CDC recommends HPV vaccine for boys!

The HPV vaccine is one of my most favoritest vaccines.

From a public health perspective, its efficacy is unprecedented.

From an immunological perspective, learning how the HPV vaccine works is going to teach us something about our immune system we didnt know before.

From a virological and evolutionary perspective, we dont have to be worried HPV is going to evolve ‘around’ our vaccine, or ‘new evils’ will take the eliminated variants place.

Its a beautiful vaccine!

It would be great, for women, if boys got the vaccine too. Of course, boys cannot get cervical cancer, but they can carry the virus and infect women and give them cervical cancer. Eliminated boys as carriers protects women. BUT…

We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people.

Turns out the HPV vaccine can help everyone, so the CDC is now recommending that boys get it too. How can it help everyone, even people who do not posses a cervix? Well, of course there are penile and anal cancers that can be caused by HPV, but a very interesting story is emerging about other kinds of cancers.

Back in the day, everybody smoked. Or chewed. Or did something disgusting and dangerous with tobacco that caused lots and lots of oral cancers. All this tobacco use was overshadowing oral cancers caused by HPV! Now that tobacco use is not fashionable anymore, we can finally see the impact of HPV on oral cancers:

Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States.

For example, HPV prevalence by Inno-LiPA increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004.

In the mid-80s, HPV caused 16.3% of oral cancers. Early 00s, 72%

Though it has yet to be explored epidemiologically, the assumption is that women who get the HPV vaccine will be protected from these cancers, and men (who no one told to get the vaccine) will become the primary victims.

We can wait until we see that (as the study authors say, the HPV oral cancer patients have decent treatment/survival rates). Or we can nip this problem in the bud and start vaccinating everyone ASAP.

CDC, the experts on this matter, chose the latter. Im with them on this one :)

Comments

  1. #1 MikeMa
    October 26, 2011

    Cool. Should have bought me some Merck stock.

    Girls are encouraged to get the vaccine prior to first sexual activity, IIRC for best efficacy. Any such directives for boys?

  2. #2 Epinephrine
    October 26, 2011

    We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people

    Why not? I ask in all seriousness – I get the objection, but for a sufficiently small risk and a sufficiently big payoff, why not?

    For example: I will go back and get my pertussis booster, even though pertussis is not a real risk for me. I will do so to ensure that I am not a vector. I think we have a duty to take reasonable measures, even accepting some risk, to protect those who are vulnerable. I think it would be unethical not to take a small risk to protect vulnerable people from disease.

  3. #3 Justicar
    October 26, 2011

    In before Salty Current calls you a liar (again).

    On a serious note, and perhaps my ethics aren’t as finely calibrated as are yours, but I do think we can ethically ask boys (well, their guardians), young men and sexually active men to take a vaccine that has a known (and disclosed – of course) set of risks even if it may well not directly benefit them. The health benefit may not apply to a male directly (or it’s for a cancer risk that is so very tiny that we can just pretend it’s zero for the academic discussion) because men, no less than women, have a vested interest in the health of women.

    Though perhaps not for the the precise reasons (no cervix after all), it is nevertheless true that immunizing them does great work to eliminating the cancers (and all that’s entailed thereby) of their mothers, sisters, wives, daughters, friends, teachers, police officers, firefighters, academics, doctors, and fellow creatures.

    Flip it around and say we found a strain of HIV for which women were only ever carriers (but not susceptible to infection say) which only infected men. Would it be similarly unethical to ask women to take a hypothetical vaccine (at little risk to their own safety) for this hypothetical HIV strain? I’m hard pressed to see an ethical dilemma here, or in the HPV vaccine.

    I’m not wedded to either conclusion; I just cannot see how it’s a breach of ethics, assuming informed consent and all that jazz. Vaccines are, after all, largely optional.

  4. #4 Justicar
    October 26, 2011

    Or what Epinephrine said.

  5. #5 Jim
    October 26, 2011

    Judicial Watch is all over this vaccine. Check out there website and research it for yourself.

  6. #6 sasqwatch
    October 26, 2011

    What Justinephrine said.

    An additional caveat is that (speaking as an epidemiologist), boys are the “infectors”, while the wimmins do the harboring (and suffer most of the consequences). We should be setting our sights long-term — on the *eradication* of such communicable diseases, esp. the viral ones that have a cumulative aspect to the way they infect whole populations. I thought the arguments for across-the-board communicable disease control were a slam-dunk when they were formulated in the 40s-50s, but given that our pubic health systems have gone to shit, I am saddened that the same bullshit-ethics anti arguments are being made on a *personal* basis. Some problems are commie problems, and communicable disease problems are a case in point.

