Saturday, September 17, 2011

Truth, NOT yak shit

The battle against cancer was set back recently, when politicians (not physicians) running for office decided that fear beats hope. False claims were made that the HPV vaccine (which has the potential to cure cervical cancer by preventing it from ever starting) causes mental retardation.

I'd therefore like to post this statement by the president of the American Academy of Pediatrics, Dr. O. Marion Burton. He is not a politician, but is an expert in the care of children.

I hope his statements carry more weight than those of politicians who are more interested in sound bites than truth.

"The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation.

There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity.

In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer."


That's 4000 young women dying each year from an easily preventable disease. One of them could be your daughter - or mine. Marie will get the vaccine next year.

I did not receive any money or gifts to make this statement, nor do I own a financial interest in companies that make these vaccines. I don't know Dr. Burton, either. I'm posting this because, as a yak herder, I know manure when I see it, and believe it should be cleaned up.

84 comments:

Anna Geletka said...

All of the nonsense over this vaccine drives me absolutely crazy. HPV can cause cancer. The majority of adults will contract HPV during their lifetime. We have a vaccine against some common strains of HPV.

WHAT IS THE FRICKIN' PROBLEM??

Solitary Diner said...

Sometimes the yak shit that people come up with astounds me. It would be funny if it weren't so potentially harmful. No wait...still not funny...just yak shit.

hekates said...

Our kids' doc recommends it for boys too. So they won't give someone cervical cancer.

PJ Geraghty said...

It's interesting (but not surprising) that the AAP chose to describe this foolishness as coming from "the Republican presidential campaign" instead of coming from just one candidate. More political bang for their buck, I suppose.

It would be nice if the AAP came out with an equally vehement statement about the shenanigans of Jenny McCarthy and other anti-vaccine nuts. Many more people have heard her yak [poop] than are aware of the recent HPV vaccine kerfuffle.

Mingle said...

these people are crazy...i'm glad you're a responsible yak herder.

Anonymous said...

Some of us still wouldn't give the HPV vaccine to our children regardless. If there's another way to prevent the illness like abstinence/monogamy. (It's not unrealistic, I did it, so can my kids.) I'll go that route for the same reason I feed my kids real beef and chicken we grow ourselves, not the pseudo-food they serve through a drive-thru: I don't put things in my kids' bodies I can't pronounce, know the full effects of or could produce myself.
That being said, I hope all the people who raise their kids to think multiple partners in a lifetime are OK do get the vaccine.
Fuck Cancer. I loathe that disease with every fiber in my being.

bobbie said...

If I had a child, they would be vaccinated... in a heartbeat.
I'm a cervical cancer survivor.

Lisa said...

Thank you, Anon. Nice to know the ostrich survives to this day.

baliRing said...

Politician should be careful to make any statements ..they should make a research or at least read health journal

Anonymous said...

Just letting you know anonymous that where I used to work one of the nuns ended up with cervical cancer. She was lucky in that it was picked up with a pap smear. As a nurse she chose to get regular pap smears even though nothing had ever gone near there. Cancer can still happen with random mutation of cells.

Ginger said...

I work in an oncology unit and I wanted to add that the HPV vaccine isn't just for girls. Not only will getting boys vaccinated prevent them from passing it to their partner when they get older, we have recently seen a huge surge in the number of men with head and neck cancer whose tumors have HPV markers in them. This vaccine can help reduce the number of cervical and neck cancer.

To Anon@ 6:21, I will never understand the argument that getting your kids vaccinated against sexually transmitted diseases will give them free reign to have as many sexual partners as they want. Even if your kids do decide to follow in your footsteps and wait until marriage to have sex, there are so many things that can happen to them in life that you can't plan for ( rape, partner infidelity, accidental exposure to bodily fluids) that you would be doing them a huge disservice to not protect them against cancer when it is so easy.

Jane said...

Anonymous, your child could be monogamous him/herself and still get HPV from a non-monogamous partner. People do sometimes cheat on their spouses and give them STDs. Or, at the beginning of a relationship, claim to be a virgin when they're not. Let's not even think about sexual assault.

Get the vaccine. You never know what's going to happen in a person's life.

Axl Rose said...

Yes, thank you for trying to spread the word on this Dr. Grumpy - I found Bachman to be downright insulting, scary, and dangerous in her ignorance.

Unknown said...

The vaccine came out when I was in my last year of high school and the second that I heard that it was in the process of becoming available soon, even though I wasn't sexually active yet, I asked my mother for the vaccine. Since then I have completed my BSc. in Biology and am now getting my pharmacy degree. And last time I checked I did not suffer from mental retardation.

Also, if you are giving the vaccine to school aged girls, how can it possibly cause mental retardation? What is the argument there? Wouldn't you have to give it to a newborn and then follow their development for quite some time to decide if they even had a mental delay? Having done my undergrad in biology and now studying to become a pharmacist, it offends me when people have no actual understanding of scientific concepts can make such claims and somehow get people to listen to them. Also, a little LOGIC goes a long way even for people who aren't science majors.

rnraquel said...

Amen. Even if someone only has one sexual partner, they can contract HPV. They need to receive the vaccine before any chance of being sexually active. I know from experience that multiple colposcopies and cryo treatment for precancerous areas of the cervix are not fun. I am thankful that both times I got treated before they turned into cancer.

Fizzy said...

I have to chime in with the others responding to Anon @ 6:21. Assuring that your daughter will be with only one person in her life and that other person will have only been with one other person in their life is nearly impossible in this day and age. No matter how much you teach your daughter abstinence before marriage, she still might get herself knocked up while you're running for Vice President.

