Here we go again.

When you’ve been blogging for over 11 years, particularly when what you blog about is skepticism and science-based medicine, with a special emphasis on taking down quackery (particularly cancer and antivaccine quackery), inevitably you see the same misinformation and lies pop up from time to time. Indeed, those of us in the biz not infrequently refer to such stories as “zombie lies,” because no matter how often you think they’ve been killed they always come back. Personally, I like to refer to them as Jason, Michael Myers, or Freddy Krueger lies (or just slasher or monster lies), for basically the same reason. You kill them with facts, evidence, science, and reason, but sooner or later they always come back. Always. That’s why trying to refute them is like playing Whac-A-Mole. This time around, a group called the American College of Pediatrics (ACP) is claiming that Gardasil is causing infertility in girls, a claim that showed up yesterday on that repository of quackery, NaturalNews.com.

The reason that slasher lies keep coming back is because they never really go away completely. They only look that way because they recede for a while until someone new discovers them or their originators decide the coast is clear. There’s one particular slasher lie that keeps coming up about the HPV vaccine, usually Gardasil (mainly because that’s the brand of HPV vaccine most commonly used in the US) but not restricted to Gardasil. Sometimes Cervarix falls prey to the same lies, mainly overseas where it is the predominant version of HPV vaccine used.

Perhaps the most distinctive lie about Gardasil and Cervarix is that it causes infertility and sterility in girls. Actually, that’s not entirely true. After all, it wasn’t so long ago that I discussed a pernicious lie being spread by Catholic bishops in Kenya claiming that it had been spiked with beta-hCG as a means of birth control. Another time, the same culprits claimed that the polio vaccine was being spiked with estrogen in order to sterilize Kenyan girls. Both claims were, of course, ridiculous, but the idea is there: Someone is using vaccines for population control. Actually, this is a very common conspiracy theory among the antivaccine faithful, that “someone” (usually involving Bill Gates) is using vaccines to depopulate the world.

So what makes the conspiracy theories about Gardasil different? Simple. Antivaccinationists have a special hatred for Gardasil. That hatred seems to be based on the fact that HPV vaccines are used to prevent a sexually-transmitted virus, the rationale somehow being that the use of such a vaccine will “encourage promiscuity.” It’s even been called the “promiscuity vaccine.” Never mind that the evidence is quite clear that this claim is simply not true. Never mind that anyone who remembers their own adolescence clearly would know that fear of catching HPV and then developing cervical cancer 20 or 30 years down the road is not a major concern among teens as their hormones rage. None of this matters to the people making these claims, however.

Perhaps the link with sex and the fact that it is designed to combat a sexually-transmitted virus are what make the most pernicious slasher lie about Gardasil, that it causes primary ovarian insufficiency, more commonly known as premature ovarian failure (POF), so hard to kill for good. Basically, POF is early menopause and usually defined as loss of normal ovarian function before the age of 40. It does sometimes occur in young women and even teenagers, for whom it is a particularly devastating problem. (Just imagine going through, in essence, menopause at age 15 and you’ll get an idea of how profoundly horrific POF can be.) The linking of a vaccine viewed as promoting promiscuity to a punishment of losing fertility is simply too natural and irresistible to cranks, regardless of how wrong it is. Not surprisingly, this is exactly what we see in the NaturalNews.com article, which is based on a press release by the American College of Pediatrics entitled New Concerns about the Human Papillomavirus Vaccine. You can tell you’re in for a heaping helping of BS from the very first paragraph:

The American College of Pediatricians (The College) is committed to the health and well-being of children, including prevention of disease by vaccines. It has recently come to the attention of the College that one of the recommended vaccines could possibly be associated with the very rare but serious condition of premature ovarian failure (POF), also known as premature menopause. There have been two case report series (3 cases each) published since 2013 in which post-menarcheal adolescent girls developed laboratory documented POF within weeks to several years of receiving Gardasil, a four-strain human papillomavirus vaccine (HPV4).1,2 Adverse events that occur after vaccines are frequently not caused by the vaccine and there has not been a noticeable rise in POF cases in the last 9 years since HPV4 vaccine has been widely used.

It’s rather amusing that the authors note that there hasn’t been an increase in POF incidence since the introduction of Gardasil, but nonetheless strain mightily blame POF on Gardasil. Given the number of girls vaccinated over the last decade, if Gardasil were linked to POF we’d expect to have found evidence in the various vaccine safety surveillance systems in place to find adverse reactions to vaccines. That no such link has been found is suggestive, albeit not conclusive, that there probably isn’t a link.

Before we go on, let’s take a look at the two references cited. Reference 2 can be dispensed with fairly easily, because I discussed at least one case in it in detail when it was published. The first case discussed in the reference, for instance, was one of the first dubious testimonials claiming to link POF with Gardasil that I ever encountered. It’s no more convincing in the article cited than it was in the BMJ Case Reports article from which it originated. Basically, the argument (as it the case with most of these stories) is that because no other cause for POF could be found upon investigation, it must have been the Gardasil. Of course, most cases of POF are idiopathic; i.e., no clear cause is ever found. It’s frustrating, but true. The second case was that of a woman who was diagnosed with POF at age 18, while she received her series of three doses of HPV vaccine at 12 years and 9 months; near her 13th birthday; and at age 13 years and 5 months. That’s right. POF occuring nearly five years later was blamed on the HPV vaccine. It was noted that she had been on oral contraceptives since age 12 for irregular menstrual periods, which were stopped briefly at age 14 with a three month period of amenorrhea, and then restarted. She also had several health problems, including cerebral palsy, asthma, epilepsy. The third case is the only one that showed a reasonable temporal correlation, with the patient’s first late period occurring after the third dose of the HPV vaccine, but even that is pretty thin gruel.

