Why, Medscape, why? Or: Gardasil is hunky-dory except when antivaccinationists say it's not.

THWOMP!

THWOMP! THWOMP!

TWHOMP! THWOMP! TWHOMP!

That's the sound of me hitting my head against the table. Hard.

What provoked this reaction in me is Medscape, specifically an article that my blog bud PalMD turned me on to. That the article, entitled HPV Vaccine Deemed Safe and Effective, Despite Reports of Adverse Events, seems to have been written in response to criticism of its previous article on the HPV vaccine Gardasil, both by me and others, criticism that led Medscape to quietly pull the old article, makes the resultant article seem even worse, particularly in wake of a truly dumb poll Medscape tried to do about the vaccine. Truly, Medscape would have been better off just staying quiet after that debacle. This new article, although an improvement in several ways, is a major step downward in others, if that's possible. I'm not sure if the improvements outweigh the sheer hunk o' hunk o' burnin' stupid that makes up one major section of the article. On balance, I don't think it does.

The article begins:

Editor's note: This article replaces "HPV Vaccine Adverse Events Worrisome Says Key Investigator," which was posted on July 26, 2008, and was removed after editorial review.

That's all very nice, but I really wish the same level of editorial review had been applied to the article that replaced it. I will admit that the new Medscape article even starts out pretty positive and definitively:

August 8, 2008 -- Reports of adverse events after administration of the human papillomavirus (HPV) vaccine (Gardasil, Merck) have been making headlines, and questions over the safety of the vaccine have been raised by consumers, parents, healthcare professionals, and others, notes a recent joint statement from the US Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). But having analyzed the available data, the agencies offer reassurance.

"Based on ongoing assessments of vaccine safety information, the FDA and CDC continue to find that Gardasil is a safe and effective vaccine," the agencies said in a statement released on July 22, 2008. "The benefits continue to outweigh the risks," they said. "This vaccine is an important cervical cancer prevention tool," they added.

The manufacturer also issued a statement, dated July 10, 2008, saying it too had analyzed available data and it "believes that no safety issue related to the vaccine has been identified. These types of events are events that could also be seen in the general population, even in the absence of vaccination."

So far, so good. All of the above is true, and it points out the problems with using the Vaccine Adverse Event Reporting System (VAERS) to try to infer causality of adverse events as being due to a vaccine. Dr. Maurie Markman, an advisor to Medscape Oncology, was quoted, and he was quite emphatic about the often coincidental nature of adverse events that may or may not have anything to do with any vaccine and where only carefully controlled epidemiological evidence can provide evidence suggestive of of causality. It's also pointed out that some events, such as Guillain-Barré syndrome, are so rare that causality is unlikely ever to be able to be confirmed, a point further explained by John Iskander, MD, acting director of the Immunization Safety Office at the CDC, who further reinforced these points and the problems with using the VAERS system to infer causality. (If you want to know more about how easily the VAERS system is swayed by publicity or even trial lawyers, read my post on the subject from a couple of years ago.)

You might think that I'd be unhappy that Dr. Diane Harper was cited again as the "skeptic" who is not so positive about Gardasil. You'd actually be wrong. As I pointed out in the first post I did on the topic, even as the resident vaccine defender on ScienceBlogs, I'm not yet entirely sold on the contention that it's necessary to make Gardasil or another HPV vaccine one of the mandatory regular vaccines in the childhood vaccine schedule. My doubts are based more on the expense and whether the evidence is convincing that the vaccine's benefits outweigh its expense and risks by a margin comparable to that of other vaccines in the routine childhood vaccination schedule, which is what I consider a necessary burden of proof to be met before the vaccine is added as a routine part of the overall vaccination schedule. So it bothers me not at all when Dr. Harper says things like:

However, there is also another very important part to the cervical cancer prevention story, Dr. Harper said, and that is regular Pap tests. Even women who are vaccinated need to have regular Pap testing, as otherwise they are still at risk of developing cervical cancer. And women who decide not to have the vaccine can still protect themselves by undergoing Pap testing.

Dr. Harper feels this message has not been made clear to the general public and that it has been overshadowed by what she considers to be aggressive and inappropriate promotion of Gardasil. As a gynecologist dealing with the general population, her advice on the HPV vaccine is that "if you are at all concerned, then don't have the vaccine -- have regular Pap smears and you will be equally protected from cervical cancer."