Grumpy: Did you see the following:

http://www.businessweek.com/news/2011-09-15/bioethicist-bets-bachmann-10-000-on-hpv-vaccine-link-to-damage.html

Brilliant.

Anonymous said...

Anon Number 1: your kids are not going to abstain from sex ALL their lives.
HPV affects anyone, anytime. Even if they are in a monogamous relationship.
Unless you marry them to another individual who abstained as well.
Still no guarantee of their sexual activity.

Christine said...

I wish there were a vaccine against idiocy.

The Merry said...

I think people who believe giving this vaccine to 11 years olds will cause mental retardation are people who do not need to worry about becoming mentally retarded; in their case it's already happened.

The Merry said...

To Anon @ 6:21,

Some people live their whole lives following a strict moral creed that leads them to abstinence and monogamy. Other people come to these beliefs later in life. If anyone has ever been sexually active in their lifetime with more than one partner, the odds are very good that they will already have HPV before they adopt a straight and narrow path.

First Lee said...

Now that everyone has stated the obvious, I want to ask a question:

What's wrong with having mental retardation? Or having a child with it?

In my opinion, absolutely nothing. If there's a sudden increase in mental retardation, we need to find out why, but darn it, there's nothing wrong with having any mental disability. I'd rather have a low IQ than die a painful death from cancer, myself.

Anonymous said...

@Anon 6:21 PM, There are very few ways to have kids and still have no sexual contact. I think you meant to say that you abstained until marriage, which, is fine, but your darling husband could still have given you HPV, it's a VIRUS! So unless you a) adopted b) had in-vitro fertilization and have never had intercourse, or c) are the reincarnation of the Virgin Mary, and had an angel visit; you are more full of than Doc Grumpy's yaks

Anonymous said...

This debate is not about the vaccine - it's about sex.

Really, if it was a vaccine that prevented, say, liver cancer, would there really be such an uproar?

I'm a doc, and newly divorced. I paid out of pocket for this vaccine even though I'll well out of the age range it's "indicated" for. The prevalence of HPV is just too high, and I have seen women dying from cervical ca.

Moose said...

Thanks, Doc, for approving comments by nitwits like the early Anonymous, so we can realize that idjitry is alive and well in more than just politicians.

Anonymous said...

My only issue with this deal is the "excellent safety record" crap from the drug manufacturer sponsored "professional" organizations (my profession, pharmacy, has them also). Look at the medicines with "excellent safety records" that have been pulled from the market in the last 20 years. And the ones that are starting to see "uh oh" problems - bisphosphonates, statins, etc, etc, etc. Until this thing is out for 30+ years, my kids will not get them. Once they turn 18, they can decide for themselves.

Once they get the shot, there is no turning back. What happens if next week it is discovered that girls who received the vaccine had a higher incidence of fatal heart attacks in their early 20s? We haven't even crossed THAT threshold yet. And we don't have to reach that far back to find a drug that we never thought would cause that (COX-2 inhibitors).

The other thing that gets my goat is that in Indiana, schools are REQUIRED to provide information about the vaccination to each girl that is of age to get the vaccination. If they are so worried about it, have the State Health Department do it. School and school corporations shouldn't have to foot the bill to provide this information. I wonder who asked for that piece of legislation be passed? It ain't the Indiana Cervical Cancer Survivors Association, that's for sure.

And Bachman sacres me. She is certifiably bat sh$t crazy.

Anonymous said...

I think as health care workers we tend to forget there are entire portions of the population we nearly never see because they are reasonable people who take very good care of themselves and refrain from risky behavior.
I bet you remember the last person you treated who didn't smoke, drink, do drugs (even caffeine) and was very careful with what (and when) they put in their bodies. You remember, because it's rare they need treatment.
I'm not advocating forgoing all vaccinations, or cervical checks.
I'm also not saying that everyone should skip this vaccine. I think I said the exact opposite. People who live a certain lifestyle should DEFINITELY get vaccinated and those who feel they might be at risk in the future should give it serious consideration.
This vaccine is for something that is preventable with what I consider to be reasonable behavior.
And as an aside, celibate nuns who get cervical cancer, don't get the kind caused by HPV. The HPV vaccine only protects against a few (3?) of the 100 odd strains of the HPV virus at any rate. (I know the stats about 2 viruses causing 70% of cervical cancer)
I fear women will forgo their pap smears because they feel "protected" by the vaccine. We don't tell people vaccines have a 20% fail rate. We don't tell them lots of things that could help them make truly informed choices and I think that's a shame.

thatsit said...

A fricken men, thank you yak herder.

Dani said...

I got the vaccine and paid for 2/3 of it out my pocket. I don't plan on having vaginal intercourse ever in my life, but what if my future girlfriend had a previous male sex partner? I got vaccinated to protect myself.

Watercolor said...

I do not understand why anyone would not get this vaccine. You can be monogamous but if your partner ever isn't or wasn't that isn't much help. It's just crazy to put your head in the sand and think kids are going to be protected by victorian values only when a simple vaccine can provide such amazingly valuable insurance.

Lipstick said...

Thanks for posting this, Dr. G. The politics of this situation is nauseating...trying to control people with fear of mental retardation, sexually active teens, etc. Slimy politics...ugh.

dsg said...

