How Safe is the HPV vaccine?

Monday, October 12th, 2009

I’ve been reading a lot about the HPV (Human Papillomavirus) vaccine and the risk of serious side effects and even death. I thought I would seek out the numbers and put them in context. Especially given headlines claiming the HPV jab is “as deadly as the cancer” it seeks to prevent.

How Safe Is The HPV (Human Papillomavirus) Vaccine?

A note about the UK. These are the figures for Gardasil, the vaccine used in the US. In the UK, the dominant vaccine is Cervarix. For which I have no figures. Ben Goldacre explores some important points around Cervarix. Worth reading.

(You can explore my data here. I’ve put the data on three separate sheets inside the spreadsheet. Here are the original source documents from the US Centre Of Disease Control).

If you have any figures on Cervarix or any other facts and sources that can add to this diagram, please get in touch. Thanks!

If you’re looking for information on HPV, Cervical Cancer and immunisation, try these links
: The NHS page on the cervical cancer jab
: General info on immunisation, including HPV


UPDATE 1: I’ve been asked to include the other side of the Gardasil story which is represented by The National Vaccine Information Centre ( – which is a nonprofit, non-medical organization founded by parents of vaccine-injured children.

In contrast to the Centre For Disease Control, the NVIC are strongly anti Gardasil. As evidence, they cite the case reports from the Vaccine Adverse Event Reporting System (VAERS) database. It tracks adverse side-effects of vaccinations across the US. Reporting is voluntary. Studies say it only catches around 10% of side-effects (source: LA Times). Though it’s fair to expect a higher capture rate for deaths.

On that database, the NVIC count 29 Gardasil-associated deaths. I’ve been through the database and pulled out the case reports on those deaths so you can read them for yourself. Download them here.

For extra info, the NY Times has an excellent article about HPV Vaccines here, exploring several perspectives.

UPDATE 2: A few people questioned how I calculated the theoretical odds for dying from Gardasil, as the numbers don’t seem to match. Yup, fair enough. I wasn’t really clear about that. Essentially, the numbers at the top of the image (20,400,000 doses etc) are not used to calculate the odds. Instead, the odds are calculated using the National Safety Council’s method. That is:

population of United States / number of deaths per year

That gives the one year risk rate. Then if you divide that number again by the average US lifespan (77.8 years) you get the lifetime risk. See the risk chart here.

UPDATE 3 I didn’t factor for the fact that women receive up to 3 jabs of Gardasil. So the 20 million doses figures does not necessarily equate to number of people receiving the vaccine. Changing the maths a bit (to assume an average of 2 jabs per person) has altered the numbers slightly on the graph. (Percentage of side effects 0.05% rises to 0.1%. Percentage of serious side effects 0.003% to 0.007%. And so on). Thanks to A for that correction.

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  • Brian

    My close friend came down with severe allergic arthritis within a few weeks of receiving the Gardasil vaccine. After a year of recovery, she is mostly functional again, although she has lingering memory issues and occasional recurrent pain. Her friend is still bed-bound, and nearly completely debilitated after receiving the vaccine. Was the vaccine causative, or coincident, with the autoimmune issues? I suspect that the adverse events reporting system is not equipped to deal with reports like these.

  • Joreth

    Well, a vaccine prevents you from getting cervical cancer, while a pap smear only tells you once you have it (or dysplasia). Personally, I’d rather not get it at all. I’m not so much a fan of invasive surgical procedures where they hack out parts of my cervix. Also, with the vaccine and the DNA testing of HPV, women could personalize their own healthcare schedule by tailoring their need for pap smears based on their specific circumstances. The pap smear is a physically uncomfortable procedure, and for some women it’s emotionally draining as well. Women who have the vaccine, and are allowed to get regular HPV-DNA tests do not need to have a pap smear done annually, and it can be pushed as long as every 3 years or more.

