Those of you who have been around the blog for a while know that I make no secret of my Catholicism. I am a weekly mass attending, Friday fish eating, former knee sock wearing, mackerel snapper. Jesus is totally my homeboy. That said, sometimes I watch my fellow Catholics do things that are so batshit crazy, so contrary to common sense and the scientific data at hand, that I can't help but wonder whether people are so caught up in the perception of their own piety that they have done prayed themselves stupid.
Figure 1: Some of the members of our Lord's flock are sheep. Some are asses.
For example, I came across a story via PharmacistScott on Twitter this afternoon about the use of the HPV vaccine in Canadian schools. According to a story over at Canada.com:
Only 38 per cent of Grade 5 Catholic schoolgirls in Calgary received at least one dose of a vaccine against cervical cancer last fall -- compared to 75 per cent of their peers in the city's public schools, new statistics suggest.
While the vaccinations for human papilloma virus (HPV), part of a provincial campaign to prevent cervical cancer, were made available at the public schools, the Catholic girls who opted for the vaccine had to go to free public clinics.
Shameful, Calgary Catholic schools! Shameful!
Do you know who else women have sex with that I am sure that the Church can totally get behind (figuratively, of course)?
Their husbands. That means that, even if we ignore premarital sex as an issue and pretend that nobody does it, we are leaving women at risk to contracting HPV from their husbands.
Also, ignoring the issue of premarital sex, failing to vaccinate these girls leaves them open to contracting the disease as a result of sexual assault or abuse. That has nothing to do with their behavior and vaccinating them doesn't make them more or less likely to be a victim of assault.
Given that the window of vaccination is 11-26 years, it is completely contrary to current medical recommendations not to begin vaccinating these girls during that window because we're afraid that the side effects include turning in your regulation white cotton panties for a g-string and a desire to work the pole.
Forcing girls to go to a free clinic to get a vaccine that other girls receive routinely is shameful and overwhelms the resources of the clinic, preventing the devotion of resources to people who really need them.
Vaccinating your daughters against a painful and frequently terminal disease will not turn them into whores. Not having open communication with your children about sex, including the consequences, makes them more likely to make bad choices.
So, knock it off.
Medicine & Health
Life Science
Comments
So Isis, I'm as pro-vaccine & anti-religious based decision making as they come. I even understand the pubic health recommendation to start vaccinating at 11. But, I'm still not going to rush out and get the HPV vaccine for my 11 year old (still a few years to decide, and I might change my mind by then). But, for now, I would wait to vaccine until I thought *my* daughter (as opposed to the average daughter) was likely to be having sex (and, hopefully, I won't be in denial about when that's likely to happen, because I do actually talk to and understand my kid).
I fear that the CDC has made this vaccine more politically fraught by making the decision that they need to push the vaccine at the age when children are still receiving child hood vaccines, rather than waiting until they are older, and fewer health decisions are being made for them by their parents. I admit, though, that I might be in denial about the number of eleven year old girls who are having sex. The thought is unimaginable to me.
And, my decision has nothing to do with holding cervical cancer over my child's head as a possible consequence of sex.
Posted by: neurolvoer | June 24, 2009 7:55 PM
Why wait? If you give the child a vaccination at 11 and they don't actually have sex until 18, no harm done. If you wait until 18 and they have sex at 17, harm may have been done.
Posted by: Anthony | June 24, 2009 8:16 PM
Wait, the public schools in Calgary are administering the vaccine? That's wonderful, but I can't imagine the kind of uproar there would be if our local school district was doing that. Between the anti-vaxers, the tight-wads, and the moralizers, it wouldn't stand much of a chance.
Posted by: Kurt | June 24, 2009 8:19 PM
neurolvoer@#1:
Please take a look at the rates of rape for ages 11-18.
Bearing in mind that very, very few cases are actually reported, even the lowest estimates are far more common than other things that parents stress over.
And the downside of getting the shots now is ... ?
Posted by: D. C. Sessions | June 24, 2009 8:30 PM
"But, for now, I would wait to vaccine until I thought *my* daughter (as opposed to the average daughter) was likely to be having sex (and, hopefully, I won't be in denial about when that's likely to happen, because I do actually talk to and understand my kid)."
No offense, but I'm a bit creeped out by this sentiment. You want to wait to vaccinate your child until she reaches an age you deem appropriate to start having sex? This goes a bit too much into chastity belt range for my liking. Wouldn't it just be simpler to vaccinate your children as early as it is healthy and safe for you to do so? Isn't it just easier to do it early enough so that your guesswork of when your daughter starts having sex doesn't even come into it, early enough so that no one would even associate getting vaccinated with sexual maturity? I'm sorry if this comes off a little harsh, but I'm quite baffled by this and would love to hear your reasoning behind it. No one seems to think that we should wait to give children tetanus shots until they're old enough to start playing with rusty nails.
Posted by: Dennis | June 24, 2009 8:33 PM
Is there any reason to suspect a side effect or loss of efficacy if it's given young?
If not, I just don't see the downside.
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Posted by: air jordan shoes | June 24, 2009 8:35 PM
I always thought it was pretty savvy to make it 11. They're NOT having sex then (and likely peri-pubertal)so it's an excellent opportunity to open the conversation about the meaning and importance of sex to others and the decisions she has to make for herself about what it means to her. Also you can point out that the HPV vaccine doesn't protect against the other potential consequences of sex, both the bad (HIV, herpes, unwanted pregnancies) and the good (love, wanted pregnancies, excellent for a headache in some cases).