Those of us from Minnesota are not surprised by anything that comes out of Bachman's mouth. She has proven herself to be ignorant at every turn of the road. However, I do believe her statement that Perry ordered the kids to be vaccinated to help his lobbyist friends.

Other Republican candidates did not object to the words that came out of her mouth.

Most of the R. canditates have some moral conflict, from cheering at the the death of prisoners, cheering the death of patients in a coma, and recommending that students not get vaccinated for HPV.


The other R. candidates don't really count, although we could deiscuss Rick Santorum. (do a google search)

Anonymous said...

Anon @6:21, I went the abstinence/monogamy route; I never had sex with anyone but my husband.

Then he had an affair.

All girls should be vaccinated.

John Woolman said...

If you live in England and you are a girl on the edge of puberty you get offered the bivalent HPV vaccine on the National Health Service. If you are a boy you don't. Both the bivalent and the quadrivalent vaccines are licenced in the UK. My experience is that health care professionals do pay to get their girls the quadrivalent vaccine and may pay to get the boys the quadrivalent vaccine. I'm sure there is a moral there somewhere.

Kat said...

I got the vaccine as my first adult action(on the day I turned 18, partyer I know). I'm not sure that regret is the correct word for my thoughts on the matter. My regret has nothing to do with sex though. At the time it wasn't known that the stock I got injected with had been contaminated with latex(which I'm allergic to) until after I finished the series. I'm still a virgin, but stuff like sexual assault and cheating can happen.

Therrin (Ben S) said...

"Informed choices" is an argument from the antivax community that obscures the issue with false balance. There is no reason to believe that receiving a potential protection to one illness will cause a person to discontinue preventative testing (that happens to also test for more than just the targetted condition).

To all the anonymouses, could you at least click the Name/URL button and make up something random? I don't really care if it changes every post (or comment), it's hard to follow a thread when more than one commenter has the same moniker.

badtothebohn said...

As a huge supporter of Michele Bachmann, her statement was incredibly embarassing and harmful not only to her campaign, but also legitimate opposition to HPV executive orders from Perry, another candidate I support. Her unverified, knee-jerk statement on national TV that some mom came up to her, stating unequivically that a vaccine caused her daughter mental retardation was incredibly dumb. Thiomersol/vaccines don't cause autism or mental retardation according to any number of professional organizations.

Anonymous said...

>>People who live a certain lifestyle should DEFINITELY get vaccinated>>

Like "technical virgins" who engage in naked cuddling/rubbing, or oral sex before marriage?

Like virgins whose spouse was divorced, or widowed?

Like date rape victims?

Like virgins whose spouse was sexually abused as a child?

I agree with the Merry. Also, Anon 9:27 is correct: this is about sex, and feeling morally superior.

(Virgin until age 22, and two sexual partners, lifetime, but see the wisdom of this vaccine for everyone - boys, too.)

Packer said...

To those who asked:what is the problem? The problem was in the nature of government forcing people to undergo vaccination. Slippery slope, forced vaccinations , sterilization of the mentally I'll or cognitively challenged, to other areas of so called medical choices. A well informed citizenry will make proper choices, provided the information gets out such as seen by the grumpy blog. However a well informed citizenry will bristle, and rightfully so, when any government seeks to force an action so personal as these. This is a government that in my lifetime purposefully infected people with diseases without informing them. Do not be so trusting of the motivations of government.

Anonymous said...

As a man in my mid twenties, I threw down cash for the HPV vaccine not long after it came out, because it is the responsible thing to do.

There is no amount of "reasonable" behavior that can prevent HPV transmission unless you stay abstinent until death or only have protected sex with your life partner with who you are monogamous (because you can't guarantee their continued monogamy). At that point you are going to make the bizarre choice to electively undergo artificial insemination to precreate without any documented issues mandating it. Saying in the 21st century that there is a "certain lifestyle" that this vaccine is for demonstrates a failure to reflect reality in your language.

Across the board vaccines that prevent viral illness are the safest class of drugs available. They are between one and several metric fucktons safer than Tylenol.

HIV is still a thing. Use that as the bugbear to scare people into practicing sex responsibly. With HPV, a virus endemic to most of adult persons, vaccines and any possible measure to make it less endemic should be welcome. When the biggest risk factor for carrying HPV is being an adult, it makes sense to administer and HPV vaccine several years before adulthood. Even if you can guarantee your children conform to your standards, the same can't be said of other people's children.

Fizzy said...

Anon @ 9:50: I think there's a huge difference between waiting to see side effects in drugs you take daily for years and a single shot. Vaccines that were deemed unsafe all exerted side effects immediately, not 20 years later. This is all just part of a general fear of vaccination.

Anon @ 9:52: You are welcome to skip the vaccine, but we're talking about children who are too young to give informed consent and probably don't have the nerve to tell their parents about risky behavior.

thethingspatientssay said...

I had a woman tell me once in residency that none of her children had been vaccinated because all vaccines were made from aborted fetus parts and it would not be a Christian thing to do. My residency director (staunch Catholic) told her she was a moron and he never wanted to see any of her children in our clinic. Only time I saw him say a bad thing about anyone.

Special Sauce said...

I just watched a 42 year old woman die from cervical cancer. Wife. Mother. It was a horrible way to die. You can bet your ass that my son will get the vaccine when it's time. If I can somehow keep one more woman from dying that way, I will.

A Doc 2 Be said...

I'm embarrassed for my state and to be represented by the candidate, from said state, who is obviously a lunatic.

Amanda said...

