November 10th, 2010
03:23 PM ET

A fraction of eligible women opt for HPV vaccine

Only a fraction of the girls and young women eligible for the human papillomavirus (HPV) vaccine actually get it, according to a study presented Tuesday at the American Academy of Cancer Research.  Research shows the three-dose vaccine is an effective means of preventing the spread of the sexually transmitted infection that can lead to cancer.

Of those who receive the first dose of the vaccine, only about a third complete the three necessary doses according to the study.

Researchers examined the electronic health records of more than 9,600 girls, teens and women, ages 9 to 26, who had been patients at the University of Maryland Medical Centers between August 2006 and August 2010. Only 27 percent of the patients who were eligible for the vaccine began the process and took the first dose.

It's not known if all the patients had received information about the vaccine during their visits or why so many of the women opted not to start the vaccine, according to the researchers.

"What's concerning is people starting and not completing the vaccine," says J. Kathleen Tracy, Ph.D., the study's author and assistant professor of Epidemiology and Public Health at the University of Maryland School of Medicine in Baltimore. "If you think you are protected and you're not...you might have a false sense of security."

Tracy and her colleagues are trying to determine what negative consequences exist, if any, when women don't complete the vaccination process. No data are currently available to determine what degree of protection a patient can get from taking only the first or second dose of the HPV vaccine. Yet it's reasonable to conclude the most significant protection is afforded to the patient who completes the vaccine, as intended.

According to Tracy, women ages 18 to 26 were the least likely to follow through with the vaccine and take all three doses. Although their health records don't give any indication why women in this age group aren't finishing the vaccine, despite it being common for women to be sexually active during these ages, Tracy hypothesizes the multi-step process can be difficult to manage.

"It's one of the first times in their life [these women] are managing their own health care," says Tracy. "They're on their own to remember to get the first dose, schedule the second appointment, show up, schedule the third appointment, and show up to that."

The electronic health records used in the study did not include the patients' reasons why they chose not to take either of the two available HPV vaccines on the market. One explanation may be the several adverse reactions associated with both of the vaccines. According to the Centers for Disease Control and Prevention, documented "non-serious" adverse reactions include fainting, nausea, fever, and headache. Serious documented reactions include cases of blood clots, a muscle weakening disorder called Guillain-Barré syndrome, and even death.

HPV is the most common sexually transmitted infection. High-risk HPV infections from certain strains of HPV may lead to cervical cancer. You can read more about HPV, and both available vaccines, here.

soundoff (98 Responses)
  1. Chelsea

    I didn't get it because of the cost, and my insurance won't cover it.

    November 10, 2010 at 19:17 | Report abuse | Reply
    • Battlekitten

      about 6 years ago before all the hype about HPV, I had an abnormal PAP exam... The doctors scheduled me for biopsy but in the meantime I had found an article in Cosmo's "health" section going over the virus... I brought the article to the biopsy appt and asked the doctor if this could be what the problem was and she said "no, no... only about 10% of women will get it in their life" well a year later and several abnormal and inconclusive biopsies later, I did have HPV and had to have invasive surgery to remove pre-cancerous cells from my cervix, with the OB/GYN saying that if I was able to bear children I would have to do it with in a couple of years and if I got pregnant that I run the risk of developing what they call an incompetent cervix where the cervix just fails to hold the pregnancy in.... Now 5 years after surgery and docs saying I couldn't have children I just had my first, a little boy... If it hadn't been for Cosmo I don't think even the doctors would have found out what it was until it was really too late... Keep going to all of your annual exams and push to get vaccinated... Fight with your insurance company if you have to, not only for your health but for your future children....

      November 10, 2010 at 19:38 | Report abuse |
    • Frank5465

      If you are already infected with High Risk HPV 16 and 18 then the vaccine will not do you any good...

      November 10, 2010 at 19:48 | Report abuse |
    • Adel

      Women do have the right to refuse this vaccine. It's NOT mandatory and, believe it or not, women can make their own decisions when it comes to their healthcare. I refused the vaccine several times and I don't regret it for one second. Cervical cancer is rare and I refuse to live my life worrying about a rare cancer.


      November 10, 2010 at 20:03 | Report abuse |
    • Carolyn

      You hit the nail on the head! It's too expensive.

      November 10, 2010 at 20:17 | Report abuse |
    • Valerie

      Merck sells Gardasil for $360 ($120 per shot in a three-shot series). Adding administrative costs, the overall cost to the public is $400-500 per child vaccinated. The cost of vaccinating 100 children will thus be at least $40,000, but only 3 out of that 100 will ever be exposed to the HPV types targeted by the vaccine.

      The average age of diagnosis of cervical cancer is 48 years old. Accordingly, the effective cost is $13,000 per child to possibly protect her against a cancer over 30 years in the future. But the vaccine is not known to be effective for more than five years; most new vaccines are not effective any longer than that.

      November 10, 2010 at 21:06 | Report abuse |
    • kiwi

      If each individual shot didn't cost me $100 out of pocket, and I didn't need three of them... I'd be first in line. However, especially when you're targeting college aged kids, price is a HUGE factor in this decision. I'd love to be able to get my HPV shots – but I need to buy my textbooks too.

      November 10, 2010 at 22:15 | Report abuse |
    • TravelDoc

      Here are some additional facts for all re: HPV... It isn't always sexually transmitted. It can be spread via saliva. That means, a shared straw with your toddler or a "French Kiss" can spread the virus. Think about those implications for a moment.... Most people have immune systems that clear the virus from the body within 1 – 2 years. BUT it hasn't been determined yet whose body will clear the virus and whose won't....Gardasil prevents infections of HPV 6 & 11 (those that cause genital warts) in men and women, and HPV 16 & 18 in women. Think again about that saliva connection... In 2008, nearly 50% of all head and neck cancers in men were caused by HPV. NOT smoking/drinking, and not in "older" men. We are talking 20-somethings at an alarmingly increasing rate. Cancer of the tonsil is the most common of these cancers. Even if you have had a tonsilectomy, there remains some of this tissue cell type in the soft palate and on the base of the tongue....If caught early, this kind of cancer (tonsil) can be relatively easily treated with radiation, BUT it is seldomly caught early (relatively unknown presentation) and radiation is EXPENSIVE andtemporarily can be quite disabling....I am a retired ENT doc (and no, I don't work for any drug company) who had HPV mediated tonsillar cancer 4 yrs ago. I wouldn't wish this on my worst enemy. I've had both of my teen-age sons immunized, and recommend immunization to every parent of a 'tween' that I come into contact with. I have even offered to pay for immunizations for my family members who cannot afford this, because I believe it is that important...If you haven't been immunized and are in the target age group (or the parent of one), please re-think your actions and get the facts. You could save a life of someone you love!