  7. #7 ERV
    October 26, 2011

    Jesus Christ, Jim. Youre posting on an article written by a virologist designing vaccines, suggesting we ‘research it for ourselves’ by reading some random jackasses website.

    Thanks for the tip, dude.

  8. #8 Justicar
    October 26, 2011

    OK, Jim. I’ve perused the article. It’s conceded by all involved here, explicitly, that there is some risk associated with this particular vaccine. Double the number of deaths from it, or quadruple them if you’d like, I fail to see how this changes the issue in the slightest. We know going in the distribution of any particular medical intervention that some few people will certainly die. This doesn’t seem to change the ethical landscape because we still do trials and dole out various medical treatments.

    It’s factored in as a cost of doing business. And, again, we’re discussing this in the context of informed consent, which is to say that the recipients of treatment x are told there are risks including death which can (and do) result.

    And that’s even assuming, contra-that article’s citation of the CDC’s statement, that this particular vaccine proximately caused the deaths of those 26 particular people.

    No one is saying that it’s not unfortunate that there are consequences and negative outcomes when taking a given medication. It just doesn’t seem to be sufficiently unfortunate that progress stops because some few people will almost certainly die/be injured in the process.

  9. #9 Dancer
    October 26, 2011

    Well, I’m a guy, and I really wanted to get the vaccine myself, as a common courtesy to any sexual partners I may have. Any study making it even slightly more likely to not cost hundreds of euro’s in the future (because governments get more incentive to offer it) is good news for me (and for public health in general, I would say).

  10. #10 Spence
    October 26, 2011

    Sorry, it isn’t obvious from your post here that this vaccine will not bring about world peace. Some people may read this and incorrectly assume that all wars will instantly end.

    This is an open letter to demand that you place a clear and unambiguous statement at the end of your post stating

    - This vaccine will not bring about world peace
    - This vaccine will not prevent aliens anal probing your loved ones
    - This vaccine will not fix the abject disappointment caused within the nerd community by The Phantom Menace

    Otherwise, it all sounds like great news :-)

  11. #11 Jim
    October 26, 2011

    Not to research the vaccine itself, just the reported side effects:

    Judicial Watch, the public interest group that investigates and prosecutes government corruption, announced today that it has received new documents from the U.S. Food and Drug Administration (FDA) under the provisions of the Freedom of Information Act (FOIA), detailing reports of adverse reactions to the vaccination for human papillomavirus (HPV), Gardasil. The adverse reaction reports detail 26 new deaths reported between September 1, 2010 and September 15, 2011 as well as incidents of seizures, paralysis, blindness, pancreatitis, speech problems, short term memory loss and Guillain-Barré Syndrome. The documents come from the FDA’s Vaccine Adverse Event Reporting System (VAERS) which is used by the FDA to monitor the safety of vaccines. The documents were obtained pursuant to a September 15, 2011 FOIA request for reports made from September 1, 2010 through September 15, 2011.

  12. #12 Justicar
    October 26, 2011

    Sorry, I shot my wad on the ethical discussion. Of course, this is most excellent news. As soon as the vaccine came out, gay men all over the place were wondering if it would be safe for us to take, and then if we could even find a doctor who would give it.

    For all I know the comment was a throwaway one, which is why I started off explaining why I think it’s a faulty conclusion (on the ethical issue). For the fact it’s being advised, I’m over the moon happy for all of the obvious reasons.

  13. #13 Justicar
    October 26, 2011

    Jim, as I said. I read the article, and you’re neatly leaving out the bit which reports the CDC’s determination that there’s no evidence to suggest these 26 purported deaths were actually caused by the vaccine:

    “[the CDC says] there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine.”

    Immediately followed by

    “These reports raise additional concerns about Gardasil’s questionable safety and provide ample reason to end the push to give it young girls and boys. And the CDC’s continued caginess on reported deaths is disturbing,” Judicial Watch President Tom Fitton. “Federal, state, and local officials need to stop promoting this vaccine for children.”

    Don’t know about you, but that’s a rather strong conclusion on the basis of the available evidence, which again, do not seem to indicate that the vaccine is a proximate cause of these particular deaths. But even were it the case, that’s the nature of informed consent. We don’t stop promoting any course of treatment on data like what you’re linking to here.

