs were really targeted at reducing rates of cervical cancer alone. What you're right, I mean, we can argue

that the ethics of that and was excited. Well, the same thing I've heard immunity. I mean, more people vaccinated means, you know, slower contagion rates. Exactly, exactly. And all these reasons are why. And one thing I should note, you also have to remember that because especially when these vaccines are being made

by, you know, for-profit companies, they're also constantly doing cost-effectiveness. And some of the early studies suggested that it was most cost-effective to just vaccinate people with a cervix. But you are right. You're leaving everybody who still has all of the other parts that I said can get cancer from HPV, even if it's rare, because it is rare. Like penile cancer from HPV, that's extremely rare. 95% of anal cancers. Yes. I'm just I mean, we're talking about more rare than cervical cancers would be the I'm not making this argument. I'm telling you what

was in the minds of people who made these guidelines. You're off the hook. I would not make this argument. I would say that the more the merrier and indeed they did do the studies to prove that of course the vaccine is safe and effective for people who do not have a cervix as well, for people with penises, for people with anises, for people with vaginas, people with a vulva, what else did I mention? People with a... People with a vulva. An oropharyngeal area.

So, people who have a mouth and a back of their mouth, that's pretty much, I mean, that's almost everybody. Yeah. That it's good for all those people. And then they did studies further to prove that not only is it not restricted to people with a cervix, it shouldn't be restricted to people under age 27. And when, when we kind of look at that age, like, why was that chosen? Again, you have to look at like risk benefit ratios and cost effectiveness ratios. That's what determined those early things.

The thought was most people by the age of 27 have been exposed to HPV if they're gonna. So there's no point in vaccinating it, because once you've been, once you've had it, they're done well, what they would say is they're done having their sex with new partners and I would say that that's not true and that if you want to get the vaccine after age 27 there's no reason it's dangerous but again we had to do the studies prove that and now it is approved for ages 9 to 45. So they gave a wider dosing range. Since they have started these vaccination

programs, the last numbers I have are from 2017 that said about half, a little under half of adolescents were up to date on their HPV vaccine series. 66% of people between the ages of 13 and 17 got their first dose. I would say that part of the problem with this is the that they're initially there were three doses. Now if you get it before age 15, you can get away with two. That's enough to create immunity. But that was part of the problem. And you will know, the CDC is proud of pointing out

that between the years, 2013 and 2017, the percentage of adolescents who started the HPV vaccine series has increased by five percentage points each year. So it's getting better. And since that time, we've seen results. Among teens with cervixes, infections with HPV types that cause most of the cancers and warts have dropped 86 percent. Among young adults with cervixes, that number is dropped 71 percent.

And when you look at people who have received the vaccine, the percentage of cervical pre-cancer caused by HPV types has dropped 40%. Now, we're not going to see the change in cancer diagnoses yet, because it takes a long time, usually, usually not always, but usually it takes a long time from the moment you're infected with a high risk strain of HPV to when that actually becomes cancer. And so, we're going to have to vaccinate a generation and then watch that generation grow up and see rates of cervical cancer among them before we're really able to see the full impact of the vaccine.

So if you see, I saw one study that or one headline, I should say not study, that suggested that rates of cervical cancer are still going up despite the vaccine. And it, yeah, that may well be true, but we're not seeing the effects of the vaccine yet. Right. So what, why is this contentious and? I think part of it are normal vaccine fears, right? Right now we are going back in terms of our, I don't, enlightenment.

We're re-entering at dark ages of sorts or we're in the midst of one where science has been called into question based on this general mistrust of everything, this idea that there is no truth that all is opinion. And so you're seeing a lot of concern about like, it's a vaccine and vaccines around natural and vaccines have secret chemicals and all those, all that propaganda that is completely false and, you know, that's hard to disrupt just because it's just wrong and it's hard to say anything other than that. I think that's part of it.

I do think that the sex thing is the other part of it. HPVs, the HPV that we're concerned about is sexually transmitted. And in my personal experience, the protests that I usually hear are, but my kid doesn't have sex. Right. And that's the whole point of why we vaccinate so young. So generally speaking, you can get that starting at age nine, it's on the vaccine schedule usually around 11. That's when most of our patients, we recommend the vaccine to them, age 11. And I think it's fair to say that at this point, at least in the US, the majority of 11 year olds are not sexually active.

Right. And that's exactly why we should give them the vaccine. Right. Because once they've become sexually active, they could have been exposed to one of these strains of the virus. Right. And if you've already been exposed, it's too late. I mean, I would still recommend the vaccine because there are other strains in it, but

we can't protect against that one now. Well, it's if you I mean You would be if you wait until your child is of a sexually active age You're putting him in position where it's like well now we have to talk about like before your sexual act to make sure you come talk to me About it so we can make sure to get you the HP.P.A. vaccine. Like no, no kid is going to do that on Earth. It's a very strange thing to me because if I, I've tried to walk down that road and say, okay, but what if you knew your kid was going to start having sex tomorrow? But they won't. That's usually the response I get.