Given that a good friend of mine got HPV from her husband and has had issues with cervical incompetence after her subsequent colpo, I wish fervently that this would have been on the market when we were 11. She delivers her first successful pregnancy next week, and you best believe she'll be getting her daughter vaccinated.
Posted by: Dr.FabulousShoes | June 24, 2009 8:39 PM
Neurolvoer:
Even if that is still as true when your girl is 11 as it is today (which I doubt), she is still at risk.
I was just barely rescued from a gang rape attempt when I was 11. (I never told my parents, of course; it was too embarrassing, and besides, I thought that they might have somehow blamed me.) My experience was not as uncommon as you might think, and I was luckier than most; far too many children are not rescued.
The earlier a kid is protected, the better. I would suggest that the shot and the discussion be part of her 11th birthday present.
Posted by: Susannah | June 24, 2009 9:14 PM
*the activities of some of the Catholic girls I knew made figure 2 look like a very tame post-mass activity
*Kurt has a point- there are multiple sources of opposition to this
*good for Calgary schools
*My university doesn't even supply the vaccine for the medical school campus
Posted by: becca | June 24, 2009 9:28 PM
Neurolover- Rumor has it there was a pregnancy in a 12 year old at a local school. And I've learned that there is so much I don't know about my 11 year old... even when I think I do...
Posted by: drdrA | June 24, 2009 9:39 PM
After reading the article, I have to agree, I am disturbed by the school's shortsightedness. I wonder if the decision was made at the school, parish, or diocese level...
At least they justify not offering the vaccines because of moral (even if illogical) convictions; not some pseudo-science crap about causing autism.
Posted by: madkathy | June 24, 2009 9:52 PM
Delurking to say:
Why bring rape into the equation at all? It's putting the burden on women to protect themselves from being raped (or from contracting HPV once they are) rather than going after those who are doing the raping.
Also, I'm 19 years old, and I haven't gotten the vaccine yet. From what I've heard, deaths in the U.S. due to cervical cancer are usually due to a lack of access or use of to medical care (specifically Pap smears), which isn't an issue for me.
Posted by: yinyang | June 24, 2009 9:54 PM
yingyang, cancer prevention is not the same as cancer treatment (Pap smears detect already-abnormal cells). And genital warts are nothing to do a happy dance about.
Also, every woman or man that gets vaccinated increases the herd immunity of the population, which helps to diminish the spread of the virus. Some people *don't* have access to regular pap smears; some people are immuno-deficient and vaccines don't work for them; some people are too poor to get the vaccine (I'd say the one drawback right now is its prohibitive cost).
I'm not trying to be a concern-troll, but I think it's common to think about vaccination (particularly for this STD) in terms of just how it affects *me*, rather than look at the widespread population effects of vaccination, which could lead one to make a different decision.
The same argument is made about men getting the vaccine, since though men can get HPV-induced cancer, it's more rare than cervical cancer. And I would hope that most men I know, even if their personal risk were negligible, would be willing to "take one for the team", as it were (considering there's been no demonstrated health drawbacks from the vaccine).
Posted by: theradicalnotion | June 24, 2009 10:13 PM
"It's putting the burden on women to protect themselves from being raped (or from contracting HPV once they are) rather than going after those who are doing the raping."
Seriously? So women shouldn't do anything to protect themselves because it's not their fault? Taking that further - no one should do anything to protect themselves from any threat that isn't his/her fault? Are you crazy?
Life is not fair. We do not live in a Utopia. Therefore, I am going to continue doing everything (within reason) that I can to keep myself out of harm's way, regardless of whether or not I'd have to do so in a perfect world.
Posted by: Katie | June 24, 2009 10:20 PM
Yinyang,
It's far better to prevent cancer than to fight it off. Bring rape into it because to some people, girls are fair game and they're not adult-strong yet. They're also coerced into sex by their step-fathers, boyfriends, neighbours, priests, schoolmates, and random strangers. No place, and no age group, is always safe.
You can get HPV from a husband, as someone pointed out. Condoms don't protect you from infection with HPV. Once you get the virus, it's yours for life. Some women with HPV develop cancer, but almost all cases of cervical cancer have HPV, so it's a big risk factor. Note that annual screening catches only 3/4 of cases before they develop into cancer.
Cervical cancer does strike young women (even teenagers), so if you're having sex, you should be getting Pap smears. The risk for cervical cancer never declines, so you should continue screening for life (and not just until menopause).
Please read "Cervical cancer: the basics" for more about colposcopy, biopsy, cancer surgery, radiation treatment, and chemotherapy.
A vaccination seems cheap insurance against that kind of a down side!
Posted by: Monado | June 24, 2009 10:27 PM
Catholic Church = Run By Old Guys = What Else Can You Expect?
As an ex-C myself, my advice to you - and everyone - is to get out now.
In nomine Patris, et Filii, et Spiritus Sancti, Ramen.
Posted by: J-Dog | June 24, 2009 10:37 PM
This is a cancer vaccine, the holy grail, what talking heads on TV have promised was around the corner. Now, because it has something to do with S-E-X we aren't going to use it???? We can't get kids to think about immediate consequences, like pregnancy, before having sex. You think the threat of cancer years down the line is preventative?
