Cervical Cancer Shots Are Gaining Reputation as Painful

Gardasil shots apparently sting more than other injections.

ByMike Stobbe<br>ap Medical Writer
February 09, 2009, 4:58 PM

Jan. 3, 2008&#151; -- ATLANTA (AP) - The groundbreaking vaccine that prevents cervicalcancer in girls is gaining a reputation as the most painful ofchildhood shots, health experts say.

As Austin Powers would say; "Ouch, baby. Very ouch."

Health officials have touted the Gardasil vaccine as animportant new protection against a cancer-causing sexuallytransmitted virus. In recent months, they've also noted reports ofpain and fainting from the shot.

During its first year of use, reports of girls fainting fromvaccinations climbed, but it's not clear whether the pain of thecervical cancer vaccine was the reason for the reaction.

"This vaccine stings a lot," said Patsy Stinchfield, aninfectious disease expert at Children's Hospitals and Clinics ofMinnesota, speaking at a recent meeting of vaccination experts inAtlanta.

It sure does, said 18-year-old Lauren Fant. She said other shotstend to hurt only at the moment of the needle stick, and not afterthe vaccine plunges in.

"It burns," said the college freshman from Marrietta, Ga.

The pain is short-lived, girls say; many react with little morethan a grimace. But some teens say it's uncomfortable driving withor sleeping on the injected arm for up to a day after getting theshot.

Officials at Merck & Co., which makes the vaccine, acknowledgethe sting. They attribute it partly to the virus-like particles inthe shot. Pre-marketing studies showed more reports of pain fromGardasil than from dummy shots, and patients reported more painwhen given shots with more of the particles.

Meanwhile, U.S. health officials have noticed a rise in reportsof vaccine-associated fainting in girls. From 2002-2004 there wereabout 50 reports of fainting; from 2005 until last July, there wereabout 230. About 180 of those cases followed a shot of Gardasil,which came on the market in 2006.

But it's not clear that Gardasil's sting is related to thefainting increase, said Dr. Barbara Slade, an immunization safetyspecialist at the U.S. Centers for Disease Control and Prevention.

Teens tend to faint from needles, so a three-dose vaccine foradolescents would be expected to prompt some added fainting, shesaid. Researchers aren't sure why teens faint more than other agegroups, but nervousness may be a factor.

Gardasil is the first vaccine approved specifically to targetthe human papilloma virus, or HPV, which causes cervical andvaginal cancer. The Food and Drug Administration approved it forgirls ages 9 to 26.

Preliminary studies indicate only 10 to 20 percent of them havegotten at least one dose.

But researchers said those rates are due to reasons other thanworries about pain, including Gardasil's $120-a-shot price, limitedsupplies initially and mixed feelings by some parents and doctorsabout a vaccination that assumes girls have sex.

Dr. Andy Andrews, an Atlanta-area pediatrician, said he doesn'tbelieve the shot's ouch has diminished demand.

"A lot of the older teens are coming in themselves, without aparent. So they themselves are motivated to come back in," Andrewssaid.

A second HPV vaccine, GlaxoSmithKline's Cervarix, is under FDAreview and could become available in 2008. Complaints of injectionpain have not surfaced in clinical trials, said Liad Diamond, acompany spokeswoman.

(Copyright 2008 by The Associated Press. All Rights Reserved.)

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