Well said, Yak Herder. My older son (age 12) will also be getting his, much to his annoyance. He has a needle thing. Too bad it's trumped by my "parental responsibility thing."

Anonymous said...

Anonymous #1, the only patient I have ever seen with syphilis was a young woman who had been a virgin when she married and thought her husband was one as well. It turns out he had had sex with two prostitutes before getting married.

In addition, a friend married a man whose first wife had died from cervical cancer. Even if both she and her husband had only been sexually active during marriage, she still could have been exposed. It's not quite as simple as you're making it.

Leslie

Anonymous said...

The vaccine came out too late for my kids. I discussed it with my daughter's pediatrician, and she was just too old at the ripe old age of 15. My son's doctor had not heard of boys getting the vaccine so at the ripe old age of 13 he didn't get it.
It's a worry to me as cervical cancer seems to run in the family (g'mothers, aunts, cousins). So my daughter has discussed this (at least she says she has) with her GYN and we will have to watchfully wait.
The only "at least" is she knows of the risk. And the male of the species (even Yak herders) can't comprehend how AWFUL GYN exams are. Speculums are cold, and it's creepy having someone poke around "down there."
So if I could spare my "baby" girl a little of that, it would have been worth it.
As to the other Anon., it's been pointed out that your child might only have one partner, but how many partners has that person had? I found that one out to my sorrow.
But, this "debate" might have had some good effects. My mother, a retired RN and a rabid Republician, caught a bit of the controversy and announced that the loudest trumpeters against the vaccine would not get her vote.

Anonymous said...

Anon @9:52 PM - It is not reasonable, and not right to expect an 11 year old to have decided what his or her life will be. Perhaps they will choose just one person, perhaps there will be two, three or thirty. They may want to yak herders now and decide to go into editing later. A vaccine is preventative - it does not dictate anything. I have a tetanus shot, but that doesn't mean I go running around rusty nails!

(Some people do enter into serious relationships after one partner passes, FWIW)

Anonymous said...

I was going to comment about how boys should be vaccinated too, but I see others have already done that. I think the government isn't pushing vaccination for boys because, AS USUAL, they think males shouldn't be responsible for their own sexual activity. HPV is a GIRLS problem just like, oh, teen pregnancy.

Anonymous said...

Well the comment and the intention of it had more to do with their political view.
To me many -not all- vaccines as well as antidepressants start a never-ending cycle that 90% of the time only pharmaceutical companies benefit from. Many vaccines and medications have more support (research)mainly because these companies see patients as their "target market" instead of human beings whom in MANY cases do not really need to be taking say antidepressants, when they could easily benefit from other treatments that doesn't require patients spending $$$ every month.

And the main problem is that with insurance companies determining whom and how many patients the doctors sees a day, and pharmaceutical companies pushing their products down ppl's throats, patients are not longer seen as individuals who CAN live productive lives without all the vaccines "required" today(many unnecessary in the case of children).
Way too many people starts taking antidepressants before the age of 10 (many take their medicine for life). You end up with numbed down people who are dependent of the medicine and whom in many cases develops secondary effects to these pills. Numbing down people not always solves their problems.Vaccines are very helpful but many are unnecessary and sometimes triggers negative responses in patient's bodies, and it seems to me that the negative effects many times outweighs the benefits. I think many are aware of this situation but nothing is being done.

This needs to change because patients have started seeing doctors as salesmen instead of caring professionals who have our well-being as priorities (not their own pockets).

And this is coming from a premed student btw, so I'm not against the benefits of medicine, but I'm hopeful that the whole system in medicine with change their direction and move towards the benefit of people not pharmaceutical companies or insurance companies.

Anonymous said...

BTW, there was an article from CNN

http://thechart.blogs.cnn.com/2011/09/09/study-less-may-be-more-for-hpv-protection/?iref=allsearch


saying that after giving less booster shots to teenagers in Costa Rica they have come out with the conclusion that: not many booster shots are needed to prevent HPV.

So how many US teenagers were given unnecessarily too many shots? how many developed side effects as a result of it?

Anonymous said...

Anon pre-med 10:33. The CDC has a recommended schedule for vaccines; most people do not take more or extra vaccines than needed!! The recommended vaccines are not frivolous if look at them one-by-one.

Autism and mental retardation are NOT the same thing! We are not talking about HPV vaccines causing just causing any old neurological damage such as autism versus mental retardation, but the politics of dingbats throwing out 'hot button' issues to mess with the minds of those whose panties are easily wadded and lose their commonsense, and those who refuse to look beyond what they've determined is a political party agenda.

Comparing this matter to antidepressant use in children is a spurious, irrelevant issue. Antidepressant or stimulant use in children is a different topic, issue and has an entirely different societal implication and impact.

I am (almost) sure Dr. Grumpy might wish to bring up the discussion some time, but somehow think it's a matter that cannot be discussed in only one column to address increased ADD, ADHD, autism, Munchhausen's, little boys versus little girls in school, and the fact that many of the older crowd went bye-bye when they were kids at the beginning of the day when they went to play and didn't come home until supper!

Anonymous said...

There's an ugly truth out there that only one commentator has pointed to: not all sex is consensual. Anon @6:21 can instill whatever values she likes in her children, and I applaud her efforts but unless she keeps them indoors until they enter the cloister, there's always a risk. I was a careful young woman and I acted in morally and hygienically responsible ways, and I got HPV from two assailants in a horrible tragedy that shouldn't have happened but did, through no fault of my own. If I'd had the vaccine when I was younger, that would have saved me a world of agony. I got HPV, I had to have part of my cervix burned away to prevent cancer, and when my husband and I planned to start our family, it was a real concern. Get the vaccine.