That's a perfectly valid comment about Gardasil from a medical standpoint. I would quibble that Dr. Harper seems to think the vaccine is far more risky than the evidence, in fact, says it is, but she's not so far off the rails as to provoke a heapin' helpin' of not-so-Respectful Insolence. If Dr. Harper had been the only "skeptic" of Gardasil quoted, I'd have no problem at all with the article. She's harsh, but she can (mostly) back her criticisms with reasoned argument and science.

Sadly, though, the author Zosia Chustecka seems to have felt the need to find a rabid antivaccinationist to interview and quote extensively. I'm talking Barbara Loe Fisher-rabid.

Oh, wait. She actually went and interviewed Barbara Loe Fisher for the article.

Yes, that Barbara Loe Fisher, founder of one of the oldest antivaccine websites in existence, the National Vaccine Information Center (NVIC) and the blogger behind the prominent antivaccine blog Vaccine Awakening. I'm talking about the very same Barbara Loe Fisher who recently showed up at Netroots Nation to try to push her antivaccine agenda and then whined about criticism. Quoting Fisher about vaccines is akin to quoting Count Dracula about garlic, sharpened wooden sticks, and that man Abraham Van Helsing. Indeed, Arthur Allen described her in his book Vaccine: The Controversial Story of Life's Greatest Lifesaver, thusly:

To be sure, Barbara Loe Fisher and Kathi Williams defined themselves as consumer safety advocates, denying that they were "antivaccine." But this self-definition was problematic, because they viewed mass vaccination itself as a dangerous process of questionable value. They felt that vaccines were a small or negative contribution to health and should be optional. When I asked Fisher whether she felt there were any "good" vaccines, she declined to mention any specifically but resopnded that she supported "the availability of the safest, least toxic, most advance vaccines that can be produced as a health care option for anybody who wants to use them."

In other words, Fisher was peddling the "Green Our Vaccines" lie back when Jenny McCarthy was still posing for Playboy and doing gross-out humor for MTV. Indeed, Fisher is later quoted by Allen as saying this about thimerosal and vaccines and how autism rates have not decreased since thimerosal was removed from vaccines:

"Thimerosal is only part of the problem," she [Fisher] told me. Vaccines, Fisher was convinced, cause the immune system to go awry in a way that affected the mind. Perhaps microbial poisons crossed the blood-brain barrier, or vaccines overwhelmed the immune system, or the very absence of diseases that vaccines prevented somehow threw the body off kilter.

Suffice it to say that Fisher is not a reliable or in any way authoritative source of information about vaccines. Period. She is a major antivaccine activist, crank, and advocate of pseudoscience--and dangerous pseudoscience at that. Because she is implacably and irrevocably opposed to the very concept of mass vaccination, her website and blog are chock full of anti-vaccine rants, exaggerations of vaccine dangers, and pseudoscience about vaccines, while the NVIC website is festooned with an image of the Statue of Liberty with the logo, "No forced vaccination, not in America." She does not belong in Medscape, at least not in a serious story about medicine and vaccines and certainly not if Medscape really wants to be science- and evidence-based in its reporting. She proves me correct in this assessment in spades with what she says, too:

The NVIC, self-billed as "America's Vaccine Safety Watchdog," has also accessed VAERS reports and made them available in a searchable database on its Web site. These data show that during 2008, reports about Gardasil have accounted for 20% to 25% of all VAERS reports on all vaccines, Ms. Fisher said. "This is striking, as Gardasil isn't a mandatory vaccine while many other childhood vaccines are, but we don't know what this means."

No, it's not "striking" at all. As I pointed out before time and time again, VAERS is very, very sensitive to publicity, which can cause spikes in reports due to the advocacy of well-meaning (or not-so-well-meaning) groups or by lawyers trying to game the database in their favor. Remember, VAERS is an entirely self-reported database. Minimal effort is made to verify reported adverse events, and anything can be reported, whether it can reasonably inferred to have been from vaccines or not. Indeed, two most unusual reports of vaccine "reactions" have been submitted to the database, including a report of a vaccine turning a man into The Incredible Hulk. Indeed, people entering reports don't even have to originate from the U.S. A couple of years ago, a British father of an autistic girl entered a VAERS report in which he claimed that vaccines turned his daughter into Wonder Woman. VAERS, as I said, is useless for longitudinal studies or determining causality. That's not its purpose; its purpose is to serve as a "canary in the coalmine," an early warning system. Although this Medscape article got that part of VAERS function mostly right in the story, it greatly undermined the point by including such moronic antivaccination idiocy from Fisher as though it had any authority whatsoever.