Ultimately, the author, Deirdre Therese Little, even had to admit at the end of the article that case reports “do not and cannot establish causation,” but she certainly tries her best to spin every cherry picked preclinical study she can find to implicate Gardasil in these girls’ POF. She even goes so far as to cite dubious studies claimed to show that polsorbate 80 in vaccines can cause infertility in rats as well as the bogus claim that detection of HPV DNA in the vaccine is a great danger, which is a bit of misinformation promoted by pathologist Sin Hang Lee. It also turns out that Dr. Little is on the board of advisors for an Australian Catholic anti-abortion group called Family Life International, whose official patron laments the growth of promiscuity and the “redefining” of marriage (big surprise, the group is against gay marriage as well). On the website is a diatribe against Gardasil, which, FLI gravely notes, is “often associated with promiscuity,” along with a link to a YouTube video of the antivaccine propaganda film The Greater Good. It also turns out that Little’s co-author, Harvey Rodrick Grenville Ward is cut from the same cloth, described as a “pro-life obstetrician/gynecologist.” He also apparently helps an antiabortion activist named Stephanie Gray give talks at local churches in Canada in which she shows graphic abortion videos to convince the audience that abortion is “wrong 100% of the time.”

Also not surprisingly, Reference 1 is an article by Lucija Tomljenovic and Yehuda Shoenfeld that claims that the HPV vaccine can trigger an autoimmune syndrome, part of whose manifestation is premature ovarian failure. The first case is a 14 year old girl who suffered amenorrhea after her series of HPV vaccine doses. The second is a case of a girl who was vaccinated with HPV at age 13, which was before she had her first period at age 15, when she had only two periods suffered by one month. The third case is a 21 year old woman who developed irregular menses after her third dose of HPV vaccine and ultimately became amenorrheic at age 23. Based on this thin gruel, Lucija Tomljenovic and Yehuda Shoenfeld conclude, “In this case, as in our three cases, no other possible causes of POF were identified other than the HPV vaccine.”

In other words, even though in the vast majority of cases of POF no specific cause for ovarian failure can be identified, to Tomljenovic and Shoenfeld that must mean it was the Gardasil that done it! It’s the classic tendency of antivaccine activists to confuse correlation with causation. Of course, we’ve met Tomljenovic and Shoenfeld before, quite recently in fact, when they tried (and failed miserably) to show that Gardasil causes behavioral problems in mice. Earlier, working with antivaccine scientist Christopher Shaw, Tomljenovic has tried to show that Gardasil kills.

Oh, and they’re both big into trying to “prove” that aluminum adjuvants in vaccines cause autism. Meanwhile Shoenfeld made up a syndrome called ASIA (“Autoimmune/Inflammatory Syndrome Induced by Adjuvants”) for which no compelling evidence exists.

None of this stops the ACP from claiming:

Nevertheless there are legitimate concerns that should be addressed: (1) long-term ovarian function was not assessed in either the original rat safety studies3,4 or in the human vaccine trials, (2) most primary care physicians are probably unaware of a possible association between HPV4 and POF and may not consider reporting POF cases or prolonged amenorrhea (missing menstrual periods) to the Vaccine Adverse Event Reporting System (VAERS), (3) potential mechanisms of action have been postulated based on autoimmune associations with the aluminum adjuvant used and previously documented ovarian toxicity in rats from another component, polysorbate 80,2 and (4) since licensure of Gardasil® in 2006, there have been about 213 VAERS reports (per the publicly available CDC WONDER VAERS database) involving amenorrhea, POF or premature menopause, 88% of which have been associated with Gardasil®.5 The two-strain HPV2, CervarixTM, was licensed late in 2009 and accounts for 4.7 % of VAERS amenorrhea reports since 2006, and 8.5% of those reports from February 2010 through May 2015. This compares to the pre-HPV vaccine period from 1990 to 2006 during which no cases of POF or premature menopause and 32 cases of amenorrhea were reported to VAERS.

Of course, as I’ve described before, the VAERS database is not a useful tool for assessing incidence or changes in incidence of adverse reactions due to vaccines. The reason is simple. Anyone can submit reports of adverse events to VAERS. Anyone. The reports undergo minimal or no vetting by medical professionals. Heck, there is even a famous description of how a man successfully submitted a report that a vaccine turned him into The Incredible Hulk. What that means is that any belief about a vaccine’s adverse effects can lead to more reports being filed. Worse, we’ve known for at least a decade that vaccine litigation itself distorts the database. So basically, none of the above claims is compelling evidence that Gardasil or Cervarix is associated with POF.

Nor is this:

Few other vaccines besides Gardasil® that are administered in adolescence contain polysorbate 80. Pre-licensure safety trials for Gardasil® used placebo that contained polysorbate 80 as well as aluminum adjuvant. Therefore, if such ingredients could cause ovarian dysfunction, an increase in amenorrhea probably would not have been detected in the placebo controlled trials. Furthermore, a large number of girls in the original trials were taking hormonal contraceptives which can mask ovarian dysfunction including amenorrhea and ovarian failure. Thus a causal relationship between human papillomavirus vaccines (if not Gardasil® specifically) and ovarian dysfunction cannot be ruled out at this time.

First off, those rat studies mentioned early in the statement used massive doses of polysorbate 80 to affect ovarian function; so their relevance to, well, anything is highly questionable. Basically, at best ACP has a few case reports, some of which aren’t even particularly convincing as single case examples of correlation, much less as evidence of causation, plus some cherry picked animal research and appeals to ignorance. For instance, Scott S. Field, MD, the author of this statement, notes a very large study that found no evidence of a link between Gardasil and demyelinating or autoimmune diseases but dismissed it not having looked specifically at POF. Of course, POF is, fortunately, a relatively uncommon condition, particularly in teenagers, and there really isn’t much in the way of compelling evidence to suggest a link. Certainly there is not enough in the way of evidence to justify Field’s last recommendation, which is that “primary care providers be notified of a possible association between HPV and amenorrhea.” No, there isn’t really any compelling evidence upon which to base such a recommendation.

