I am a public health epidemiologist; I haven't heard anything about vaccine related deaths. There does seem to be a lot of vaccine paranoia in general, and Gardasil is particularly controversial because it's for an STD. Sex, religion, conservative politics, and medicine don't mix.
11,000 people is a fairly large clinical trial. I wouldn't be put off by the sample size.
70% of cervical cancers are caused by one of 2 different HPV strains. 70% odds of success are pretty good; 100% will never be reached with this vaccine or any other one.
Most women with HPV don't know that they have it; estimates are that up to 80% of the sexually active adult population has it. And not everybody gets regular Pap smears, if they've even had one at all. In the United States and most developing countries, this is a service that has to paid for and lots of people don't even come close to having the money. And in places like New Zealand, where the service is free, lots of women still don't get it. A lot of people just don't like the idea of having their privates poked and prodded in a medical office. Pap smears for everyone just isn't going to happen.
The statement that it's mostly women with underlying immune system issues that go on to have cervical cancer isn't really true. Chemotherapy patients are definitely immunocompromised, but most of them either recover, or die of sepsis or metastasis of the original tumor. Most AIDS patients die of sepsis, and kidney failure takes out a lot of lupus patients. Given the actual prevalence of HPV infection, and the large number of immunocompromised people (AIDS, cancer, autoimmune disease, old age, etc), the actual number of cervical cancer cases would be expected to be much higher than it actually is if having a competent immune system were the only issue involved. For example: the number of annual cervical cancer deaths in NZ is about equal to the the number of HIV patients, and the HIV patients are mostly men who don't have a cervix. And the skin cancer rate here is quite high: a lot of the female melanoma patients would be expected to develop cervical cancer and they just don't.
The majority of people with HPV never go on to develop cancer. And for those that do, it's probably more of a genetic issue: the person's immune system is generally good but just not against HPV. The genetics are still being worked out. And since the genetics haven't been completely sorted, it's difficult to say exactly who will get cancer and who won't. And even if it were completely an immunocompetence issue, the fact that your immune system is good right now doesn't mean that it will continue to be that way in the future. So better to take all possible measures to avoid getting HPV in the first place.
The argument that the vaccine might be proven harmful 20 years from now isn't a very good one. For all we know, those of use who have been eating large quantities of microwaved food since Nixon was president might go on to develop weird esophageal cancers. Or the heavy cell phone users might develop cancer of the auditory nerves. Both forms of energy are generally considered safe today, but not enough time has passed that we can say they are harmless. My generation is technically the large scale clinical trial: don't think I'm going to be ditching my microwave or my wireless internet connection any time soon
I would get the vaccine if I were in the target age group, and recommend that you do the same. The odds are much higher that you will die in a traffic accident than from adverse side effects of Gardasil or any other vaccine.
