Gardasil is a good idea

What if we had a vaccine against cancer? Or even against some cancers? Wouldn’t this be a huge news story, with people everywhere clamoring for the shot? Maybe…

Or maybe, some people could find a way to turn that smile upside down. Gardasil, the new vaccine approved for prevention of certain cancer-causing strains of the Human Papilloma Virus (HPV), is the first widely available vaccine aimed directly at preventing cancer. (The Hepatitis B vaccine also helps prevent liver tumors, but that’s another story.) Gardasil can prevent cervical cancer, certain mouth and anal cancers, and perhaps other cancers of the naughty bits. So, who wouldn’t love that?

The Religious Right is who. You see, the infection that leads to these cancers is usually spread by sexual contact. Thats right, sex. SEX!! And sex is a big no-no for the fundies, at least outside of making babies with your opposite-sexed spouse.

But as much as I dislike fundamentalism, most of the “mainstream” fundamentalist groups have taken a more nuanced stand on Gardasil.

For school vaccination requirements, Christianity today favors an “opt-in” policy, while Focus on the Family sets a vaguer, “let the parents decide” policy. Both groups, quite wisely, recognize that the vaccine is valuable and that evangelical children are at risk for HPV. The Family Research Council also has an “opt-in” policy with the additional honesty of explaining why they do not like an “opt-out” policy. All of the groups do seem to over-emphasize potential negative arguments, however. Cost comes up as an issue–as it should with any medication. But if the vaccine prevented, say, ovarian cancer, I don’t think anyone would focus much on the price.

“The wages of sin is death”, and while most Christians do not subscribe to a literal interpretation of this idea, it does infuse the Right’s decision-making, perhaps blinding them to the benefits of this vaccine. In order for the vaccine to be effective, it must be given before the onset of sexual activity (which can even mean touching “down there”). While none of us likes to think about our kids having sex at 14, it may happen, and to punish them with cancer seems, well, excessive.

An “opt-in” policy for vaccinations is not a good approach to public health. Vaccines work by protecting people before they may be exposed, and by creating herd immunity. Everything that can be done to encourage vaccination should be. Opt-in carries an implication that the vaccine is either unimportant or of uncertain utility. Opt-out, while less negative, makes it too easy for people do put off a decision until it is too late.

As with any vaccine, safety and efficacy are important. And, as with any disease, education is an excellent public health measure. Mandatory sex education would go a long way toward preventing sexually transmitted diseases and unwanted pregnancies. I wonder how Focus on the Family feels about that?

Comments

  1. #1 Oldfart
    March 30, 2008

    It is not just the fundies. I cannot convince my daughter to give her daughters this vaccine because there have been no long-term tests done. (If there have been, I have no knowledge of it.) They don’t want to vaccinate their daughters only to find out in 10 years or so that they have become infertile (or other serious complication) because of the vaccination. In other words, there is an attitude among normal people as well as fundies that “I don’t want to sacrifice my child on the altar of scientific experimentation.” They also grapple with the same problems as the religious right. “Will giving my daughter this vaccination imply to her that it is ok to have sex now?” Reminding them of their own misspent youth just doesn’t seem to work for some reason.

  2. #2 Bill
    March 30, 2008

    I have 2 daughters, ages 19 and 21. I can tell you that the argument of, “well, I did it and I turned out okay.” doesn’t cut it with me. My “misspent youth” is far from the example that I wish I could show my girls. It would be more of an example of what NOT to do.

    As for the hesitation regarding gardisil, for me, the problem isn’t a mistrust of doctors or a problem with vaccination or even any thoughts of promoting sexual promiscuity.

    How much does the doctor (the average doctor that my daughter is likely to visit) about this product other than what Merck has told him/her? What are the odds of contracting the HPV virus without the disease? What are the odds after vaccination? The trials that were done, are there any third parties that have looked at them?

    I have the greatest respect for (most) doctors that have dedicated their lives to the profession. I also have a high distrust of the system.

  3. #3 Bill
    March 30, 2008

    I hate not being able to edit my post…
    “How much does the doctor (the average doctor that my daughter is likely to visit) about this product other than what Merck has told him/her?”

    should read:

    “How much does the doctor (the average doctor that my daughter is likely to visit) know about this product other than what Merck has told him/her?”

  4. #4 PalMD
    March 30, 2008

    Actually, you’re both wrong…yes, wrong. For example:

    They don’t want to vaccinate their daughters only to find out in 10 years or so that they have become infertile (or other serious complication) because of the vaccination.

    What a load of bullshit. Hey, it might cause accessory nipples and green goo to come out of your ass too, but there is not reason to think that. The vaccine is based on the same biological principles as all vaccines. The only difference here is the SEX!!111!

    Oh noes!!!!

    Hey, believe what you want, but don’t try to pass it off as logical.

  5. #5 Bill
    March 30, 2008

    I didn’t know that I stated anything to be wrong about, I was asking questions…

  6. #6 Brendan S
    March 30, 2008

    I think the point Pal is trying to make is that The vaccine works on the same basis as MMR or Flu or anything else. So if it were likely to make you infertile, then so would the MMR vaccine.