But who is the ACP, after all. It sure sounds like a professional organization for pediatricians, such as the American Academy of Pediatrics (AAP). Wrong. The ACP does little resembling what a professional society does; certainly it doesn’t offer continuing medical education credit. Certainly it is not the “leading association of pediatricians” in the nation, as its advocates claim. In fact, here’s the origin of the ACP:

In February 2003, the American Academy of Pediatrics (AAP) issued a policy statement declaring its support for homosexual parenting. The statement urges the states to extend the status of legal parent to same-sex partners, as well as marriage-equivalent status to homosexual and lesbian couples.

However, a new group–the American College of Pediatrics, a Tennessee-based alternative organization headed by Dr. Joseph Zanga–has just responded by requesting that its fellow organization reverse its stand.

Zanga’s group was formed by 100 dissenting members of the AAP. His organization disagrees with the AAP’s point of view on gay parenting, as well as numerous other social issues.

That’s right, the ACP is a small group of conservative pediatricians who broke away from the AAP over its support for parenting by homosexual couples 13 years ago:

“We are essentially a Judeo-Christian, traditional-values organization,” he noted, “open to membership for pediatric medical professionals of all religions who hold to our core beliefs.” Those beliefs, he said, are that “life begins at conception, and that the traditional family unit, headed by an opposite-sex couple, poses far fewer risk factors in the adoption and raising of children.”

The chief purpose of his organization, Zanga commented, is to see to it that children and adolescents receive optimal healthcare, with children’s needs coming first, taking precedence over the political aims of socio-political activists.

And here’s how the ACP describes its values:

The American College of Pediatricians:

A. Recognizes that there are absolutes and scientific truths that transcend relative social considerations of the day.

B. Recognizes that good medical science cannot exist in a moral vacuum and pledges to promote such science.

C. Recognizes the fundamental mother-father family unit, within the context of marriage, to be the optimal setting for the development and nurturing of children and pledges to promote this unit.

D. Recognizes the unique value of every human life from the time of conception to natural death and pledges to promote research and clinical practice that provides for the healthiest outcome of the child from conception to adulthood.

E. Recognizes the essential role parents play in encouraging and correcting the child and pledges to protect and promote this role.

F. Recognizes the physical and emotional benefits of sexual abstinence until marriage and pledges to promote this behavior as the ideal for adolescence.

You get the idea. The ACP is anti-gay marriage, anti-abortion, and promotes the pseudoscience that claims that abstinence-only education is an effective means of reducing the incidence of teen pregnancy. Basically, it’s a phony medical group peddling anti-gay propaganda and pseudoscience to schools.

Unsurprisingly, the ACP now appears to have latched on to anti-Gardasil antivaccine pseudoscience as well. Surprise, surprise.

Comments

  1. #1 herr doktor bimler
    March 1, 2016

    Gardasil, which, FLI gravely notes, is “often associated with promiscuity,”

    The main association with promiscuity being in the minds of evil-minded perverts like FLI.

  2. #2 MI Dawn
    March 1, 2016

    This compares to the pre-HPV vaccine period from 1990 to 2006 during which no cases of POF or premature menopause and 32 cases of amenorrhea were reported to VAERS.

    Wait. What? So before teens were getting a “OMG they are going to have sex” vaccine, there were no reports of POF given to VAERS. Why on earth would there have been? Or should I think that the antivaxxers would link ANY vaccine to POF in a teen?

    It’s too early to think like an antivaxxer and I need coffee. My brain hurts. But, Thanks, Orac, for explaining who the ACP is. I’ve had friends link to their stuff and I’d never heard of them. Now I can refute more logically.

  3. #3 Chris Preston
    March 1, 2016

    The main association with promiscuity being in the minds of evil-minded perverts like FLI.

    And the ACP.

    Actually, I do hope the ACP members might visit this blog where they can be confronted by advert to the syphilitic penis in all its glory.

  4. #4 Chris Preston
    March 1, 2016

    But, Thanks, Orac, for explaining who the ACP is. I’ve had friends link to their stuff and I’d never heard of them. Now I can refute more logically.

    Sadly you will no longer be able to counter the links with the statement that “The ACP is so insignificant that I have never heard of them.”

  5. #5 AR
    March 1, 2016

    I’ve been awaiting your take on this, Orac. Another stellar deconstruction. Many thanks!!!

  6. #6 Eric Lund
    March 1, 2016

    “We are essentially a Judeo-Christian, traditional-values organization”

    I have found this statement, from any organization, to be a red flag. In this context it translates into a belief that sluts must be punished for non-marital sex. And as many such groups do, they conveniently ignore Exodus 20:16:

    Thou shalt not bear false witness against thy neighbour.

  7. #7 AR
    March 1, 2016

    The ACP demonstrates why separation of church and medicine should be a thing.

  8. #8 janet
    where winter isn't gone yet
    March 1, 2016

    Many years ago, I was assigned an OB/GYN as my primary care physician. When I went to get a prescription for my birth control pills, I was told he didn’t “believe” in them. I had to give a reason to my insurance company as to why I didn’t want this doofus as my doctor. I wrote on the form that “He believes in ‘go ye forth and multiply’ and I don’t.” Form was returned, reassignment of physician approved, and whoever handled it wrote “good one!” and a smiley face.
    And somehow, the syphlitic penis seems appropriate for this group of doctors.

  9. #9 capnkrunch
    March 1, 2016

    The chief purpose of his organization, Zanga commented, is to see to it that children and adolescents receive optimal healthcare, with children’s needs coming first, taking precedence over the political aims of socio-political activists.

    I hope everyone left their irony meters at home today because otherwise you are going to need replacements.

  10. #10 Todd W.
    http://www.harpocratesspeaks.com
    March 1, 2016

    Pre-licensure safety trials for Gardasil® used placebo that contained polysorbate 80 as well as aluminum adjuvant. Therefore, if such ingredients could cause ovarian dysfunction, an increase in amenorrhea probably would not have been detected in the placebo controlled trials.

