This blog entry is authored by Toy McGee, one of Orin Levine's graduate students at the Johns Hopkins Bloomberg School of Public Health. This post is the third of a three week series entitled "Tomorrow's Vaccine Policy Leaders."
They will inevitably be challenged intellectually in school, get into a few fights with friends, and get their hearts broken before they graduate high school. Yet, as a student of public health at Johns Hopkins Bloomberg School of Public Health, I am most worried about their potential for contracting sexually transmitted diseases. High school is hard enough for them without contracting a disease that could potentially endanger their lives. For this reason, the Gardasil vaccine to prevent against HPV infections should be mandated for all sixth graders - both male and female.
Human papillomavirus, colloquially known as HPV, poses a health threat to the sexually active, regardless of age. HPV is a virus with over 40 strains that can cause painful genital sores and lead to a variety of cancers in both males and females. It accounts for approximately 12,000 cases of cervical cancer each year, and it is estimated that 50% of the sexually active population will contract HPV at some point during their lives. Twenty million Americans are currently infected with HPV, and each year 6 million more will be newly diagnosed. While women carry most of the morbidity and mortality burden of this disease, men can easily spread HPV since the majority of those infected can remain asymptomatic for long periods of time. Women can learn of their HPV status by receiving a pap smear, but there is no similar test that can detect if a man is infected with HPV.
Fortunately scientists were able to produce a vaccine - known as Gardasil - which, if administered correctly, can completely block the transmission of four HPV strains. These four common HPV strains account for more than 70% of cervical cancer cases and 90% of the HPV cases that result in genital warts. In order to protect a person from the illnesses caused by HPV, the vaccination should be administered prior to exposure. For this reason, the FDA approved the use of Gardasil vaccine in pre-adolescent boys and girls. It is recommended that all children and young adults between the ages of 9 and 26 years of age be vaccinated.
Yet, even with the health benefits that can be gained from a vaccination program, Gardasil has not yet been mandated prior to school entry. Some religiously affiliated organizations have argued that receiving Gardasil will give their young daughters permission to engage in promiscuous sexual practices. Additionally, Focus on the Family states that a mandate would remove parental rights and they therefore resist State Legislatures' attempts to mandate Gardasil. This abstinence-based, anti-mandate argument is dangerous and misguided for two main reasons.
First, protecting your child from cancer does not condone the behavior that might lead to cancer. Prevention from HPV transmission does not give permission to become sexually active. The decision to engage in sexual activities is going to be made by thousands of high school aged children regardless of vaccination status. Each of these children will in some way be counseled about the dangers of sexually transmitted diseases, whether it is from a parent or in health class. But as any parent, teacher, or mentor can attest, sometimes kids don't listen.
In fact, before this year's sixth grade class graduates high school, as many as 62% of girls and 70% of boys will have ignored the advice to practice abstinence. According to the US Centers for Disease Control, in 2007 thirty-nine percent of these sexually active high school kids ignored safe sex practices and engaged in sex without the use of a condom, which drastically increases their risk of contracting a disease from their sexual partner. Every parent and mentor wants to believe that their child will be smarter than to risk their health in frivolous sexual activities before marriage, but the statistics prove that many of those parents will be wrong.
The lack of an HPV vaccination program puts everyone at risk of exposure - even those people who wait until marriage to engage in sexual relations. One study found an HPV prevalence of 14.3% amongst women who engaged in sex with only one lifetime partner.
Secondly, parental choice will not be removed by the implementation of a school mandated HPV vaccine. Gardasil would be treated as any other school mandated vaccine. Every state already has a procedure for parents to claim a religious or philosophical objection to vaccinations, which would allow their child to be granted an exemption from vaccination requirements. Claiming that parental rights would be violated is a lobbying technique meant to spread misinformation and doubt about the proposed vaccination program. The Gardasil vaccine should not be used as a means for religious or anti-vaccine organizations to impose their views on the rest of the population.