Teri said...

"Other Republican candidates did not object to the words that came out of her mouth."

Bachman did not say this during the debate, she said the woman came up to her afterward, then Bachman started braying this nonsense on talk shows.

As for the hootin' and hollerin' at the debate about the death penalty, people in comas and whatnot, how in the world can you assume that every person in the audience was a Republican? When Wolf Blitzer asked Ron Paul if "society should just let him die," two people in the audience said "yeah!" and Ron Paul said NO.

Perry wanted to make the vaccination a mandate with an opt-out, because of a technical issue that if it's a mandate, insurance companies would have to cover it. If it had been an opt-in, then people would have had to pay out of pocket.

I say all of this as the parent of a severely autistic son. Vaccines don't cause autism, and it's totally ludicrous to think that a 12-year-old could suddenly become mentally retarded by anything other than a head injury or some severe neurological illness. Am I right about this, Dr. Grumpy?

ERP said...

I think Bachmann must have gotten the vaccine because she is clearly retarded.

essgirl said...

My parents both died of cancer.I was diagnosed with cancer 3 years ago so if there is anyway I can prevent my daughters from getting cancer then you bet I will.Both my daughters were given the HPV vaccine at school last year.My oldest daughter was almost too old to be given the vaccine at school so I would have been more than willing to pay for it.

Laura K said...

Thank you for being the voice of reason, Dr. Grumpy. (Did I really just say that?!) And ERP - amen to that!

Anonymous said...

What about... the number needed to treat?

Loren Pechtel said...

A bunch of comments:

1) If you look at the position of the sex-only-in-marriage types is to make anything else as dangerous as they can make it. Their positions make a lot more sense evaluated this way.

2) Sure, everything has risks. The problem with such arguments comes from the fact that the null case also has risks. We know the risk of no HPV vaccine and it's thousands of deaths/year. Is there *ANY* vaccine out there that is anywhere near that dangerous??

3) For those who think I just want to go have casual sex safely: I'm 46 and still on partner #1.

Anonymous said...

I didn't take the time to read through all the comments,but I want to say to those who think monogamy will prevent the spread of disease,this weekend a 12 year old school friend of my grandchild's was beaten and gang raped.We live in a "good neighborhood",things like this can happen anywhere,anytime and to anyone.Monogamy is a great,I'm not against it but things happen and HPV could be one less thing to worry about in a world gone mad

Frantic Pharmacist said...

Well said, Dr. G... That woman makes me absolutely crazy. I'm so tired of these politicians whose social agenda trumps everything else, even preventing cancer, for God's sake...
leaves one speechless.

JoAnna said...

thethingspatientssay - actually, many common childhood vaccinations use aborted fetal stem cell lines. The "Catholic" who said that was bunk obviously didn't do his/her research.

The morally problematic aspect with effectively profiting off the death of aborted children to benefit ourselves is why my husband and I have chosen to selectively vaccinate our kids. I would LOVE to have my kids fully vaccinated, but the ethical versions of the problematic vaccines simply aren't available for private purchase (or haven't been approved for use in the U.S.), and we haven't yet found a physician who is willing (for financial reasons) to order what ethical versions are available (we've been told that they can only order in bulk and it's not cost-effective for only 3, soon to be 4, patients). But unless there is immediate, proximate danger, I can't justify profiting off the lives of babies who were killed to make these vaccines.

Anyway. Regarding Gardasil, Bachman's comment was moronic. I don't think it's a bad idea -- even if you're firmly convinced your daughter will stay a virgin her entire life, or only have one partner, what about rape? I doubt rapists have any qualms about potentially passing HPV to their victims. I do, however, have a problem with the government mandating any vaccination.

Fizzy said...

JoAnna: Babies were not killed to make vaccines. Decades ago, some viruses were cultured on aborted fetal tissue. But even the *Vatican* issued a statement in 2005, saying it's okay to use vaccines if there's no alternative. I think it's less ethical to spread disease and possibly death to living children than to protest use of fetuses that were aborted decades ago.

Anonymous said...

To the mom who said her kids were "too old"...the vaccine is licensed for ages 9-26 years. It is free to children through age 18 who qualify for the federal VFC program. Contact your state or local HD for more info on this.

Indiana schools do have to report HPV vaccine uptake by girls entering grade 6. However, parents are NOT required to respond to the request for info, and the process is anonymous so there is no way to track who responds or who doesn't. Should the schools be required to do this? Well, it was the best way they had to get the data, I think. The law needs to be done away with, there are better ways to do this. The best thing about it is the educational component--they also provide info on the disease and vaccine. Is there a better way to reach this population?

Old MD Girl said...

Anon 12:06 -- Autism and ADHD are not caused by daycare or babysitters.

Thanks.

OldSquid said...

Oh boy, a vaccine is ideally used as one step in prevention. Take the flu for example, get the vaccine, wash your hand frequently, and eating a balanced diet will all help to prevent it.

With HPV, get the vaccine, practice safe sex, pap's (for secondary prevention,)etc.

One a side note, any chance in this prevention oral cancers as well?