    Man. If only the pre-clinical trials included a saline placebo. I mean, the package insert clearly notes that there were no saline placebos used, in the Clinical Trials Experience section:

    6.1 Clinical Trials Experience
    Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in practice. Studies in Girls and Women (9 Through 45 Years of Age) and Boys and Men (9 Through 26 Years of Age)

    In 7 clinical trials (5 Amorphous Aluminum Hydroxyphosphate Sulfate [AAHS]-controlled, 1 SALINE placebo-controlled, and 1 uncontrolled), 18,083 individuals were administered GARDASIL or AAHS control or SALINE placebo on the day of enrollment, and approximately 2 and 6 months thereafter, and safety was evaluated using vaccination report cards (VRC)-aided surveillance for 14 days after each injection of GARDASIL or AAHS control or SALINE placebo in these individuals. The individuals who were monitored using VRC-aided surveillance included 10,088 individuals 9 through 45 years of age at enrollment who received GARDASIL and 7,995 individuals who received AAHS control or SALINE placebo. Few individuals (0.2%) discontinued due to adverse reactions. The race distribution of the 9- through 26-year-old girls and women in the safety population was as follows: 62.3% White; 17.6% Hispanic (Black and White); 6.8% Asian; 6.7% Other; 6.4% Black; and 0.3% American Indian. The race distribution of the 24- through 45-year-old women in the safety population of Study 6 was as follows: 20.6% White; 43.2% Hispanic (Black and White); 0.2% Other; 4.8% Black; 31.2% Asian; and 0.1% American Indian. The race distribution of the 9- through 26-year-old boys and men in the safety population was as follows: 42.0% White; 19.7% Hispanic (Black and White); 11.0% Asian; 11.2% Other; 15.9% Black; and 0.1% American Indian. Common Injection-Site Adverse Reactions in Girls and Women 9 Through 26 Years of Age .

    The injection site adverse reactions that were observed among recipients of GARDASIL at a frequency of at least 1.0% and also at a greater frequency than that observed among AAHS control or SALINE placebo recipients are shown in Table 1.

    I emphasized each spot that saline was not mentioned, to assist the reader.

  11. #11 Delphine
    waiting for the storm
    March 1, 2016

    E. Recognizes the essential role parents play in encouraging and correcting the child and pledges to protect and promote this role.

    “Correcting the child” gave me a mild shiver. These are vile, disgusting people. It is NEVER okay to hit a child. https://www.acpeds.org/the-college-speaks/position-statements/parenting-issues/corporal-punishment-a-scientific-review-of-its-use-in-discipline

  12. #12 Delphine
    rage
    March 1, 2016

    “When a child defies a parent’s instruction, spanking is one of a few options parents can consider to correct the misbehavior,” says Den Trumbull, MD, FCP, principal author of the statement. “Spanking is most appropriate with children 2 to 6 years old, and when milder types of correction have failed.”

    Drs. Hickie and Gordon, what say you??

  13. #13 Todd W.
    http://www.harpocratesspeaks.com
    March 1, 2016

    Also, it looks like ACP probably got the image of the girl getting a shot from Getty Images’ iStockphoto.com. The photo is by “elenathewise” (Elena Elisseeva), who is a professional Canadian photographer with a rather large portfolio. The photo is titled “Girl Getting Flu Shot”.

  14. #14 Orac
    March 1, 2016

    I’m still thinking that syringe looks mighty large. After all, for the flu shot, there’s only—what?—0.5 or 1.0 ml of fluid.

  15. #15 Dangerous Bacon
    March 1, 2016

    ““Correcting the child” gave me a mild shiver.”

    “My girls, sir, they didn’t care for the Overlook at first. One of them actually stole a pack of matches, and tried to burn it down. But I “corrected” them sir. And when my wife tried to prevent me from doing my duty, I “corrected” her.”

    – Delbert Grady

  16. #16 Delphine
    not Wendy
    March 1, 2016

    I’m re-reading it because of you, DB.

    These people advocate hitting a two year old. Putting aside the moral and psychological implications of hitting any child, just for some perspective, at age two, my skinny little girl weighed a whopping 21 lbs. Now picture a grown adult striking her, “correcting” her, a TWO YEAR OLD.

    These people are shameful and wrong on so many levels. I shudder to think that there are people who buy into their BS because of the authoritative-sounding name of their organization.

  17. #17 Todd W.
    http://www.harpocratesspeaks.com
    March 1, 2016

    @Orac

    Typically 0.5mL. And, yeah, that’s a ridiculously large syringe for a flu vaccine. Here’s a more appropriately sized syringe.

    And it looks like I borked my link. Here’s the link to the stock photo.

  18. #18 Rich Woods
    March 1, 2016

    @Todd W #13:

    The photo is titled “Girl Getting Flu Shot”.

    That would explain why she looks to be about four years late in getting her Gardasil shot.

  19. #19 Kristina
    March 1, 2016

    I’m pretty sure that’s a 1mL syringe, and it looks like the plunger is pulled back to the halfway mark, which would be right for a 0.5mL flu shot. Maybe I’m wrong, but it doesn’t look ridiculously oversized to me, just a particular syringe type that I have used on occasion. I usualy draw up vaccines into 3mL syringes, so the meds don’t seem to take up as much of the total volume of the syringe.

  20. #20 Rich Woods
    March 1, 2016

    @capnkrunch #9:

    with children’s needs coming first, taking precedence over the political aims of socio-political activists.

    No, you see, the ACP’s actions aren’t in support of their political aims but their social aims. That’s a very different thing, and quite OK to inflict upon children. After all, a little bit of lying for Jesus never hurt anyone.