    When men voluntarily spread their legs, allow cold metal instruments to be inserted, then opened wider to allow a stranger with rubber gloves on to peer inside, scrape the insides with a long Q-tip, then insert their fingers and press outwards on the abdominal cavity, and they do this every year faithfully for their entire adult lives, that’s when I’ll be more willing to listen to them when they casually suggest that an annual screening that tells you after the fact that you have cancer is preferable to a 3-time shot. I’ll still pass and take the shot, but at least I’d be willing to listen.

    Also, the FDA requires at least 7 years of testing before even considering the approval, so it’s not like a bunch of scientists woke up in August of this year and said “hey, how about we sell them some of this stuff I whipped up in the lab last night? I’m pretty sure it’s safe”.

    HPV is also the second-leading cause of head and throat cancers, behind smoking. This affects men and women. HPV is also responsible for some anal and penile cancers, which affect men. Since men do not get screened as often as women do, and since people in general do not get oral screenings as often as women get pap smears, although the cancer rate is lower than cervical cancer, the mortality rate for these other cancers is much higher than cervical cancer.

    And the comment about remaining abstinent gives a 0 percent chance of catching it … STDs are not a punishment for immoral behaviour, and that kind of suggestions implies you think it is. As an atheist, I’m appalled to think that anyone would even hint that we should not research and utilize a method of reducing/eliminating suffering and death of another human being simply because *some* people do not agree with that person’s behaviour. I have a much higher regard for the value of human life than that.

    Everyone deserves a chance at a happy and healthy life, and life-saving, life-prolonging, and life-enhancing measures should be made available to all, regardless of income, race, religion, or even personal life choices. You, sir (or ma’am, I didn’t check for gender), should be ashamed of yourself for implying that people who choose to have a sexual relationship don’t deserve the chance to prevent cancer.

    I’ll skip the part where it’s a completely bullshit premise to begin with, several people have already commented on that. Then there’s the part where we can’t predict which of our teenagers will become adults with low-income and no health insurance or access to regular screenings. So rather than impart upon them the wisdom of regular checkups only to have them be poor as adults and have no means of acting on that sage advice, how about we give them a little preventative defenses instead? That way everyone has a chance, even the poor people.

    • Po

      I just wanted to point out that the vaccines only protect against two strains of HPV, which are responsible for 70% of all cervical cancers. Pap smears are still necessary even with the vaccine and people should still practice safe sex to avoid STDs. The sad thing is HPV can be transmitted with the use of condoms.

    • Chelsea

      Thank you, well stated.

  • Ella

    It would be a wonderful world if we could be guaranteed that everyone else had as high standards as you do. Odds of a partner having a fling are pretty high in today’s world though, so one’s personal fidelity means nothing.

    @J Thomson re:
    Chances of dying of cervical cancer if you don’t smoke and practice abstinence/fidelity: 0

    Chances of dying from the vaccine if you don’t take it: 0

    Seems like a no brainer.

  • blue

    @ella But the chances of keeping your daughter abstinent approach 0% and the harder you try, the closer to 0% become the odds. That is how teenage girls work, sorry.

  • catgirl

    Chances of dying of cervical cancer if you don’t smoke and practice abstinence/fidelity: 0

    Unless someone decides to rape you or your husband decides to cheat on you.

  • Steven

    I have a question. You have the odds of dying from cervical cancer at 500:1. Is that 500:1 that you would die from the types that are caused by HPV strains that Gardasil protects against?

  • Melinda Toumi

    What about the 70% of women in the study that I participated in at KU that cleared the virus from their body naturally?? Since I have some immunity to the virus, do I need the vaccine now? No one knows.

    Unfortunately, we (scientists, including myself) do not know enough about the immune system or viruses. There is a risk of vaccination, there is a risk of NOT vaccinating. When others do not vaccinate, they put my kids at risk. But, did my son suffer ill effects from his vaccinations? Would he have had the same neurological dysfunction had he not received his shots? Would he have suffered the same fate from a serious case of the measles?

    All I can do is my best, with my family and my research as a scientist.