    Just because the virus is spread by sexual contact doesn’t change the basic viral mechanism.

  7. #7 Bill
    March 30, 2008

    I got that. I just don’t understand how it applies to my post. My question isn’t regarding the safety, it’s regarding the need for the product and it is admittedly because I am ignorant of the facts.

    I don’t have 100% trust in the information disseminated by any large for profit company regarding their own products. Perhaps I should have asked my questions better.

    For example, I have looked at the zostavax. In my opinion, the effectiveness doesn’t justify its existence. (JMO) Is this the same way? (I understand the fact that one is live virus and the other isn’t. I’m not trying to get into a comparison of the two other than the fact they are both Merck products and that the zostavax is on the market for profit rather than a clear cut advantage to the patient, IMHO.)

    I haven’t spent any time researching this product and, since I am starting to have some level of confidence in PAL’s knowledge and his advice, I was hoping to hear that he had looked at the actual trial data rather than just repeating what the Merck rep has told him. (I suspect he actually has done so.)

  8. #8 Jeb, FCD
    March 30, 2008

    Why can’t boys get this yet? Is it only because it was tested in females?

    I would certainly like to get my son vaccinated.

  9. #9 Christina
    March 30, 2008

    My daughter has finished her 3 shot round of Guardasil.

    I’ll be damned if I’ll watch her bleed to death from cervical cancer in a decade or two if there is any chance to keep that from happening.

    As for promoting sex, sex is one human activity that needs no promotion. I didn’t need any. I did it anyway regardless of the “wait for True Love” b.s. my parents gave (and modeled!) for me. What I needed was information and supplies by which to protect myself. I got *those* from my school’s sex ed class–not from my parents and they are decidedly *not* fundies.

    When they approve it for boys here, like they have in the UK, I’ll be getting my son vaccinated as well–to help protect my future daughter-in-law as well as him.

    Because HPV doesn’t cause only cervical cancer, it also causes genital warts.

  10. #10 PalMD
    March 30, 2008

    I’m still waiting to hear about boys. One, they serve as a vector. Two, they can get penile and anal cancer, and some oral cancers from HPV.

    It takes a lot of time, money, and work to get specific approvals for any drug or vaccine…

  11. #11 PalMD
    March 30, 2008

    @Bill—there is no reason to expect, based on initial data, any untoward effects from the vaccine, but, like all drugs that are relatively safe, it takes lots of people-years of exposure to see rare and unexpected effects. Over time this will become clear, but there is no reason that this vaccine shouldn’t be as safe as any other.

    That being said, the risks (however unlikely they may be) and benefits must be weighed. It is somewhat likely that a young woman will be exposed to an oncogenic strain of HPV. A certain percentage of those women will go on to develop cancer. If vaccinated, this is far less likely to happen.

  12. #12 Bill
    March 30, 2008

    So, take it because it probably won’t hurt you and it MAY do you some good.

    Got it. Thanks.

    http://www.abcnews.go.com/Health/Story?id=4489640&page=2

  13. #13 Alexandra
    March 30, 2008

    But, but, but… didn’t you see I am Legend? They had a vaccine for cancer and it destroyed the world. Wait, I mean… it DESTROEYD THE WORLD!!!11one!

    Fortunately that atheist scientist came back to God just in time and sacrificed himself to save the few survivors. (All good, church-going, god-fearing people who were wise enough not to get vaccinated in the first place.) Clearly a lesson to be learned there, eh?

    It was a real big movie too, grossed half a billion dollars, and there were like fi’ty-eleven MDs in the credits, so it must be accurate, right?

  14. #14 Alexandra
    March 30, 2008

    So, take it because it probably won’t hurt you and it MAY do you some good.

    If you’re waiting around for something that can’t ever, even hypothetically, do any harm to anyone anywhere and at the same time promises to do everyone substantial good, well… good luck with that! Of course not even eating food or breathing air has such a wonderful balance.

    When the cost-benefit analysis has your child risking cancer on one side and a vague, nebulous, unfounded fear of something bad on the other… how hard is that to decide?

  15. #15 Bill
    March 30, 2008

    Don’t get me wrong. I am not saying it isn’t worth it. I’m just asking where’s the proof that it IS worth it. There is a difference.

    I’ve been doing a little reading this morning on the subject. (That’s why I love this blog, gets you thinking and wondering.) Here are a few things I have found:

    According to the ACS website, “Doctors believe that women must have been infected by HPV before they develop cervical cancer. Certain types of HPV are called “high-risk” types because they are often the cause of cancer of the cervix. These types include HPV 16, HPV 18, HPV 31, HPV 33, and HPV 45, as well as some others. About two-thirds of all cervical cancers are caused by HPV 16 and 18.”

    ” Two types of HPV, HPV 6 and HPV 11, cause most cases of genital warts.”

    “Many women become infected with HPV, but very few will ever develop cervical cancer.”