  21. #21 Science Mom
    http://justthevax.blogspot.com/
    March 1, 2016

    We’ve got a live one peddling the ACP drek as an editorial: http://www.modbee.com/opinion/letters-to-the-editor/article63253432.html

  22. #22 Orac
    March 1, 2016

    I’m pretty sure that’s a 1mL syringe

    I’m pretty sure that that’s a 5 mL syringe—3 mL at the least. The size of the plunger gives it away.

    However, the size of the syringe is not what this post is about. If discussion of the syringe size continues much beyond here, I will simply delete the caption that has apparently distracted everyone like Dug the Dog and delete any further comments on the syringe size. You’d think I’d have learned by now that the slightest off-topic little snark on my part can lead to a complete derailing of the comment thread over minutiae.

  23. #23 Takiar
    March 1, 2016

    @ Science Mom

    That Editor’s comment is priceless though !

  24. #24 Orac
    March 1, 2016

    I do applaud the editor. 🙂

  25. #25 JP
    March 1, 2016

    The main association with promiscuity being in the minds of evil-minded perverts like FLI.

    Speaking of evil-minded perverts, how long until See Noevo shows up to start raving about “peeking under the hood”?

    Or maybe he finally hit the bricks.

    Oh, and where’s ann these days, anyway? I miss her.

  26. #26 Chris Hickie
    March 1, 2016

    Having been both a foster parent and seeing a lot of foster kids in clinic, I’m convinced that spanking is neither safe nor effective.

    Regarding the topic of this post, I return to my somewhat annoying broken record statement regarding the apathy of the AAP on anti-vaccinationism. The AAP appears to have completely lost whatever residual spine it had over the last few years, refusing to stand up to even the ACP, NVIC or anyone else anti-vaccine (including of course, Bob Sears and Jay Gordon, two of its own members). It’s just disgusting, especially with all these anti-vaccine billboard popping up everywhere.

  27. #27 Calli Arcale
    http://fractalwonder.wordpress.com
    March 1, 2016

    The whole thing is that while parents are supposed to correct their children, it is disturbing that some parents’ entire armentarium of “correction tools” is corporal punishment. Encouragement for doing the right thing is far more effective than trying to put the fear of God into them for doing the wrong thing. Especially since the latter will last only so long as the fear does.

    Heck, think of dogs who learn to ignore the shocks from an invisible fence. They don’t want to get hurt, but they want to get out. All you want is a dog who wants to get out more than they want to avoid the shock and then the punishment doesn’t work. Whereas rewards, properly given, can train a dog to sit at bold attention outside a store in a busy city, ignoring all who pass by, until you are finished with your errand. (Not saying you should leave a dog unattended in a city; they’re liable to be stolen. But you can totally train a dog to stay like that.)

    But alas, the people who emphasize “correction”, and particularly the ones who favor corporal punishment, tend to regard that as bribery, and the choice of a weak parent. *sigh*

  28. #28 JP
    March 1, 2016

    Having been both a foster parent and seeing a lot of foster kids in clinic, I’m convinced that spanking is neither safe nor effective.

    Yeah, my dad was firmly against spanking, having been one of those kids who used to go out and have to pick his own switch off of a tree. My mom swatted me a few times when I was tiny (don’t touch the hot wood stove, that kind of thing), but I was so sensitive, all it took was a raised voice to have me burst into tears anyway. My brother was kind of a different story.

    Actually, my dad was the much more emotionally demonstrative of the two parents, it was a real blow to the family to lose him so early. My mom was always kind of a hard-a**, but she was raised by Norwegian farmers, I suppose she can’t help it.

    She has mellowed out a lot having the grandkids around. She even lets my brother’s dog in the house, which was almost unheard of when I was a kid, save for fireworks and bad storms. Our old shepherd dog, Annie, kind of preferred living outside anyway, though, she always had lots of room to run around and stuff.

  29. #29 doug
    March 1, 2016

    Squirrels? I haz squirrels!

    The syringe looks to me like a BD 1 mL Luer-Lok tuberculin syringe. They are made of polycarbonate and have very thick walls, so the OD is about the same as as standard 3 mL syringe (most tuberculin syringes are slip tip, polypropylene & slender; the BD LL are 4-5 times the price).

    Gardasil is also put up in prefilled odd little 2 mL syringes.

    An aside on LL tuberculin syringes – when I was reading articles on cataract surgery, one surgeon described how he used a slip-tip tuberculin syringe for the final flush-out of the viscoelastic goop used to maintain working space. The blunt needle popped off the syringe, did some damage (don’t remember detail) that necessitated doing a vitrectomy and other repairs. IRRC it added something around 90 minutes to a 20 minute procedure. He subsequently developed a 2-handed technique.

  30. #30 doug
    March 1, 2016

    It is horrible trying to find details on BD site; here’s a sheet for the LL TB syringe

  31. #31 Orac
    March 1, 2016

    OK, down comes the caption on the picture. In fact, I changed the picture, so that no one else obsesses over the damned syringe in the original image!

  32. #32 Todd W.
    http://www.harpocratesspeaks.com
    March 1, 2016

    @Orac

    I think the picture adds a fair bit to the post. It’s a good example of the kind of fearmongering that ACP does and how others use the ACP to try to legitimize their rhetoric.

  33. #33 Mephistopheles O'Brien
    March 1, 2016

    There’s no need to be insecure about the size of your syringe. It’s what you do with it that counts.

  34. #34 doug
    March 1, 2016

    Would anyone expect the slightest shred of plausibility to the notion of Gardasil causing POF?
    There certainly isn’t anything in the vaccine, other than the antigens, that isn’t in many other vaccines. Unless any of the strains of HPV for which Gardasil is used have been shown to cause POF, it would seem very unlikely that the antigens in the vaccine would.

  35. #35 Orac
    March 1, 2016

    @Todd: I’ve made up my mind, and my decision is final. The image is gone for good. Clearly, it only distracts from the message as about a quarter to a third of the comments are about nothing other than the syringe and my now regretted offhand remark.

    I’ve become a lot less patient with such diversions in my old age.

