Earlier today a discussion regarding Gardasil began in a support group I am a member of. Many people are claiming that Gardasil, the HPV (human papilloma virus) vaccination, caused their POTS. As a result of the discussion, I began to some research of my own into these claims.
The cause of POTS is primarily unknown. So it is natural for patients to search for what the cause may be. However, these claims have not been scientifically substantiated and it is important they are before we let these claims affect our health decisions.
Correlation is not causation
This phrase is so ingrained in my brain from my first Statistics class that I will never forget it. Basically, just because two things are related doesn’t mean one causes the other. As a kid, my dad used to joke that he didn’t like to eat fruit because everyone who has ever eaten fruit has died(commence eye roll from my sister and I). Don’t worry; he knows this is not actually true. What is true is that there is a correlation between fruit consumption and dying, but it occurs because these are both universal human experiences.
POTS is most commonly diagnosed in women who are young. Gardasil is most commonly administered to young women. So there is an obvious correlation, but can we infer causation? Or is the only link that they are both common in the same gender and age? This same question comes up when people argue that vaccines cause autism. Vaccines usually are given just previously to when autism is diagnosed and people assume causation when it isn’t there.
One reason these claims fail is because they claim vaccines are the cause of autism or because HPV is the cause of POTS. There are children with autism who were not vaccinated. There are also people with autism who were not vaccinated. In the same way, there are people with POTS who never had Gardasil.
I believe the connection between these diseases and vaccines is due to the population involved. The symptoms occurring at the same time may seem like a clear cause for some patients. As S. Blitshteyn said, “It is probable that some patients who develop POTS after immunization with Gardasil or other vaccines are simply undiagnosed or misdiagnosed, which leads to underreporting and a paucity of data on the incidence of POTS after vaccination in literature.” POTS is a hard disease to get a diagnosis for and complicates this further.
Reactions to Gardasil Safety Allegations
After allegations against Gardasil, the Vaccine Safety Datalink and CDC looked into the adverse effects. They found that all the severe adverse effects were no more common in the comparison groups. (Read more at http://www.snopes.com/medical/drugs/gardasil.asp#O3jC8GFs0WQMUEJk.99). I believe that more research should be done, but that is my feeling on most things.
In the group, I am in the discussion about Gardasil began when someone posted this article:
http://www.sciencedirect.com/science/article/pii/S0264410X15004375. Everyone jumped on the Gardasil hate bandwagon, but I am not sure they actually read the study. In the study it says, “In a population referred for symptoms of orthostatic intolerance and other symptoms consistent with autonomic dysfunction that began in close temporal association with a quadrivalent HPV vaccination, we identified a 60% prevalence of POTS”. Well, let’s take a look at what that result means with less jargon. “For patients with POTs symptoms that started around the same time as Gardasil, they identified 60% of them had POTS”. Is that really even surprising? All they concluded in this study is that people who had POTS symptoms, around the same time as Gardasil, were found to have POTS. The study again just demonstrates a correlation, but not causation.
So is it worth it? HPV
HPV is more common than you may think. HPV causes mouth cancer, throat cancer, genital warts and cervical cancer. HPV causes so many problems that I think people should have solid, scientific evidence before dismissing the vaccine as an effective preventative measure.
I can’t say with any certainty that Gardasil is completely safe, but I can tell you it is certainly not the only or primary cause of POTS. Many patients have not even had the vaccine! Research suggesting Gardasil causes problems are case studies of too small to be statistically significant. I can also say with certainty that HPV if a real problem in human health and that we should be working on preventative measures, ensuring that they are safe, and developing a vaccine that prevents more than four types of HPV. The causes of POTS, as always, need to be better researched and identified.
Wondering if you should trust an article? Here are some tips: https://chronicallyridicilous.wordpress.com/2015/04/14/lets-have-a-little-talk-about-a-thing-called-science/