    “…a vaccine that protects against HPV types 6, 11, 16 and 18 (Gardasil®)…”

    ” It requires a series of 3 injections over a 6-month period.”

    “To be most effective, the HPV vaccine should be given before a person starts having sex.”

    “Gardasil is expensive – the vaccine series costs around $360 (not including any doctor’s fee or the cost of giving the injections).” [is that per dose or for a round of 3 injections?]

    “It is important to realize that the vaccine doesn’t protect against all cancer-causing types of HPV, so routine Pap tests are still necessary.”

    “One other benefit of the vaccine is that it protects against the 2 viruses that cause 90% of genital warts.”[It may be worth the cost for this reason alone. I don’t know.]

    “The cervical cancer death rate declined by 74% between 1955 and 1992. The main reason for this change is the increased use of the Pap test.”

    “The death rate from cervical cancer continues to decline by nearly 4% a year.”

    “The 5-year relative survival rate for the earliest stage of invasive cervical cancer is 92%.”

    “The number of women stricken by cancer of the cervix is steadily decreasing. Overall rates of US women diagnosed with invasive cervical cancer declined 17% between 1998 and 2002…”

    So, is the $360 the cost of each of the 3 treatments or a combined cost?

    What I see is take the vaccine, but continue to do the pap smears just like you didn’t take it, because it isn’t 100% effective. Okay, what percent effective is it? How many actual lives will be saved by using this vaccine? Since the ones that will benefit the most are the ones that will not be able to afford it, will it be utilized effectively or will the parents of the least at risk group be scared into buying it for their daughters? Since incidence of cervical cancer is already on the decline, is there a more cost effective way of achieving the same or better results?

    I still don’t know the answers and I am not saying that the vaccine is a bad thing. My question is, and has been from the first post, Has anyone besides Merck looked at the numbers to see if it really is of benefit to anyone?

  16. #16 Bill
    March 30, 2008

    Why don’t I trust pharmas? http://www.nytimes.com/2008/03/30/business/30cnd-vytorin.html?ref=business

    Just read that. Thought it was apropos.

  17. #17 DuWayne
    March 30, 2008

    Bill –

    I have 2 daughters, ages 19 and 21. I can tell you that the argument of, “well, I did it and I turned out okay.” doesn’t cut it with me. My “misspent youth” is far from the example that I wish I could show my girls. It would be more of an example of what NOT to do.

    I daresay that most of us really hope that our kids will avoid the same sort of bad decisions that we made when we were kids. Having taken sex and drugs to a fair extreme as a kid, believe me, I am doing and will continue to do everything I can to ensure my kids (the oldest six, the youngest almost five months) don’t follow their old man’s footsteps. But in the interest of harm reduction, I am also making the assumption that they will and will do everything I can to ensure their safety if that’s indeed the case.

    I am really hoping to see this available for the boys, by the time mine are old enough. It is not because I want to see them having the sex, I most certainly hope to raise them bright enough to use condoms. But I am well aware that all it is is hope. I know that no matter what I do, they may still have the sex, possibly without protection. As a parent, I feel it’s my responsibility to do everything I can to keep my kids safe, even if they choose to ignore my advice based on experience. Not wanting to see them die of cancer or lose important parts of their bodies to cancer, an HPV vaccine could be an important part of that.

  18. #18 Bill
    March 30, 2008

    WHHH… WHHHH… Is this thing on?

  19. #19 Oldfart
    March 30, 2008

    Let’s see. If you excercise caution with respect to your own children, you are just being STUPID. Right almighty medical massas? We, your ignorant lowly slaves, have no right to caution, introspection, hesitation because we don’t know nuthin…. The great, all powerful, 100% correct, flawless medical profession in combination with the generous, paternal, altruistic drug companies who have only our best interest at heart, will take care of us and therefore, WE HAVE NO NEED TO LOOK BEFORE WE JUMP. Right?

    There ARE idiots around here but they ain’t us, massa, they’s YOU.

  20. #20 Bill
    March 30, 2008

    ^^I was nicer about it…

  21. #21 J. J. Ramsey
    March 30, 2008

    PalMD: “What a load of bullshit. Hey, it might cause accessory nipples and green goo to come out of your ass too, but there is not reason to think that. The vaccine is based on the same biological principles as all vaccines.”

    Yes, and the principle of vaccines is to introduce a weakened or dead form of a pathogen so as to spur immunity to the real pathogen–which means a small risk of suffering the effects of the real pathogen. Obviously, in practice, the risk is about nil, especially for the tried-and-true vaccinations. However, it’s not exactly as if the pharmaceutical companies have always been on the up-and-up lately, especially with the “business-friendly” Bush administration in charge, and I can understand why someone like Bill would be suspicious of whether Merck cut a few corners that might not have been cut if the FDA were on the ball.

  22. #22 Sandra Porter
    March 30, 2008

    We had our two daughters get vaccinated.

    I don’t see how anyone could justify a chance to prevent a common cancer in one’s children.

