HPV, Texans, And You

by tristero

Updated Below

Recently, in a post about the failure of Texas to mandate HPV vaccination, and in a follow-up, I opined that the issue has been so ludicrously framed by the Republican Representative Bonnen that it is impossible to discuss within such a frame. Let’s recall what this clown actually said:

“We should not and are now not going to offer the 165,000 11-year-olds in Texas up to be the study group for Merck to find out what the implications of this vaccine would be for these girls…”

I pointed out that rhetorically Bonnen knows he doesn’t have any reasonable objections. That’s because despite some faux precision – those 165,000 11-year-old Texan girls – Bonnen’s statement is so vague that it actually objects to nothing, just some “implications.” And what, pray tell, are we supposed to imply these implications are? Has the vaccine been tested? What are the ethics of forcing people to be vaccinated against their will, or their parents’?

Who can tell? Who knows what was in Bonnen’s brain? So fuck him. Meanwhile, let’s hear from people who’ve actually studied the vaccine and its efficacy and effects. Here are the results of some independent evaluations of the vaccine, called Gardasil:

“Investigators in these trials have hit their mark soundly: the vaccine showed significant efficacy against anogenital and cervical lesions,” Dr. George Sawaya and Dr. Karen Smith-McCune of the University of California, San Francisco, wrote in a commentary in the New England Journal of Medicine, where the studies appear.

“The vaccine also appears safe.”

…

One team of international researchers, led by Dr. Laura Koutsky of the University of Washington, studied 12,167 women aged 15 to 26 in 13 countries. Half got three doses of the vaccine and half got placebo shots.

The vaccine prevented pre-cancerous lesions in 98 percent of the women who had never been infected with the HPV-16 and HPV-18 strains over three years, Koutsky’s team reported.

Dr. Suzanne Garland of the Royal Women’s Hospital in Melbourne, Australia, and colleagues tested 5,455 women aged 16 to 24 and found the vaccine was 100 percent effective against the lesions that can develop into cervical, vulvar, vaginal and anal cancers.

Now I’m no statistitician, but 100% effective sounds pretty good, yes?

The U.S. Centers for Disease Control and Prevention has recommended the vaccine for 30 million women and girls aged 11 to 26.

But state proposals for mandatory vaccination have met with resistance, even though all allow parents to exclude their child.

So any parent who wants to can opt out, according to any of the state proposals.

The vaccine does not work after a woman is already infected and HPV is very common. By age 14 to 19, one-quarter of U.S. teens are already infected with at least one strain.

“Delaying vaccination may mean that many women will miss an opportunity for long-lasting protection,” Sawaya and Smith-McCune wrote.

And that’s one very good set of reasons to vaccinate women when they’re very young: it doesn’t work after you’re infected and by age 14, 25% of all teens are, in fact, infected.

But how bad, really, is HPV?

Cervical cancer is the second most common type of tumor in women and the leading cause of cancer deaths in some countries. Such tumors kill about 300,000 women worldwide each year, mostly in developing countries.

And how much does the vaccine cost?

$360 for three doses over six months

Any others do the same thing?

GlaxoSmithKline is also developing an HPV vaccine called Cervarix. A study released in April showed it protects women for more than 5-1/2 years.

In short, here is a vaccine that has been tested, in the reports mentioned here, on some 18,000 women. It has been shown to be nearly 100% effective. A report in the New England Journal of Medicine says the vaccine appears safe. The USCDC recommends females aged 11-26 receive the vaccine. And according to all the state proposals for mandating vaccination, any parent can have their child opt out.

But hey! Y’never know! All these people could be in cahoots with Merck, including the editors of the New England Journal of Medicine. And in making a decision as to whether Gardasil is a good idea, we really should assume they are. As for that 100% number, what if it fails just once? Hey! Y’never know! And for side-effects, did you notice? The article didn’t mention any, more proof that they’re all paid off by Merck! I’ll bet that stuff’s so bad for you it’s what caused poor Gregor Samsa’s horrible condition! Worse than thalidomide, for sure. Oh, wait:

542 adverse health complaints have been reported about Merck’s human papillomavirus vaccine Gardasil, but agency officials said the side effects of the vaccine are minor and that the vaccine does not require additional warning labels, 42 adverse health complaints have been reported about Merck’s human papillomavirus vaccine Gardasil, but agency officials said the side effects of the vaccine are minor and that the vaccine does not require additional warning labels…

Yeah, but that’s only on a mere 18,000 experimental subjects. How do we REALLY know how serious it is, HUH? Oh, wait:

…health officials estimate hundreds of thousands of women and girls have received at least one dose of the vaccine, but they do not have an exact count. According to CDC data, nearly 20% of the complaints about Gardasil involved soreness at the injection site and 9% involved fever or nausea. There were three cases of Guillain-Barre syndrome, which is a paralyzing side effect that has occurred with other vaccines. About 11% of the complaints involved fainting or dizziness. There have been no deaths or serious injuries resulting from fainting reported.

Reaction

Health experts said it is common for teenagers to faint from other vaccinations, and the number of fainting cases related to Gardasil is not higher than expected. “There is absolutely no reason to think that there is anything in this vaccine, as opposed to another vaccine, that’s going to make people more likely to faint,” John Iskander of CDC’s immunization safety office said, adding that it is not “worrisome” to the agency that there is “any sort of association” between Gardasil and Guillain-Barre. Health officials have recommended that patients wait 15 minutes before leaving a physicians office after receiving Gardasil in case of fainting or other side effects.

Ah ha! But you omitted this which entirely changes the picture:

The National Vaccine Information Center on Wednesday issued a release about Gardasil’s side effects that said there was not enough research on whether Gardasil could lead to problems when given with other vaccinations.

You see? Who can tell what will happen if you take Gardasil and the polio vaccine at the same time? And who knows what the interaction with fluoridated water might be? Have they tested every single possible contingency? I thought not.

Folks, time for a little bit of that cracker-barrel philosophy. There ain’t no sure things in this world of ours beyond death, taxes, and idiot Republicans. But given a near-100% rate of efficacy on a potentially lethal cancer, given hundreds of thousands of administered doses with minor side-effects, given that any parent who wants to can opt their child out…

As for Gardasil being another thalidomide…yeah, right. Thalidomide was a horror, but horrors don’t happen that often. It is technically possible that some serious medical problems might arise with Gardasil in a population of millions, but balanced against the extraordinary efficacy – a balance which always must be made – puh-leeze.

As with objections to evolution and the evidence for global warming, objections to the mandatory programs for HPV are completely, utterly without any scientific substance whatsoever. But hey! Y’never know!

That’s right, y’never do. Who knows? Maybe, just maybe, Bush/Iraq could have worked out! And maybe, just maybe, Gardasil is the worst horror ever for western medicine.

Riiiight.

[UPDATE: Some medical concerns regarding Gardisil were voiced in an editorial in the New England Journal of Medicine:

The long-term side effects of the vaccine are unknown — the most recent study followed women for three years — and that earlier research hasn’t considered what effect the vaccine has on the remaining 13 strains of HPV that also cause cervical cancer.

It’s possible, McCune said, that the remaining strains may fill a “niche” left if the two most common strains are wiped out entirely. If that happens, the vaccine might not make any difference on overall cervical cancer rates, she said.

But while many doctors agree that there are still questions about the vaccine, they note that there is no question that Gardasil is effective at stopping the most common cancer-causing HPV strains.

Also, in comments, one commenter found the figure of 100% effective highly dubious and doubts about some of the details of the discussion. Regardless, apparently Gardasil is highly effective even if not perfectly effective.

There may still be serious objections to the vaccine, but nothing mentioned by the critics quoted in this update makes Gardasil “controversial.” At most, there are some small legitimate concerns – but even the critics tacitly admit there are no important side effects over the course of a three year study.

So what makes it controversial? Only one thing: Republicans have somehow gotten the insane notion that this vaccine encourages young girls to fuck. And it is for this utterly idiotic reason, a potentially life-saving medication has become fraught with an utterly bogus controversy.

It’s very simple, people. If this vaccine is as effective and as safe as claimed – and so far, I’ve seen nothing to say it isn’t – then it is simply criminal to withold this from young girls. There are always going to be doubts and dangers with any medication. So far, this one looks pretty damn good and so my daughter will be taking it next year.]