      November 11, 2010 at 08:50 | Report abuse |
    • Kayt

      This is actually a reply to TravelDOC, who may been and ear nose and throat doctor but he is slightly mislead. I am a graduate student studying public health so that I can teach sex education and there is no evidence as of yet that HPV can be spread through kissing. Throat cancer is linked to HPV, as of right now, by the virus being transmitted through oral sex.

      Some other interesting facts about HPV, 50% of people who are sexually active will have HPV in their lifetime. Out of the 50 some odd strains of HPV, only a handful cause genital warts. There is no test for HPV in males so most males will not know they have it unless they get genital warts. Genital warts also may not appear for several years after the infection. While kissing is not yet proven to transmit HPV, contact such as oral sex, sexual intercourse, anal sex and even touching the infected genital area can transmit HPV. Also, many people who have HPV, and have a good immune system, will get rid of the virus, eventually, on their own.

      As for Gardasil, it protects against a handful of the strains that cause cancer, but there about three handfuls of strains that are linked to cancer. And as a public health student, I feel obligated to push vaccines on people because it reduces the spread of the virus, but Gardasil is new and that is one of the reasons I have not done it. The FDA's job is to make sure it works, and makes sure it doesn't cause serious damage right away before they can put it on the market, then they watch to see if anything happens. This means that there are few serious immediate risks, but it hasn't been tested in the long run.

      November 11, 2010 at 09:44 | Report abuse |
    • Kayt

      Oh yeah, so please use condoms 🙂

      November 11, 2010 at 09:45 | Report abuse |
    • stefynie

      My doctor told me to get the vaccine when I was about 22. I completed it all. Now I've come to find out it only blocks some strand of the virus. My husband contracted HPV before we got together, he told me about it and I thought because I was vaccinated I should be ok. WRONG!!! I now have it. I now have to go to many exams to make sure nothing more comes of this. I don't blame my husband at all, I blame my doctor for not fully educating me on the vaccine. If I was told the only some strands would be prevented I wouldn't have gotten caught up in the moment and I would have had my Husband checked out to see what strand he has.

      November 11, 2010 at 12:27 | Report abuse |
  2. Stephanie

    Being in that age group I had to ask to get the vaccine from my doctor, she never even brought it up, and I had to figure out when to schedule my second and third injections. So I don't think that my experience would be unique, unless someone is motivated to get and complete the vaccination they very likely will not get it. There really is not a lot of money in getting someone vaccinated for this sort of thing, when the doctor could use the time to bill another client for something more costly.

    November 10, 2010 at 19:22 | Report abuse | Reply
    • Battlekitten

      Something more costly like surgery to remove what a vaccine could have kept from happening...

      November 10, 2010 at 19:39 | Report abuse |
  3. ridicilous

    my friend simply didnt KNOW you could get shots so she never got them. and yes, she got HPV due to no innoculation.
    doctors really need to do a better job at telling people things they can be innoculated against. especially so common of a STD as HPV. i had no idea you cuold get innoculated. some doctor should have told ME when i was < 26. but none ever did. that kinda makes me mad actually. if there is an innoculation against a very easy to get STD but you have to get it by a certain age, doctors are being jerks by not telling us. how else is the person supposed to find out? by contracting it. thats how my friend found out. ridicilous.

    November 10, 2010 at 19:46 | Report abuse | Reply
    • Valerie

      The vaccine didn't even come to market until around 2006. You were more likely to have a reaction to the vaccine than to get one of the four strains of the virus it supposedly protects against.

      November 10, 2010 at 21:05 | Report abuse |
  4. Rachael

    I will pray for anyone who takes this dangerous vaccine due to the number of deaths and side effects mounting up.............The public interest group Judicial Watch, published results of its review of new documents on the adverse reactions to the vaccination for human papillomavirus (HPV), Gardasil. The documents are from the U.S. Food and Drug Administration (FDA) under the provisions of the Freedom of Information Act (FOIA)
    The documents showed 16 new deaths (including four suicides) between May 2009 and September 2010. The information also showed 3,589 Adverse Reactions Related to Gardasil between during this time frame, 789 “serious” reports, with 213 cases resulting in permanent disability and 25 resulting in a diagnosis of Guillain Barre Syndrome. Beware of what you inject in your body people................

    November 10, 2010 at 19:58 | Report abuse | Reply
    • Kate

      Just throwing out numbers is a tatic to scare people. Sure, 16 deaths is a lot, but how many women actually had their shots?

      There is a major flaw in the vaccine reporting database: Reports are filed, regardless of whether or not the vaccine is the cause. It's quite possible for many of these serious events (including death) are in NO WAY related to the vaccine. They just happened to occur at/around the same time as the shots.

      November 11, 2010 at 08:13 | Report abuse |
    • HPVFan

      Nah. You're wrong. You have a larger chance of being killed by lightning or earth quake than this shot. Don't be so ignorant.


      November 11, 2010 at 10:06 | Report abuse |
    • Valerie

      But if the shot does not protect you from getting cancer, then what is the point of getting the shot, no matter how the risk compares to getting hit by lightning?

      November 11, 2010 at 10:43 | Report abuse |
  5. Rachael

    Here is some more scary information taken from this website. w w w dnaindia.com/india/report_cancer-vaccine-programme-suspended-after-4-girls-die_1368681. The Indian Council of Medical Research (ICMR) has told Andhra Pradesh and Gujarat to immediately suspend the cervical cancer control vaccination programme for girls. The programme is part of a two-year study to look into the utility of a vaccine in public health programmes and acceptability of Gardasil, the human papillomavirus (HPV) vaccine made by Merck. The programme was marred by controversy after four deaths and complications among 120 girls were reported after vaccination. The girls complained of stomach disorders, epilepsy, headaches and early menarche. Now here's the big kicker...................For a drug to be administered to children, Karat said, it has to go through stages of clinical trial, including phase 3 adult clinical trials. With Gardasil, only one trial has been carried out with a small sample of 110 girls, which has followed up with them for a month after completion of vaccination and that too only to look at the immune response post-vaccination, Karat said. The vaccine has also been approved for adult women aged 27, Karat said, without any trials on them.