  23. #23 PalMD
    March 30, 2008

    I find the protestations here to be entirely disingenuous, if not outright mendacious. Gardasil differs from other vaccines only in that the disease it prevents is associated with sex.

    A virus doesn’t care if you feel “enslaved” by modern medicine. It doesn’t care if you wish to wait 20 years, just to make sure there is nothing left unthought of.

    It is always reasonable to question new medical interventions, and, hey, if you’re not interested, then, so be it.

    You are correct in that some vaccines are less safe than others. Smallpox is not the safest vaccine we have, and since it is no longer much of a threat, we don’t use it widely.

    The first rotavirus vaccine was found to be associated with a rare bowel condition, and was immediately withdrawn.

    If something happens with Gardasil, however unlikely, it will be removed. But the risk of cervical cancer appears to clearly outweigh any risks of this vaccine.

    Gardasil would protect against most oncogenic strains of HPV, and would NOT mitigate the need for pap smears…but pap smears are an attempt to corral the horse after it has left the barn.

  24. #24 revere
    March 30, 2008

    If my daughter were of the right age I wouldn’t hesitate to have her get the HPV vaccine (she is a parent herself, now). But I don’t think this vaccine is ready for “mandatory” status. We need a little more experience with it, which it appears will come. It has been tested in very few young girls of the age recommended. There is the question of subtype shift, too, and the cost is not insignificant. If made mandatory, it would be the only mandatory vaccine where the cost is determined by the manufacturer. It also does not eliminate Pap smears. Whether vaccinated or not, you still need a periodic Pap smear, so there is no cost savings.

    The cost is a concern for another reason, too. Cervical cancer is not a major health issue in the US but it is a major issue in the developing world, which can’t afford this kind of vaccine. It is in the developing world where this vaccine can be a real life saver, not the US.

    Finally, pushing mandatory status for HPV vaccine is aggravating an already serious situation on opt outs. Once you make opt out a common and expected practice for parents you encourage this also for other vaccines whose status is much more urgent.

    I recently organized a symposium on HPV with all the major players, including the guy who was head of Merck vaccines when it was developed, someone from the UN, the head of the Women’s Health Book Collective (Our Bodies, Ourselves) and a state legislator holding hearings on HPV mandatory vaccination. No fundies, no discussion of its effect on sexual behavior. Just public health. The keynoter was the writer of the Editorial for JAMA on HPV prevalence. Going into this I thought this was a public health no brainer. It turned out, on peeling back layer and layer of the onion, it is more complicated than I thought at the outset.

    This is not a live or killed virus vaccine, by the way. It uses Virus Like Particle (VLP) technology, essentially a viral protein particle antigen without any genetic material.

  25. #25 Bill
    March 30, 2008

    I’m reminded of a story that a friend once told me. This guy is sitting next to a beautiful young lady at a bar and asks her, “Excuse me Ma’am, would you sleep with me for one million dollars?” The young lady, without much delay responds, “Sure.” The man pauses, then says, “Would you sleep with me for one hundred dollars?” The woman turns and very obviously irritated responds, “Of course not! What kind of woman do you think I am?” To which the man responds, “We’ve already established that, I’m just trying to negotiate a rate.”

    I would happily pay 10 times the cost of gardasil EVERY YEAR if you could guarantee that my daughters will never get cancer. A 50% reduction in an already miniscule chance of contracting a specific type of cancer might be worth something. According to the ACS website, less than 4000 women are expected to die from cervical cancer in the US in 2008. If all 144 million women in the United States get this vaccine at a cost of $500 each (vaccine cost plus office visit), that is $72 Billion dollars. Will it eliminate all 4000 deaths? Will it eliminate half of them? Perhaps the morbidity cost will justify the vaccine. Is that what you are paying for? I think Mercola has some stuff on his website that is purported to fight cancer for a lot less money. From the data that you have shown me (none), it may be just as effective.

    SHOW ME THE NUMBERS!!!!

  26. #26 Bill
    March 30, 2008

    Pal: Take gardasil. It’s safe.

    Me: But is it effective?

    Pal: It’s safe.

    Me: But does it do what it says it will do? Is there a real need for this?

    Pal: What are you, some kind of fundamentalist freak? Quit worrying about whether it’s safe or not.

    Me: It doesn’t seem like that much of a problem if you catch it early enough. The ACS says there is a 100% cure rate for stage 0.

    PAL: You’re just being entirely disingenuous, if not outright mendacious. It’s just like any other vaccine. IT’S SAFE!

    Me: Okay. Sorry for being so hard headed. I see it’s safe. Here’s my $500. Where do I send my girls?

  27. #27 Mondo
    March 30, 2008

    More like:
    Pal: Take gardasil. It is effective and safe as any other vaccine.
    Internet nut job: But is it effective?
    Pal: Yes.
    Internet nut job: But does it do what it says it will do?
    Pal: Yes.
    Internet nut job: But is it really needed? I mean is cancer that bad? Plus IF they catch it early maybe its not that bad.
    Pal: (waking up to the fact that Bill is a troll) You people are tards.
    Internet nut job: Vacinnes are teh devil.

