HPV Vaccine Debate Plagued by Ignorant Opposition

Yesterday, September 27, was my mother's 52nd birthday.

She died of cervical cancer in November 1992.

So last year, when news broke that Merck produced a potentially life-saving vaccination, Gardasil, against the human papillomavirus (HPV), a leading cause of cervical cancer, I cannot describe the joy I felt at the thought of future families not having to bury 37-year old mothers of four like mine did.

Meghan O'Rourke, writing at Salon today, picks it up there.

So when Merck announced that it had a created a drug that could prevent some 70 percent of cervical cancers from developing, you would think Americans would rejoice. Instead, there was a backlash. Last February, Republican Gov. Rick Perry signed an executive order that would have made Texas the first state to mandate the vaccination of schoolgirls against HPV, the sexually transmitted virus that is a frequent cause of cervical cancer. He promptly came under fierce attack. The Texas Legislature expressed its deep reservations about the vaccine, and the media reported that Perry had received a campaign contribution from Merck prior to signing the order. Ultimately, the order was vetoed by the legislature. Earlier this year, 24 states were contemplating making Gardasil--as the cervical-cancer vaccine is known--a mandatory vaccination for young women. Today, only one state, Virginia, has such a law, and it leaves a loophole for parents to opt out.

In one sense, this reluctance seems understandable. Merck is the same company that made headlines in 2004 for failing to disclose that its painkiller Vioxx raised the risk of cardiac arrest and stroke in patients. Gardasil is a brand-new drug, and the company has conducted only limited testing on it. Though the pre-release studies suggest it is highly efficacious, the vaccine's long-term side effects are not fully known. What's more, the vaccination comprises three painful shots, at an estimated cost of $360. Given all this, it is hard to blame parents who resist putting their daughters on the drug's front line, preferring to wait until more is known about it.

That is a totally understandable, precautionary skepticism that any responsible parent would display. Just as O'Rourke points out, it is the other argument pushed forward by opponents that is problematic.

Much less understandable, though, is the position taken by many opponents: namely, that a cervical-cancer vaccination would "promote promiscuity" among teenage girls. Implicit in this argument is the assumption that good girls don't get cervical cancer; only "loose" ones do--and they may get what they deserve. Earlier this year, State Sen. George Runner of California told the Los Angeles Times that American money would be much better spent on other types of vaccines, since cervical cancer is a result of lifestyle choices, rather than bad genetic luck.

O'Rourke notes the rank ignorance of proponents of this absurd argument. With this logic, cancer research -- namely, much needed governmental funds -- should be chauffeured away from deadly illnesses such as AIDS/HIV and lung cancer caused by emphysema.

Also, State Senator George Runner (R-Los Angeles) doesn't seem to realize that HPV can be caused as easily as casual skin-to-skin contact or environmentally, notes Wikipedia. Ever take a shower in a college dorm with a community bathroom? It is that easy.

In fact, most Americans don't even know they have it, and can unknowingly pass it along to others. O'Rourke notes the troublesome data:

The CDC reports that at least 50 percent of Americans are infected with HPV over the course of their lives, and a whopping 80 percent of American women are infected by age 50. Admittedly, the chances are slim that HPV would lead to cervical cancer: Only a small portion of HPV infections become cancerous. Still, according to the National Cancer Institute, roughly 11,000 women will be diagnosed with cervical cancer this year in the United States. Nearly 3,700 women will die. If you are one of those 3,700 women, you might feel that a vaccine could have changed everything. And--contrary to Runner's insinuations--you needn't be a slut to be among them: You could have married a guy who slept with just one other girl. Or, of course, you could be one of the approximately 13 percent of American women who, according to a 2003 study, are or will be a victim of rape over the course of their lives.

Sluts, all of them, according to George "the Cruel."

Disgraceful.

[This post is not endorsing a mandate for Gardasil, but I do hold out hope for its potential in sparing families the pain that mine went through. The medical evidence is not all in, and skepticism is healthy, especially given Merck's history. But the rhetoric of those like Runner has no place in this debate. At all.]

Cross-posted at MattOrtega.com

Comments

[MikeMoore]

The main image problem for Merck came as a result of their initial marketing strategy, airing TV ads showing little girls jumping rope. That was borderline creepy.