    November 10, 2010 at 20:15 | Report abuse | Reply
    • Maria

      You do realize if you get an annual flu shot they don't even run trials on them correct?

      November 11, 2010 at 00:32 | Report abuse |
  6. Elizabeth

    This vaccine has more dangerous potential side effects than the cancer t it is supposed to keep you from getting.
    It should never have been approved by the FDA.
    Our FDA is a joke!
    They are constantly approving dangerous medicines, vaccines etc. and not approving ones that will help us. It is rumored to be very corrupt. Since there are so many recalls now I am inclined to believe them.
    Just because something has been approved by the FDA does NOT mean it is safe!!!!!
    Never trust the FDA and do your own research before using anything that has been approved by the FDA!

    November 10, 2010 at 20:15 | Report abuse | Reply
  7. Valerie

    Google 'Sanjay Gupta Gardasil' for a good story. The HPV vaccine (any HPV vaccine) doesn't even work well enough to even consider using it.

    November 10, 2010 at 20:56 | Report abuse | Reply
  8. chokedup

    The vaccine does not just protect against cervical cancer – also vulvar, vaginal and anal cancers. Although it hasn't been proven, yet, most oropharyngeal cancers have been demonstrated to be caused by the same HPV strains and, therefore, likely will be reduced by the vaccine. Plus, the quadrivalent vaccine, Gardasil, prevents most genital warts – not life threatening but very common and costly in terms of money and time to treat. My daughter will get this vaccine as soon as she turns 12.

    November 10, 2010 at 21:14 | Report abuse | Reply
    • Valerie

      If it's still on the market at that time. Chances are it won't be.

      November 10, 2010 at 21:22 | Report abuse |
    • mimi

      Maybe you should just teach your daughter about safe sex. And, even if she had HPV, if she had annual pap smears, any precancerous cells would be detected and removed before it even got that far. You might want to do more research because regardless of whether the vaccine is effective or not, it is true that the incidents of serious side effects are mounting, and they are severe (seizures, suicidal thoughts). I know of several pediatricians who have advised parents with daughters that they are extremely hesitant to recommend the vaccine, and would not vaccinate their own daughters.

      November 10, 2010 at 22:41 | Report abuse |
    • Chokedup

      I'm a MD,Ph.D and OB GYN. Condoms don't universally protect against warts or vulvar cancer as there is still exposed skin. And I don't expect my daughter to use condoms forever after marriage and who can predict what he will bring to the table? Yes, routine paps can find dysplasia but the treatments are destructive and can cause obstetric complications. The deaths after gardasil have almost all been attributed to other issues – it certainly didn't cause a tumor to occur in he young woman's chest in he UK, for example, that happened to rupture shortly after the injection.

      But don't worry, I'll still be here to shave off parts of cervixes, burn off warts and do hysterectomies for those who decline vaccination. Fortunately for me these procedures all reimburse well.

      November 10, 2010 at 23:14 | Report abuse |
    • Kristen

      I paid for the vaccine and now I'm also paying someone for all of the costly procedures you offer. This vaccine is not a cure-all and doctors should be frank with their patients by telling them that although Gardasil protects against 4 strains of HPV there are still 36 others that they wont be protected against...

      November 11, 2010 at 11:25 | Report abuse |
  9. chokedup

    Those saying the vaccine is ineffective have not read any of the evidence – open up the New England Journal of Medicine instead of something a celebrity has written to get valid information.

    November 10, 2010 at 21:17 | Report abuse | Reply
    • Valerie

      Are you trying to say that the NEJM doesn't have it's biases as to which studies it will publish?

      November 10, 2010 at 21:22 | Report abuse |
    • notmyrealname

      Are you saying the NEJM is as biased and uneducated as some dopy celebrity?

      November 10, 2010 at 22:00 | Report abuse |
    • mimi

      What celebrity has spoken up about Gardasil?

      November 10, 2010 at 22:44 | Report abuse |
    • Valerie

      Just Sanjay Gupta, to my knowledge.

      November 11, 2010 at 06:25 | Report abuse |
  10. KM

    I got the vaccine @ age 26 and I've been fine since. The vaccine did not cause any sort of reaction. And while it might be expensive, if you have health insurance, it will be covered. I paid nothing out of pocket. In my opinion, girls should be getting vaccinated for this. Men carry HPV without any signs or symptoms, and once a woman has sex, she can contract it. A woman can stay a virgin until she's married, and the man she marries, could be a carrier and there ya go, he infects her time and time again without either's knowledge, and then when she's 45, she's got cervical cancer. We're not talking about the genital warts type of HPV you can see, we're talking about the HPV that infiltrates the cervix. Females, get yourself protected. You get a flu shot every year, yet it only protects against very few strains of the flu, you get a tetanus shot every 10 years in case you step on a piece of rusty metal, get the shot that protects you from some very harmful strains of HPV that causes cancer. I'm a nurse, and I will tell every one of my patients to protect themselves.

    November 10, 2010 at 22:32 | Report abuse | Reply
    • Maria

      I finished my vaccine as well and I didn't have any side effects. I have been urging women I know to get it.

      November 11, 2010 at 00:30 | Report abuse |
  11. gale

    Ever read about all the side effects to this vaccine? I mean some bad ones. Too new and not for me.

    November 10, 2010 at 23:09 | Report abuse | Reply
  12. bkmm08

    Back in the 90's the big rage was the "chicken pox vaccine". Little did we know at the time that all the "vaccine" did was postpone when you got the chicken pox. Now that my children are in their teens, I am told they will need a booster shot. I will not have my daughter get the "HPV vaccine shots" until all the LONG TERM side effects are known.

    November 10, 2010 at 23:44 | Report abuse | Reply
  13. Maria

    I just finished my last shot and I'm happy I did it. I talked it over with my doctor and he said both of his daughters got it and he urges all women eligible to get it to get it. He gave me all the information and answered all my questions. Luckily my insurance covered it. But even then with the cost it is worth it. When my little girl is old enough I will have her vaccinated. The media over blew the side effects and deaths. All of those cases the women had an underlying medical condition. It is perfectly safe. I was told it would hurt and I would have swelling around the area....but I didn't. I had a worse reaction to my flu shot.
    If you want to talk side effects then you are just being silly. I have taken medicines for various things and if I was scared to have a stroke or a rash from one of them I would be dead by now from not taking them. Any of you women who wont get it because of the side effects or you think it won't do anything – plain and simple – you need to look at the evidence again.