My daughter was 17 when the vaccine was finally approved. She denied being sexually active (maybe) but I dragged her into the clinic as soon as they stocked it. They weren't certain if my insurance would cover the cost; I said do it anyway. A few hundred bucks to prevent HPV? What a bargain!
Preventing infectious disease, regardless of its route of transmission, is a moral imperative. And believe me (I am in pediatrics), we need to start at 11 to get most of the population protected before their first intercourse!
Posted by: Pascale | June 24, 2009 10:46 PM
On a lighter note, one of my nurses describes herself as "a recovering catholic."
Posted by: Pascale | June 24, 2009 10:48 PM
yinyang:
To add to the pile, my friend caught hers in the early stages due to good screening practices (yay pap smears!), but the treatment (a colposcopy) involves cutting away the abnormal layers of the cervix under a microscope placed in the vagina. This treatment can result in something called cervical incompetence - in other words, the cervix can no longer stay shut and a woman can miscarry due to the shear force of the fetus on this weakened muscle. Treatment for this involves sewing the cervix shut, bed rest and hoping for the best. So not only is it a cancer vaccine,and a genital wart vaccine but also a vaccine against the heartbreak of repeated miscarriages as well. Really, if you're sexually active, and test negative (or not sexually active yet), get it NOW.
Posted by: Dr.FabulousShoes | June 24, 2009 10:53 PM
To neurolvoer:
As much as parents love their children, and as much as they may have the best intentions in the world, they don't always know everything that's going on in their children's lives. I'm not saying this out of malice or with any desire to attack you - it's just one of those awful truths I've had to learn the hard way.
For me, sexual abuse started sometime before I turned six. My parents had no idea - the individual responsible was one of their best friends and they never suspected a thing. He had a magnetic personality and little kids and adults alike were attracted to him. I thought his actions must have been a normal part of life - I didn't figure out what it really meant until much, much later. When I finally told my parents, when I was 19, it came as a complete shock to them. It wasn't that they didn't love me or even that they weren't paying attention - they just didn't know as much about my life as they thought they did, and they weren't as perceptive as they thought they were. They aren't particularly stupid or emotionally dense - they're just human. And no human is omniscient.
I'm not saying that this is the case with you - I sincerely hope that it is not! I wouldn't wish it on anyone. And I know that six is much younger than 11 - 26. But my parents didn't think it was the case with them, either - so, on the whole, I think it's safer not to assume that you have all the information and just try to minimise what damage you can, whatever happens. I'm not saying that all six year olds - or even all 11 year olds - are likely to be targets for abusers, but the latest statistics I heard indicate that women have a one in four lifetime risk of sexual abuse or attack, so why not include a vaccine, along with the other things you would do to protect a child?
Posted by: C | June 24, 2009 10:55 PM
...
Dr. I quoted...
Well... I am not sure 'overwhelming of reources' has been demonstrated. I am also not sure that 'forcing girls' and their parents to make informed medical care decisions is such a bad thing.
.
@ Kurt, No. 3
...drolllol...
I guess I would rather have my 'local school district' spending their (no, my) time and dollars educating kids rather than administering health care.
But perhaps that is all coming when the US buys into this whole Canadian health care model...
...tom...
.
Posted by: ...tom... | June 24, 2009 11:19 PM
It's being sensible about managing risk from things beyond your control. Like wearing seatbelts: it doesn't matter whose fault the collision may be, what matters is coming out of it with your bod undamaged.
Posted by: D. C. Sessions | June 24, 2009 11:32 PM
In Calgary, vaccinations are done at a public health/vaccination clinic, so you aren't using the drop in clinics/urgent care/ERs, and don't have to sit around and wait without an appointment.
The Calgary Separate School System (the Catholic school system) is public, too, not private. So that's public money at work, too.
Posted by: Cheryl | June 25, 2009 12:17 AM
@Tom, 22
I think part of the reason to vaccinate at school is that it's not simply about the health of one child, but that it's a considerable public health issue within schools. There's also the fact that parents might not know or might not remember to take their kids to get inoculated. We shouldn't punish kids because of those reasons (and again, it's public health issue). School is a good venue to take care of that because you have a lot, if not most, of the children who need to be vaccinated gathered together.
Posted by: LostMarbles | June 25, 2009 12:53 AM
I am amazed that educated people even consider NOT vaccinating their children. The "lock up your daughters" approach is straight out of the Fritzl Good Parenting Guide and I commend you Dr Isis for this post.
It seems however that you and many of the commenters have missed the whole point. This is not a choice between a dead virgin and a live slut. Valid arguments on this issue do not, and never should, include lame statements like: "what if she's raped" or "her non-catholic husband gave it to her" (because catholic boys would never have sex outside of the sanctity of marriage).
To not immunise your child is abuse of the worst possible type. And if you think you will get some sort of absolution in heaven you are wrong (neither dog nor heaven exist).
The layers of stoopid in the religiously deluded is so deep it will take more than a scalpel to cut through. Isis, you are at heart an enabler for this obscenity by perpetuating the sky fairie fiction. Prove your deity is the callous, vile genocidal entity your bible documents or leave the children alone. They are not your property.
