VACCINE FOR HUMAN PAPILLOMA VIRUS (HPV): SAFE AND USEFUL?

INTRODUCTION AND OBJECTIVE: This review aims to bring evidence to facilitate a shared decision making between patients and clinicians about vaccine for HPV. It is known that the infection with HPV is necessary for the development of cervical cancer, but it is not enough. The cervical cancer is a chronic illness, with a slow progression rate, estimated to last 10-20 years from the HPV infection. FDA states “vaccines represent a special category of drugs aimed mostly at healthy individuals and for prophylaxis against diseases to which an individual may never be exposed.” METHOD: Searched on Pubmed and EMBASE using the MeSH term “Papillomavirus Vaccines”. Then selected studies concerning efficacy and security of the vaccines, preferably systematic revisions without conflict of interests. RESULTS AND CONCLUSIONS: The vaccines developed by Merck and GSK laboratories were approved early, without solid evidences of safety and effectiveness. In the United Kingdom the Cervarix leaded the adverse effects ranking in 2010, with rates 24 to 104 times higher than any other vaccine. In the United States, Gardasil and Cervarix were responsible for 61,6% of all severe adverse effects reported. By analyzing of a cervical cancer database from WHO Tomljenovic found that, among others factors, only pap test coverage had a statistical correlation with decreased death rate. With so many inconsistencies, there is one certainty: the screening of women with the Pap test has proven to be effective in reducing mortality and the incidence of cervical cancer, remaining a necessary procedure, even considering a consistent vaccine coverage.