    November 11, 2010 at 00:28 | Report abuse | Reply
  14. diana

    Can't we just give it to men? Why do scientists always make women the ones to have to get them. Men are the ones who go to hookers and give women this stuff anyway, let them deal with the risks of a vaccine.

    November 11, 2010 at 00:30 | Report abuse | Reply
    • charles s

      Men should get it too. This vaccine was originally developed for women but men can use it too. Who would want to get any cancer that can be avoided by a vaccine. I hope that my granddaughters will get it when they are old enough. If I had grandsons, I would want them to get the vaccine too.

      November 11, 2010 at 14:56 | Report abuse |
  15. katy

    I would have loved to have gotten this vaccine but I'm in my thirties and am not elligible....despite testing negative for HPV after I had to get a second Pap after an abmormal cell finding on the first. I would have to find a practicioner to give it to me (my OBGYN won't because it's not recomended for women my age) and my insurance won't cover it. I don't have the cash for it. I'd like to see if studies could be done for "older" women who've tested negative for HPV.....oh, and men too! I think a lot of young women would like to get the shot but with more and more ladies without health insurance and fewer good job oportunities for young people I don't see a lot of eligible women rushing to get it.

    November 11, 2010 at 00:51 | Report abuse | Reply
  16. Cat

    I do not trust new vaccines. This one is quite the little money maker. There are just too many factors. I think of the first 100,000 or so doses as uninformed, unwitting (and unpaid) "human trials" and, so sorry drug companies, my daughter is not a guinea pig. I had some guilt when she got chicken pox but hey, now she has a life long immunity. And guess what? She caught it from someone else who did not get the vaccine. They do not know the long term effects of this HPV vaccine. Why isn't it approved for older women? What are the contra-indications? What if they find out it causes sterility? How will they fix that? And most insurance companies DO NOT PAY for this.

    November 11, 2010 at 01:43 | Report abuse | Reply
  17. Andy

    Figures. People are idiots.

    – A

    November 11, 2010 at 03:12 | Report abuse | Reply
  18. Gaven

    I see a lot of you women sticking your head in the proverbial sand. This vaccination, depsite the money it costs to get the series, can save your life. If you have sex, you are at risk of contracting HPV 16 or 18, even if you use condoms. If there is a chance of you being raped or sexually assaulted, you stand the risk of contracting HPV 16 or 18. If you contract one of these strains of HPV, there is a chance you will get cervical cancer. How much is the price of life? I'd say it is worth more than the thousand or so dollars the series of shots costs, wouldn't you? How much does peace of mind cost? I bet if there were a price tag on it, it would still be cheaper than what the series costs.

    Every single one of you women denouncing this vaccination are fooling yourselves. If you are a women, regardless of how old you are, and you have sex AT ALL, despite how well you think you know your partner, there is a chance you could get strain 16 or 18. If there was a comparable vaccine males could get to prevent ANY kind of HPV, I guarantee you we'd be lining up in droves to get it. What makes you think you are immune to STDs? What makes you think you won't get cancer? Dare I say, NOBODY has a say if they get cancer or not.

    Don't be stupid – Get the three-shot series!

    November 11, 2010 at 03:51 | Report abuse | Reply
    • Valerie

      I think if you were to get raped then contracting HPV would be the least of your problems. As for men getting it, the type of man who would give this to a long term partner because of cheating is most likely not going to be able to afford 'a thousand' dollars for some series of shots at his doctor's office, nor would he be that considerate of his partner's health in the first place if he could afford it. Do you work for Merck?

      November 11, 2010 at 06:31 | Report abuse |
    • Christy

      Are you serious? Worth the $1000? How about my rent, or my groceries? That is far more important to me than saving 1/4 of my yearly income for a vaccine.

      November 11, 2010 at 08:53 | Report abuse |
    • Valerie

      Elizabeth, did you read the part where I said that if a man will cheat on you then I doubt he's considering your health? Name calling doesn't make you look too good, lady.

      November 11, 2010 at 10:38 | Report abuse |
  19. OyVay

    It's because women don't want to be human guinea pigs. Who knows what the consequences of these injections will be years from now?

    November 11, 2010 at 08:31 | Report abuse | Reply
    • KM

      How do you know what the long term effects are of the flu shot that you get every year are? Or any of the vaccines we get? Of course you take a chance and a risk, but you also get into your car every day, risking dying by getting into an accident, or eating fat-laden food choices, increasing your risk for a heart attack with every gram of fat you consume, yet, we all do it, and I bet half of the people posting on this story are smokers, who in some shape way or form will die from their habit but won't get the HPV vaccine because of the "risk." get a clue, and get the shot. You have a chance to prevent cancer! Everybody says, we have to find a cure for cancer, but as soon as something does become available, you all shoot it down! it's pure hypocrisy!

      November 11, 2010 at 11:09 | Report abuse |
  20. Christy

    I'd happily get the vaccine. I'm within the target age range, I'm sexually active, and I don't want cervical cancer. However, my insurance does not cover any kind of prophylactic medical care, including this vaccine, and frankly, the vaccine costs about the same as a month's rent. Drug companies haven't figured out that while parents will pay basically anything to keep their kids healthy, young women without means don't feel anywhere near the same way...

    November 11, 2010 at 08:51 | Report abuse | Reply
    • uknow

      You might try calling around to a city or county Health Dept in your area. Many will do the vaccine for low or no cost to eligible people. I know they do in Dallas where I live. I have 2 young boys and I am having them vaccinated, why would I want them to have or pass on any disease that is preventable? My insurance does pay but I have a copay which I gladly pay to prevent disease. Cheaper to prevent than treat people!

      November 11, 2010 at 10:52 | Report abuse |
  21. Dan

    Vaccines are bad Mmm Kay. Just say no.

    November 11, 2010 at 09:36 | Report abuse | Reply
  22. Courtney

    There's a lot of misleading and incomplete information about HPV out there. The media does a good job making women worry that if you do get HPV then you will eventually get cervical cancer. To clarify: not true. Cervical cancer takes YEARS to develop, and it's most likely in women who have not had their PAPS in say, 10 years. If you are going to your yearly PAP, you are doing everything right to take care of yourself. Up to 80% of sexual active people have this virus or have had it and condoms do not always prevent it.