Posted by: PeterM | June 25, 2009 1:29 AM
not wanting to increase the stereotype of my home country as a backward state, but...
http://www.irishtimes.com/newspaper/breaking/2008/1104/breaking64.html
http://www.dailymail.co.uk/home/ireland/article-1096762/Interview-Health-minister-Mary-Harney-wont-fund-cervical-cancer-vaccine-girls-Ireland.html
you'll notice however, that this decision was not made based on religion, but funding. either way, it is deplorable
Posted by: annie | June 25, 2009 3:53 AM
@annie: yep, am proud of my country for that!!
the reason i haven't gotten the vaccine so far is cost, pure and simple. i don't have the €€, and as annie pointed out, it is not free or subsidised here.
if people aren't getting their daughters vaccinated, how will we persuade them to vaccinate their sons against HPV? (I am assuming both that 'herd immunity' would be impossible without including the male population, and that the vaccine/s will prove to be safe and effective for men).
Posted by: QoB | June 25, 2009 4:53 AM
yinyang:
Welcome to reality: Rape happens, that's a matter of fact.
Those who do the raping are (hopefully) gone after. Still, it will probably never be possible to avoid it completely any more than it's possible with other crimes.
Taking actions to reduce consequences from a possible event isn't "putting the burden" on the victim any more than telling motorcyclists to wear helmet, boots and good gear or car drivers to wear their seat belts. There are things you can't control, but you can at least mitigate the effects.
And in the case of an 11 year old girl it's the responsibility of the parents. Or would you take a child on a ride in a car without fastening the seatbelt or using a children's seat, because the burden shouldn't be put on you, but rather one should go after those who drive drunk and cause crashes? No? Then why not vaccinate?
Posted by: maschinenbaeuerin | June 25, 2009 6:32 AM
Can you really blame the Catholics, if the FDA approves the vaccine only for women? I mean, if the health service has as an official policy that girls need to take all the precautions and boys aren't even allowed to get the jab if they want to be responsible, I think it is inevitable that people will pick up on this and throw their own baggage onto the pile.
Furthermore, herd immunity is restricted to lesbian communes.
I reckon that if the vaccine had been rolled out for everyone in the first place, it would be no less controversial than Hep vaccines.
Posted by: Lab Lemming | June 25, 2009 8:24 AM
@Lab lemming: I agree, males definitely should be getting the vaccine. I have friends who have researched on this, noting that by vaccinating both males and females, you have a far greater effect at lowering the incidence of HPV. Plus, HPV causes other things besides cervical cancer (genital warts anyone?) that guys would definitely benefit vaccination from.
I'm proud to say that I'm vaccinated! (And catholic). There is hope....
Posted by: Eugenie | June 25, 2009 8:45 AM
Do parents really have to even think about sex when deciding to have their kids vaccinated for HPV? Why not just tell the kids "These are the shots everyone has to have" and just get it done? Why treat the HPV vaccine any differently from other standard mandatory vaccines in word or attitude? My parents just took me to the doctor and said "you have to get certain shots to keep you from getting really sick," and that was all I needed to know. Kids at least understand things like "it's required by the rules" and "because I said so." If an 11-year-old girl got all the other shots without making a fuss or asking too many questions, why should one more be a problem? Just treat it as another shot.
If you're really hung up about explaining HPV and talking about ess-ee-ex, then fudge the details a bit -- just say "HPV is a contagious disease, so you have to get immunized;" you don't have to explain, right then and there, exactly HOW it's transmitted. That can wait. Just get her the damn shot before it's too late, and deal with "The Talk" later.
PS: I notice neurolover has not yet responded to an explicit invitation to explain her thinking. That doesn't make her a bad person, but I do kinda fear for her daughter's safety.
Posted by: Raging Bee | June 25, 2009 9:58 AM
Lab Lemming @31
Guardasil protects against HPV types 16, 18, 6 and 11.
Cervarix only protects against types 16 and 18.
These vaccines will protect against cancer of the cervix, vulva, vagina, anus and penis.
(above from wikipedia)
Farrah Fawcett is dying right now from a cancer probably caused by HPV.
HPV has also been implicated in "oropharyngeal squamous-cell carcinoma" (HPV type 16, mostly as a result of oral sex).
When researching today I was shocked at how many types of HPV there are - and how many other cancers and diseases are suspected. Maybe a vaccine to cover more types could all but (who knows, completely?) eradicate all sexually transmitted cancers and a whole lot more we didn't expect.
Some estimates claim that 100% of all males will contract some form of HPV in their lifetimes, most of which will "clear up" and show no symptoms. If it works like Herpes, it will probably still be infectious during asymptomatic active periods.
I find it very encouraging that regardless of religion, most parents are being responsible. Any free programs (imho) should be extended to include all males in the same age group and then extended to the remainder of the candidate population. The importance of this vaccine is up there with the smallpox vaccine and penicillin/antibiotics.
Professor Ian Frazer (former Australian of the Year) invented Guardasil then went on to invent a vaccine against melanomas. This one seems to work for my neighbour. Ian Frazer is my homeboy - since I gave up on imaginary friends I tend to prefer real people.
Posted by: Peter McKellar | June 25, 2009 10:18 AM
Those of you who have been around the blog for a while know that I make no secret of my Catholicism. I am a weekly mass attending, Friday fish eating, former knee sock wearing, mackerel snapper. Jesus is totally my homeboy. That said, sometimes I watch my fellow Catholics do things that are so batshit crazy, so contrary to common sense and the scientific data at hand, that I can't help but wonder whether people are so caught up in the perception of their own piety that they have done prayed themselves stupid.
AMEN sister! Thank the LORD for someone scientifically minded to say something like this! As someone who's at least "rediscovering" Catholicism and learning how terrifically awesome science is, this makes me a happy muffin.