    Tyenol use causes some 3.5k hospitalizations per year, some of which do not stop death from acute liver failure. So, I guess knowing the risk of the chemical isn’t insufficient. The authorities need to stop promoting it as a pain remedy, too? http://www.fda.gov/Drugs/DrugSafety/ucm239821.htm

    30 some thousand people die a year in entirely preventable car crashes in the US. I guess the government needs to stop promoting motor vehicle transit also.

    There are risks which attend all actions in life. An informed person is, presumably, capable of weighing the risks and the benefits and then either accepting or declining the risks if the payoff is insufficiently attractive with respect to taking a course of action.

  14. #14 Jim
    October 26, 2011

    I agree that informed consent is a must here. The problem is thatwe have government types like Governor Jerry Brown Of CA declaring the informed consent of 12 year old girls as a justification to inject!

  15. #15 Justicar
    October 26, 2011

    Yes, I see the problem. We should definitely not let 12 year old girls who are capable of making the decision to engage sex have a vaccine that might well save their lives. It’s definitely a superior option that we let them learn a valuable lesson – even if we have to make sure they die to learn it.

    It’s like talking to my kids about condoms. I would prefer they make smart decisions about having sex, and abstain until such time as they’re capable of fully appreciation all of the consequences, good and bad. Minor point though – I’d rather not have to kill them with HIV or cancer or childbirth to teach them that particular lesson. There’s a learning curve in life, and deaths from sexual encounters are a preventable consequence. It therefore follows that we can either provide to people a safety net so that the ‘shit, screwed that up’ isn’t a death sentence. After all, the lesson being learned is hardly beneficial if to learn it you have to die.

    But hey, you’ve got some puritanical values that are just sooooooo important to promote. Don’t let the petty concern of suffering experienced by not hypothetical people get in the way of that!

    Oh, the informed consent isn’t the ‘justification’; it’s the instrument by which an agreement is reached to accept or decline medical intervention. The justification for that conversation culminating in an informed patient is that tens of thousands of women die, and we have the means to prevent almost all of those deaths by the treatment under consideration. The justification, you see, is that there is a disease which kills women for their engaging in sexual activity with a carrier of a pathogen. They are going to have sex either way, so what remains is attenuating risk and mitigating deaths as a consequence of the not-going-to-be-avoided sex life.

    You ideologues are cute. Deadly stupid. But cute.

  16. #16 Jason
    October 26, 2011

    Jim,

    So – what does it mean when you see a VAERS report?

    First thing the CDC notes about VAERS is limitation
    VAERS data cannot be used to prove a causal association between the vaccine and the adverse event. The only association between the adverse event and vaccination is temporal, meaning that the adverse event occurred sometime after vaccination. Therefore, the adverse event may be coincidental or it may have been caused by vaccination, however we cannot make any conclusions that the events reported to VAERS were caused by the vaccine.

    Further, I’m not sure what to make of the FOIA request – as it seems this information in the public domain.
    http://www.cdc.gov/vaccinesafety/vaccines/hpv/gardasil.html

    For example, for the death claim:
    In the 34 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

  17. #17 Stephen Bahl
    October 26, 2011

    Jesus Christ, Jim. Youre posting on an article written by a virologist designing vaccines, suggesting we ‘research it for ourselves’ by reading some random jackasses website.

    Abbie wins the internet.

  18. #18 Justicar
    October 26, 2011

    Jason, reading one source further is a lot of extra work when dude here can’t even be assed to properly cite the reporting article with any degree of fidelity of what is actually contained in it.

    Going beyond their citations to sources closer to the primary ones is, to my mind, to do him a courtesy greater than he did to us by misrepresenting what he actually cited*.

    *well, he didn’t cite anything actually; he mentioned there exists a website that has a name, and is watching the issue, which required googling said site, and then searching in it to find a relevant article. Or, if that counts as a citation, then I too would like to cite as my primary source ‘the internet’ generally, and ‘google’ in particular, with the following keywords: retarded judicial watch. Using ‘retarded’ required two extra mouse clicks to find the article he alluded to than did just using ‘judicial watch’.

  19. #19 Prometheus
    October 26, 2011

    Jim@#11

    VAERS is a raw data heap that doesn’t correct for confounds. Without confounding variable adjustment it is the same stupid crap the anti-vaxers wave around.

    It is like saying that Wham-O Slip ‘n Slides cause yellow fever epidemics.

    Judicial watch needs to go back to worrying about catching the gay or having their taxes given to brown people.

    Dancer@#9

    Thank you.