  • Mary

    A big problem with this info is that many cases of side effects never get reported. At my daughter’s pediatrician’s office I was told that they don’t have to report anything. It’s only ‘recommended.’ So what incentive would MDs have to report side effects?

    How many cases are out there that no one is reporting? There is absolutely no incentive for anyone to report side effects, not for doctors, certainly not for the manufacturers. Their profits are directly dependent on the vaccine being safe.

    As long as vaccines are related to big $$ for large corporations, we’ll never see the full picture.

  • 20tauri

    Agree that this is awesome and that you need to do one for the swine flu vaccine!


  • Wayman McAllister

    MMR and autism is another controversial (and incredibly misunderstood) causal assumption. A similar graph for those odds/chances would also be extremely helpful. Thanks for your efforts, great resource.

    • NickO

      There is no association between MMR and autism. Fact the man that proposed this link has been barred from practicing medicine due to poor science and lack of an association. There is NO ASSOCIATION between MMR and AUTISM. Benefits of vaccine and disappearance of diseases because of vaccination has led to fear of the vaccine rather than fear of the disease. This could also be stated causal ignorance.

  • hm

    The American Cancer Society estimates that in 2006, about 9,710 cases of invasive cervical cancer will be diagnosed in the United States and about 3,700 women will die from the disease.

    More than twice as many African-American women die from cervical cancer as Caucasian women. Hispanic and Native-American women have higher rates of the disease than Caucasian women. Cervical cancer rates also are rising among Vietnamese women. The highest rate of cervical cancer is in underdeveloped countries.

    Both incidence and deaths from cervical cancer have declined markedly over the last several decades, due to more frequent detection of pre-invasive and cancerous lesions of the cervix from increased Pap screening.

    The five-year survival rate for early invasive cancer of the cervix is 92 percent. The overall five-year survival rate (for all stages combined) is about 73 percent. For pre-invasive cervical cancer, the five-year survival rate is nearly 100 percent.

    The majority of cervical cancers develop through a series of gradual, well-defined precancerous lesions. During this usually lengthy process, the abnormal tissue can often be detected by the Pap test and treated.

    Pap tests, like other early detection tests, are not 100 percent accurate. Though not infallible, when performed properly, the Pap smear detects a significant majority of cervical cancers — usually in the early stages when the likelihood of a cure is the greatest, according to the American Society of Clinical Pathologists.

    Source: National Women’s Health Center

  • thuc

    if you ever create any more of these for health related issues, i’d love to blow them up and hang them in my office for my patients.

  • Aaron Zinman

    This is slightly misleading, in that the vaccine hasn’t been out for very long. It takes many years to fully understand the effects to medications on the population at large. Risks of getting hit by a car, etc, however, are well understood and can be taken at face value. I’d be careful about what you present so authoritatively, as people automatically think ‘oh well if it doesn’t instantly kill me then it must be ok!’. Its useful to understand the short-term risks, but it must be labelled as such.

  • Garrett

    VAERS is a horrible reference. It simple takes things that happen after a vaccine. It in no way determines causation. It is not scientific, and the reports have no context.

  • Elizabeth Burt

    The focus of injuries related to the administration of vaccines vs. the illness the vaccines can prevent is misplaced. There is substantial data to support disease prevention through vaccines, and very little (if any) supportive data about injury received from vaccine administration. Measles/Mumps/Rubella (MMR) can cause (for example) sterility, blindness and death and the vaccine definitively causes…? This is a compelling article for the HPV vaccine.

  • Areyoukiddingme?

    Too bad the information is misleading. It says 24,000,000 doses distributed NOT administered. Plus the percentage of people administered the vax is not being properly equated to how many people get cervical cancer FROM HPV. They should have taken the number of how many people get HPV (which is extremely high) and how many subsequently get cervical cancer from HPV, then take the number of deaths from cervical cancer, as a result of HPV, as the percentage, THEN match that to the number of vaccinated and the number of vaccine side effects and deaths. Totally different story. Gardisil only protects against 4 of the over 100 strains of HPV. So with the tiny bit of “assumed” protection it offers to HPV viruses that have a small chance of causing cervical cancer, the risk enormously outweighs the benefits. This is absurd. This illustration looks like a good bit of propaganda for the people that don’t think.

