Today I am featuring a guest column by Nevada NOW President Jessica Brown. Here she breaks down the supposed controversy surrounding the HPV vaccine and myths that have come out of the media who cover it.
The truth about the HPV vaccine
With little haste, local television, newspapers and radio broadcasts have jumped on the “controversy” over the HPV Vaccine, known in more sane circles as an “incredible breakthrough” in women’s health.
Right-wing ideologues work very hard to make anything that has to do with women’s reproductive health seem controversial, because they know that the appearance of controversy grabs our collective attention, puts a negative spin on the subject, and conveniently makes for good ratings and newspaper sales.
If you’ve been paying attention to local news, you may be under the impression that the vaccine is controversial among public health officials and that the Nevada legislature is considering legislation that would make the vaccine mandatory for girls going to public schools. Of course, neither of these things is true.
To understand what is actually being proposed in the Nevada legislature, and why other states are making the vaccine mandatory, it helps to understand what HPV and Gardasil are. Journalists have been heavy on the fake controversy, but pithy on the actual facts. The following is from the Centers for Disease Control, FDA and Merk websites:
- By the age of 50, more than 80% of American women will have contracted at least one strain of HPV. HPV is highly communicable. Condoms do not protect against HPV.
- HPV causes 99% of cervical cancer cases.
- All women who have ever been sexually active are encouraged get a yearly pap-smear solely to detect cancer cells caused by HPV.
- There are more than 30 strains of HPV. Four of these strains are responsible for causing cancer. Other strains cause genital warts.
- The HPV vaccine, Gardasil, protects against the two strains of HPV that cause 70% of cervical cancer cases, and one strain of HPV that causes 90% of genital warts.
- Both men and women are carriers of HPV. To eradicate the disease, men will eventually need to be vaccinated. Studies are being conducted now to determine the efficacy of vaccinating boys with the current vaccine.
- The vaccine was tested in over 11,000 girls (ages 9 to 26). It has no side effects, and is considered completely safe. It does not contain mercury, thimerosal or live virus (only dead virus).
- 12,000 Americans die from cervical cancer every year, and there are thousands more who are treated for cervical cancer by freezing the cervix with liquid nitrogen or hysterectomy.
- The vaccine is delivered in a series of three shots over three months at a cost of $360 or more for those who are uninsured.
- The FDA and CDC recommend that girls and women between the ages of 12 and 26 get vaccinated.
From a public health perspective, getting as many girls vaccinated as early and as quickly as possible will reduce the cases of cervical cancer among middle-aged women in 30 to 40 years and reduce the transmission of this highly communicable disease. Unfortunately, there are hurdles to getting this done. These include the limited understanding by many people that HPV causes cervical cancer, the difficulty of getting pre-teens and teens into the doctor’s office to get a shot, and the high cost of the vaccine (more than $360 per dose).
One way to bring down the cost of the vaccine and to educate the public on the benefits of vaccination is to make it mandatory for girls entering school. This approach has been taken with vaccines for mumps, measles, rubella, and hepatitis (which is also sexually transmitted) so many state legislators have penned bills that do just that. Who knew that religious ideologues would put up such a stink about making the vaccine mandatory? Well, apparently, state legislators did because each piece of legislation introduced in state legislatures has an opt-out policy for those with religious objections.
This opt-out policy is what makes the controversy over the vaccination fake. Parents who object to the vaccination can simply write a letter to the school principle saying something to the effect that protecting their daughter against cancer is contrary to their religious practices; that God will protect girls who wait to have sex until after marriage (and presumably only with husbands who are virgins until marriage); that sexual assault is preventable; and that a hypodermic filled with dead HPV vaccine is the female equivalent to Viagra. (Seriously – one has to wonder about conservative religious ideologues who claim that getting a shot encourages girls to have sex…)
So, it is clear that religious fundamentalists not only want to deny their daughters the vaccine, but they also want to push their agendas on the rest of America. Apparently, God wants “bad” girls and non-fundamentalists to get cancer.
Of course all of this is moot in Nevada because we don’t have a bill making the vaccine mandatory, though you wouldn’t know it from the local news. State Sen. Dina Titus introduced a bill that would require insurance companies to cover the cost of the vaccine. The only people opposed to the legislation in Carson City were (surprise!) lobbyists for insurance companies. (Someone even posted a comment on the Nevada Legislature website asking the legislature not to support the Titus bill because it would make the vaccine mandatory.) The bill passed the Senate before Republicans who originally voted for the bill rescinded their vote on the demand that insurers who cover county employees (such as those in our own Clark County) be exempt. It eventually passed with this exemption. But the Assembly put the requirement to cover county employees back into the bill and combined it with a different bill that would mandate insurance coverage of prostate exams for men. Now it goes back to the Senate, where at least one Republican will have to vote for it for the bill to pass.