Now their ads show adult women. As they should have from the beginning. Then, after a while, they could have gradually eased up to the idea that younger females might benefit too.

But their greed blinded them to the fact that most parents don't want to contemplate their twelve-year-old daughter's cervix. Icky.

Forget about all this supposed "I don't want my daughter to become promiscuous" uproar. The plain truth is that the yuck factor ruined any chance that parents would ever get on board with this idea. Those original ads almost seem like they were shot by some sick, leering pedophile.

If Merck had been more insightful and patient, and less greedy, they would have marketed only to adult women in their TV ads, all the while quietly and below the radar screen whispering in the AMA's and FDA's ears that young teen girls would be well-served by adding this vaccine to the mandated list.

Eventually it would have been quietly added to the list, and each parent would find out individually only when their daughter was already at the doctor's office. Then the individual parent would have thought their gut reaction against it was all in their head. There wouldn't be this massive support system against it brought about by Merck's foolish ad blitz and lobbying of states.

Whomever designed the marketing strategy that Merck started out of the gate with should be fired.

[Pyrum]

My issue with the HIV vaccine is it's being marketed to 12 year old girls. The manufacturers themselves claim it provides immunity for about five years. What are the chances of an adolescent girl getting cervical cancer? How is a vaccination that's only effective for five years going to protect a woman once she's old enough to contract cervical cancer?

I'm sorry for your loss, but please don't let your grief cause you to exaggerate the effectiveness of the HPV vaccine. It's effect is temporary, not lifelong.

[Matt Ortega - Huffpost Blogger]

See Matt Ortega's Profile

HPV is an easily contractible virus, as I point out in the post, by simple things as casual contact with someone.

A young person could get it just from the floor of the community bathroom in a college dorm. It is that easy.

Also, as I note, I am not saying that this is a cure, or end-all-be-all. Rather, I am writing against the empty-headed rhetoric that this will make young women more promiscuous, and that HPV is obtained due to "personal choices." (Wrong.)

By that same logic, we should not commit research funds to AIDS/HIV or emphysema because, as State Sen. Runner callously suggests, those are contracted through "personal choices." (Someone can get HIV from a blood transfusion. I don't think one should condemn that person, or anybody with HIV, to die.)

It is ridiculous to argue that.

[Pyrum]

I agree with you, but only to a point. I don't approve of any medical procedure being denied to anyone for any reason, but I also don't approve of any medical procedure being forced upon anyone.

The HPV vaccine is currently listed on the Federal mandated list, meaning it's required for 12 year old girls to attend public school, although that can vary upon which state the girl lives in.

Do you really want young girls to be guinea pigs for an experimental new vaccine? Look at the list of side effects the manufacturer admits to:

fever
nausea
pharyngitis
dizziness
NVD (neurovascular disease)
upper respiratory infecton
gastroenteris
appendicitis
PID (pelvic inflammatory disease)
bronchospasm

If you have a daughter, and you believe in vaccines enough to submit her to this one, (and "belief" is an applicable term here, because vaccine theory is not based on any real science) fine, but both parents and children deserve to know the both the pros and cons of vaccination, and to weigh them against each other before making a decision whether or not to vaccinate.

[Matt Ortega - Huffpost Blogger]

See Matt Ortega's Profile

This post does not weighing in on the to-mandate or not-to-mandate debate.

It is opposing the "loose morals" argument.

[ihavenobias]

Well, unless I'm misunderstanding something, that's what booster shots are for (assuming your info is correct).

Get a shot before middle school and then before college. Sounds like perfect timing to me.

[Pyrum]

O.K., get a booster shot right before college at 18 and be protected until you're 23. The average age at which women contract cervical cancer is 50! Are you proposing booster shots every five years for a woman's entire life? If so, it only makes sense to start the shots later in life.

The only reason Merck is recommended the vaccine for 12 year olds is because they knew it would cause the Ferderal government to add it to the Federal mandated list for school children, creating a huge market for the vaccine. It's all about the money.

If you don't trust my information, take a look at the Physicians Desk Reference for yourself.

[OldKnute]

No DUH!

According to George 41 the greatest threat to the civilized world is unwanted pregnancies in the 3rd world and over population.

Whose unwanted pregnancies?
Who claims them as unwanted?

Who made Daddy Bush King?

HPV?

