German scientists criticize recommendations on HPV vaccination (GARDASIL etc.): In a joint declaration thirteen renowned scientists, including two editors of the arznei-telegramm and the chairman of the Medicines Commission of the German Medical Profession, criticized the recommendation of the STIKO (German Standing Vaccination Committee) to provide blanket vaccinations of young girls against human papilloma virus (HPV, statement on the efficacy of HPV vaccination, 25/11/2008: http://www.uni-bielefeld.de/gesundhw/ag3/downloads.html). As we have already discussed on a number of occasions (a-t 2007; 38: 57-9,   101-3; a-t 2008; 39: 17-8,    43,   92-4) the benefits of HPV vaccination remain unclarified. Efforts directed towards the vaccination of as many girls as quickly as possible are, therefore, not justified according to our current state of knowledge. The thirteen scientists rightly question how STIKO came to assume a "lifelong vaccination efficacy of 92.5% in the prevention of cervical cancer" (without any limitation to certain HPV subtypes) in their reasoning for recommending the vaccination (Epid. Bull. 2007; Nr. 12: 97-103): apart from the fact that there is absolutely no evidence to prove any lifelong protection, and that experiences with other vaccines contradict such an extreme efficacy, even the manufacturers of the vaccines refrain from making such extraordinary claims. Since STIKO provides no literature references to support this "assumption", it is not possible to track how it was arrived at. The whole affair reminds us of the lax way the commission went about considering the efficacy of influenza vaccination (a-t 2008; 39: 101-2). Even the often claimed 70% reduction of cervical carcinoma following HPV vaccination may be overestimated, since it is only based on the fact that HPV 16 or 18 could be demonstrated in approximately 70% of all carcinomas. With the introduction of tests with higher sensitivity it has become apparent, however, that mixed infections with other oncogenic HPV subtypes are more common than was previously assumed (THIRY, N. et al.: HPV Vaccination for the Prevention of Cervical Cancer in Belgium. HTA; Brussels; Belgian Health Care Knowledge Centre [KCE]; 2007; KCE reports 64C). An increase in disease induced by other HPV subtypes (e.g. through replacements) may therefore weaken the aspired for 70% reduction in cervical cancer even further.