Meanwhile, Nevada’s women wait.
5 thoughts on “The HPV vaccine: What’s all the hullabaloo?”
1) GARDASIL is a vaccine for 4 strains of the human papillomavirus (HPV), two strains that are strongly associated (and probably cause) genital warts and two strains that are typically associated (and may cause) cervical cancer. About 90% of people with genital warts show exposure to one of the two HPV strains strongly suspected to cause genital warts. About 70% of women with cervical cancer show exposure to one of the other two HPV strains that the vaccine is designed to confer resistance to.
2) HPV is a sexually communicable (not an infectious) virus. When you consider all strains of HPV, over 70% of sexually active males and females have been exposed. A condom helps a lot (70% less likely to get it), but has not been shown to stop transmission in all cases (only one study of 82 college girls who self-reported about condom use has been done). For the vast majority of women, exposure to HPV strains (even the four “bad ones” protected for in GARDASIL) results in no known health complications of any kind.
3) Cervical cancer is not a deadly nor prevalent cancer in the US or any other first world nation. Cervical cancer rates have declined sharply over the last 30 years and are still declining. Cervical cancer accounts for less than 1% of of all female cancer cases and deaths in the US. Cervical cancer is typically very treatable and the prognosis for a healthy outcome is good. The typical exceptions to this case are old women, women who are already unhealthy and women who don’t get pap smears until after the cancer has existed for many years.
4) Merck’s clinical studies for GARDASIL were problematic in several ways. Only 20,541 women were used (half got the “placebo”) and their health was followed up for only four years at maximum and typically 1-3 years only. More critically, only 1,121 of these subjects were less than 16. The younger subjects were only followed up for a maximum of 18 months. Furthermore, less than 10% of these subjects received true placebo injections. The others were given injections containing an aluminum salt adjuvant (vaccine enhancer) that is also a component of GARDASIL. This is scientifically preposterous, especially when you consider that similar alum adjuvants are suspected to be responsible for Gulf War disease and other possible vaccination related complications.
5) Both the “placebo” groups and the vaccination groups reported a myriad of short term and medium term health problems over the course of their evaluations. The majority of both groups reported minor health complications near the injection site or near the time of the injection. Among the vaccination group, reports of such complications were slightly higher. The small sample that was given a real placebo reported far fewer complications — as in less than half. Furthermore, most if not all longer term complications were written off as not being potentially vaccine caused for all subjects.
6) Because the pool of subjects were so small and the rates of cervical cancer are so low, NOT A SINGLE CONTROL SUBJECT ACTUALLY CONTRACTED CERVICAL CANCER IN ANY WAY, SHAPE OR FORM — MUCH LESS DIED OF IT. Instead, this vaccine’s supposed efficacy is based on the fact that the vaccinated group ended up with far fewer cases (5 vs. about 200) of genital warts and “precancerous lesions” (dysplasias) than the alum injected “control” subjects.
7) Because the tests included just four years of follow up at most, the long term effects and efficacy of this vaccine are completely unknown for anyone. All but the shortest term effects are completely unknown for little girls. Considering the tiny size of youngster study, the data about the shortest terms side effects for girls are also dubious.
8) GARDASIL is the most expensive vaccine ever marketed. It requires three vaccinations at $120 a pop for a total price tag of $360. It is expected to be Merck’s biggest cash cow of this and the next decade.
These are simply the facts of the situation as presented by Merck and the FDA. This vaccine was just approved in June, 2006. It was never tested on pre-teens except in a tiny trial run with at most 18 months of follow up. Even if we subscribe to the theory that HPV causes cervical cancer, there is ZERO hard data showing that this vaccine reduces cervical cancer rates or cervical cancer mortality rates, which are both already very low in the US and getting lower every year. Now Texas has already made this vaccine mandatory for middle school with all sorts of useful idiots and Big Pharma operatives clamoring for more states to make this vaccine COMPULSORY immediately.
Mitch, I hate to tell you but some of your “facts” just don’t ring true.
For one thing, Texas does NOT require the vaccine and in fact there was a showdown between that state’s legislature and governor over this very topic. They so desperately did NOT want to make the vaccine required for every girl that they instituted a rider on the law which said it can’t even be brought up again for years.