George (The Cruel) probably shares the views of his Daddy and the Eugenics Society. Forced sterilization. Population control. *Them little 3rd world-er sluts*

This disease can bring on cancers for women at all ages.

Condoms and circumcision. I agree.

OH WAIT!

For 3000 years we all thought circumcision was just a funny old tradition? You know, a mutilation of the male for stupid superstitious reasons or ego and esthetics.

No wisdoms there.

ODD, how many women have been saved from the horrors of uterine and cervical cancers over the centuries??????

Oh,,,,,, WAIT Again.

George (the Cruel) Would probably discourage even the passing out of condoms. You know,,,,, *It would give the little sluts ideas.*

Even,,,,,,,, MORE Population Control. Gosh will Daddy be happy or what. But, diseases (HIV) (HPV) slow, agonizing, oh so fitting punishments for these deviants,,,,,, BUT take so darn long. There must be a better way for population control of the unwanted, the odd and the different? Darn it! People are even sneaking them condoms.

Humm? What to do? What to do?

They outlawed Gas Chambers.

Shoot!!!

Wait,,,, wait,,,, wait.

I know!!!!!!!!!!!!

Thermal Nuclear War!!!!

YEAH!!!!!!

All the best

Knute (Neo-LIB)

[Purple Girl]

This is an area that must be looked at first for it's safety, then it's efficacy. We must always be cognizant of a perosns right to say No. but we can not limit our research & discussion due to religous concerns or fears. Since we know this is sexually transmitted- why are we not also pushing the use of condoms? Oh yeah that lays the responsibilty on the males door step to use one.
Ladies, carry one, insist on it's use and teach your daughters.

[ihavenobias]

As I mentioned before, condoms are not 100% effective against a skin to skin virus like HPV.

Granted, you're *less* likely to contract it using a condom but still.

I also pointed out that new research indicates a potential for an increased risk of throat cancer, which to me says oral sex (where a condom is almost never used) is also a risk for HPV transmission (among other things).

PS---Seriously though, how could anyone possibly think an HPV vaccine would lead people to start having sex like crazy? It's such an ABSURD idea.

Most people don't even KNOW about HPV, despite that fact that it's the most common STD. It's not like people would suddenly forget about, say, Aids and Herpes, not to mention pregnancy.

[ihavenobias]

The default position should be (and is if I remember correctly) that it's mandatory but parents can opt-out.

I think it should be that way as opposed to having parents opt-in, because FAR more kids would end up NOT getting the vaccination if the parents had to opt-in. In the long run that means higher rates of HPV and ultimately, cervical cancer.

Which reminds me, there is some new research suggesting HPV can cause an increase in throat cancer (use your imagination as to why).

And again, if the vaccine bothers YOU that much, then YOU take a minute and opt-out (who says you don't have choice? There it is).

Also, keep in mind that condoms aren't 100% effective against HPV, even when used properly (because skin is still exposed).

Deciding that a certain age group is simply "too young" to get this vaccine is ridiculous. Do you really want to play Russian roulette with your kid's health just to pretend your little princess won't have sex until she's 30 and married?

And what about rape and molestation? How awful would it be if your daughter contracted HPV after an already horrible event outside of her control? Now the poor girl has a regular reminder of the traumatic event in the form of pap-smears to detect early cervical cancer.

PS---Of COURSE an HPV vaccine would increase promiscuity. I mean, after all, who doesn't have fond memories of chewing their first rusty nail on the way home from their tetanus shot?

[OldKnute]

Yes I see your point. I understand.

Oh,,, not to worry.

Fox News will search the basements of some obscure Fundamentalist University and come up with an EXPERT that refutes the efficacy of immunization. All tog tether.

I can hear them now!

**If God wanted us to be immunized he would have4 passed out needles to Adam and Eve.

**If God wanted to eradicate HIV, he would have passed out condoms to Adam and STEVE.

Sheeese!

Go Fox new GO!

You doofs!!!!!

All the best

Knute

[NCGigi]

The rusty nail thing is perfect. Great analogy.

[kwright]

as sorry as i am for your great loss, i know all the facts are still not in on this drug. as with any drug only time and human testing will tell. i believe it should be a choice based decision. a womans choice. not the government. not mandatory. unlike other childhood disease, this is not contagious. you need to think of the long term effects. women were also told that hormone replacement was good. now there is proof that just the opposite is true.