As a mentor, I fear that children will engage in sex too soon. As a Catholic, I appreciate the religious belief of abstinence before marriage. However, I also realize that the risk of HPV is much too high to simply be ignored. For this reason I resent the attempts by some religiously affiliated groups to block a broad vaccination program that can protect all children from the potentially deadly risks of HPV. Write to your State Legislature today and tell them that you, too, want all children protected against HPV.
About the Author:
Toy McGee recently graduated with her Master's degree in Molecular Microbiology and Immunology from the Johns Hopkins Bloomberg School of Public Health, where she also completed a certificate of vaccine science and policy. Prior to attending Johns Hopkins, she earned her B.A. in Political Science from the University of Notre Dame after which she worked for two years as a paralegal at the Department of Justice. Ms. McGee is currently seeking employment in the fields of public health or vaccine science.
Follow Dr. Orin Levine on Twitter: www.twitter.com/orinlevine
In some states, religious exemptions are all or nothing. A parent who wants their child to have all of the vaccines except for Gardasil would be out of luck, wouldn't they?
Also left out was the big push by Merck to get mandates passed by state legislators. Merck is the company behind Gardasil. They have already made millions on this vaccine. Should companies be able to lobby for laws mandating the use of their product?
Merck doesn't have a great track-record for safety. Vioxx anyone?
Great point Doybia! This was not discussed before here. Great point!
Side effects are always under reported by a large margin because people usually don't associate symptoms they have with a drug or vaccine they took in the past . Also doctors are not required to report side effects to the FDA and studies have shown that most doctors don't report side effects. Patients can fill out their own FDA side effect reports online but this is rarely done.
http://www.cbsnews.com/stories/2009/08/19/cbsnews_investigates/main5253431.shtml
" Amid questions about the safety of the HPV vaccine Gardasil one of the lead researchers for the Merck drug is speaking out ............"“If we vaccinate 11 year olds and the protection doesn’t last... we’ve put them at harm from side effects, small but real, for no benefit,†says Dr. Harper. “The benefit to public health is nothing, there is no reduction in cervical cancers.....'She also says that enough serious side effects have been reported after Gardasil use that the vaccine could prove riskier than the cervical cancer it purports to prevent. Cervical cancer is usually entirely curable when detected early through normal Pap screenings.
Dr. Scott Ratner and his wife, who’s also a physician, expressed similar concerns ..... One of their teenage daughters became severely ill after her first dose of Gardasil. Dr. Ratner says she’d have been better off getting cervical cancer than the vaccination. “My daughter went from a varsity lacrosse player at Choate to a chronically ill, steroid-dependent patient .... I’ve had to ask myself why I let my eldest of three daughters get an unproven vaccine against a few strains of a nonlethal virus that can be dealt with in more effective ways.â€....."
Dr. Levine these concerns are legitimate. Excuse me but ....
http://www.cbsnews.com/stories/2008/07/07/eveningnews/main4239462.shtml?tag=contentMain
As I said earlier to you, one should be careful with stones when one lives inside a glass house. You are the one who despises "labels" yet have no problem labeling me. Read all of my comment exchange with HX and then tell me if my support of the pharmaceutical industry is "unconditional". My only support that is unconditional is for logic, reason, and evidence. As I said previously, if one didn't have to spend the time correcting factual misrepresentations, perhaps I would actually be able to express my own opinions.
"And, did you really say, "Respect is earned, not freely given."?"
Again, as I asked HX, please provide the quotations where I was "rude". I have never suggested she was unintelligent, stupid, or ignorant. I said she was wrong and that her opinion wasn't based in evidence and mixed in a bit of sarcasm. If that qualifies as rude, so be it. As I said to HX, I do not subscribe to the post-modern relativist idea that all ideas are equally valid and equally deserving of attention and respect.
I will also point out yet again that you have yet to address the actual point of my posting detailing the risk of death from the vaccine versus the risk of death from cervical cancer. But I would imagine that it is far easier to harp on my "rudeness" than it is to actually refute mathematical calculations.