  28. #28 PalMD
    March 30, 2008

    However, i must point out that revere’s contribution is useful, relevant, and I mostly agree with it.

    HPV is not ready for mandatory status for many of the reasons listed. Cervical cancer is does have a significant footprint on american health care, as do other HPV-related diseases, however, compared to pertussis, influenza, and other vaccine preventable diseases, it is less significant.

    However, much of the debate about Gardasil has focused around it’s “social implications” and attracted the anti-vax nutters, rather than engendering real discussion, as revere has.

    The religious right has taken this on as another one of their causes, since they keep losing ground on others.

    I have been approached in the past by representatives of companies who market the vaccine, and have declined their offers to push their drug, not because I don’t think it will be useful, but because it’s rather unseemly to let that type of conflict of interest enter in to the discussion.

    After a few more years I’m guessing we will know a lot more.

    Meanwhile, as soon as my daughter is old enough, she’s getting it, along with all the other usual vaccines.

    Hey, I’m not obsessed with vaccines just because they are the most important public health innovation since clean water. If my kid was offered a smallpox vaccine in the current environment, I’d say “no”. If smallpox became a public health threat, I’d weigh the pros and cons.

    I have a feeling that some of the commenters wouldn’t take a pertussis, polio, or any other well-regarded vaccines, using and argumentum ad absurdum.

  29. #29 Johnpatrick
    March 30, 2008

    HPV vaccination is different that other forms of mandatory school vaccination in that the primary goal is not to achieve herd immunity. If it was, we wouldn’t be immunizing half the population. I don’t see what the harm in an opt-in policy would be here, at least to those who wanted to take the vaccine. You could make policy arguments that mandatory vaccination saves children from their overbearing parents, but I don’t think everyone’s ready for the CDC to raise their kids.

    As to the question of cost, I think the benefits of the vaccine are offset by the fact that women should still be receiving the same preventive care (pap smears) that they would normally undergo yearly if they were not vaccinated, since the vaccine does not prevent all forms of cervical cancer caused by certain strains of HPV.

    Because we already have such effective screening and treatment for cervical cancer in this country, it is not a major killer like it is in developing nations. However, the vaccine is not being marketed there for obvious reasons. I feel the vaccine was rushed into our countries schools without sufficient public health policy to back it. The only party that stands to gain from these hasty decisions is Merck.

  30. #30 PalMD
    March 30, 2008

    Ask any woman who has had a cervical conization or LEEP whether they’d rather have been successfully vaccinated…

  31. #31 isles
    March 31, 2008

    I smell a troll. Couple of ‘em, maybe. The ones that start out just pretending to be good old reasonable folks are the most annoying kind.

    Did Merck buy off the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetrics and Gynecology, the Advisory Committee on Immunization Practices, etc., etc., etc…….?

  32. #32 meg
    March 31, 2008

    Jeb, anyone can get Gardasil if 1) you’re willing to pay for it yourself out of pocket; and 2) you can find a doctor willing to give the injections. Though I’m older than the target age group, I decided to have the vaccine after testing negative for HPV (never got it? cleared my system? who knows?). Because I’m outside the target age range, insurance didn’t cover the vaccine; my out-of-pocket costs ran slightly over $800 in total (spread out over many months).

    However, I have a couple of good friends who were diagnosed with cervical cancer – one after multiple misdiagnoses, no less – and countless who have had to have abnormal cells that have reached some precancerous level frozen (ow ow ow). If possible, I’d like to avoid going through the same experiences, and do my part to help fight against HPV a bit. I also figured that it couldn’t hurt the company to have as much actual usage data as possible. (One odd side effect – I had “regular” warts as a child, but hadn’t had any in a couple of decades. After I got either the first or second Gardasil shot, I got a wart-looking growth on one of my previous wart areas. It went away quickly with a little over-the-counter treatment, though.)

    Will I continue to get Pap smears on a yearly basis? Of course – no Pap smear, no birth control pills! Based on my extensive experience with my female friends, I don’t think getting the shot will cause anyone to stay away from the doctor who would have gone otherwise – either you get in your bones why Pap smears are one of the best tools of prevention out there, or you don’t. If you do, the vaccine will make you feel a bit more confident of the outcome of your Pap smear, but that’s it. If you don’t, well, Gardasil is better than nothing.

    I did, however, find the reaction on both sides to Texas Gov. Rick Perry’s plan to mandate Gardasil to be…amusing. Yes, there was the expected protest from various religious types. But, on the other side, there was much dark muttering about Perry’s ties to Merck AND many statements along the line that, if a Republican were recommending it, it HAD to be a bad idea! For the record, I do wonder what role Perry’s ties to Merck played…but I also *know* that cervical cancer rates among poor immigrant girls and women in Texas are unacceptably high, and I have to imagine that Perry knows it too. Moot point now, though.