    November 11, 2010 at 10:07 | Report abuse | Reply
    • Valerie

      The FDA’s own press release from 2003 admits that, “Most women who become infected with HPV are able to eradicate the virus [without intervention] and suffer no apparent long-term consequences to their health… most infections are short-lived and not associated with cervical cancer.” (Source: “FDA Approves Expanded Use of HPV Test,” March 31, 2003, http://www.FDA.gov)

      November 11, 2010 at 10:32 | Report abuse |
    • KM

      contrary to popular belief, an annual pap smear DOES NOT test for HPV. you have to get an STD exam to test for that. If you get a regular pap smear it is NOT testing for STDs. And most women do not ask for an STD exam, especially those in monogamous relationships, but their husbands can be carriers, and over the course of years of reinfection, you can end up with cervical cancer. I'm a nurse who works in this field.

      November 11, 2010 at 11:13 | Report abuse |
  23. Billy

    Society should be cautious and critical of vaccines. I think Gardsil is an excellent vaccine, but price and inconvenience get in the way of this vaccine being administered.

    Vaccines are far from perfect, but the overall benefit far outwieghs the risks of most vaccines. The evil darwinian side of me would like to round up all people that are too dumb to use vaccines and have them all living together in a small paranoid community, this will vaccinate humanity effectively against the dumb genes.

    November 11, 2010 at 10:25 | Report abuse | Reply
    • Billy

      For clarification I would like it if all vaccines were free of mercury and cells from aborted babies.

      November 11, 2010 at 10:32 | Report abuse |
  24. AC

    I disagree. I had annual paps for years and then one day I was hit with a Stage 0 cervical cancer diagnosis. This cancer CAN spread quickly no matter how healthy you might be.

    November 11, 2010 at 10:26 | Report abuse | Reply
  25. Kristen

    I received the Gardasil vaccine before I was sexually active and still got HPV. It's unfortunate how little research is done or is known about HPV. What they don't tell you at all in this article is that there are 40 different strains of HPV that are sexually transmitted. Gardasil prevents only 4 of those strains. The other issue with HPV is that there isn't even a test available for people to check their overall "HPV status" and many people have it without even knowing they have it. I think they should have a test since the vaccine only prevents a fraction of the strains that can be transmitted. As far as I'm concerned, until we have a test that can determine virus strains, the vaccine is worthless.

    Merck stands behind the statistics that the 4 types of the virus Gardasil prevents cause 90% of genital warts and 70% of cervical cancer cases. I just want to know where those statistics come from, because my doctor was not able to tell me what strain of HPV I have. The standard "HPV test" is only given to women who have an abnormal pap test and it only tests for "high risk" strains & not any specific strain. If you have the type that causes genital warts (which Gardasil claims to prevent the two strains that cause 90% of these cases) there is no way for your doctor to test you and determine which strain you have, or if you even have HPV. The doctor makes the diagnosis just by looking at what you have. So how does Gardasil know these 2 strains are causing 90% of cases. My doctor doesn't know what strain I have and told me there was no way for her to test what I have, so am I just unaccounted for in these statistics?

    Gardasil is a waste of money. Unfortunately I was suckered in by the hype... that there was a vaccine that could prevent women from getting cervical cancer. Since then I have been made aware of the games these drug companies play. Gardasil was a waste of my time... Ladies, please educate yourself on this disease and press your doctors for more information. If they really want to do something about HPV, the most common STD, they need to start with developing a test, not a vaccine that hides behind washy statistics...

    November 11, 2010 at 10:27 | Report abuse | Reply
    • Kristen

      To clarify, I'm not saying you shouldn't get the vaccine, but for it to be truly effective there should be a more thorough test available so that people can take other preventative measures other than just hoping their partner does not have one of the many strains Gardasil doesn't protect against.

      November 11, 2010 at 10:54 | Report abuse |
    • charles s

      I am sorry that you became infected with HPV in spite of the vaccine. However the vaccine does not protect against all strains of HPV. The main benefit of the vaccine is future protection from cancer. Some protection from cancer is better than none. Hopefully you will not get the cancer that it protects against.

      November 11, 2010 at 15:04 | Report abuse |
  26. Missouri Lady

    Valerie–you are an idiot. back in 1994 I was raped, and I did get HPV from it, and now I have both the mental and physical scars from it. Stop speaking for all women. You are just another paranoid anti-vaccine nut job that reaps the benefits of everyone else complying with routine inoculations. Get over yourself and don't ever speak for all women!

    November 11, 2010 at 10:43 | Report abuse | Reply
    • Valerie

      Counseling and a healthy diet to boost your immune system will do you more good than this particular vaccine, especially in your case if I believed you. If I am so paranoid about vaccines then why did my children get all of their vaccines from 2 months on? Ad hominem attacks mean that you have no argument.

      November 11, 2010 at 11:04 | Report abuse |
  27. uknow

    As I suggested to someone else here, try your city or county Health Dept. In some places they will provide the vaccines for little or no cost if you fall within the recommended population for that vaccine. Also, see if your insurance compancy sponsors a vaccine drive like a Care Van, they will also do vaccines for lilttle or no cost. You can also try contacting the drug manufactuor as many have programs for people who can't afford their products. It is worth the effort, don't give up!
    The life you save may be your own.

    November 11, 2010 at 11:08 | Report abuse | Reply
  28. Where is the logic?

    Here is something wrong with the logic of HPV and vaccines:
    1. most women are already sexually active before 19, so their chances of having the virus are very good.
    2. vaccine is denied to women over 26? I have not heard reasonable explanation yet why?
    3. is hpv sexually transmitted or not? Can you get it though saliva? why is the disease being presented as a SEXUALLY transmitted disease? I get cold sores, always have since I was a baby, I will always have them but i have learned that having a strong immune system and addressing the cold sores with Vaseline or anit-cold sore medication does the trick.

    Here is what I think:
    1. Adult women are shamed, yes i said SHAMED, because they got the STD, into having "surgeries" that can destroy our ability to have kids latter on. It is out of pocket and expensive. SHAME on the doctors!
    2. If HPV is a virus, you don't treat virus by removal, you treat it with antibiotics. Unless it is a wort, in most cervical abnormalities cases it is a thin lining of cells. Is anyone else getting this? ANTIBIOTICS. that is how other STD are treated. Why not this one? Hold on, $$$$ made on surgeries on women who can shell out the money?
    3. I think it will take a lawyer to sort this out. Too much just does not make sense in vaccine, treatment and this HPV hysteria.