    Of course you can ask boys to get the vaccine. Jury duty and selective service are mandatory and statistically riskier to health…meh.

    Saying the vaccine had no real benefit for males was essentially saying that no males were invested in their sexual partners and or didn’t give a shit about the overall well being of half of their society.

    Decreasing oral cancer is great but was never essential to a sound ethical position in favor of the the vaccine being available to males of.

  20. #20 Jim
    October 26, 2011

    So, it looks like informed consent has gone out the window here. Considering some states require this vaccine to attend school. Informed consent when it comes to vaccines is just catchy phrase. As far as VAERS is concerned, all we can do is trust that the judicial system in this country is just. It has paid out millions of dollars to vaccine injured children while protecting the vaccine industry from lawsuits thru a compensation program. Imagine..you create a product that is forced upon the consumer by the government and you are protected from all liabilities that result in injury and death from that product by that very same government. I mean it doesn’t get any better than that.

  21. #21 Justicar
    October 26, 2011

    So, Jim, you say that informed consent has been defenestrated? Very well then. I have a small question / favor-to-ask of you then: can you please show me a (or the) passage which has been suggested by anyone (other than yourself of course) that informed consent is no longer a relevant concern for medical interventions of any kind, let alone the particular one under consideration here? Thanks!

    (yes, I know I’ll be waiting until the [happy] cows come home for that since not a single person–other than you, of course–has suggested informed consent is not an operative, necessary condition here. Only you have suggested that anyone is being forced into anything here. Curious that you’re so stupidly arguing a position first announced by you that is contrary to my explicit statements to the contrary is a necessary condition.)

  22. #22 Jim
    October 26, 2011

    When a childs education becomes dependent on their vaccine status, informed consent doesn’t matter much. That was my arguement. If that child does not attend school, the parent can be imprisoned. I made him an offer he can’t refuse.. Again, going back to my previous post: Imagine..you create a product that is forced upon the consumer by the government.

  23. #23 david
    October 26, 2011

    When issues of public health are at stake, informed consent becomes a difficult issue. People with infectious diseases such as TB can be forced to confinment and treatment. Preventing an infectious disease is bordering on the same territory. We’re clearly in a novel area and balanced thinking is required.

    disclaimer: I work for a pharma, but have no conflicts regarding any vaccine program.

  24. #24 Jason
    October 26, 2011

    Jim,

    Informed consent matters a great deal to me; and side effects are still being communicated to the guardians of those taking the vaccine, if not the patients themselves. That aside, I don’t think you get the difference between causation and correlation. You quoted Guillan-Barre but that is specifically addressed in the VAERS commentary from the CDC – the rate of GBS is the same as what would be expected in the background population. IE the incidence is not indicative of the vaccine being causative.

    Many (most? all?) of the deaths noted don’t have anything to do with the vaccine; if you vaccinate 40 million people and no one has a cold or another ailment in the period following that vaccination, that’d be pretty amazing. That said, some number of individuals are going to get a fever or a sore throat for completely unrelated reasons – and they still go to the VAERS report. So looking back at deaths, if 1 in 1 million people die, in this age group, over the course of ~2 years… is that rate really that high? If it were significantly higher, that would hint that the vaccine could be causative, but you’d still need something mechanistic, too. Do you see the point here?

    For these “side-effects” to be true side-effects, they need to be, in some capacity, demonstrated to be a result of the vaccine (i.e. higher than you would expect in the background population).

  25. #25 Epinephrine
    October 26, 2011

    Jim – we are part of a society. We have obligations to one another. A long-time example are quarantine rules, which protect the public at the expense of restricting the freedom of another. It is recognised that in order to protect many, we sometimes have to restrict the rights of a few. While you may object to vaccination, it is the same principle – we protect one another via herd immunity, and we take small risks to prevent larger ones.

    That is a true measure of a good society – its willingness to be dedicated to the publc good, to protect the weak and vulnerable. Putting personal whims and an absurdly inflated sense of personal freedoms ahead of public health is obtuse.

  26. #26 D. C. Sessions
    October 26, 2011

    Y’all are having way too much fun with Jim, but if that’s your kind of entertainment you can get it 24/7 over at misc.kids.health

    I confess to dipping over there from time to time over the last twenty-some years [1], and one thing about it: nothing ever changes.

    [1] As in, my ABD daughter wasn’t yet in kindergarten. And, yes, I leaned on her pretty hard to get the HPV shot as soon as it was available.