Posted by: JMG | June 25, 2009 10:21 AM
Apologies, last post referencing Lab Lemming @31 should have been for Eugenie. I hit post instead of preview :(
Posted by: PeterM | June 25, 2009 10:22 AM
I am a former catholic, in case this is relevant. I will vaccinate each of my children against HPV when they reach 11 (I might have to pay for the boys).
When I was in 6th grade, girls were vaccinated at school against rubella, as the vaccine was just being introducoded in my country. It was an easy way to vaccinate all an age group together without puting any strain on the medical structures. It does makes sense.
Posted by: estraven | June 25, 2009 10:41 AM
Not to be a downer, but since it hasn't been said yet and both Peter McKellar and Pascale's comments are otherwise so informative, this vaccine will not prevent cervical cancer. It will decrease the odds of developing cervical cancer.
The protection afforded might be as significant as "never smoking will decrease your risk of lung cancer"- i.e. a no-brainer as far as risk reduction goes. It's an important vaccine. But it's not a simple disease.
For one thing, there are oodles and scads of HPV variants out there and guardacil only protects against two of the most common and two of the most problematic strains (ceravix only protects against the ones most strongly associated with cancer). For another, it's probably *possible* (although basically unheard of) to develop cervical cancer without HPV.
From a scientific literacy standpoint, we probably need to emphasize the probabilistic nature of contracting any form of cancer, as well as the heterogeneity of cancer. The very phrase "cancer vaccine" makes me a little uncomfortable.
And of course, Pap smears are also a no-brainer as far as risk reduction, vaccine notwithstanding.
@neurolover- One can make the argument that there's about a 7.6% chance that 11 years old is already too late.
(J Med Virol 1998 Nov;56(3):210-6:
Presence of antibodies to human papillomavirus virus-like particles (VLPs) in 11-13-year-old schoolgirls.)
Mother-to-child transmission during birth is plausible (at least inasmuch as having an active outbreak can actually, in rare cases, cause a respiratory disease in infants). Or some of the more sad possibilities for 11 year olds having STDs may apply.
Posted by: becca | June 25, 2009 10:53 AM
becca @37
You make a number of good points I neglected. HPV is not the only cause of cancers overall and not even in cervical cancer (although as becca noted, genital warts are seen in almost all cases).
I have been armchair researching for a few years around this subject and at every turn it appears some biological agent is associated with cancers, if not actually known to be causative (normally viral, eg the epstein-barr virus). Most seem to be fairly specific to tumour type, location etc. HPV seems to be everywhere though.
Where one STD can be transmitted, so can others. Safe sex is still the best method (given that abstinence programs have been shown to increase both teen pregnancies and STD levels). I had heard that most catholics ignore the papal ban on condoms, a victory of common sense over dogma. My memory could be wrong on this.
Regardless, full, open and honest sex education should be provided to all children. In country areas in Australia it is rarely a problem - I saw my young nephew (age 3?) trying to increase the numbers of his toy farm cows by having the "bull" mount all the cows (it didn't work btw). Kids are far smarter than parents give them credit. I must admit to using one of those cheesy cartoon books "How I was made" or similar. stupid move - I discovered to my horror (2 years later!) that my 8yr old daughter thought her new brother came about because I had a bath with my wife. I didn't repeat that mistake. Don't confuse it with "when two people love each other..." or "married couples..." because it just isn't true. I have heard of many kids that have never seen their parents naked...bizarre.
Reliance on Pap smears alone is however also not 100% I had a family member return a pap smear negative and was found to have extensive cancer through the whole genital area only 1 month later. Unfortunately I don't know any specifics, so I don't know the specific cancer.
I found the mother to child transmission interesting, but not a surprise. thx
I am off to bed now (nearly 2am). nite all
Posted by: PeterM | June 25, 2009 12:03 PM
Lab Lemming:
I agree that men should be vaccinated, but I disagree with your statement that "herd immunity is limited to lesbian communes". In order for a man to get HPV, he has to catch it from someone. If a woman doesn't have HPV in the first place, she can't pass it on to her (male) partners. So, vaccinating women does help with herd immunity.
Of course, it'd be more effective if men could be directly vaccinated, but you're going to have to ask Merck about that one.
Posted by: Benjamin Geiger | June 25, 2009 12:07 PM
Last post, I promise.
Nothing I have seen suggests that this can't be given to males, and according to wikipedia it is in high demand in gay communities.
I think the main problem is (initial) cost to governments.
Posted by: PeterM | June 25, 2009 12:13 PM
You are are all wrong . The catholic church is right. you should all be taken to the guillotine for heresy . you devil adulterers . god will punish .
Posted by: coconut | June 25, 2009 1:15 PM
THe Catholic Church is a very strange institution, as are all religions.
I can understand that you might want the comfort of a ritual, with friends and family members all engaged in a ceremony without a care as to the whys and wherefors....
but
Did you ever study the beliefs of Catholics and Christians? Do you actually believe (hold to be true) ANY of the tenets of your "religion?"
I can understand if you say "I just don't care what they teach because I don't listen to it..." but that makes you an enabler..
and if you say "Yes I fully believe in ...." then that makes you delusional...
so I thinks its odd that a scientist would be a believer, although it's not uncommon I'm told.
Posted by: Kevin (NYC) | June 25, 2009 1:27 PM
We need to change this healthcare system.