  33. #33 davidp
    March 31, 2008

    For Bill,
    Benefits:
    70% of cervical cancers are caused by the strains targetted by Gardasil
    80% of people are exposed to HPV during their lifetime
    By the age of 75, there is a 1 in 191 risk of contracting cervical cancer [I’m not sure if this is for women only, or the community average]
    In Australia the 5 year survival rate is 75%, but the survivors have all “had cancer” and gone through major treatment.

    So you’re avoiding 70% of about a 1 in 800 chance of dying, and 70% of a 1 in 200 chance of cancer.
    You’re also protecting against major strains of genital warts (90% of genital warts worldwide).

    Risks:
    In Australia, with 2.2 million doses administered, there have been 11 reports of anaphylaxis and 61 reports of hives after Gardasil vaccination.
    Gardasil vaccination hurts quite a lot, and a few kids faint (Source: My brother who is a GP, media reports from a local school, vaccine data sheet)

    Ingredients: I think Gardsil is just selected proteins from virus, made by gene insertion into bacterial cells, not whole virus, so there is zero possibility of infection with HPV (unlike inactivated virus vaccines where a mistake in the factory resulting in failure to kill the virus could cause a problem – low but non-zero). There is aluminium based adjuvent and borax in the does too.

    Data sheet: http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/cscgarda/$File/cscgarda.pdf

  34. #34 Colugo
    March 31, 2008

    PalMD: “So, who wouldn’t love that? The Religious Right is who.”

    Of course it’s more gratifying to skewer the religious right, but this thread is an example of the deep antipathy to vaccination (and mainstream biomedicine in general) among broad segments of the Left.

  35. #35 Bill
    March 31, 2008

    DavidP: THANK YOU!

    From the very first comment (or perhaps the second, I don’t remember) I admitted that my questions were rooted in ignorance of the subject and a distrust of Merck. I understand your post and trust those sources. I will be recommending my daughters get vaccinated.

    (Now, is it safe? ;-))

  36. #36 Ed Darrell
    March 31, 2008

    It is somewhat likely that a young woman will be exposed to an oncogenic strain of HPV.

    “Somewhat likely?” By the time they reach 50, if unvaccinated, 80% of women will have contracted one of the viruses this vaccine protects against.

    Four out of five.

    Your wife.

    Your daughters.

    You do the math.

    Opposition to Gardasil is led by Judicial Watch, a group known for loud denial of all sorts of sane things, a group not known for medical expertise nor for giving a damn about children.

    I gave a longer explanation of the stupidity of avoiding the vaccine at my blog:
    http://timpanogos.wordpress.com/2007/05/31/voting-for-cancer-against-prevention/#more-658

    It has links to the Merck site and others with real statistics.

  37. #37 meg
    March 31, 2008

    “Gardasil vaccination hurts quite a lot”

    Hmmmm. That wasn’t my experience, and I HATE needles. Oh, it’s a shot – it doesn’t feel like getting a massage or anything – but the individual shots themselves were no worse that those for the average vaccine.

    Actually, probably the most painful part for me was the price – I’m outside the target age range, so insurance didn’t cover it. More than $800 total out of pocket (albeit spread over three shots). But, I test negative for HPV (either I’ve been incredibly lucky or it cleared out of my system), so I figured this was an unusual opportunity to increase my chances of avoiding cervical conizations, LEEPs, or a hysterectomy. Many of my friends have not been so lucky.

    And note: Cervical freezing can lead to female infertility. Brooke Shields mentioned in her recent book that her own cervical freezing essentially destroyed the cells that produced cervical mucus, making her unable to conceive without intervention (i.e. IVF). Now, she got pregnant on her own the second time around, so evidently the body can self-heal this stuff under some circumstances, but my friends who had to have their uteruses removed in their early 30s are not so lucky.

  38. #38 J. J. Ramsey
    March 31, 2008

    PalMD: “I have a feeling that some of the commenters wouldn’t take a pertussis, polio, or any other well-regarded vaccines, using and argumentum ad absurdum.”

    Maybe, but if so, they haven’t tipped their hands yet, and your initial response was almost pure table-banging. Contrast your response with revere’s, who pointed out that the vaccine had no genetic material at all and thus couldn’t act as a virus, which obviously should assuage fears that the vaccine could have the negative effects of a real HPV infection.

    Contrast Bill’s comments with, say, Mountain Man’s on the Aetiology post “Objection to vaccination: they cause immunology,” where he writes, “Vaccinations are mostly bullshit. Natural immunity is much stronger and much more efficient.” Yes, he really said that. That‘s a straight-up crazy anti-vaxer.

  39. #39 PalMD
    March 31, 2008

    Perhaps I’ve become a little jaded by the typical stealth tactics of, “I’m not really anti-vaccine, but…”

  40. #40 Cynthia Janak
    April 1, 2008

    I really enjoyed reading this blog. The only thing that was missing was the real science.

    The ingredients of Gardasil.

    Each 0.5-mL dose of the vaccine contains approximately 225 mcg of aluminum (as amorphous aluminum hydroxyphosphate sulfate adjuvant), 9.56 mg of sodium chloride, 0.78 mg of L-histidine, 50 mcg of polysorbate 80, 35 mcg of sodium borate, and water for injection. The product does not contain a preservative or antibiotics.