    I do hope a lawyer reads this and gets a class lawsuit going. Women are being shamed and undergoing procedures that are painful and harmful. I do believe in vaccines, this one however raises so many questions, such as why don't the older women get it and why is there no antibiotic available for most commonly transmitted virus of all time. Come on follow the money, this one will make someone very rich.
    Yes, I am very angry, Instead of explaining yourselves and trying to figure out why this has happened, women have to stand up and realize something is amiss in this convoluted plot of HPV. Like a reasonable explanation and logic.

    November 11, 2010 at 11:12 | Report abuse | Reply
    • Valerie

      You treat bactieral infections with antibiotics, as long as they are not antibiotic resistant. You do not treat viruses with anything, your immune system should fight those off for you so long as it is working well. Sometimes, you can get a virus and it develops into a situation where bacteria are able to take over, in which case you can take antibiotics at a later time (after the bacteria over populate the area). Other than that I do not take issue with anything you have said.

      November 11, 2010 at 11:28 | Report abuse |
    • amy

      Where is the logic....

      You do not treat viruses with antibiotics...other STDs are in fact bacterial infections not viruses, these are not the same thing. If you try to get your doctor to give you antibiotics for everything you are part of the problem – they are being overused and soon will not be effective at all.

      Also Herpes Simplex Virus I causes cold sores, not Human papillomavirus (HPV). These viruses are different and are passed differently please do some research.

      November 11, 2010 at 11:48 | Report abuse |
    • miki

      Your entire argument is undermined by your assertion that you treat viruses with antibiotics (you treat bacterial infections with antibiotics NOT viruses). I agree that the vaccine should be avoided (due to the studies that show that its potential side effects are more likely to harm you than the probability of getting the cancer). BTW, even Tim Johnson (MD for ABC) has come out and said that he can't recommend it. My daughters will NEVER get this vaccine (and FLU shots? no way! talk about messing up your immune system!!).

      November 11, 2010 at 11:54 | Report abuse |
    • Where is the logic

      OK I meant anti-viral drugs, as defined below, available for other viral infections somehow not for HPV. Quote from Wikipedia, search under antiviral drugs. They do exist. My point is: as women we need to ask questions and stand up to the BULL we are being fed by "experts" . So if you are a woman, stop explaining yourself how you got it, why you got it etc. its stupid, pathetic and leads NOWHERE. It does not matter, start asking better questions, a MAN would not put up with this illogical, irresponsible marketing campaign crap. And the sooner we get the answers, the sooner we can stop the needless operations and deaths of other women who are our grandmothers, mothers, sisters, daughters etc.
      "Antiviral drugs are a class of medication used specifically for treating viral infections.[1] Like antibiotics for bacteria, specific antivirals are used for specific viruses. Unlike most antibiotics, antiviral drugs do not destroy their target pathogen; instead they inhibit their development."

      Antiviral drugs are one class of antimicrobials, a larger group which also includes antibiotic, antifungal and antiparasitic drugs. They are relatively harmless to the host, and therefore can be used to treat infections. They should be distinguished from viricides, which are not medication but destroy virus particles outside the body."

      November 11, 2010 at 14:39 | Report abuse |
    • charles s

      Virus infections cannot be cured by antibiotics. HPV is a virus infection. If you catch the flu, you might be given antibiotics for a bacterial infection that follows the flu but the antibiotics does nothing for the flu.

      November 11, 2010 at 15:11 | Report abuse |
    • Where is the logic

      Antiviral drugs are better then nothing or a barbaric, painful expensive and ineffective scarring of cervix. I get its not a cure, also mentioned in wiki article, but again its better then nothing. The virus remains in the body, however the impact of it is lessened.
      My point with about a cold sore is that its something i have always have and will always have in my system, yes i realize it is different then HPV, but its a virus, if there is enough money to make a $7 remedy to slap it on and literally make the sore heal, then why is it not available for HPV. Yes, one more time, i know the virus will remain.
      I think it is quite possible most of the population has the HPV virus, and like cold sore virus it hides, to come out when the body immune system becomes weak. Even more of a reason to have an effective way of treating the infection instead of barbaric and painful surgeries.

      November 11, 2010 at 15:44 | Report abuse |
    • Stephanie

      Antivirals are not the same as antibiotics, they have very different effects on the body. Antibiotics can usually target some structure on the bacteria that is unique among bacteria, like the cell wall. Where as antivirals must interfere with DNA or RNA replication so they are potentially more harmful in that each and every cell in our bodies contain DNA and RNA, so getting a drug to act on a specific viral DNA/RNA sequence is often detrimental to the host (us humans) and thus not as effective.

      November 11, 2010 at 16:17 | Report abuse |
    • Where is the logic

      Look, this is not a hypothesis at the moment, because there is a vaccine that works on women under 26, not over 26 (?????) , we got a live vaccine that works. IT WORKS, sometime, most of the time, better then nothing. Same way you don't care how your computer works as long as it works, or that this website works as long as it works, I do not care how a treatment/vaccine works, as long as it works. I do appreciate the spins, but is is just that a spin. the object stays in place.
      So at this point I am sort of sure of few things:
      1. Pharmaceutical reps/lawyers/opinion makers read this blog,
      2. There is a hungry, laid off lawyer, hopefully female, to fill in the gaps in logic, which I obviously have issues with. And will talk retrovirus, anti virus, bacterial, viral until the pharmaceutical lawyer turns blue in the face. I wonder how many women has their cervix sliced and diced by now, how many times the virus has returned and size of their cervix has diminished do to surgeries and scarring to a point of not being able to carry a baby.
      3. Stephanie, so don't get your flu vaccine, it could cause your system irreparable harm. Yes flu is a virus. there is a vaccine and treatment for it, even if its rest. As long as it is not scraping the surface of the lungs or removing a part of them, you would be fine. Yes, that is a STUPID analogy, good.
      4. There is more women like me who are angry at the lack of answers, lack of accountability and stupidity of answers,

      If you are a certain pharma fire your marketing firm. What a mess:
      1. Having children vaccinated against STD in this political climate at taxpayer expense, not going to happen. I do not find anything wrong with it, there are lots of people who do, and their children being minors, guess what? they will make decisions for them.
      2. Making the vaccine available to women under 26? Duh, yah, they need groceries and utilities, and birth control, not $300 out of pocket.
      3. Not making vaccine available to women over 26? It will add to final bill, calculate pain and suffering and then not being able to have kids because well there is no cervix left, occasional death and being sued by the family. What a mess.
      4. Saying HPV is transmitted by sexual contact only. That would have been Ok like in the 50s, depending on a woman probably not.
      5. Missing the golden opportunity of selling vaccine and treatment to women who have money. The income level actually rises with age, did you know that? You could SHAME a whole bunch of women for 2 or 3 times the amount of money for the vaccine, treatment whatever. These women could have paid you money, put their shamed tails between their legs and shut and and go home, quietly. Guess not for a while????