Chustecka then lets Fisher ladle some more stupid into the article:

In addition, the NVIC has been running its own private vaccine reaction registry for the past 26 years, and it currently has about 140 reports on Gardasil, Ms. Fisher said. "These include reports of injury and death, and we are seeing a pattern of what we have termed 'atypical collapse,' " she commented. "These include cases where a girl suddenly passes into unconsciousness either immediately or within 24 hours of vaccination and then revives feeling weak and unable to speak properly or exhibiting other neurological signs. What we are concerned about is that girls are not aware of this possibility and could be crossing the road or driving a car and suddenly pass out."

PalMD demolished this bit of antivaccine nonsense so that I don't have to. Suffice it to say that Fisher is making it up as she goes along. This "atypical late collapse" is an invention of antivaccine people; nothing more. It's not a recognized clinical entity. Finally, Chustecka gamely reports Fisher's words as she pulls the dreaded antivaccine aluminum gambit:

Ms. Fisher added that the fact that the placebo used was aluminum based, and so the results may not give a true picture of the events associated with the vaccine, and noted the lack of any prelicensure data on administration of Gardasil simultaneously with other vaccines, in particular the meningococcal vaccine, which is targeted at a similar age range. She suggested that the vaccine was recommended for preadolescent girls prematurely.

This is all nonsense, and it should have been flagged as such by Medscape. Vaccines are always tested with the rest of the routine vaccination schedule; this nonsense about Gardasil not being tested with other vaccines is just that--nonsense. It's nothing more than the standard antivaccine trope that it's some undescribed "interaction" between different dreaded vaccines that causes all those horrible problems--except that there really aren't horrible problems to be found when one looks at the data dispassionatedly. In addition, there is no evidence that aluminum in vaccines at the doses used causes neurological problems. Antivaccinationists harp on aluminum now because accumulating evidence has failed to find any link between mercury (their previous favorite whipping boy) and autism, and antivaccinationists need a new bogeyman in vaccines. That's why they've switched their attention to aluminum, even though it has an 80 year track record of safety, and on "toxins." Aluminum's a metal, right? That makes it just like mercury or plutonium, right? Therefore, aluminum must be bad. Or at least so antivaccinationists seem to think.

Looking at this utter debacle on the part of Medscape's recent reporting on Gardasil, I'm left scratching my head. I just can't figure out what happened or why Medscape seems to find it so hard to avoid bringing pseudoscience into their reporting on this particular issue. What on earth were the editors thinking when they allowed the first execrable article to be published and then posted that utterly silly push poll? It seems to come down to that lazy journalistic mantra of "tell both sides" of the story. Indeed, I have to wonder if Chustecka counted up two doctors being very positive about Gardasil and only one (Dr. Harper) being negative or skeptical about the vaccine and decided that for "balance" one more "skeptic" was required to round out the article. The problem, of course, is that while Dr. Harper, although I disagree with a some of what she said and she fairly harsh, for the most part she was reasonable and (mostly) science-based in her comments, Barbara Loe Fisher was not at all reasonable. She's about as hardcore an old school an antivaccinationist as there is in existence, so much so that it is not going too far to categorize her as the grande dame of antivaccinationism in the U.S. To quote such a crank as though she were a medical authority criticizing Gardasil is no different than quoting Ken Ham or Roy Comfort as "experts" criticizing evolution. To me, quoting Barbara Loe Fisher as though she had anything useful to say at all about Gardasil or vaccines in general is arguably worse than quoting Christiane Northrup in the previous article, who, although definitely a flake, is not implacably antivaccine.

The "tell both sides" mantra beloved of reporters and inculcated into them in journalism school is all well and good for political stories and many other types of stories, but it can easily become anathema in science or medical reporting. For example, there aren't "two sides to the story" when it comes to the theory of evolution, at least not scientifically speaking; yet we continue to see stories quoting creationists as though they had a valid scientific point. This is no different. When it comes to science, there aren't "two sides to the story" when it comes to vaccines, or if there is antivaccinationists have yet to be able to produce any compelling scientific evidence why we should take them seriously as the "other side of the story." They're excellent at manufactroversy, but when it comes to defending their viewpoints they're all pseudoscience and misinformation. If Medscape wants to be taken seriously when reporting medical science, it needs to realize that not every story has two valid sides and to recognize when it's dealing with a story with science on one side and nonsense on the other.