A few links for those who are interested from the folks at SBM:


http://www.sciencebasedmedicine.org/index.php/beware-hpv-dna-in-gardasil/

http://www.sciencebasedmedicine.org/index.php/mercola-gardasil-and-toyota/

http://www.sciencebasedmedicine.org/index.php/gardasil-safety-revisited/

As a part of routine post-licensure follow-up and to address these very concerns, “Postlicensure Safety Surveillance for HPV Vaccine” was funded by the FDA and CDC and published last month in JAMA. This article is the largest attempt to evaluate the adverse events seen since qHPV was released. In it, the authors compared the adverse events reported to VAERS to the expected background rate of reported events in the unvaccinated general population of women aged 9-26, re-evaluating the previously reported adverse events known from licensure as well as the reports of more serious events that have gained public attention. The results are reassuring.

Over the first 2.5 years since its release, 23 million doses of qHPV were administered, and VAERS received 12,424 reports of adverse events. Of these, only 772 (6.2%) were classified as serious or life-threatening.

Of all of these events, only two are above what one should expect from their respective baseline rates and not previously identified by the original licensure studies. The first is Venous Thromboembolic Events (VTEs). These are blood clots within the blood vessels that can be quite serious; these occurred in 0.2/100,000 doses. The second was syncope, or loss of consciousness, which occurred in 8.2/100,000 doses. This does not establish that qHPV causes these events; remember that this study and the VAERS in general are not designed to establish causation. Nevertheless, further studies are certainly warranted to confirm or refute qHPV’s role in these rare events, and physicians should bear the correlation in mind when considering the administration of qHPV.

Notice, however, that the rates of major events of concern, namely Guillain-Barre syndrome, autoimmune disorders, transverse myelitis, and death, were all exceedingly rare, and not above what one would expect to occur in the normal unvaccinated population. In spite of the clear limitations inherent in the use of the VAERS database, this study should strongly reinforce the confidence of physicians and parents regarding the safety of HPV vaccination.

Mad Pharmacy Tech said...

The thing that strikes me most about debates is how each side treats the other as if they were wrong to think how they think. In the end, what it comes to is being informed about the vaccine and making your own decision on it. This applies to any vaccine or drug therapy.

From where I sit, if there's a vaccine that would help prevent my future daughter from getting cervical cancer, I'm for it. Someone I know recently was diagnosed with it, but they aren't sure how far along it is yet.

That said, if you are against it, then so be it. But anyone who wants to take advice from a politician, a celebrity, or some random person in line in the grocery store is not making an informed decision. Fact is, I could write an entire blog about how ridiculous it is that vaccines are being blamed for causing autism and so forth and how people like Jenny McCarthy use their pseudo-celebrity status to push their cause because something tragic happened to them.

thethingspatientssay said...

@joAnna, I know the origin of many vaccines, but there is a large group of non-medical people out there and I simplified it. Her argument was that people were aborting fetuses just to make vaccines. Now, let me ask you this: is it not better to allow those children who unwillingly gave their lives to go on to save others? They were not aborted simply to make vaccines, but something good came from their demise. Liken it to whole organ transplant, if you will. Note that the Catholic church does not forbid vaccination although there is a small but noteworthy movement within the church to use "ethical" vaccines.

offwhitecoat said...

What's weird is that we already routinely vaccinate against Hep B, another sexually transmitted disease, without having to deal with puritanical comments. (That's what it comes down to: sex is sin, and anything that makes sex safer leads to more sin.)

Perhaps if we reframed HPV as a "bloodborne infection" rather than "the sex virus" (apparently this is how teens refer to it, according to my friend who is in peds) people would be more OK with it?

Anonymous said...

To the Non Pre-Med student.
Please change your field. You obviously don't understand medicine, healthcare or research.

Anonymous said...

My biggest problem in high school was that with all the vaccines they touted it was never MY choice to get one or not. I intellectually understand "herd immunity" (In college I made my own choice to get a whooping cough vaccine). I love the IDEA of vaccines but someone else deciding what I should and should not do with my own body feels like and has always felt like a violation.

Diane said...

I'll leave my name.. we decided against it for our girls - AS one poster said - there have been so many medications put on the market, then withdrawn when they find out hey.. it's not such a good idea Plus, living in TX It's none of the government's business if my girls get or don't get the HPV shot. I can see shots for polio, mmr, et al, as these diseases are making a comeback (thankk you porous border). It is up to each individual family..and your scurrilous name-calling of people who choose NOT to, guess that goes to show the quality of your argument. "oh, I disagree with you, I have no dog in the fight, i have no real statements to back me up, but you're a troglodyte (or whatver). Talk about stuffing your desires onto other people's families. Its crap like this (and perry's trying to make it mandatory) that makes me run towards libertarianism and away from statists and republicrats/demicans.

Teri said...

"Fact is, I could write an entire blog about how ridiculous it is that vaccines are being blamed for causing autism and so forth and how people like Jenny McCarthy use their pseudo-celebrity status to push their cause because something tragic happened to them."

Not only that, but Jenny McCarthy didn't actually have autism happen to her - her son was mis-daignosed. She still wants to be a "voice for autism" and I want to say, "No thanks, you've done quite enough already!"

Todd said...

I bet most people that oppose vaccines for "safety reasons"

(1) Drive a car (pretty much one of the most dangerous things you can do).

(2) Take the occasional tylenol, aspirin, or advil (Much worse safety profile then vaccination for much less benefit).

(3)Use "natural" supplements that have no research behind them, no quality control standards, and no reporting programs to have any knowledge of adverse effects.

Just Me said...