      November 11, 2010 at 18:10 | Report abuse |
  29. Big Sister

    My little sister, after having had one boyfriend in her entire life, discovered at 20 that she had full-blown cervical cancer. (She wasn't even sexually active until age 18...and yes, all these years later she is still with that "boyfriend," though now he's her husband,) #1) The first problem I have is that some people assume that all cervical cancers takes years to develop...this is not true, in her case it was less than two years and up until that point they had always used a condomn. #2) She had full blown cancer by 20, yet they now recommend that even sexually active women don't need a pap before 21...if that's the case, my sister would've lost her reproductive capacity and I worry about the young girls that may lose theirs. #3) Her husband had only been with one other women before her, granted that one had kind of been around the block, but it was still only one. #4) My brother-in-law has still never shown symptoms from his infection though he did test positive for it at the time. #5) The shot does protect people, and there are tests for HPV. In my sister's case, she had a form that was very rare and not covered by the shot, but she is an exception to that rule. #6) As a Health Teacher I can tell you that several of you are misquoting percentages on HPV infection rates. Someone says there is not test, then someone says that there doctor said only 10% of women get it and everyone on the anti-shot bandwagon jumps on. First the FDA is bad, then it's good. Look folks, you are entitled to your opinions but when you make up statistics people can die from your ignorance and that's not right either. PLEASE, do a little research on a topic before you make yourself an expert. And, since everyone else is quoting statistics, I'll quote one from the multi-state Annual HIV/AIDS/STD and Human Sexuality Education Conference I went to this summer. In 99.7% of all cases of cervical cancer, HPV is also present. Since any abnormal pap is a precursor to cervical cancer, and since there have been several studies implying it, one can say that 99.7% of abnormal paps also have HPV present. Since your body can fight-off HPV in many cases, it might explain why so many of those bad paps heal on their own...

    November 11, 2010 at 11:20 | Report abuse | Reply
  30. Missouri Lady

    Valerie-Frankly my dear, I don't give a rats a$$ if someone the likes of you believes me or not. After reading your posts it is apparent to myself and my coworkers sitting here reading this on break that you are indeed an anti-vaccine nut job and I don't believe that you vaccine your kids either for that matter. Some of those vaccines are newer than this too, so you better be careful! Hopefully one famous doctor will say they are good so you can feel better about yourself.

    November 11, 2010 at 11:28 | Report abuse | Reply
    • Valerie

      You must not have read anything about Sanjay Gupta and Gardisil. Basically, everyone in the media was questioning his journalistic integrity and therefore the integrity of CNN for supporting this vaccine despite the lack of evidence that it worked in the initial trials. You guys had better get back to work, since you're on the clock and all.

      November 11, 2010 at 11:37 | Report abuse |
  31. Courtney

    Correct, and nowhere in my comment did I say a pap tested for either of these.
    So, to say this again: every woman, married or not, should get a pap every year or every other- depending on previous results. While a pap doesn't TEST for hpv specifically- it will indicate if there is a cervical problem and hpv could be the cause.

    November 11, 2010 at 11:35 | Report abuse | Reply
  32. DewDroppingInn

    Women over 26 aren't cleared for this vaccine because it is assumed that they've already gotten the virus. Most women have it by that age no matter what some people on here are saying. (Ex-Pharmacy Tech)

    PS: Does anybody know what are the credentials of Valerie, Rachel, Elizabeth & Courtney?

    November 11, 2010 at 11:42 | Report abuse | Reply
    • Valerie

      I have a PhD in BS with an Masters of Associates. How that? 🙂

      November 11, 2010 at 12:04 | Report abuse |
    • Courtney

      Gosh, I didn't know I had to be a Dr to post about actual facts about HPV. Please.

      November 11, 2010 at 13:38 | Report abuse |
  33. ERL

    People need to stop coming onto this website and giving medical advice. Simple fact: You need to speak to your doctor because EVERY woman is differnt. I'm a 24 year old VIRGIN female dating a 25 year old VIRGIN male and we have been together for 6 years-my doctor (who is at NIH) has told me to get my pap smear every 24 months and she does not recomend the shot. Again-stop giving medical advice on a website and go see a doctor-because every woman is differnt.

    November 11, 2010 at 12:28 | Report abuse | Reply
  34. Brian from PA

    My sister in law started the Gardasil regimen. She had a stroke after the first injection. Her vision was effected in her one eye. After looking online there are many women that this happened to. I would probably think twice about doing this. Remember the drug companies make a fortune off of this, and then they support our politicians. I wonder why something like this is pushed so much.......

    November 11, 2010 at 12:29 | Report abuse | Reply
  35. bellum

    Am I the only one who thinks these researchers had absolutely no right to view women's medical records without written permission? Electronic medical records are a huge security risk for all of us. Do you want your sexual history on the internet?

    November 11, 2010 at 12:41 | Report abuse | Reply
  36. Valerie

    Is not telling a woman to go to her doctor giving medical advice?

    From the NIH's own website: "Partnerships between NIH-funded researchers and industry are often essential to the process of moving discoveries from the bench to the bedside. However, managing Financial Conflicts of Interest (FCOI) can be a major challenge because of the complex relationships among government, academia, and industry."

    November 11, 2010 at 12:41 | Report abuse | Reply
  37. Lillian

    Not wanting the disease is not enough to make the vaccine safe. You may not have an immediate reaction, but there are no long-term studies on what the cumulative effect of the dozens of vaccines in the current recommended schedule. You can't put toxin after toxin and foreign matter into your body year after year and not expect side effects.

    My daughter will not be getting this shot.

    November 11, 2010 at 12:54 | Report abuse | Reply
  38. John

    So, wouldn't celibacy be more cost effective?