When the vaccine first became available, I was at the upper limit for the recommended age of vaccination. I asked my provider for the vaccine, and my insurance wouldn't cover it. I couldn't afford the cost out of pocket so I didn't get it. I still want it. I will ask for it again. I know that my insurance will now cover the vaccine for women in the recommended age group, but I'm no longer in that age group, so they won't cover it for me. I'm hoping the out of pocket cost has come down. If it has, you bet I'll get it. I wish my partner would too. Though insurance certainly won't pay for men to get it which is patently stooooooooopid.
Posted by: ambivalent academic | June 25, 2009 1:58 PM
Why either/or? I say go with both; give women the capacity to protect themselves from rape, and the possible consequences of rape, and also deter the rapists.
Suspenders and belt.
Posted by: cicely | June 25, 2009 2:35 PM
Ooh, I do love being challenged (I wasn't monitoring comments, and got busy).
I'm aggressively pro-vaccine, so my discomfort with the HPV vaccine for 11 year olds is something I'm willing to be educated about. You may not change my mind, but you might. And, as I discovered when I jumped into the MMR vaccine debate when my children were younger, was that in advocating for the medical decision making, you have to listen to people, even when you think they're being silly.
"Kids at least understand things like "it's required by the rules" and "because I said so." If an 11-year-old girl got all the other shots without making a fuss or asking too many questions, why should one more be a problem? Just treat it as another shot."
My kids are not at all understanding of "it's required by the rules." I just took my five-year-old in for vaccines and the event required a pretty extensive discussion of vaccines, including the concept that your body learns to fight the "bugs" after getting a little bit of them injected. Fortunately he didn't ask us to explain the whole live/dead vaccine concept, or the more specific details of immunology (since that's not my field, I would probably fail).
My reasoning depends on a few things I haven't researched completely (because I do not yet have an eleven year old) or that have yet to be determined. First, is HPV only transmitted sexually? If other modes of transmission are possible, it would change my thinking. Second, what are the vaccine related risks? All vaccines do have some risks, and though I certainly don't want to over estimate them, they are not irrelevant. Third, I feel like I have a reasonable assessment of my child right now, but don't know how I'll feel when she's eleven.
All those things might change my mind then, and I can't really know what I would do at a time point far away from now.
My reasoning right now (about a decision I'm not currently making) is that my daughter does not have to be protected against a sexually-transmitted disease if she's not having sex (and, concurrently that I will have some reasonable probability of knowing that she is having sex and that the vaccine does indeed confer reasonable protection at the risk level). I probably wouldn't vaccinate my child against a disease only present Borneo, either, unless I thought there was a reasonable probability of exposure.
I'd like to hear more from people who are currently making the decision to vaccinate their girls and their reasoning.
Posted by: neurolover | June 25, 2009 2:42 PM
"You want to wait to vaccinate your child until she reaches an age you deem appropriate to start having sex? "
No, I want to wait until I think there's a probability that she's having sex. I'm hoping that I'll know when that is, or at least know that I don't know enough (like DrDr says about her own daughter). And, the threshold for recognizing that I do not knowing enough is pretty low.
Posted by: neurolover | June 25, 2009 2:47 PM
@Neurolover (keep in mind I read nothing other than your very first comment):
I am 26 years old, which is the maximum age that a woman can get the HPV vaccine. I want the vaccine, but my insurance company doesn't cover it. Yes, I am married and intend to stay that way, but because of the age cutoff and the fact that there is no way to know what the future brings, I want it just in case.
If my insurance company ever does decide to cover it, I will be too old by that time to benefit from it. Had the vaccine been available to my parents when I was 10 or 11 years old, I would have wanted them to get it for me.
To everyone in this debate: This is not birth control. This is not a vaccine against pregnancy and all STDs that would give teens a free pass to go out and have orgies. Young girls don't even need to know that the vaccine is for an STD - all they need to know is that it's for a certain type of cancer that only women can get.
I really just don't see the merit in the argument against it. I don't see what's controversial about protecting girls and women from cervical cancer.
Unfortunately, I will never be one of the women who had the benefit of this vaccine.
Posted by: JLK | June 25, 2009 3:17 PM
Oh, and I forgot to add:
Neurolover, most teens don't "plan" to have sex. It just kinda happens. And if it happens to your daughter before she has had the vaccine, then she won't have been protected from that particular encounter. There is still debate last I knew about whether the vaccine is retroactive.
Posted by: JLK | June 25, 2009 3:19 PM
Alright, I haven't read all the comments, but I do want to address this idea:
So, are you also suggesting we give birth control to all menstruating women and girls, to protect them from getting pregnant if they are raped? Because this kind of logic, quite frankly, seems ridiculous to me.
Posted by: yinyang | June 25, 2009 3:30 PM
yinyang--please please please please get yourself vaccinated. just because pap smear screening is very effective at catching cervical cancer before it's too late doesn't mean you should rely on screening as your only defense.