    Note that it has already been observed that one of the ingredients in the vaccine, polysorbate 80, has been observed to cause infertility in mice. Add to that borax, which is used to kill ants, add neurotoxic immune system sensitizer aluminium hydroxyphosphate, and directly inject all of that and any viral material (which is not proven to be in a harmless form) past the very important natural lines of defense in the immune system, then what do you think we are asking for, trouble or protection?

    http://en.wikipedia.org/wiki/Sodium_borate

    Boric acid, sodium borate, and sodium perborate are estimated to have a lethal dose (LD50) from 0.1 to 0.5 g/kg in humans[verification needed][5]. These substances are toxic to all cells, and have a slow excretion rate through the kidneys. Kidney toxicity is the greatest, with liver fatty degeneration, cerebral edema, and gastroenteritis. A reassessment of boric acid/borax by the United States Environmental Protection Agency Office of Pesticide Programs found potential developmental toxicity (especially effects on the testes).[6] Boric acid solutions used as an eye wash or on abraded skin are known to be especially toxic to infants, especially after repeated use because of its slow elimination rate.

    http://www.renewamerica.us/columns/janak/080330
    https://www.nvic.org/Issues/VAERS.htm

    In my article on Gardasil dated March 28th, 2008 I gave the newest stats on Gardasil. They are as follows.

    5238 reported incidents +2141 = 7379 (I will update the multiple incident number at a future date.)
    89 were considered life threatening
    204 were hospitalized
    913 had not recovered at the time of the report
    124 are disabled at the time of the report
    13 have died

    Because of this vaccine three more young women died and we have an increase of 932 incidents reported. That is approximately 310+ girls that had an adverse reaction to this travesty every month.

    I am going to start with this sentence in the first paragraph. “It is estimated that only 1�10% of all doctors report a severe health problem which occurs after a drug or vaccine is given to a patient.” (I took this from The National Vaccine Information Center. Link above.)

    With this in mind I am going to take the higher percentage which is 10% and figure what the new numbers should be that include the potentially unreported incidents by the doctors.

    73790 reported incidents
    890 were considered life threatening
    2040 were hospitalized
    9130 had not recovered at the time of the report
    1240 are disabled at the time of the report
    130 have died

    Why would our doctors not report an adverse effect like fainting or seizures?

    Here are only a couple of comments from my article.

    My daughter, 21 had the HPV vaccine administered on 8/8/07, at 0400 am on 8/9/07 she fainted and had a seizure. She is now hospitalized with slurred speech and left-side weakness. Please, give me more insight into this relatively new vaccine. Is there anything to counter-act the effect of Garasil.

    posted on Friday, August 10, 2007 at 1:14 PM by Carol

    ——————

    I am 21 and received the vaccine in dec and have fainted 20 times since then. I have been hospitalized and am still under the care of a cardiologist. I was healthy and athletic up until the vaccine, now I am always tired and hurt from fainting.

    posted on Friday, August 17, 2007 at 12:33 PM by Blondie

    ——————-

    I have had my symptoms for 8 months now and I received the 2nd dose but was advised by my neurologist not to receive the 3rd.

    posted on Monday, August 20, 2007 at 1:57 AM by blondie

    ——————–

    Do you still think that this vaccine is safe. I have read hundreds of comments just like the ones above. Yesterday I had a young woman from Australia that was beside herself with worry send me an email asking me what to do. She has had a severe adverse reaction to the vaccine and I told her to go to the hospital.

    It breaks my heart to hear all these stories from mothers and daughters about what is going on with this vaccine. But I must say that not all the reports are bad. I have read many that the young woman did not have a reaction.

    But you all need to make an educated decision about this vaccine. Look at the data and the ingredients and decide for yourself is it worth the chance.

    Oh, one more item. According to a document that was presented to the FDA from Merck it states that “the vaccine may increase the risk of developing high-grade dysplasia by 44 .6% in a patient if she has concurrent infection by one of the four HPV types contained in the vaccine. In addition, diseases due to other HPV types also have the potential to counter the efficacy results of GardasilTM for the HPV types contained in the vaccine, according to this document.”

    There you go. Research this vaccine before you decide to receive the shot. That is all I ask.

  41. #41 Tom
    April 1, 2008

    Cynthia: there is NO WAY the FDA would still let Guardsil be around if 130 people had died from it.

  42. #42 J. J. Ramsey
    April 1, 2008

    Cynthia Janak: “I really enjoyed reading this blog. The only thing that was missing was the real science.”

    “Real science”? Is that the term they are using these days to replace “sound science”? :P

    Judging from Ms. Janek and a bit of Googling, one of the sleights of hand that the anti-vaxers use is to scare people by showing the effects of certain ingredients at really high doses and use that to insinuate that these effects would happen even at doses several times less. Given the supposed horrible effects of polysorbate 80 on fertility, it’s a miracle that we don’t have an underpopulation crisis, considering that it’s such a common food additive.