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I haven't time to shuffle my way through the registration process to check who the author is, and read the original, etc., but I suspect the bottom line with these sorts of articles would be how well educated the author and editors are in the particular subject matter that the article covers.

Seems to me its more-or-less the same issue as in mainstream journalism, but on a more specific and exacting issue. Its why specialist writers and editors are needed and they have the sense (and ability) to cross-check what they are told and that they recognise when they are off their home turf and have the good sense to call in others to cover it if they honestly lack the depth to do so. A lot to ask!, but its what good articles need, I guess.

By Heraclides (not verified) on 13 Aug 2008 #permalink

Zosia Chustecka is news editor for Medscape Hematology-Oncology and prior news editor of jointandbone.org, a website acquired by WebMD. A veteran medical journalist based in London, UK, she has won a prize from the British Medical Journalists Association and is a pharmacology graduate. She has written for a wide variety of publications aimed at the medical and related health professions. She can be contacted at zchustecka@medscape.net.

Medscape Medical News 2008. © 2008 Medscape

Send press releases and comments to news@medscape.net.

I love how American cranks and kooks almost inevitably use some invocation of "Americanness" as a bolster to whatever weird-ass argument they're making. It's a strange sort of logical fallacy, almost a mutated Argumentum Ad Verecundiam (Argumentum Ad Patria?) that has evolved specifically to fill a rhetorical niche in the American political discourse. I really can't think of another example of that specific sort of speech act appearing out of anywhere else.

By Interrobang (not verified) on 13 Aug 2008 #permalink

"Aluminum's a metal, right? That makes it just like mercury or plutonium, right? Therefore, aluminum must be bad"

Just hope they don't find out that anything can be a metal if you try hard enough. (I mean that literally. Compress hydrogen hard enough and it turns into a superconductive liquid metal.) :-P

I'm being facetious, of course. There's no reason to stoop to that kind of silliness (an element's theoretical ability to become an exotic metal) when there is much simpler silliness for them to exploit. Really, if one is sufficiently paranoid, and doesn't know any chemistry, there is a limitless bounty of silliness upon which to base ridiculous claims.

By Calli Arcale (not verified) on 13 Aug 2008 #permalink

Aluminum nothing, you know what else is a metal? IRON. Do you have any idea how many people have been killed by iron over the ages? I am told that when applied internally it can cause massive bleeding, organ damage, degraded nervous function and all sorts of horrible things! And this is the real kicker -- the needles they use to put vaccines in people are made of steel which is a form of iron! Coincidence? I think not!

By Chris Anderson (not verified) on 13 Aug 2008 #permalink

Damn, it ate my (end sarcasm) tag. Just in case anybody thought I was that unhinged, my unhinging runs in quite different directions from science denialism :)

By Chris Anderson (not verified) on 13 Aug 2008 #permalink

Orac wrote:

Quoting Fisher about vaccines is akin to quoting Count Dracula about garlic, sharpened wooden sticks, and that man Abraham Van Helsing.

This is not an entirely apt analogy - research has shown that garlic, wooden stakes, and Van Helsing actually ARE harmful to vampires - we're still waiting for the research showing that vaccines are harmful to Fisher - or anybody, really. ;->

By Silverloc (not verified) on 13 Aug 2008 #permalink

Oracs next post is a visual representation of the antivax argument.

Oh Jim, that is such a powerful observation!

And Calli, been hanging out at space dot com too much? We hear about metallic hydrogen there quite often.

Wow! Dr. Orac, this is a really good argument. Let me repeat: Wow!

"It's also pointed out that some events, such as Guillain-Barré syndrome, are so rare that causality is unlikely ever to be able to be confirmed".

Dr. Orac, my epidemiology exam is just around the corner, and I was wondering if somebody as brainy as yourself could tell me exactly how strong does a correlation to be to make it causation?

Nah just kiddin' tee hee. But I see you optimistically include gardasil among the routine childhood vaccines:

"My doubts are based more on the expense and whether the evidence is convincing that the vaccine's benefits outweigh its expense and risks by a margin comparable to that of other vaccines in the routine childhood vaccination
schedule".