I have never seen you post a single comment expressing concern about a vaccine safety issue. [Please repost it, if I missed it.] More importantly perhaps, and this is key, I have witnessed you post repeated, insulting, pedantic (even bullying) attacks on those who are concerned about various aspects of vaccine safety. Even someone as good hearted and good natured as HX. It is not usually the content of your pro-immunization arguments that is the problem Cable, it is the tone you choose to use toward others.
Read below. I made a post to HX below that I disagree with Merck's marketing of Gardasil. That certainly does not qualify as "unconditional support". But in reality, I am not particularly affected by whatever it is you call me or label me. If you want to call me a BigPharma shill, so be it. Having been exposed to my share of prejudice and discrimination in this world, there is nothing that an anonymous commenter on HP can say to rattle me.
"The children who suffer vaccine injuries are real. They are not just statistics."
Please point to where I suggested they are not. I have nothing, but sympathy for those who have suffered vaccine injury, but that doesn't mean that every individual who claims that their child has suffered vaccine injury actually has been injured by vaccines. Vaccines carry risk and I would be interested to see you point to the vaccine supporter who suggests otherwise. I'm sure you have some examples in this comment thread of Sheldon or I suggesting such, right? The only thing I have suggested is that those arguing on your side of the equation over-inflate the risks of vaccine injury.
As an aside, the women who suffer from cervical cancer are also real. The 12000 who are diagnosed every year and 3600 who die from cervical cancer also have names, faces, and families. Also relevant are any individuals who die from vaccine preventable diseases, especially if they are infected by an individual who is unvaccinated. Are they equally relevant to the discussion? If I have an infant who died from pertussis transmitted by an unvaccinated child at daycare, does that make my arguments automatically correct or worthy of more attention?
However, (1) Medicine is never going to be able to prevent all morbidity and mortality due to all infectious illness. (2) You said, “Also relevant are any individuals who die from vaccine preventable diseases.†Please provide the mortality data on individuals who have died in the US in the last 10 or 20 years (your choice) due to infectious disease for which we vaccinate for. (3) According to the CDC data I have seen, infant mortality as a result of pertussis infection typically runs 0-10 deaths/year in the entire United States. Please recall that ~4 million children are born in the US every year. There is no epidemic of death occuring in the US due to pertussis infection (or any other vaccine preventable disease). (4) Please provide the documented case of an unvaccinated child transmitting pertussis to a vaccinated child who subsequently died.
Where did I imply that it would? But
"Please provide the mortality data on individuals who have died in the US in the last 10 or 20 years (your choice) due to infectious disease for which we vaccinate for."
But we aren't talking about mortality data and, in fact, its not relevant to the current point of discussion. Try to stay on the same subject. What we are discussing is whether or not personal anecdotes are relevant to a scientific debate of facts. As you said above, "The children who suffer vaccine injuries are real. They are not just statistics." Likewise the children who die from pertussis are real, no matter what the statistics are, but how does a personal anecdote of an autistic child or a pertussis death contribute to the scientific facts? They don't, in either case, which was my point.
Exactly, thanks to vaccination, hence the term vaccine preventable. But if people stop vaccinating, then the reality would be quite different, wouldn't it?
"Please provide the documented case of an unvaccinated child transmitting pertussis to a vaccinated child who subsequently died. "
What if the child was my child? Is my word that it occurred not sufficient? Do you also therefore support my asking HX for documentation on her child's autism? I have certainly never questioned whether or not her child has autism. But again, as I pointed out above, the documentation isn't actually necessary for you to address the question, that you still haven't addressed, of why such a personal story would be applicable to a scientific debate. You have asked above for statistics and documentation, but your initial point was that it's not just about statistics, that these people are real. So which is it that is valued in the debate? Seems like you aren't quite sure yourself.
But I have no illusions about the altruism of the pharmaceutical industry. I know too much about it works. I have been exposed to how it works for too long. I have been immersed in the medical world all my life (due to my MD father). As a result, I am not naïve to how the pharmaceutical industry operates. What I have seen over the last 30+ years never ceases to amaze me. Perhaps if you worked in the medical field as long as I, you would better understand my perspective.