    November 11, 2010 at 13:19 | Report abuse | Reply
  39. Sasha

    You know, throughout the years, many new "miracle" cures and preventions have been introduced to the market and it's just amazing how many of them (I'm looking at you, morning sickness pill of the 70s) turned out to be incrediably harmful.

    Now, to be fair, I don't know that this shot will be one of them. I do know, however, that I'd rather not find out by having whatever happen to me when I'm already in a monogamous relationship. And yes. Some women in that age group are married and monogamous.

    November 11, 2010 at 13:40 | Report abuse | Reply
  40. Courtney

    Good grief. I commented a total of TWO times on here and in neither post did I try to give anyone medical advice or tell anyone to not go to your dr and only listen to me. This is called a message board. And look. I get to write what I would like on it! See!
    Get the shot, don't get the shot, do what you want. All I was trying to say is that hpv is a very widespread virus and I hope we eventually get more research on this to learn how to better prevent it...

    November 11, 2010 at 13:50 | Report abuse | Reply
  41. Melanie


    I have a PhD in BS with an Masters of Associates. How that?


    Yes – you do have a Bull/S degree.... If YOU want to risk getting cancer, warts – that is YOUR choice... Hopefully, most young women in their early teens will GET the vaccine. Remember people LIE about their sex lives and it is up to YOU to protect yourself!

    November 11, 2010 at 13:54 | Report abuse | Reply
    • Valerie

      I am too old for the vaccine and most likely have or have had the virus at this point, but at least I'm not willfully ignorant of the fact that it will not stop you from getting cervical cancer in all cases. The degree thing was a joke.

      November 11, 2010 at 13:57 | Report abuse |
  42. darinu

    Line up Sheeple and get your shot. Baa, Baa.

    November 11, 2010 at 13:59 | Report abuse | Reply
  43. Melanie

    I know a woman in Dallas who has had multiple procedures done to remove abnormal cells on her cervix... She is divorced with two kids... had a relationship with a man who was separated from his wife... He went back to his wife... Wife now has HPV that can lead to cancer... Know another young girl – college age – 19 – HPV positive with an adnormal PAP – will watch herself for the rest of her life and should tell all her partners but probably won't... Know another woman in NYC – had cervical cancer in her early 20's and herpes – got it from her long-time boyfriend who said he was a virgin before her... Bottom line – you can protect yourself with this vaccine for 4 types of HPV strains – consider ALL THE RISKS for yourself and/or your daughter – TALK to your DOCTOR – and decide for yourself!!!!

    November 11, 2010 at 14:14 | Report abuse | Reply
  44. K

    Beofre we got together, my boyfriend was with a girl who had cervical cancer, so I had a pretty in depth discussion with my doc about HPV. His assessment: HPV is not nearly as big a deal as Merck wants you to think it is, but the shot's not a bad idea anyway. The tales of adverse reactions are scary, but they aren't the norm. I broke out in hives that took a month to clear up after my first shot, so I was advised not to finish the series. Given my situation, I would have liked to have had the added (but yes, I know, not total) protection of immunization. After all, I know far more women who have had serious complications and cancer from HPV than reactions to the vaccine. I just have to be diligent in screenings.

    November 11, 2010 at 16:24 | Report abuse | Reply
  45. HS Health Teach

    My first comment: I hope that any young woman eligible for this shot makes an informed decision under doctor's advice about this without listening to scare tactics presented by some irresponsible posters stating inaccurate information. (Yes, there are adverse reactions due to the shot, but there are also adverse reactions due to having cervical cancer. The shot is most likely the lesser of the two evils.) Please do your research teens.

    My second Comment: To the one called Valerie, I couldn't help but notice that you've been on and off here for almost an entire day. Don't you have anything else to do? Perhaps a job would help you fill your empty time or maybe you could parent the children you claim to have. Whatever the case, you're constant snippy replies are getting old. Why can't you state your case in a civil tone the way others have? Now, please feel free to attack me with a barb in just the same way you have to everyone else who states something that you don't like. I teach/coach teens all day and I'm used to little girls (or big one in this case) with attitudes.

    November 11, 2010 at 18:47 | Report abuse | Reply
  46. Laurie

    It was completely free for my daughter. We didn't get the other two doses because she became violently ill, is still very sick over a year later and has to be home bound schooled...At least after 11 months she was finally able to hold down a complete meal!! The CDC needs to update their side effects like Merck was finally forced to do...there is way more than meets the eye here...and if your child does become cripple, epileptic or die, the Vaccine company is covered by the National Vaccine Injury Compensation Program...which is a joke...try to get, not only every single medical record your child has ever had, then add the doctor's notes during the delivery AND the nurses notes!! These things on most cases do not exist and if you can't provide them, you get nothing!! Well, except screwed and a very sick kid that has no idea what the future holds!! And ironically, the amount of vaccines that our children are bombarded with have more than doubled since the induction of this protection program...sorry, I mean compensation program. The president of truthaboutgardasil.org site just received an invitation to China to speak at the next vaccine introduction convention. There were dozens of pages listing vaccines trying to be approved...the most shocking were vaccines for stress, drug addiction, migraines...etc...I was shocked that there wasn't one for crooked teeth!! I hope this makes people think and research. I was never against vaccines! My daughter has had every one without incident...I am against vaccines that are flying by protocol standards, being approved in record time, and advertised to be a cancer drug...it's sickening when you actually see how many girls all over the globe whose lives have been turned upside down from this "cure". You will see...it won't be long and this poison will finally be pulled from the market...then you will be so grateful that they were greedy and you couldn't afford it!

    November 11, 2010 at 18:52 | Report abuse | Reply
  47. A

    I'm 26 years old and have had numerous abnormal pap smears, colposcopies, and biopsies of my cervix. I wish that I had had the vaccine as a kid, as it is fairly effective in preventing the 2 strains of HPV that cause these cervical changes that can eventually develop into cancer. It certainly would have been thousands of dolors cheaper.

    December 23, 2010 at 07:34 | Report abuse | Reply
  48. Norman Schwerin

    animal vines


    September 22, 2016 at 11:02 | Report abuse | Reply
  49. スーパーコピー 実店舗

    配送の費用も無料とし、品質による返送、交換、さらに返金までも実際 にさせていただきます。
    また、従業員一同、親切、丁寧、迅速に対応 させて頂き、ご安心になってお買い物を楽しんでくださるよう精一杯力 を尽くしていくつもりです。

    October 1, 2018 at 20:17 | Report abuse | Reply

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