    Then again, it is April Fools’ Day.

  43. #43 Cynthia Janak
    April 1, 2008

    Tell that to the woman that lost her daughter in her sleep. Her daughter received the last shot in the series for Gardasil in the early part of August and she died August 31. The office of Medical Investigators in her area do not know why this young girl died suddenly. That was just posted on a blog that I am on. Sad.

    One of the things that you have to remember in my post is that I used the 10% as a rule. Also, one of the things that I have noticed with this vaccine is that the side effects do not necessarily show up the next day. Many people are seeing side effects in one to two weeks after. Because of this it would be logical for a medical professional not to associate the symptom with the vaccine. Therefore, I believe, they will not report it as an adverse effect. I think the delay could be because each person has a varying degree of sensitivity to something that is in the vaccine so some will get a delayed reaction. Or the vaccine compromises their immune system to such a degree that other viruses that are usually dealt with are able to multiply because our natural line of defense our immune system has been severely compromised.

    There could be many theories as to why this is happening. My opinion is that this vaccine was put on the fast track to approval and should not have. The FDA should have required more extensive studies be done before allowing it to go to market. Why the FDA would have done this, I will leave that up to your imagination.

  44. #44 ozzy
    April 1, 2008

    Cathy, here’s some real science. Based on your LD50 values for sodium borate and assuming an avg 12-yr old girl weighs 80 lbs or 36 kg that means she would need to be exposed to 3.6-18 GRAMS of boric acid. A dose of gardasil contains 0.000036 grams of boric acid. So this average girl is being exposed at levels 100,000 to 500,000 lower than the lethal dose. That’s a highly adequate margin of safety.

  45. #45 Bill
    April 1, 2008

    Sounds like it should be marketed as a homeopathic treatment for boric acid allergies…

  46. #46 Cynthia Janak
    April 1, 2008

    To J.J. and Ozzy,

    You are comparing apples to oranges with your statements. There is a difference between injesting and injecting a chemical directly into our blood stream. Our whole digestive system is one of the first lines of defense our body has to defend itself against disease and the chemicals that we put into it. Whatever the body does not like comes out in the end, so to speak. But if you inject the same chemical directly into our blood stream our body reacts immediately to expel the chemicals through our liver, kidneys, etc. Sometimes the reaction is so severe that the body has a problem with distinguishing between the offending particle and the body and it can attack itself. Look at MS as an example.

    Ozzy,

    Thank you for your comment because it shows me that you are thinking and reading. I appreciate discussions with people that are willing to educate themselves by looking for the facts.

  47. #47 PalMD
    April 1, 2008

    Cynthia, before you comment at a place called “ScienceBlogs”, you may wish to read, for instance, a high school bio text. You come off as sounding ignorant, when I’m sure that is not your intention.

  48. #48 ozzy
    April 1, 2008

    Cathy,

    Vaccines are not injected right into the bloodstream via intravenous injection. They are injected intramuscularly where the components are diluted by extracellular fluid.

    However, IV tox studies might be more relavant to an IM exposure situation than oral exposure. So for comparison, Adults intravenously injected with ~8.5 mg BA/kg BW (our average 12-yr old is being exposed to 0.001 mg BA/kg BW) suffered no adverse effects.
    Jansen, J. A., J. Andersen, and J. S. Schou. 1984. Boric acid single dose pharmacokinetics after intravenous administration to man. Arch. Toxicol. 55:64-67.
    The boric acid was primarily excreted in the urine.

  49. #49 Cynthia Janak
    April 1, 2008

    To Ozzy,

    Thank you for your clarification and the study. I really appreciate it when someone gives me new information that I can learn from and use in the future. I believe that you never stop learning unless you choose to.

    PalMD,
    Thank you also for your comment. I must admit that I do not have your expertise in the medical field. Not everyone has had the opportunities that you have had. Considering your chosen field I thought that you would be more understanding and less confrontational. Have a wonderful day.

  50. #50 PalMD
    April 1, 2008

    Cynthia, if you don’t feel like life has afforded you the opportunity to read a high school bio text, that’s fine, but then don’t write pseudoscientific lies online. If you do, expect to be called out on it, and by people a lot more snarky than I.

  51. #51 Pearl
    April 27, 2009

    When I was 18 I became pregnent, and that is when I found out that I had HPV. I had to have a microscopic look at my cervix and go to the doctors two times more than the usual after my son was born. Lucky for me the HPV went away and my pap smears have been normal since. If I hadnt gotten pregnant than I might have not known about the HPV until it became a serious problem. But if I would have had the vaccine I couldve been protected.
    The fact is that many parents dont even know that there children are sexually active, and you dont even have to have sex to get HPV, sexual contact is enough. If parents take the time to educate their daughters about sex and the vaccine, than they wouldnt have to worry about their daughters having sex just because of a vaccine. Condomms are easily accessible, and doesnt that cause more teens to have sex. Either theyre going to do it or theyre not. wouldnt it be better just to have them protected anyways?

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