And, as anyone who has followed my posts for a long-time knows, I support a National Vaccine Program (otherwise morbidity for infectious disease for which we target will significantly increase). However, vaccine injuries are real (and under reported). Any many significant vaccine safety issues are real.
"However, vaccine injuries are real "
And as I asked you above, point to the place where I said they weren't. Vaccine injuries are real, but that doesn't imply that everyone who says their child was injured by vaccines actually has a child that was injured by vaccines.
I am tired of trying to keep track of that far too long thread so I will address your points here.
"criticizing HX because she has told her personal story is absurd"
I did not criticize HX for sharing her personal story. I didn't say she couldn't or shouldn't share her personal story. What I said was that it isn't actually relevant to the argument and that is true. A personal anecdote isn't relevant to an objective debate about scientific information. That is not a criticism, but a point of logic. Why would the fact that HX has an autistic child make it more or less likely that vaccines contribute to autism? Please be specific in explaining how the two follow. If anything, it simply adds evidence that one has a conflict of interest and is unable to objectively analyze evidence. However, I don't use her family against her as I do not consider it relevant to the discussion at hand.
The children who suffer vaccine injuries are real. They are not just statistics. The pain that their parents feel is real. It is not just a statistic. These facts and these feelings may be inconvenient to you and to your position of unconditional support of the pharmaceutical/vaccine industry, but they are hardly irrelevant to the larger issue of vaccine safety.
"The very purpose of these forums is to exchange ideas, opinions, information, and experiences; civilly and without name-calling (“anti-vaxerâ€)."
So all opinions are equally valid? Is the opinion of a birther who insists Obama is a Muslim spy equally valid to a person who knows Obama is a US citizen due to the evidence? Is the opinion of a holocaust denier equally valid to a holocaust survivor despite the mountains of evidence showing the holocaust occurred? Are the homophobic opinions of Fred Phelps about gay marriage equivalent to a gay man who cannot visit his dying partner in his hotel room? No, because not all opinions are equally valid or based upon rational evidence. Is it wrong to call a birther a birther, a homophobe a homophobe, or a holocaust denier a holocaust denier? I certainly don't think so.
It's okay guys. I have an extremely thick skin. My only hope is that other parents of children with ASD's won't be deterred in telling their story. Our children need our voices and the other parents need support. I've been blogging long enough to glaze over the nonsense and try and see the points being made. Cable wants a very sterile conversation. I can't offer him that and he knows it. My love for my son and the suffering that he has endured drives me to post. So I hope he's well represented here and elsewhere.
Sleep well everybody,
Heather
http://www.cbsnews.com/htdocs/NVICGardasilvsMenactraVAERSReportFeb2009.pdf
If you want to see the details, your sort critieria must include VAERS ID and you have to select the check box below the sorting criteria. For an education, do a search for Death in symptoms and select all the symptoms that contain death (leaving out suicidal intentions) and select Gardasil as the vaccine.
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I was very sloppy when it came to discussing 'mandatory' HPV vaccination. I knew that vaccination exemption policies varied by state and said so. They vary from philosophical exemptions to only allowing exemptions for valid medical reasons. So I knew McGee was wrong when she wrote that all states had philosophical and religious exemptions from mandatory vaccination. So that's what I wrote.
So far so good. But where I went off the rails was not thinking about HPV vaccination in particular. I ASSUMED that no American state would have a law that made it hard for parents to opt-out their child from HPV vaccination. But I didn't check that out and didn't state my assumption. Let me fix that now.
Toy McGee is correct when she says that parents can opt-out of 'mandatory' HPV vaccination. That's true of all state laws passed. See http://en.wikipedia.org/wiki/HPV_vaccine#State-by-State Since this is a blog entry on HPV vaccination, her correct statement on HPV is more important than her error in thinking that the opt-out provisions for HPV vaccination were the same ones used for the other vaccines.