If only it were so well. If only. But tell me, at what age do you, dear doc. think the benefits of injecting this extremely important vaccine into little girls would outweigh the cost and the risk? Age 1, 6, 10 months? Personally I think an in utero shot wouldn't be out of the question. But your expert judgment is highly appreciated. I mean, after all, you've got a blog and everything. That makes you kinda sexy.

By Undergraduate-gal (not verified) on 13 Aug 2008 #permalink

Oopss, missing word alert. I meant to write "How strong does a correlation NEED to be" Sorry about that.

U-g

By Undergraduate-gal (not verified) on 13 Aug 2008 #permalink

To help U-g with that epidemiology exam she must be dreading, here's some information on Guillain-Barre syndrome from emedicine.com:

"Up to two thirds of patients with GBS report an antecedent illness or event 1-3 weeks prior to the onset of weakness. Upper respiratory and gastrointestinal illnesses are the most commonly reported conditions. Symptoms generally have resolved by the time of medical presentation for the neurologic condition.
C jejuni is the major organism identified in most studies and is responsible for both AIDP and AMAN cases. In one major study, previous diarrheal illness had occurred in 60% of patients with axonal GBS by neurophysiologic testing.
Vaccinations, surgical procedures, and trauma have been reported as triggers for GBS. Much of this information is anecdotal, although vaccination with the 1976 swine flu vaccine was shown to carry a small, but definable, increased risk of contracting GBS. Other studies of vaccinations have not shown a significant relationship with GBS."

Note the last sentence.

Good luck cramming for the exam,

DB

By Dangerous Bacon (not verified) on 13 Aug 2008 #permalink

Undergrad, if your epi class had taught you anything worthwhile, they should have taught you the rules for establishing causality.

Yes, you need a pretty damn stong relationship between the variables, but you also need temporality, biological plausibility, coherence, experimental evidence and some other goodies that you can look up in the Gordis book if you have it handy.

You should have also learned that vaccines are most effective when delivered prior to exposure, and that the somewhat-normal distribution of sexual debut makes it necessary to shoot up the kiddies early. Why? Because some of them will be molested or raped. And some of them will simply make really bad decisions about how to use their bodies.

By Rogue Epidemiologist (not verified) on 13 Aug 2008 #permalink

Rogue Epidemiologist said "And some of them will simply make really bad decisions about how to use their bodies."

During this summer we hosted a 14 year old young lady for about a month. After she left I was informed that she is already sexually active.

Though that is not quite as bad as the young lady I met in 8th grade gym class. She already had a baby and was planning on marrying the father as soon as she had her 14th birthday to comply with the very southern state's laws.

Then last year in the news was the story of the 12 year old who went off with a friend of her sister. The "friend" took her to a nearby city where he became her pimp as she became a prostitute. Apparently her family did their own sleuthing and found her, and had to talk her into coming home.

Those are just some anecdotes, but they do show some very bad decisions.

By Random Parent (not verified) on 13 Aug 2008 #permalink

Rogue, I'm really starting to heart you. You say the epi things I want to in a more elegant an informed way.

Thanks for the checklist Rogue, very helpful.

"Yes, you need a pretty damn stong relationship between the variables, but you also need temporality, biological plausibility, coherence, experimental evidence and some other goodies that you can look up in the Gordis book if you have it handy."

I guess "relationship between the variables" and
"temporality" is easily demonstrated by the fact that like 0.1% or something like that of HPV positive women get cervical cancer after a latency period of only 40 years.

"biological plausibility" and "experimental evidence" are unquestioned, since we all know that behind every profitable cancer there's a profitable virus. And human experiments have shown that gardasil increases the risk of progressing to cancer in those already HPV positive. How could the vaccine cause cancer if HPV was innocent?

If I further add that it is highly irresponsible of the authorities to wait until age eleven to shoot up the young nymfos, so let' shit 'em hard and hit 'em early, do you think I would get a good grade if I draw an HPV question for my exam?

By Undergraduate-gal (not verified) on 13 Aug 2008 #permalink

I hope for the sake of future medicine that you're not actually a medical student, undergraduate-gal, as you're coming across as a standard anti-vaccination nutcase with strong overtones of Big Pharma paranoia.