  36. #36 Delphine
    pho
    March 1, 2016

    Loss of female fertility is tied into what these fine child abusing folks value most. Women are breeders, valued above all for their parts and their capacity to do what an illiterate poor 13 year old is doing right now somewhere in the world. It also ties in to the whole “be a slut/consequences” mentality, but I’m too tired to go there and depressed over the lack of syringe photo.

  37. #37 Todd W.
    http://www.harpocratesspeaks.com
    March 1, 2016

    @Orac

    Understood. Sorry for my contribution to the off-topicness.

    On topic, it always amuses me when I see someone quoting VAERS without any caveats. Do they not read that disclaimer that you have to agree to before you log in and start using VAERS? Or maybe they’re using the NVIC interface that excludes the disclaimer.

  38. #38 ebohlman
    http://turnipsandpotatoes.wordpress.com
    March 1, 2016

    Position E is even more frightening than it sounds: it’s not just about endorsement of spanking; it’s about not reporting marks on kids’ skin resulting from being hit with objects (like belts) as suspected abuse.

    Oh, I’m also pretty sure that they’ve endorsed sexual orientation change efforts (SOCE), aka “ex-gay therapy”.

  39. #39 shay simmons
    March 1, 2016

    Wait…the ACP does not want pediatricians–who are mandated reporters–to report signs of physical abuse in their patients? Are you ***ting me?

  40. #40 Science Mom
    http://justthevax.blogspot.com/
    March 1, 2016

    I somehow get the feeling that the slimebags of the American College of Pediatricians is going to get the light of day shone on their more nefarious activities. And I’m giddy about it.

  41. #41 Chris
    March 1, 2016

    Orac: “I’ve become a lot less patient with such diversions in my old age.”

    As your elder I say “Welcome to the club.” I found myself shouting “No” at a financial services phone mail tree (it does not seem to understand the request for “human!”). Though I think spending ninety minutes listening to Theresa Deisher rant less than two meters from where I sat aged me a bit.

  42. #42 herr doktor bimler
    March 2, 2016

    it always amuses me when I see someone quoting VAERS without any caveats.

    Whelp, SaneVax have all this time been advising people on how to rort the VAERS system, and encouraging them to flood it with spurious claims. They know they’re destroying its value for detecting genuine problems, but on the other hand, they have made a commercial gamble on the general rejection of Gardasil.

    Anyway, if anyone quotes VAERS without caveats, I figure they probably know that the data have been corrupted but they figure that to be outweighed by the propaganda / entertainment purposes.

  43. #43 Daniel Corcos
    France
    March 2, 2016

    Well, the syphilitic penis is still here, and it is tempting to make an association with Gardasil and sexual promiscuity.

  44. #44 Narad
    March 2, 2016

    Or maybe they’re using the NVIC interface that excludes the disclaimer.

    I’m way too tired to go looking for historical versions, but MedAlerts does now feature the disclaimer. The “demographics” tab isn’t working for me at the moment, but the last time it did, it offerered no simple way of re-creating the default VAERS “U.S.+Territories” flag, hence John Stone’s massive failure, etc. – including foreign reports was a stubborn “feature.”

  45. #45 MI Dawn
    March 2, 2016

    @Daniel Corcos (#43) and others: based on your comments about the ad commonly associated with this post, I’m delighted that my computer blocks ads.

    Thinking back to my nurse-midwifery days, remembering the poor girl (teen) who was so covered with HVP warts that you couldn’t identify any of her genital structures, I am thrilled this vaccine exists and that my daughters both got it.

  46. #46 Todd W.
    http://www.harpocratesspeaks.com
    March 2, 2016

    @Delphine

    Loss of female fertility is tied into what these fine child abusing folks value most. Women are breeders, valued above all for their parts and their capacity to do what an illiterate poor 13 year old is doing right now somewhere in the world.

    I think the promiscuity aspect may also play into the POF part of it. Not only will they not be able to be good little Christian women who fruitfully reproduce, if they are unable to get pregnant, that is one less obstacle to wanton sex. So not only does HPV vaccine, in their eyes, remove the punishment that is infectious disease, it removes the consequence of getting pregnant outside of the righteous and morally just institution of marriage. Sex is solely for procreation, not pleasure, again, in the minds of the religiously myopic.

  47. #47 Orac
    March 2, 2016

    Yep. Sad but true.

  48. #48 has
    March 2, 2016

    Considering 50% of GOP supporters are right now championing Benito Mussolini for the next US presidency, I think it’s wildly unrealistic to expect any kind of honestly, empathy, or rationality out of the US Right at this time. Maybe after the next World War…

  49. #49 Daniel Corcos
    France
    March 2, 2016

    @ Mi Dawn
    Actually, RI is the only website where I find this syphilitic penis, I don’t know why, we should ask Orac. In the other sites I visit, ads consist mostly of pictures of scantly dressed women, emboldened by the protection conferred by Gardasil, fearing neither God nor HPV and pregnancy.

  50. #50 Sean Jungian
    United States
    March 2, 2016

    Just chiming in to say that, to help combat the misinformation about Gardisil, I did take my son to get his 3 rounds when he was 13. Everyone I have mentioned this to has said, “I didn’t know boys could/had to get that one.”

    I told him (and tell those who’ve commented) that boys can definitely get HPV, and it also helps him protect his future partners.

    The anti-vax movement has had at least one positive effect: I am FAR more diligent about vaccinations – including the flu shot – than I used to be.

  51. #51 Orac
    March 2, 2016

    I’ve complained to the powers that be about the syphilitic penis again. I’m told that the reason it showed up is because I wrote about STDs. If they don’t fix it I might never write about Gardasil again on this blog and save such posts for my not-so-super-secret other blog. 🙁

  52. #52 JP
    March 2, 2016

    Considering 50% of GOP supporters are right now championing Benito Mussolini for the next US presidency,

    Donald Drumpf (his real name) is not nearly as classy as Mussolini, just to be frank. When I see him, I think, even schmukier (if it’s possible) little version of Adolf Hitler.