  27. #27 Composer99
    October 26, 2011

    Jim:

    Please provide a citation to support your statement:

    If that child does not attend school, the parent can be imprisoned.

    I’m neither a lawyer nor a student of American educational policy, but as far as I know home schooling is perfectly legal in most/all states, as are private/charter schools which can waive vaccination status requirements at their leisure.

    So I’m sure you’ll forgive me if I suggest that you asserting this claim, without substantiation, makes it dubious.

  28. #28 John C. Welch
    October 26, 2011

    Now, now, if you keep blocking off paths for jim to drag his goalposts along, he’ll just have to resort to godwinning the entire thing.

  29. #29 Niche Geek
    October 26, 2011

    Jim,

    You seem particularly confused about this issue. Can you clarify the following for me:

    1. How are the vaccine manufacturer’s protected from liability? I assume that you are aware that the US Vaccine Court makes it *easier* for claimants to succeed if they experience a known side-effect and that claimants are not precluded from going to the regular court system.

    2. In what way are vaccines “…forced upon the consumer…”? IANAA (I am not an American), but it does appear that you can decline any vaccine if you so choose however that choice may prevent you from participating in other activities including public school. I assume you aren’t suggesting that people have some right to make choices without consequences?

    Thanks

  30. #30 0verlord
    October 26, 2011

    Jim, given an ideal world where everyone takes responsibility for themselves, such great freedom is perhaps possible. That is not the world we live in.

    With deadly and contagious diseases, the protection of life ought to take precedence over well-meaning but misguided opinions about personal liberty and Big Guvment. Given that the best way we know how to curb deadly diseases right now is prevention on a wide scale, for government to do nothing to encourage and even force vaccinations is nothing short of a dereliction of its duty to safeguard our rights.

  31. #31 Tsu Dho Nimh
    October 26, 2011

    We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people.

    How about getting a vaccine that will protect their children by minimizing the risk of HPV and cancer to the as yet unknown mother of those children.

    Call it a low-risk high-payoff bet on their future happiness.

  32. #32 dustbubble
    October 26, 2011

    ERV sez: “We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people.”
    Oh yes we can.
    +1 to what #2, #3, #4, #25, #30 said.

    Luckily, inhabiting a hideously overpopulated vicious communistical dictatorship as I do, the concept of “herd” immunity is taken pretty seriously, and one’s parents would have to push pretty dam’ hard to opt out (unless a cunt like Wakefield successfully seizes control of the abysmally ignorant chatterati).

    And fuckit, it’s all free-at-the-point-of-use here, for under-16s (scratches ancient BCG scar, admires lovely straight un-polio-ed legs, grinds half-a-century’s worth of fully-functioning teefs). Damn those totalitarian swine! I gots mah rights!

  33. #33 D. C. Sessions
    October 26, 2011

    Hey, TDN — you’ve been around Orac’s rants on the subject long enough to know that the “ethics” in question here are formal medical ethics. Which exist for some very good historical reasons, even if they go to the “bend over backwards” point in being ethically scrupulous.

    The problem is that the principle of beneficence requires (esp. where children are involved) that the medical procedure be of benefit to them, personally. Abbie can probably guess the difficulty of getting an IRB to approve a study with nonzero risk to boys/girls where the only expected benefit is to the general welfare of girls/boys but not to the subjects.

    Which, fortunately, isn’t binding on us as individuals. The main consequence of the recommendation is that insurance is going to be covering this one for boys now. People willing to pay out of pocket could always have the jab for their sons, and many did so.

  34. #34 Tsu Dho Nimh
    October 26, 2011

    Jim – Before you repeatedly post that link, I suggest you read the adverse events in VAERS for yourself, paying attention to the onset (how long after vaccination the death occurred) the autopsy results and clinical findings.

    When I read a report like this, I am inclined to dismiss it, but it’s one of the deaths being blamed on HPV vaccine: “Information has been received from a Nurse at the physician’s office who heard from another Nurse that a patient came in to the office to receive the third dose of GARDASIL and the friend of the patient told her not to get the third dose because she knew of another girl that received the third dose of GARDASIL and died “”within the last month””

    I note one death reported of a male with Asthma who died playing hockey … and one of a male who was thought to have been given Gardasil who collapsed and died playing lacrosse.

    Another sudden death, linked in VAERS to HPC vaccine, says “Toxicology survey findings: urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.”

    One suicide showed up in a search for HPV vaccine related deaths. Went off meds and hung herself.