If you genuinely want to learn something, why not read this:
http://monographs.iarc.fr/ENG/Monographs/vol64/volume64.pdf. It's nice and short and gives a basic idea of the lines of evidence supporting the HPV/cervical cancer link. As a student (aha), you should also have easy access to journal articles describing the underlying experiments and analyses.

Pretty obviously a troll, if only because who'd have an exam in the middle of August?

The "let's shoot up those fetal sluts" talk is just strawman-flavored icing.

Dear Dr. Frank and N. C.

Very perceptive of you, except for the trolling part (The icing part I didn't even understand).

I am indeed one of those denialists, which you guys have so much adolescent fun thinking you're beating up on. I thought that was plainly obvious from ny first Comments - funnily enough posted on the "Denialists aren't going to like this" thread concerning a grievously flawed study of HIV+ life expectancy.

Dr. Orac was right, this denialist didn't like the facile, superficial, poor quality, factually erroneous character of the so-called analyses by him and the distinguished Dr. Novella.

DrFrank I would love to learn something new, but the page you are referring to has apparently been removed. Fortunately, I am actually pretty familiar with the HPV-cervical cancer link. What makes you think otherwise?

By Undergraduate-gal (not verified) on 14 Aug 2008 #permalink

In the article Orac stated, "Vaccines are always tested with the rest of the routine vaccination schedule; this nonsense about Gardasil not being tested with other vaccines is just that--nonsense. It's nothing more than the standard antivaccine trope that it's some undescribed "interaction" between different dreaded vaccines that causes all those horrible problems--except that there really aren't horrible problems to be found when one looks at the data dispassionatedly".

I think Orac needs to research before posting such nonsense. According to the maker of Gardasil, Merck, has stated that this vaccine has ONLY been tested in conjunction with Hep B. Please see link below, page, 8 Under "Use with other vaccines".

http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf

So, please Orac, get your facts straight before you speak about subjects you know nothing about - or AT the VERY LEAST, please read the vaccine literature supplied with the product. I will spare you the embarrassment of picking apart the rest of your reported misinformation too.

I got the Gardasil shot before I became sexually active even though I was intending on a monogamous relationship with a guy I made take an STD test six months after his last sexual encounter. I would get it for any of my daughters, unless the risk had been proven to be sufficiently dangerous that the vaccine was only recommended for very small groups of women. HPV is so incredibly prevalent out there that even the most careful of sexually active women can contract it.

"But tell me, at what age do you, dear doc. think the benefits of injecting this extremely important vaccine into little girls would outweigh the cost and the risk? Age 1, 6, 10 months?"

Any vaccine for an entirely sexually-transmitted disease such as HPV (NOT like Hepatitis B, which can be transmitted through non-sexual contact) should be administered sometime between age 9 and age 12 to guarantee that the girl will be covered when she is sexually active, and with the assumption that if she's sexually active before then, cervical cancer's the least of her concerns. Even if a girl is not going to become sexually active, there's no way to know for sure because teenage girls will always, always lie to parents and doctors about their sexual history and if they intend on becoming sexually active. Better to cover them a little early for when they eventually enter into a perfect Monogamous Christian Heterosexual Marriage (TM) with a man who happened to have HPV than to miss the 13 year old who is already giving blowjobs to half the boys in her class.

I guess I just don't understand the logic behind parents injecting their children with an STD with the hope that it will prevent cervical cancer. What do you think is in that vial? A cultered STD! What the maker of the product didn't tell you is that if you have been sexually active, exposed to one of the strains (there are over 100) you are then subsequently vaccinated against, you will INCREASE your risk of cervical cancer by roughly 48%. So, you'd better hope that you child told you the truth about their sex life.

Basiorana,

Who told you HPV is exclusively sexually transmitted, Merck's advertizers?

HPV is rife among infants, as you can read here for instance:

"Transmission of High-Risk Human Papillomavirus (HPV) between Parents and Infant: a Prospective Study of HPV in Families in Finland"

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=540188

like I said before, if it's a girl, let's shoot her up in utero, way before she starts giving all those BJs to the other kids in the kindergarten.

By Undergraduate-gal (not verified) on 14 Aug 2008 #permalink

"What the maker of the product didn't tell you is that if you have been sexually active, exposed to one of the strains (there are over 100) you are then subsequently vaccinated against, you will INCREASE your risk of cervical cancer by roughly 48%."

Reference please Dawn.