  53. #53 Gilbert
    March 2, 2016

    Sex is solely for procreation, not pleasure, again, in the minds of the religiously myopic.

    Perhaps for some, Todd W. #46, but that limiting view is in no way *biblical*.

    Tuskegee! Just…. testing?

  54. […] On February 1 2016, Henkel shared the demented post from Truthkings, the work of Sherri Tenpenny,NursingNursingbased on the HPV vaccine misinformation from the ACP: […]

  55. #55 Jay
    March 3, 2016

    “Women are breeders, valued above all for their parts”

    You might not like the pseudo-medical group of Christian pediatricians and their not-so-scientific stance, but…..over-the-top-caricature much? Jeez….

  56. #56 Delphine
    March 3, 2016

    Dr. Joseph Zanga, who heads ACPeds, described what he hoped his group would become: “essentially a Judeo-Christian, traditional-values organization … open to membership for pediatric medical professionals of all religions who hold our core beliefs … that life begins at conception and that the traditional family unit, headed by an opposite-sex couple, poses far fewer risk factors.

    http://www.acpeds.org/for-true-happiness-be-fruitful-and-multiply

    http://www.acpeds.org/the-college-speaks/position-statements/health-issues/induced-abortion-risks-that-may-impact-adolescents-young-adults-and-their-children

    I stand by what I wrote.

  57. […] outlined by the Respectful Intolerance blog, the studies cited by the ACP are dubious at ideal and thoroughly debunked at worst, and the ACP in […]

  58. #58 Kathryn
    CA
    March 7, 2016

    I got the syphitic penis photo on all the posts starting with the review about evidence-based vaccination and reading backward to this one.

  59. #59 Daniel Corcos
    March 7, 2016

    @ Kathryn
    I put the syphilitic penis photo on my website too, and it has boosted the number of visits.
    https://www.researchgate.net/profile/Daniel_Corcos2

  60. #60 Amethyst
    The Crystal temple
    March 7, 2016

    Syphilitic is a fun word. Like neolithic.

    Syphilitic neolithic cavemen. Killer band name, that.

    And yeah, it is probably because of your subject matter Orac. I’m reading some of your older posts under “Evolution” and -surprise surprise- I’m getting suggestions in that very window to similar evolution-themed post by other bloggers such as PZ Myers.

  61. #61 Daniel Corcos
    March 7, 2016

    @ Amethyst
    Don’t be misled by the apparent etymology. It has nothing to do with “pissing stones”.

  62. #62 Margaret Paton
    Australia
    March 9, 2016

    The first place in the world where Gardisal injections were given to schoolgirls was in Victoria Australia. My daughter had all her early childhood vaccinations, but I decided that she not be given the Gardisal injections and that she make the decision for herself as she got older. At the age of 23 she has recently married her first boyfriend whom she met at university when they were both aged 19. Neither she nor her husband has ever been sexually active with anyone else. (Believe it or not, not everyone has multiple partners. – Not that I am against that). I am a University graduate myself and like to keep myself well informed across many areas. I am not religious in any way. I have no knowledge as to whether the Gardisal injections cause serious illnesses as has been suggested by some people. My point is this – HPV is not airborne, but is sexually transmitted. How many people on this site agree with Merck’s push to have this vaccine become mandatory for all young schoolgirls? If vaccines for HIV or gonorrhoea or syphillus or any other sexually transmitted diseases are developed, should these also be added to the list of required vaccines for young people?

  63. #63 Amethyst
    The Crystal Temple
    March 9, 2016

    @Margret: HIV vaccine? Hell-to-the-yeah to make that mandatory! As for the others two: what is your argument against it?

    That it will encourage kids to have sex?
    That vaccines are dangerous somehow?

  64. #64 TBruce
    March 9, 2016

    If vaccines for HIV or gonorrhoea or syphillus or any other sexually transmitted diseases are developed, should these also be added to the list of required vaccines for young people?

    Of course. Do you have a point?

  65. #65 Todd W.
    http://www.harpocratesspeaks.com
    March 9, 2016

    How many people on this site agree with Merck’s push to have this vaccine become mandatory for all young schoolgirls?

    Merck’s push? No. However, I do agree with the CDC’s and AAP’s push for young girls and boys to receive it before they are sexually active. Why? Because the best time to protect them, and the greatest efficacy, is before they are sexually active or get infected.

    If vaccines for HIV or gonorrhoea or syphillus or any other sexually transmitted diseases are developed, should these also be added to the list of required vaccines for young people?

    HIV? Yes, definitely. Syphillus and gonorrhea? I’m not sure. I’d need to look more into the burden of disease and treatment options, but possibly.

  66. #66 MI Dawn
    March 9, 2016

    @Margaret Paton: That’s wonderful. Now you have to hope that 1)your daughter is never sexually assaulted by someone with the virus and 2) your son-in-law never has sex outside of marriage and gives it to her. As a midwife, I’ve seen devastation from both scenarios. I’d rather my daughters be protected *just in case* rather than hope it doesn’t happen.

  67. #67 Todd W.
    http://www.harpocratesspeaks.com
    March 9, 2016

    @MI Dawn

    Might I amend your two cautions slightly? Hope that 1) neither her daughter nor her son-in-law is sexually assaulted by someone with the virus, and 2) neither her daughter nor her son-in-law has an affair with someone who has the virus.

  68. #68 Amethyst
    The Crystal Temple
    March 9, 2016

    Thank you Todd. Men can indeed get raped, and women cheat too.

  69. #69 MI Dawn
    March 9, 2016

    @Todd W. and Amethyst: yes, you are correct. And I should have worded my comment as Todd corrected. Thank you.

  70. #70 Narad
    March 9, 2016

    Syphillus and gonorrhea? I’m not sure. I’d need to look more into the burden of disease and treatment options, but possibly.