1.5 years ago i had an abnormal pap smear, followed by a colposcopy, a biopsy, and a LEEP, which is where the doctor uses an electric loop to cut away the abnormal tissue and then cauterizes it. it was a horrible experience, scary and painful, and much more traumatic than a shot or two.
just this week i found out my most recent pap was abnormal, and now i'm heading into round 2.
my tests have come back hpv positive, so there is a good chance all of this could have been prevented by a vaccine had it come out when i was younger. the possibility that i could have multiple miscarriages as a result of this, in addition to the nagging fear that some day it will become cancer are terrifying. and if you think you have to be promiscuous to get hpv, you're wrong--i've had two committed partners in my life and it happened to me.
so please get vaccinated and get your daughters vaccinated. a couple of shots and an awkward conversation are well worth it when they can prevent such an awful disease.
by the way, a colposcopy is just the exam where the doctor uses a microscope to look for abnomal tissue on the cervix. if anything abnormal is seen, the doctor may do a biopsy, which involves using forceps to pinch off a bit of the tissue. if the biopsy comes back as abnormal, then the abnormal tissue will be removed, often with the LEEP procedure i mentioned. i just want to make sure someone with an upcoming colposcopy doesn't get scared thinking that it involves removing part of the cervix, that comes later if it is needed. i was told that abnormal cells found in pap smears are often removed by the immune system before the colposcopy even happens, so needing a colposcopy does not mean you have cervical cancer or pre-cancerous tissue.
thanks for bringing this up, dr. isis. until i was faced with abnormal results i didn't give the issue much thought, but educating women about this is crucial.
Posted by: k | June 25, 2009 3:53 PM
Neurolover, most teens don't "plan" to have sex. It just kinda happens.
Au contraire. The boys "plan" to have sex, alright. Constantly. The hit rate is just really, really low...
Posted by: BikeMonkey | June 25, 2009 3:59 PM
yinyang, you're right, the logic is ridiculous--mostly because you've created a completely false equivalence. There are other, routinely used and effective, ways of not getting or staying pregnant as the result of an unplanned sexual encounter, whereas there is no way other than the vaccine in question to prevent transmission of HPV in the absence of abstinence and/or religious condom use. Do you see why these are different situations?
Posted by: Jennifer B. Phillips (aka Danio) | June 25, 2009 4:01 PM
So, are you also suggesting we give birth control to all menstruating women and girls, to protect them from getting pregnant if they are raped?
*cough cough* morning after pill *cough cough*
Posted by: leigh | June 25, 2009 4:35 PM
Jennifer - Yes, I suppose I do. But, the idea that this vaccine will be useful in case of rape still bothers me immensely. I'm not sure I can explain why very well.
Everyone else - Thanks for your concern, sort of. I have another major reason for not having gotten the vaccine (yet! which means I plan to!) that doesn't have anything to do with the reason I gave, but I'd rather not share, so I didn't (and won't). So, please, you can stop trying to convince me to get it.
Posted by: yinyang | June 25, 2009 4:36 PM
yinyang:
No, because, very different from a HPV infection, a pregnancy can be dealt with after a rape. There's the morning after pill for example, or if it's too late for that, there's still the possibility of an abortion. As far as I know, once you get HPV, that's it. Do you see the difference?
So do you ride a car without a seatbelt because wearing it would put the burden to protect yourself on you while what really should happen is that nobody causes an accident?
Posted by: Maschinenbäuerin | June 25, 2009 4:58 PM
@neurovlover:
Side effects for Gardasil (trade name for HPV vaccine) are reported here. The most common effects are:
# Pain in the area of the injection -- occurring in up to 83.9 percent of people
# Swelling in the area of the injection -- up to 25.4 percent
# Redness in the area of the injection -- up to 24.6 percent
# Fever -- up to 13 percent
# Nausea -- up to 6.7 percent
# Dizziness -- up to 4 percent
These are common side effect for ALL vaccines and relate more to having an injection of any antigen rather than specific risks of the HPV vaccine.
Everyone's entitled to their own opinion, but if the vaccine had been available when I was eligible (I'm not anymore - see my previous comment), I would have jumped at the chance to have it and if my parents were the ones making that decision for me then I hope they would have got it for me. It would not have made me more promiscuous. Those side effects are NOTHING in comparison to the risk of genital warts, cervical cancer or multiple miscarriages that any woman carrying HPV is susceptible to.
Posted by: ambivalent academic | June 25, 2009 4:58 PM
As to your own decision regarding the vaccine--hey, it's your body, your call. I hope this discussion has provided you with some additional information on which to base an informed choice, and I wish you the very best.
JBP
Posted by: Jennifer B. Phillips (aka Danio) | June 25, 2009 5:32 PM
Dang, I keep forgetting to get this! I really have to move on that before I'm out of the age range. I don't know why I'm being so resistant, I was way more excited to get my smallpox vaccination, and I *knew* that was going to be a pain in the ass all summer.
And really, for the people who say that their 11 year-old will demand to know what this vaccination is for; as I recall that period of vaccinations I was a veritable pincushion and even if anyone had told me it was a jumble of acronyms. Just because I'd had my Hep B didn't mean I was about to go picking up dirty needles. So while a 5-year-old might want to know why they have to get shots, an 11-year-old knows what vaccines are, and mostly wants them to be over.
Right, calling my insurance right now!
Posted by: JustaTech | June 25, 2009 5:46 PM
The Calgary School Board and other Catholic school boards in Southern Alberta are highly influenced by the Bishop. A few years ago school fundraising groups were told that they couldn't raise money by working in casinos or bingo halls because the Bishop objected to it. These fundraisers raised thousands of dollars for one night of work. As a result, many fees for sports and other extracurriculars had to be increased. He also stopped a teacher's AIDS fundraiser because he was concerned that it would promote birth control. Even while I was trying to plan an AIDS awareness week for my school we were told to focus only on what can be done to help AIDS victims in Africa, and to limit it to Africa and pretend like it isn't happening here because it will open up the safe sex discussion. What the Bishop is done will hurt small towns in Southern Alberta more than in Calgary because in small towns, there often isn't much of a choice between Catholic and public schools, and it is harder to access healthcare when compared to Calgary, especially on reserves, where many of the students in my Catholic highschool were from. Not to mention that teenage pregnancy rates here have gone through the roof because of the abstinence only sex ed that the Bishop has promoted and continues to ignore the needs of students in Catholic schools
Posted by: Jen | June 25, 2009 10:07 PM
"So while a 5-year-old might want to know why they have to get shots, an 11-year-old knows what vaccines are, and mostly wants them to be over."