  • Tamara

    But isn’t it true that most of us already have these viruses? I heard something like 94% of us have multiple strains of HPV, several of which are associated wiht cancer. So do you have data on the number of people to get the vaccine and get cervical cancer anyway? I think that would change the picture.

  • nicola

    Why on earth are only teenagers being given the vaccine in the UK?? it seems entirely unfair

  • hm

    Why not add this to your visualization:

    Journalist John Carreyrou, quoting from FDA and Merck presentations, recently reported that
    “in clinical trials, 361 of 8,817 women who received at least one shot of Gardasil went on to
    develop precancerous lesions on their cervixes within three years of vaccination, just 14%
    fewer than in a placebo control group.”

  • Areyoukiddingme?

    Here’s some more facts: Gardisil Researcher Drops A Bombshell You should be embarrassed by this “chart”!

  • xmas gifts

    I just get so disgusted with “the double standard”. Its okay to take a chance with my girls’ future health, but “let’s wait and see” if it effects the little boy gonads! Screw all of you doctors who just want the referral fee anyway. You’re more dangerous than the possible HPV! I’m NOT giving it to my girls and I’m urging them NOT to have sex. BUT, if it might not be safe for boys, IT MIGHT NOT BE SAFE for girls!

  • gifts for men

    I can say it depends on what vaccine you are talking about. the flu and swine flu vaccine are nearly completely useless. the levels in those vaccines range anywhere from 10-25 mcg of mercury. that’s 100-250 times what the environmental protection agency considers healthy for human beings. doctors can’t even promise your safely when giving you the vaccine.

  • http://InformationIsBeautiful lynn

    I waited to get my Daughter the vaccine. I am an RN and give it to sooo many girls all the time. I still waited. Then a friend of the family was raped, (20 years old) and within a couple of months had the beginning of HPV Cervical Cancer. My daughter got the vaccine the next week. YOU NEVER KNOW!

  • hoorah

    i have a question. did the HPV vaccine pass the clinical trials then? the information above is very confusing..
    can you provide more background information and explain the advantages and disadvantages of receiving the vaccine?
    should girls be given the HPV vaccine? What is everyones opinion?

  • mongey

    Please help I am engage to a wonderful man that has hpv. What should i do im confused and afraid. please respond

  • ChatOmbre

    Thank you for this, and well done.

    I had the vaccine (all 3 shots) and am just fine. I’m very sensitive and react easily to many things, but I didn’t have any side effects.

    I think it’s worth it to get the shot… after all, even if a female is abstinent until marriage, their husband may have been with someone before or might have a fling, or she might be raped. None of those would be her fault, but she could get HPV from them.

  • Unlucky

    I got HPV from a man who cheated at only 18 years old. My immune system cleared it on its own after about a years time. I got the vaccine all 3 shots, because there are still other strands it protects against, and i’m not taking the risk again. I never had any side effects, and I am fine today (5 years later) As a woman even if you are careful and smart about what you do, it does NOT mean other people (significant others) will hold your health in as high a regard as you do.

    And condoms do not protect you from this STD either, it is genital area skin to skin contact, which occurs with or without a condom.

  • trackfodder

    I am paranoid and suspicious of big pharma and the Bilderbergs, who want to ill us and make us slow and stupid. The flu shots are stabalized with ethyl mercury and an elderly man receiving 3 successive annual shots has a 90% greater likelyhood of developing Alzheimer’s and the 16 or so shots they pump into our schoolkids contain aluminum compounds, which also cause Alzheimers. We are under attack. The MSG makes us slow and stupid, as does the fluoride in the water that displaces the iodine our thyroids need to produce the hormones our bodys need. Also the big push of soy is making queers out of our young boys due to the estrogen compounds it contains. The soy infant formula is NOT GOOD.