    And my favorite kind of report:Information has been received from a consumer who saw a report on the internet about a 23 year old patient who was vaccinated with 3 doses of GARDASIL. Subsequently the patient died, the cause of the death was unknown. This is one of several reports received from the same source. Additional information has been requested.

    But they are all in VAERS, 70 reports, some of which are just reports made by someone who “saw it on the Internet”, or read it in a magazine.

  35. #35 daedalus2u
    October 26, 2011

    I think this is great! It is going to make the heads of all the religious nuts assplode.

    Women having sex is nasty and evil, so doing anything to protect women from fatal diseases acquired during sex is nasty and evil, so HPV vaccination for girls and women is nasty and evil.

    Women having sex is always nasty and evil, so HPV vaccination for any woman, gay or straight is nasty and evil. No need to check if a woman is gay or straight, HPV vaccination for her is nasty and evil.

    Straight men and boys having their organs of manhood disfigured with disease is nasty and evil, so anything that protects straight men and boys from acquiring organ of manhood disfiguring diseases is doubleplusgood, so HPV vaccination for straight men and boys is doubleplusgood.

    Gay men having sex is nasty and evil, so doing anything that protects gay men from fatal diseases acquired during sex is nasty and evil, so HPV vaccination for gay men and boys is nasty and evil.

    But how do you tell if a prepubescent boy is gay or straight? If he is gay, HPV vaccination is nasty and evil. If he is straight, it is doubleplusgood. But if you ask a boy if he is gay or straight, you will put gay thoughts into his head and turn him gay which is the worst possible thing you could do to him because then he is guaranteed to go to Hell which is INFINITELY worse than having his organ of manhood disfigured.

  36. #36 Poodle Stomper
    October 26, 2011

    “Though it has yet to be explored epidemiologically, the assumption is that women who get the HPV vaccine will be protected from these cancers, and men (who no one told to get the vaccine) will become the primary victims.”

    When will women stop making victims of men!!!!!!??????

  37. #37 Chris
    October 26, 2011

    Ah, Jim, Jim, Jim… you seem a bit dim.

    First, VAERS is a passive reporting system, essentially a self-reported survey. If you’ve ever taken even the most basic statistic course you would know that it is the worst form of data. Especially one that lets a person who does not live in the USA report a vaccine turned his daughter into Wonder Woman. It cannot be considered valid until the claims are investigated, and often the vaccine had nothing to do with perceived reaction.

    Also, HPV is not one of the vaccines required for school attendance (at least in our school district). They are mostly concerned with diseases that will be transmitted by their students, which is why the rotavirus is also not required (since it is dangerous only to babies and toddlers). This a paragraph showing the required vaccines for school attendance:

    Immunizations that are required before a student can attend school currently include DTP/DT/Td (Diptheria/Tetanus/Pertussis), OPV or IPV (Polio), MMR (Measles/Mumps/Rubella) and Hepatitis B. Other vaccine combinations may meet the requirements of this procedure.

    Before you get your panties in a twist about HepB, it is also transmitted through blood and other bodily fluids. Kids get skinned knees on playgrounds all the time, and one who has hepatitis b can transmit it to another kids. One way to tell someone is lying or ignorant is if they tell you that hepatitis b is only sexually transmitted.

    My issue with the new policy is that I have had trouble getting my son to go the university’s health clinic to get an influenza vaccine. It is going to be just about as fruitless to get his 21 year old body in for the HPV vaccine. Though girlfriends tend to leave after he spends way too much time playing Dungeons and Dragons.

    Oh, Jim, here is a great video about Michele Bachmann. (for everyone else it is a Noel Kristi parody of a Lady Gaga song)

  38. #38 Composer99
    October 26, 2011

    Chris:

    If your son plays Dungeons & Dragons, then he’s probably safe. :)

  39. #39 Justicar
    October 26, 2011

    Jim, I can understand what’s going on here. In your world, making sense is just something that happens to other people, huh?

    Look, sparky, HPV isn’t a requirement for school since, you know, fucking isn’t part of any school curriculum of which I’m aware. (well, outside of certain Catholic schools, but that doesn’t seem to be relevant here since HPV is a threat primarily to girls/women.)

    TDN @ 34: wait a second there! See my post at 18; I too am citing ‘the internet’ as a source!

    Dustbubble @ 32: I’m fairly certain your legs are anything but straight, if what I’ve read somewhere on the internet* is true.

    Chris @ 37: that’s hysterical. I love the part, ‘even though some say my husband Martin is . . .’ he breaks in ‘great at dancing’. Hi! Larry! Us!