Honestly you guys, do you actually have kids? I can guarantee that there will be a long and extensive discussion with my kids as part of their vaccinations (maybe my 11 year old will be completely different from her current self, that's always a possibility). My discussion with my five-year-old required google searches for pictures of varicella, a discussion of their grandparent's memory of my having chicken pox (they think, 'cause they used different words for it), and a discussion of polio and Franklin Roosevelt. He might even be able to remember what DPaT stands for and symptoms of each disease.
And, I was actually a teenage girl once, and I certainly did plan to have sex. I've always been happy that sex was a result of my plan. I *plan* to teach my daughter the same. Of course, she might be different from me, and from the girl I now know, but, that's really a discussion for us to have.
I think people's worry that people might avoid the vaccine because of Ooh, the big sex thing is skewing the discussion. If there was a vaccine against a sushi-borne organism, that could only be transmitted by sushi, I wouldn't be getting that, either for me or for my daughter. Yes, the world might turn over, and my daughter might eat sushi (or someone might force it down her throat, or through peer pressure), but it's pretty reasonable to assume that she won't. I'm pretty sure that she will have sex some day, and its a good plan for her to be vaccinated before then, but I don't think that's going to be at 11. It's also not going to be at 18, or 6 months before her wedding date.
(and, I do imagine having my daughter take the vaccine -- as a child, probably around the same time we have discussions about birth control).
Posted by: neurolover | June 26, 2009 12:32 AM
I am amazed that virtually nobody (except by Dr. I) ever mentions the likelihood that most women probably have/will be infected with the HPV from their HUSBANDS! (I wonder if there are any data regarding the cervical cancer rate among women who have had only one partner -- presumably, their husband...) It seems that parents who withhold the HPV vaccine from their daughters to protect their chastity are making two huge assumptions: a) their daughters will actually remain virgins until marriage (in part, due to fear of cervical cancer, even though fear of pregnancy of other STDs seems generally ineffective), and b) their future son-in-law (who they probably haven't met yet) will have done the same. It is highly unlikely that both of these assumptions will be valid. Blindly trusting (hoping) that your daughter's future husband will not have been infected with HPV is a naive crap-shoot with her health/life.
Posted by: glfadkt | June 26, 2009 11:17 AM
The Journal of the American Medical Association (JAMA, June 16th 2009) calls it superb and a terrific contribution to society…. book on “The HPV Vaccine Controversy: Sex, Cancer, God and Politics” authored by Shobha S. Krishnan, M.D, Barnard college, Columbia University educates both professionals and the public about HPV infections, the diseases they cause and the role/ controversies surrounding the new vaccines. The book is written without the influence of any pharmaceutical companies or special interest groups and is available at amazon.com and Barnes and Noble .com. Link to the book: http://www.greenwood.com/catalog/C35011.aspx
Posted by: Annon | June 26, 2009 3:58 PM
@neurolover:
Not trying to be irritating, but what exactly are your reasons for waiting past the age of 11 to give your children the vaccine? Assuming that they will (eventually, in the distant future) have sex, and that the vaccine will, at some point, become necessary, what is your rationale for delaying? Maybe my thinking on this whole issue is simplistic, but to me there are no reasons to delay, and a number of reasons to get the vaccine as soon as possible.
Your sushi argument... doesn't hold up.
Posted by: sonambula | June 28, 2009 12:24 AM
I just can't understand the opposition to the HPV vaccine, and I'm really hoping the approval comes through for boys soon so our sons can get this, too.
I mean, imagine we came up with a vaccine for dental caries. Would it make sense not to give it to kids because it might result in some of them eating more sweets and risking obesity?
Posted by: Ray Ingles | June 30, 2009 8:59 AM
I know this post was a while ago, but the gardasil vaccine isn't universally safe. The phase III clinical trials Merck conducted suggested that there may be an increase in side-effects (and possibly death) the younger the patient. Hence this vaccine isn't considered mandatory by physicians in line with, say, the measles or HBV vaccines that we give all kids (I'm a physician).
Additionally, vaccinating young boys is semi idiotic considering that the clinical benefits for young boys aren't substantial but that the risks of the vaccine are possibly death (i.e. the probability of death from the vaccine is non-zero for a benefit that is not life-saving for the young boy). I doubt many of you would be fine with the notion of increasing the mortality of young boys to help decrease the mortality of young girls who have sex early.
I'm as pro-gardasil as they get, and your point was to demonstrate that the fears behind giving the vaccine related more to pre-marital sex/religious fundamentalism rather than the side-effect profile. However, while the church seems anachronistic on their views with this issue, the people on this board seem more bent on using the vaccine to fuel a gender argument rather than research some of the reasons why some rational parents choose to hold off. And I respect the choice of those parents even though I (usually) disagree with them.
Posted by: Nish | August 15, 2009 11:26 PM