Just some factual information 4,000 women die from cervical cancer yearly - horrible (mostly in their 20-30s). HOWEVER, 2,000 girls (12-17 year old) are seriously hurt by the vaccine that may never have gotten cervical cancer and who may still actually get HPV later after it wears off. Make choices, but consider looking at the information that we know about this vaccine. Get CME from non drug reps/drug companies before recommending this drug to others. Information from the CDC and NIH. My concern for this vaccine is the death of a 12 year old who may or may not have ever gotten HPV.
http://vaccineconsult.com/ce-courses/pre-recorded-webinars/hpv-vaccine-warts-and-all-pre-recorded-webinar/
This is a fabulous non-partial CME on the topic taught by an immunologist.

DreamingTree said...

@anon 10:33 - A little off topic, but I feel the need to respond to a med student who thinks that too many children are being given antidepressants. As a psychiatric nurse who works with children who have mental health problems, I think you need a little more experience on this subject. Try working with a kid who has a mood disorder before claiming that the medication is numbing him. It would also be helpful to spend some time with a child who has ADHD -- choose a day that she is unmedicated.

The conclusion that medications are not needed is simple from a theoretical standpoint. It's easy to just expect parents and kids to adapt - it must be the environment, right? I work with parents to adapt their interventions, and behavior modification can be quite effective. With that said, I believe that when medications are needed, we should not be so judgmental.

Anonymous said...

If a politician said it, it's probably Yak shit.

Therrin (Ben S) said...

To me many -not all- vaccines as well as antidepressants start a never-ending cycle that 90% of the time only pharmaceutical companies benefit from.

Did you forget to wear your tinfoil hat this morning?

The second was syncope, or loss of consciousness, which occurred in 8.2/100,000 doses.

Fear of needles. -.-

The thing that strikes me most about debates is how each side treats the other as if they were wrong to think how they think. In the end, what it comes to is being informed about the vaccine and making your own decision on it. This applies to any vaccine or drug therapy.

Except that most pro-vaccine have already evaluated the risk and concluded that it is BETTER to vaccinate IN SPITE OF the very low risk negative outcomes. To say that those favoring vaccination aren't aware of that risk is arguing from ignorance.

I love the IDEA of vaccines but someone else deciding what I should and should not do with my own body feels like and has always felt like a violation.

What about other peoples' bodies? Do they not have a legitimate concern that you (the hypothetical refuser) might pass the virus on to them? Having it be mandatory isn't [only] about one person's health, it's about everyone's.

I can see shots for polio, mmr, et al, as these diseases are making a comeback (thankk you porous border).

Actually, they're making a comeback because of people like you, Diane. It's because of vaccinations these diseases have been decreasing, and it's because of ignorant refusal to vaccinate that they are resurfacing. And your passive-aggressive tone trolling is far more "scurrilous" than outright name-calling. I offer to you a decayed porcupine, in the hope that you've trolled elsewhere and know what to do with it.

Its crap like this (and perry's trying to make it mandatory) that makes me run towards libertarianism and away from statists and republicrats/demicans.

Oh please. Why don't you ask Somalia how libertarianism is working out for them? You seem to think life was better in the 19th century, maybe you should turn off Fox Newz and read a history book.

Just Me, your link doesn't work, and I wasn't able to find the actual video on the site itself (which is quite poorly designed and lacking in content). I'm left to assume the "doctor" you're referring to is the one who's name appears around the site, Hilary Andrews. This person does not appear to be a medical doctor, or at least is not licensed to practice in Oregon, and is actually a naturopath (yay colon cleanses and homeopathy).

Oh wait, I just found how to get it, I have to PAY to be (presumably) lied to. Pass, thanks.

Anonymous said...

I agree with Therrin.
A lot of infectious diseases are resurfacing because of the idiotic attitude of people like Diane.
If you don't to immunize yourself and your kids, go live in an jungle. Don't come near immunized people and ruin herd immunity.
And who does it cost when your kids get sick because you were too stupid to vaccinate them? The Taxpayers! When your kids end up in the ER, and consume costly resources, I hope you pay for each and every medical service you use.

Thanks for adding the burden to tax payers.

quixote said...

I've seen this point a couple of times in this thread: we decided against it ...[because]... there have been so many medications put on the market, then withdrawn when they find out hey.. it's not such a good idea

The conflation of medications and vaccines can only happen if you don't understand the difference between the two.

Medications are like bulldozers that build, say, a new road. If it turns out not to be done right, you could get landslides. Depending on the type of problem, the landslide could happen 30 years later.

Vaccines are like a new stop sign. If there's a problem with where it was put, say in the middle of the road, and a car smashes into it, that happens with the first car that comes along. Not 30 years later. If there are no immediate problems with a vaccine then there is no problem.

Also, I want to second the commenter who said the resurgence of some preventable infectious diseases is due to anti-vaccine prejudices. Definitely not to porous borders. Vaccination rates in less-developed countries, when people can get the vaccines, are higher than in developed ones. They're much more aware of what disease can do, and are much better at evaluating the relative risk posed by vaccination.

Albert said...

You read the above comments and you realize how accurate this research is: It shows an inverse correlation between IQ and degree of religious belief.

Anonymous said...

premed student is back. To the person who advised me to leave medicine, or my plans to go to med school: thank you for your advice, but I doubt I will ever change my mind regarding Medicine. As far as I know Medical School values diversity, and people with different backgrounds, beliefs, lifestyles, etc. That way the new trained professionals can actually help and interact with all types patients, even with people whom we disagree with. I bet there are plenty of students like me who love the field and would like to improve things that might need to be improved.