    I don’t want to know what keywords took you to the wonder woman article: autism, super, power, woman, hot injection?

    *true fact: Dustbubble’s legs are gay

  40. #40 dustbubble
    October 27, 2011

    Justicar@39: Ooops. More than likely. The legs prolly got infected with teh ghey by lifelong proximity ..

    (topic) being a stoopid forner ‘n’ all, I am dumbfounded by the naysayers. This general extension of HPV protection is a prize beyond rubies, like all vaccines.
    And the smartybrains who figgered it out are now freed up to work on the next unlovely human pox. ( =(win+win)).

    How would the “ethically concerned” deal with the “rights” of a Typhoid Mary? And people have died of ‘toxic shock’ from tampons, yet I don’t hear a clamour for their being kept out of the hands of teenagers.

  41. #41 Mu
    October 27, 2011

    Orac had explained the ethics issue over and over, if the treatment doesn’t have a direct positive effect to the individual you cannot recommend it even if the overall effect on the population is beneficial. This is why this is such a great deal, the CDC has finally found enough benefit even for the boys to recommend it independently from the benefit that would be obvious to girls.

  42. #42 Chris
    October 27, 2011

    Composer99:

    If your son plays Dungeons & Dragons, then he’s probably safe.

    He told me that he recently spent most of a night painting a lead D&D figure. He thought he was on a roll and creating something great, only to find out after he got some sleep he did not do a very good job. He seems to be safe, for now.

  43. #43 Jim
    October 27, 2011

    So, I read some of the replies to my earlier posts. I must say that the mind-numbing logic you people conjur up defies all reality. And the moronic comments are soaked with an elitist attitude, and that’s what’s so laughable..
    Basically you feel that heavy handed persuasion does not increase vaccine uptake. You also don’t understand that homeschooling is not an option for all parents..
    You support the philosophy of utilitarianism as it relates to vaccination requirements. I personally don’t share your philosphical viewpoints. It’s a fact that vaccine manufacturers are protected from litigation by the Vaccine Injury Compensation Act set up thru the federal government. You people have abandoned science for scientism. >> I’m out here …so don’t bother blathering more of your senseless nonsense.

  44. #44 ERV
    October 27, 2011

    soaked with an elitist attitude

    Says the guy trying to tell a virologist to ‘research’ novel topics like ‘epidemiology’.

    My commentors dont need to read that stupid website to learn about vaccines.

    You need to read this blog and learn about vaccines.

    I’m out here
    Bawwwww. *rolleyes*

  45. #45 Chris
    October 27, 2011

    Jim:

    You also don’t understand that homeschooling is not an option for all parents..

    What school district requires their students to get the HPV vaccine?

    Oh, and since I had a child who needed protection through herd immunity when he was very young, I have a distinct dislike of those who ignore public health policies.

    I see no reason why public schools need to accommodate those who ignore public health policies and reduce herd immunity. If they don’t want to homeschool, then those who flaunt public health can gather together and create their own school. Just don’t ask us to foot the bill, especially if there is an outbreak of pertussis or measles.

  46. #46 Lee
    October 27, 2011

    Oh, the unbearable elitism of those who know what the fuck they’re talking about, and dare to correct those who clearly don’t.

    I especially like the claimed use of FOIA to get data from a publicly available data set, from which anyone with even minimal competence can get the data faster than writing an FOIA request.

  47. #47 0verlord
    October 27, 2011

    Jim, flounce on brother. If you make your way back, it would be nice to at least try to be involved in the discussion instead of crying about people disagreeing with you and rage-quitting.

  48. #48 Dave
    October 27, 2011

    What school district requires their students to get the HPV vaccine?

    AIUI, Perry mandated it for Texas girls entering the sixth grade in 2007.

    In 2008, Virginia also made it a requirement, but allows parents, “in their sole and absolute discretion” to opt out.

    FWIW.

  49. #49 Chris
    October 27, 2011

    Dave, please point where on the following document the HPV vaccine is listed:
    http://www.dshs.state.tx.us/immunize/docs/school/6-14_2011-2012_bilingual.pdf

  50. #50 Chris
    October 27, 2011

    And yes, it is in Virginia, with an opt out:
    http://www.vdh.state.va.us/epidemiology/immunization/requirements.htm

    Human Papillomavirus Vaccine (HPV) – Effective October 1, 2008, a complete series of 3 doses of HPV vaccine is required for females. The first dose shall be administered before the child enters the 6th grade. After reviewing educational materials approved by the Board of Health, the parent or guardian, at the parent’s or guardian’s sole discretion, may elect for the child not to receive the HPV vaccine.