Finally, no vaccination opponent corrected me. Some of them had to know I was wrong when it came to HPV vaccination. Those people put ideology ahead of accuracy. Think about that when it comes to deciding who you should trust.
S, who are you talking to? You do not have legions of followers. Sorry, but you are not Rush Limbaugh.
(I'm glad you didn't say "...Sorry, but you are not Orac." I like Sheldon much better than Orac!)
Some of your recent posts have been really long...I guess I'll need to make sure I have some coffee before logging into HuffPo.
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I like this blog entry and this set of comments because it focuses on the effectiveness and safety of one vaccine to prevent a specific disease. It also allows you to see the strength of the arguments between those who argue that the vaccine is safe and effective in doing what it is supposed to do AND those who argue that the vaccine isn't safe or effective or that even if it is effective that this won't result in substantially fewer cases of cervical cancer.
“Gardasil Researcher Drops a Bombshell.â€
On October 25, 2009, Dr. Diane Harper, lead researcher in the development of Gardasil and director of the Gynecologic Cancer Prevention Research Group at the University of Missouri, told an audience of medical professionals (at the 4th International Public Conference on Vaccination) that Gardasil is largely unnecessary, and that it has never been fully tested on females under the age of 15. This, despite strong marketing efforts to make the drug mandatory for girls, and product literature and advertising that state the product can be used by girls as young as age 9.
"Dr. Harper began her remarks by explaining that 70 percent of all HPV infections resolve themselves without treatment within a year. Within two years, the number climbs to 90 percent. Of the remaining 10 percent of HPV infections, only half will develop into cervical cancer, which leaves little need for the vaccine." [1]
When asked why she was speaking out, Dr Harper said: “I want to be able to sleep with myself when I go to bed at night.â€
[1] http://thebulletin.us/articles/2009/10/25/top_stories/doc4ae4b76d07e16766677720.txt
http://www.profitableharm.com/the_therapist.html
You decide & don't listen to others working to fool you; Your children are too important to take anyone's word so hear both sides & come to your own conclusion.
The Tainted History of the DPT Vaccine
"I guess you haven't seen the "SCIENCE" that shows a resurgence of whooping cough ...in the vaccinated population? Either the vaccine does not work, there is resistance or the dz has mutated. Research is showing that vaccine-induced immunity is occurring. The truth is we have no idea what we are creating thru vaccines."
http://www.facebook.com/l/d1da1S700VSnb_MjCcTe0kjaGpA;www.ncbi.nlm.nih.gov/pubmed/15876927
"Epidemic of pertussis in Cincinnati -- Resurgence of Disease in a Highly Immunized Population of Children"
http://www.facebook.com/l/d1da1ZzuMhV7inkr1XwUG8ZNZFg;content.nejm.org/cgi/content/short/331/1/16
Pertussis has re-emerged in countries with high vaccination coverage and low mortality
http://www.facebook.com/l/d1da1TJVMFD2ufG6YtstLi8xLGw;www.bmj.com/cgi/content/full/324/7353/1537
http://www.facebook.com/l/d1da1aJjUyWv72umQDbXvqoepng;www.cdc.gov/ncidod/eid/vol6no5/pdf/srugo.pdf
In the UK between 1970 and 1990, over 200,000 cases of whooping coughoccurred in fully vaccinated children. (Community Disease SurveillanceCentre, UK)-
In 1979, Sweden abandoned the whooping coughvaccine due to its ineffectiveness. Out of 5,140 cases in 1978, it wasfound that 84% had been vaccinated three times! (BMJ 283:696-697, 1981)-
Headline from the Feb. 11, 2010 Daily Telegraph:
"The bacteria that causes whooping cough has mutated, eroding the protection provided by the vaccine now given to children, scientists warned yesterday."
http://www.dailytelegraph.com.au/news/whooping-cough-strain-now-immune-to-vaccine/story-e6freuy9-1225828959714
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This comment make more sense if you've read this comment found below first:
Wrong: --- If infected, HPV Vaccinated increases cancer by 44.6%
The permalink is http://www.huffingtonpost.com/social/Sheldon101/excuse-me-but-your-opinio_b_683082_58259266.html
This comment demonstrates that Leslie Botha and Norma Erickson have been (you pick) negligent, ignorant or deliberately intending to mislead those who don't check their bizarre claims.