Btw, I recall saying that although I disagree the way prescriptions are given today specially to children I'm all for taking advantage of medicine to improve people's quality of life.Medicine is great but the whole interaction with insurance companies is negatively affecting the field, the professionals and as a result, the patients.

To the psychiatric nurse: I understand your point of view and your reasons, obviously you have seen many cases in which medication have helped children with special needs, but I was more referring to children of parents with "busy" lifestyles who use antidepressants as a quick way to deal with their kids behavioral problems (or to help them focus on school to get good grades). You probably know this, but there are way too many children from rich families unnecessarily taking antidepressants for the wrong reasons.

There is so much to do, there are many fields that could benefit medicine, to give u an example I've heard great things that could be done with plant-based vaccines. We could improve the quality of the vaccines (less risks for people), lower the costs, and make it more accessible to people in need.

K-Man said...

Michele Bachman is nuttier than a can of peanuts, but there is a hard core of concern in her comments that needs to be addressed. And Texas Gov. Rick Perry had no business making Gardasil opt-out.

Government vaccination requirements make perfect sense for the highly contagious diseases that can kill or maim: polio, smallpox, German measles, and so forth.

But we have seen in recent decades the requirements go beyond that. It started with requiring vaccinations for diseases that are far less lethal, and are actually more of a nuisance for most children than a real threat: chicken pox, mumps. Remember that one such vaccine that many states had required was to combat a bug that caused diarrhea—and it had to be taken off the market after it was linked to intestinal blockages in infants. A raging debate continues about the efficacy of this group of vaccines, with (for example) the possibility that the chicken pox vaccine will lose its effectiveness rapidly in just a few years, requiring (conveniently mandated) booster shots. And this group also introduced more parents to vaccine-caused side effects.

Now the government is mandating, or attempting to, shots to combat lifestyle-related diseases. The odds of someone getting hepatitis B is actually slim, yet newborns must have the vaccine. Why? I took the shots as an adult working in the high-risk field of corrections and see no need for it for the general public. Except the well known risk groups, you or your children basically have to make an appointment to contract hep B. Then came another example, Gardasil... Just wait till the HIV vaccine.

We have seen vaccine mandates run amok. Maybe the measles-mumps-rubella vaccine doesn't "cause" autism, but what about the possibility that the hep B vaccine at birth or the combos of all these other newer ones are having some effect? Maybe the mercury preservative thimerosal doesn't cause autism when injected as part of a vaccine, but can you say it's totally free of side effects? After all, it's basically Merthiolate without the orange dye; and Merthiolate carried warnings against internal use, and you can't find it any more at most pharmacies anyway.

And there is wide suspicion in some scientific circles that overvaccination had led to the glut of immune disorders in children because their immune systems don't get to contend with normal diseases but instead react to innocuous things. Asthma, increasingly rampant food allergies, and Type 1 diabetes are examples of such disorders.

A fund set up in the 1980s is supposed to compensate victims of injuries caused by vaccines. In practice, parents who had seemingly ironclad cases consistently report stonewalling and denial of compensation. Victims of the more recent shots won't be any better off.

A side issue is that many parents are uninsured or underinsured and must pay full price for a never-ending, growing series of mandated shots. I once worked for a self-insured corporation that would not cover well-baby care, so this is a real issue. $100 here, $300 there—it all adds up, especially if the mandated shot is for an inconvenient, as opposed to a deadly, disease.

Many parents are justifiably concerned about such issues. Bachmann is simply playing to their concerns.

Government has no business mandating the latter two series of vaccines. They are nonessential. If you want to give them to your children and you are informed of the risks, fine. But as another poster remarked, this is the same government that actually gave or refused to treat grave diseases in select groups of people before; you trust its "concern" for your health with vaccine mandates now?

And if the government were to mandate (hypothetical) shots for children to prevent gonorrhea, syphilis, herpes, and HIV, would you really go along with this? Or would you have had enough and would instead refuse or protest?

This is where Bachman is coming from. And it resonates well with many parents—for good reason.

Diane said...

@ therrin (ben) my children have been vaccinated - but - if a vaccine came out suddenly claiming to cure xyz, would you jump on the bandwagon to get it - only to find out the side effects later? You seem to lump me in with the anti-vaccine crowd. Let's see.. dengue fever is growing here in S. Texas. Is there a vaccine against a disease that they're not very likely to get? You have to figure risks vs. benefits. What are the risks of Gardisil? I notice you can't find a full list of side effects online. They say "ask your doctor". Why? Because they have so much spare time to read through reams of paper? We looked at side effects when we got our girls vaccinated with polio vaccine.. injected vs. oral. we decided on ipv, as the risks were lower on ipv than opv. I prefer to *know the risks vs benefit* tyvm. As for diseases decreasing, are you saying that suddenly teh cancer rate will have a sharp spike downward due to the HPV vaccine (which has already killed a bit over 100 women since 2007)? Plus the list of drug interactions. Really? I guess Hepatitis B is because your child could have sex with, or become an IV drug user. Let's just bubble-wrap everyone, and duct tape them to the wall so that no ill effect ever hits anyone.

Anonymous said...

Way late comment on this thread (just found the blog), but as a pediatrician, this crap drives me INSANE. It's so infuriating to see parents refuse to protect their children with vaccines. I guess it's better if they die of something easily preventable.
As for the poster who wanted his daughters to prevent with abstinence, do you expect them to abstain even after marriage? They can be exposed to HPV even if their ONLY partner was exposed. Get them the vaccine for safety's sake.
End of rant.

 
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