    So perhaps Jim should not live in Virginia, or have the gumption to sign an exemption.

    (by the way, all but two states allow for exemptions, though those seem to be tightening up, Washington State now requires a doctor’s signature on the exemption form, though there may be doctors there just like Drs. Jay Gordon and Bob Sears in California who create their own unscientific vaccine schedules)

  51. #51 Justicar
    October 27, 2011

    Dave: it’s not much of a requirement if it’s optional. Like, I’d even stop being against capital punishment so long as we added the rider that the condemned had available the option to decline the execution. Just sayin’. =P

    Mu, I get it. Medical ethics are unrelated to actual ethics. Makes sense. I realize that’s snarky, but I fail to see how deciding in advance that a member of society is too stupid to be allowed to be competently informed of the benefits and risks of a given option is an ethically tenable one. We don’t generally consider the willful refusal to give people information on something to be an ethical way of arranging our society.

    Group x is ethically entitled to be made aware of situation a by profession m while group y is not allowed to be made aware of situation a by profession m is not an ethical framework. That is until the moment someone arbitrarily slaps ‘medical’ in front of ‘ethics’, and then presto – magic time.

    Yes, I’m aware of this ethical system. We generally reject this reasoning in almost all other realms of discourse – save for the most extreme situations. I’m glad that the CDC has determined avoiding HPV caused anal/penile cancer is now in men’s and boy’s interests. I fail to see how this improves the situation one jot in a framework wherein a person may be advised that x exists, has y potential negative outcomes,z potential positive outcomes and then is allowed to engage their reasoning processes and evaluate the ratio to see if it’s worth their while in their own estimation.

    Dustbubble, I’m no expert on tampons, but I’m fairly certain it’s not the hands anyone would try to be keeping them out of.

  52. #52 Justicar
    October 27, 2011

    Ok, so as to not leave an overly long comment on an ancillary point, I’ve blagged more fully more thoughts on this ethics issue. I’m sure someone can tell me how I’m wrong on this. http://integralmath.blogspot.com/2011/10/magic-time.html

  53. #53 Dave
    October 27, 2011

    it’s not much of a requirement if it’s optional.

    True and I found the language in the VA statutue amusing. On the other hand, I hear VA has very liberal opt-out provisions for all vaccines, as do many other states. Personally, I think opt-out provisions for non-medical reasons (philosophical and religious) are a farce, but they exist and in many states all that is required is a parental signature. So if HPV is not required because of an opt-out provision, isnt it equally valid to say the MMR isnt required since there is an opt-out for that as well?

    Chris — upon further reading, it appears that the TX legislature over-ruled Gov Goodhair’s executive order.

  54. #54 Chris
    October 27, 2011

    Dave:

    So if HPV is not required because of an opt-out provision, isnt it equally valid to say the MMR isnt required since there is an opt-out for that as well?

    Exactly. There are studies that show that states with more liberal exemption rules have higher rates of pertussis and measles. That is why some of them are tightening up the rules, especially since disease outbreaks are expensive for the taxpayers:

    Because of community vaccination rates of 90%, the outbreak began to subside before containment started, but a vigorous public health response halted transmission beyond the third generation at a public-sector cost of more than $10 000 per case.

    Dave:

    Chris — upon further reading, it appears that the TX legislature over-ruled Gov Goodhair’s executive order.

    That is what I thought I had read, so I had to look it up. It seems that the vast majority states do not require HPV vaccination for schools.

  55. #55 Narc
    October 29, 2011

    Just discovered this post, so it’s probably dead, but…

    We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people.

    When those same boys turn 18, we demand (not ask) that they register for the draft. Is the risk from this vaccine really that much higher than the risk of being drafted into the next big war? (Assuming there ever will be such a thing.)

  56. #56 B. Lam
    November 1, 2011

    Abby, may I ask you… as someone who just passed 40, the chances that I’ve been exposed seem pretty high. What I’m wondering is if the vaccine would reduce the chance of me communicating it. If it does that, taking it seems like a kindness to people I care about a lot. (I’d do it *anyway* just to be sure, but it’s not cheap.)

    Do you know, or know where I could find, the answer to this question?

    Thank you!

  57. #57 FlickingYourSwitch
    November 7, 2011

    I find it amazing that so many cancer cases will actually be prevented due to this. It reduces death and suffering and, if I can be that guy, it reduces healthcare costs.

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