And there's, and some of that is coupled with this idea that if we start vaccinating everybody against sexually transmitted infections, they won't be afraid of sex and they're more likely to have sex. I think we know there's tons of data to say that's not true. It's the same idea that if you give people access to birth control or you give people access to abortion care or you give people access to condoms that they're going to be more likely to have sex and that's not true. They're more likely to engage in safe sex and they're less likely to get sexually transmitted infections in these cases. That's what the statistics have borne out. People are either going to have sex or they're not and getting a vaccine is certainly not going to make that difference. Some of it is I just think parents don't want to have that conversation.

It's another vaccine. Their kid's going to fight them. They don't want it. They're not having sex anyway. I don't want to worry about this right now. Please just, I don't want to talk about it. And then part of the fault is us, healthcare professionals, doctors. Not you and me.

No, well, me included. I'm a doctor. But not me. But what they found is that doctors tend to because of all these issues, they tend to spend less time discussing HPV vaccines. We tend to throw it to the end of the conversation after we've talked about a T-dap or a meningitis vaccine or a flu vaccine. The last thing we want to do is the HPV vaccine. And we are not as staunch advocates for it. Even though

we know it's safe and effective just like all the other vaccines, we don't sell it as well. I mean, there's data to support this. It's like you're pitching the clear coat right when the person is trying to take their new car off the lot. No, I'm not getting the windshield insurance and not getting into that. Just, just, please let me go. A lot of the, they when they asked parents why they refused to let their kid get the vaccine, a lot of their answers were that they really didn't know much about it or they didn't think it was necessary. I mean the the or the their kid wasn't going to have sex.

The last fears were safety honestly. And that was on the list. I'm not saying were safety, honestly. And that was on the list. I'm not saying they aren't fears. Safety concerns were on the list, but it doesn't seem to be that people think it's more dangerous. It seems to be all this other social stuff around it that is the big, one of the big barriers. In terms of the safety stuff that is arisen, because there's a lot of, I mean, it's just, frankly, it's misinformation. It's untrue. There are no increased risks with the HPV vaccine compared to any of the other vaccines that

you get in your routine childhood vaccination schedule. The most common reactions are the same as literally every shot you're ever going to get. Pain, redness, swelling at the injection site. There were some early concerns that we were seeing a slightly higher rate of people passing out when they got it, like when they got the vaccine, because that's always a risk, right?

When I take your blood, if you see blood, if I stick a needle in your arm, some people pass out, it's a vasovagal response, some people just do it. I'm glad I didn't or med school would have been hard. But there was a concern initially that was there a higher rate. Even that does not, has not been born out by the numbers. We still warn that when I give the vaccine,

I still say after we give it to you, we're gonna have you sit here in the office for a few minutes, don't stand up right away. Just make sure you're feeling okay, you're not lightheaded or dizzy, simply because we don't want people crashing to the floor. But nothing dangerous. There's no other, anything else you read is entirely unfounded. The HPV vaccine has proven since its inception to be safe and incredibly effective in preventing cancer, which is revolutionary landmarks should be caused for celebration. I mean, I personally gave my sister Riley one of her

Gartasil shots, one in her series. I personally administered it to her at the office because she was so scared. I would do it for myself. I would do it for my own children when they're old enough. I would recommend if you have somebody in your family who is anywhere from 9 to 45, they can get the vaccine. I want to get me one too, Sid.

You can get it, Justin. You can get it now. Let's go. Let's wrap up this episode so I can get my guard. Really? Still get your pap smears. If you're someone who should get a pap smear. Hey, fine. That's going to be a longer conversation, but I think they, I mean, I'll try. I always like to throw that caveat in there. A lot of people ask, like, well, once I get it, do I not have to get pap smear? No, because as I mentioned, even though it is incredibly effective at preventing cancer, it is not 100% effective.

And so it is still worthwhile to get your pap smeers. But we're, you know, the thing is like things will change as we hopefully see a higher and higher rate of people receive the vaccine and we see lower and lower rates of cancer as a result. So there's no reason to be scared if you have people who are scared refer them to this episode. Get the vaccine. Well, it's sorted all out. Folks, thank you so much for listening to our program. We hope you have enjoyed yourself. We really appreciate you tuning in every week. If you like our show, it'd be great if you could head on over to iTunes or wherever you listen to podcasts and leave us a rating or a review. It really does help the show and it'd be super nice if you would take the time to do that. We have a book called The Sob Un's Book,

you find it bookstores and Online Bookstores. There's a kind of version. There's an audio book version. If you want to listen to us read the book based on our podcast in a truly metamoment. Thanks to the taxpayers for these, so there's some medicines as the intro and outro of our program.

Sydney. I want to thank one, whenever I find an article that was particularly helpful in putting together an episode, I like to thank the author, Emma Smith, who wrote a comprehensive history of HPV in the vaccine and lots more than I included in this episode. But thank you for doing all that research. I'll Google that.

I'm sure they can find that piece and check it out. Folks, that is going to do it for us for this week. So until next time, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't Joe, hold in your head. Alright! Yeah! Maximumfun.org Comedy and culture Artist-Oant? Audience-supported.