She claims: "According to FDA documents if a woman is exposed to HPV and gets vaccinated with the HPV vaccines her risk of getting cervical cancer increases to 44.5% with Gardasil and 32.5% with Cervarix."
I had a hard time finding the Cervarix number earlier. I must have screwed it up. It was harder to find because I think that Botha and/or Erickson found this one themselves and didn't copy from elsewhere. Of course, a proper link would have been nice.
This found it: site:fda.gov cervarix 32.5%
The pdf is http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/VaccinesandRelatedBiologicalProductsAdvisoryCommittee/UCM181425.pdf
Leslie Botha and her co-conspirators have done exactly the same thing with Cervarix as they did with Gardasil. Find a number that they like and leave out any explanation.
continued...
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This time they pick out the number -32.5%. Yup, in one of the two major studies on Cervarix, a higher number of those infected with strains 16 or 18 at the start of the study ended up with bad things (CIN2+) than those on the placebo. That's on page 18. Of course, on page 19 we learn:
" The sponsor also notes that when considering the overall number of subjects with abnormal
cytology at entry progressing to CIN2+ (a total of 1484 subjects had abnormal cytology at
baseline), there were 103 subjects in HPV group (13.6%) and 101 in the HAV group (13.9%)
with progression to CIN2+. Therefore, administration of vaccine subjects with abnormal
cytology did not enhance the risk of developing CIN2+. "
Read pages 18 and 19 for more details.
Having had this 'mistake' pointed out, the question is what will Botha and Erickson do. My money is that they won't come here, apologize and make changes to websites they own or participate on. My guess is that for them facts are fungible and only the end matters. But who knows, I could be surprised.
Dr. Diane Harper, the lead researcher of Gardasil
http://healthwyze.org/index.php/component/content/article/208-the-lead-vaccine-developer-comes-clean-so-she-can-qsleep-at-nightq-gardasil-and-cervarix-dont-work-are-dangerous-and-werent-tested.html
Balance that low risk with the more substantial risk from an adverse event from the vaccine. Well, it's simple math.
No.
Oh, and thanks for the chemistry lesson, but I am already well versed.
You need to get your facts straight, Doc! Actually, not every state has a religious or philosophical exemption and two states (WV and MS) only offer medical exemptions. Furthermore, it is not only people with particular religious beliefs who are refusing vaccinations for their children. A map indicating which states offer which specific exemptions can be found here:
http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements.aspx
As a parent of a child with autism who regressed following rounds of vaccinations, I thank my lucky stars (and my politicians!) every day that I have the right NOT to vaccinate my child. Just like any prescription drug, or ANYTHING, vaccines are NOT a one size fits all kind of thing. They can and do harm some individuals and even the government acknowledges this fact with the VAERS (Vaccine Adverse Event Reporting System) program and the NVICP (National Vaccine Injury Compensation Program).
While you may consider the opinions of some people to be putting others at risk, it is also YOUR misinformation that is putting others at risk as well. Using your medical degree to incorrectly inform people of their rights regarding vaccine objection such as you did above may do just as much harm as you are claiming others are doing by objecting to vaccines.
In the United States two states only allow exemption for valid medical reasons. Some states allow philosophical exemptions. Some states allow religious exemptions. Some states allow religious and philosophical exemptions. The author made the error of claiming that all states had philosophical and religious exemptions.
You write: "While you may consider the opinions of some people to be putting others at risk, it is also YOUR misinformation that is putting others at risk as well." That is correct. However, you have the risk exactly wrong. People following this specific mistaken advice may not have their children vaccinated thinking there is an exemption in their state that applies to them when it does not.