And frankly, have you ever looked at the research methods of many popular drugs on the market today? If you find fault with Merck’s methods, perhaps your real beef is with the shoddy practices of the FDA. I won’t argue that they let a lot get through the cracks (can anyone say Fen/Phen?) but that doesn’t make every single drug that gets approved suspect.
As for the price. I’ve heard this mentioned a lot in debates. Here’s the wonder of the modern insurance industry. They have the ability to use collective bargaining, much like the super-size of Walmart, to force drug companies to lower their prices. In fact, that’s mostly how it works on nearly every drug out there. If you don’t like that system, and I don’t blame you for not liking it because it is fucked, then perhaps you should get on board with a national healthcare system that makes rates more fair for everyone. While capitalism works in alot of ways, I don’t think I should have to count on corporate greed to insure that I have adequate health care.
Finally, and this is perhaps most important: Cervical cancer is one of the most deadly of all cancers. It’s true that it’s prevalence has gone down (according to the American Cancer Society by 4% each year). And thank goodness it has! But the reason that cervical cancer can be very deadly is because if it is dedetected too late in the disease there is very little you can do about it. (According to the National Cancer Institute, the cancer is a slow-growing disease that often has no symptoms.) And while regular PAP screenings have reduced the occurances (it was once the leading cancer killer of women), even those screenings do not detect all strains and are not fool-proof. And don’t forget that thanks to our glorious healthcare system, many women simply can’t afford regular PAP screenings each year!
And now that there is new research that HPV can cause throat cancer in those who engage in oral sex, there is an even wider pool of people to be concerned for – i.e. both women and men. In fact, this new research has scientists thinking that maybe the bulk of throat and mouth cancers are actually from HPV strains, rather than tobacco use, a radical shift in medical thinking.
So I wonder why you would want to limit people’s access to a drug that can help against a deadly form of cancer. It’s true that more people die of heart disease. And it’s true that there are more deadly forms of cancer. But could you really look a person dying of cervical or throat cancer in the eye and tell them that it just doesn’t mean as much because not as many people get that disease? Or perhaps you think they deserve it? Or is that you can take care of yours so fuck everyone else? No matter which it is, Mitch, that’s a pretty callous and petty way to go through life, don’t you think?
What? Huh? A communicable disease is by definition infections, but not all infectious diseases are communicable.
he cause of infectious disease is disease-producing organisms—such as bacteria, viruses, fungi or parasites—invading a host. A communicable (contagious) disease is one that can be transmitted from one person to another.
Not all infectious diseases are communicable. Salmonella is highly infectious, but it is not contagious. Chickenpox is both infectious and communicable. Airborne droplets can easily transmit it from one person to another.
The organisms commonly responsible for the spread of disease are viruses and bacteria. Viruses cannot normally multiply outside a living cell. However, viral disease can spread if a person contacts an inanimate surface contaminated with fluids/blood containing the virus. Bacteria can multiply outside the body.
HPV and hysterectomies and cryotherapy
Pap smears do not in and of themselves protect against cervical cancer; pap smears only detect cancerous cells on the cervix. Hundreds of thousands of women ever year will endure hysterectomies and cryotherapy, a medical treatment that uses liquid nitrogen to burn the cervix and part of the vagina to kill cancerous cells, as a result of HPV infection that becomes cancerous. By vaccinating against the virus, we prevent the majority of those women who would have contracted virulent HPV from having to undergo these painful and unfortunate medical procedures.
According to the National Cancer Institute, 12,000 women a year are diagnosed with cervical cancer and 4,000 will die from it in part because these women did not receive annual pap smears. Many of these women do not have medical insurance or adequate health care. Vaccinating all women against virulent HPV will help many women who cannot afford basic health care. In a report, the National Cancer Institute writes:
“Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds, if all women were to take the vaccine and if protection turns out to be long-term. In addition, the vaccines can reduce the need for medical care, biopsies, and invasive procedures associated with the follow-up from abnormal Pap tests, thus helping to reduce health care costs and anxieties related to abnormal Pap tests and follow-up procedures.”
Vaccines are POISON. The only one[s] who benefit from vaccines are PHARMACEUTICALS. Lots of Vitamin D will protect you from the flu and many other diseases. DON’T be fooled by paid off media hype. STOP the sickening assault on humanity.
Pingback: This is my 1000th Post! « The Sin City Siren