    With congenital syphilis on the rise (in the UK, at least) and antibiotic-resistant gonorrhea looming, there’s a decent case to be made. I wouldn’t hold my breath, though, especially for the former.

  71. #71 Mephistopheles O'Brien
    March 9, 2016

    If vaccines for HIV or gonorrhoea or syphillus or any other sexually transmitted diseases are developed, should these also be added to the list of required vaccines for young people?

    It depends – what would the vaccine safety and effectiveness studies say? Would the risks of harm from the vaccines be greater than or less than the lifetime risks of the diseases? What side effects could one expect and how would those compare to the diseases?

  72. #72 Dangerous Bacon
    March 9, 2016

    “How many people on this site agree with Merck’s push to have this vaccine become mandatory for all young schoolgirls?”

    What “push” are you alleging? While Merck has been involved in some lobbying efforts to add HPV vaccine to the list of those mandated for public school entry, it’s news to me that the company currently espouses the position that “all young schoolgirls” be vaccinated against HPV (do more than two states even have such a mandate (never mind the available exemptions)?.

    As it happens, while I think it’s common sense for parents to have their children vaccinated against HPV, the expense of the vaccine and its being perceived as a wedge issue to drive antivax sentiment, make me wary of having it mandated by schools or other governmental entities.

  73. #73 janerella
    Australia too
    March 9, 2016

    Might I add to the cautions – that Margarets daughter never has to find another partner in life for whatever reason – divorce, death, etc.

  74. #74 Julian Frost
    South Africa
    March 13, 2016

    http://www.theprovince.com/health/journal+permanently+spikes+canadian+study+critical+vaccine/11771257/story.html
    Journal permanently spikes Canadian co-authored study critical of HPV vaccine

    A Canadian co-authored study critical of the human papillomavirus vaccine (HPV) has now been permanently spiked by a prestigious medical journal, with one outside expert suggesting it contained numerous “gross errors.”
    The small animal study had actually been accepted by Vaccine and published online, then pulled temporarily last month by the editor, who had it peer-reviewed a second time — an unusual sequence of events…
    A new notice on the journal’s website says the article has been permanently withdrawn because of “serious concerns” about its scientific soundness and claims in it that are unjustified.

    BLAM

  75. […] the number of studies that use plain old-fashioned saline as the placebo. This issue came up in the comments after a recent post about Gardasil as well, and it’s a common antivaccine lie. None of this stops Adams from […]

  76. #76 Terra Acox
    United States
    April 14, 2016

    I really, really didn’t want to believe this. A friend’s mother whom I’m friend’s with on facebook, who regularly posts pseudoscience links to questionable websites with no credibility posted a link about it from some “natural news” site. So naturally, I just opened a new tab to get to the bottom of it, and I’m afraid I was disappointed with the answer, the ncbi did in fact address it, apparently some young girls can be predisposed to an autoimmune disease that can be triggered by the vaccine. From what I understand there is no way to detect their risk for it before administering it. Such a shame that a potentially life saving vaccine could have the potential devastating side effects.

    http://www.ncbi.nlm.nih.gov/pubmed/23902317

  77. #77 Chris
    April 14, 2016

    How about reading article before commenting? The “ncbi” is just part of the URL that of the medical paper index, it is not an entity that “approves” nor “addresses” the science.

    Ummm, one of the authors is “Tomljenovic L.” Yeah, you can ignore that paper. Or go up and actually read the article where that exact paper is referenced in this sentence: “Also not surprisingly, Reference 1 is an article by Lucija Tomljenovic and Yehuda Shoenfeld that claims that the HPV vaccine can trigger an autoimmune syndrome, part of whose manifestation is premature ovarian failure.”

  78. #78 herr doktor bimler
    April 14, 2016

    the ncbi did in fact address it

    The National Center for Biotechnology Information did not “address” anything. They provided the Pubmed indexing database that allows anyone to look up papers published in a large number of medical journals (most of them legitimate). They do not, however, place their imprimatur on every author who publishes in those journals.

    In this case, a Natural News story has pointed you to a Pubmed reference to the same article that was referenced by Orac in the main post, above:

    Also not surprisingly, Reference 1 is an article by Lucija Tomljenovic and Yehuda Shoenfeld that claims that the HPV vaccine can trigger an autoimmune syndrome, part of whose manifestation is premature ovarian failure

    I’m afraid I was disappointed with the answer
    You will be reassured with the above discussion of that article, and why it is a load of wibble.

  79. #79 herr doktor bimler
    April 14, 2016

    Chris has faster fingers. Also the bytes take longer to get to here on the far side of the world, and back.

  80. #80 capnkrunch
    April 14, 2016

    @Chris
    Before I clicked that link I said to myself “this is going to be a Shoenfeld paper”. Want to see how dishonest that bunch is?

    Methods:

    The medical history of three young women who presented with secondary amenorrhea following HPV vaccination was collected.

    Results:

    All three patients developed secondary amenorrhea following HPV vaccinations

    Conclusion:

    We documented here the evidence of the potential of the HPV vaccine to trigger a life-disabling autoimmune condition.

    As with all Shoenfeld papers the conclusions supporting ASIA require prior evidence to be supported. You can’t bootstrap conclusions like that.

  81. #81 capnkrunch
    April 14, 2016

    Heh, didn’t put 2 and 2 together that this paper was referenced by Orac. Ought to read more carefully.

  82. #82 Chris
    April 14, 2016

    hdb: “Chris has faster fingers. Also the bytes take longer to get to here on the far side of the world, and back.”

    Great minds, etc. And yes, your bytes had to travel to the opposite side of this globe from the future. (My brother was stationed in Wellington, New Zealand’s capital (clarifying for others, not you), for a couple of years — the time difference was interesting as they were often from “tomorrow”, and there was an actual sound delay on phone calls. India was interesting because the time difference was twelve hours and thirty minutes!)

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