Ozzy, my source is the FDA. Research "Gardasil" HPV Quadrivalent Vaccine, May 18, 2006 VRBPAC Meeting - Vaccines and Related Biological Products Advisory Comittee Background Document

You should be able to access these documents by request through the Freedom of Information Act. I wouldn't advise googling the information because information can be altered on the internet, like I stated in one of my earlier posts.

Somehow I think that if that document said Dawn claims it says then it would be freely available, and if Dawn has seen and read the document she would not understand it. Obviously this is something she read on some anti-vax website and does not want to reveal which one (like her using TinyURL links to Barbara Loe Fisher's blog and to a "vaccineshop" commercial website).

Dawn you really are a piece of work. The supposedly altered minutes are exactly the same as what all of these anti-vax websites are putting up on their sites. They actually try to say that this information is being suppressed because the links are dead. But they place a quotation mark after the .pdf. I really am surprised sometimes at the audacity of these guys.
Anyway, back to your 48% increased risk stat. That was found in a SINGLE study in which the group that received the gardasil had higher levels of smoking, other non-HPV STDs and other risk factors for the development of pre-cancerous lesions. This "increased risk" dissappeared when these factors were controlled for.

When you say something is unscrupulously altered, the burden of proof is on you. Show me the unaltered MMWR.

So Ozzy, a 48% increase in risk disappeared when smoking was controlled for. Not very well randomized that study eh?

Perhaps we should simply encourage young girls not to smoke.

But how about a little practicing in addition to all the preaching, you know linking your source and perhaps quoting the critical passages?

By Undergraduate-gal (not verified) on 14 Aug 2008 #permalink

Dawn said: "What do you think is in that vial? A cultered STD!"

Sorry Dawn, that comment has disqualified you from participating in any further discussions, though the words uncultured STD keep floating through my mind.

By notmercury (not verified) on 14 Aug 2008 #permalink

It's from the suppossedly altered study posted on naturalnews that Dawn supposedly got via the FOIA. It's funny that it's the same one on the FDA's website.
http://www.naturalnews.com/downloads/FDA-Gardasil.pdf
You can find it and read it for yourself.

When smoking and OTHER risk factors for precancerous lesion formation were controlled for.

Quiting smoking would definitely help but I believe that preventing infection through vaccination is an additional important step. Since you're all fired up about a 48% reduciton in risk of precancerous lesions (which, by the way, don't mean cancer), how about an potential 70% reduction in the risk of actual cervical cancer. But you're a serial Denialist so it's pretty pointless to keep this going.

Yes, Ozzy it is pretty pointless to keep this going. I gave you a source and you in turn spew your bullshit. You make things up as you go along.

Ozzy stated: Quiting smoking would definitely help but I believe that preventing infection through vaccination is an additional important step. Since you're all fired up about a 48% reduciton in risk of precancerous lesions (which, by the way, don't mean cancer), how about an potential 70% reduction in the risk of actual cervical cancer".

Sources please???

I gave the FDA's documents as my proof and YOU give me Natural News??

Dawn - you say "The whole cell pertussis vaccine was developed in the early 1900's" ... yes, but it was not used as a preventive vaccine the way it is today. It was "prophylactic and therapeutic". They gave it to kids who already had whooping cough to help their immune systems develop immunity.

Dawn says, "a local elementary school has 35 Special Ed teachers and 28 regular teachers. There are less than 400 children in the entire school! Further proof that vaccines are to blame." Care to give the name and location of the school so we can check staffing for ourselves? Is this perhaps a magnet school that specializes in children with special educational needs?

Dawn says: "FYI - the "Spanish Flu" only affected the vaccinated. How many died from it?" 25 to 50 million people died, but I want to see your source for the claim that it only affected the vaccinated. Between June 1918 and July 1919 over 16,000,000 people in India died of the virus ... and India at that time had no vaccination requirements, or programs.

By Tsu Dho Nimh (not verified) on 14 Aug 2008 #permalink

Thank you Tsu Dho Nimh for taking a closer look at my previous posts. I appreciate it.

This school now houses 450 students (since my last post their website was updated to reflect 50+ more students).

http://www.ges.gilford.k12.nh.us/
http://www.ges.gilford.k12.nh.us/sites/staff.htm

Regarding the Spanish flu - I have to make a correction to an earlier post. Yes, people in third world countries also died from the disease. However, in this country alone - it strickly affected the military - military persons who were vaccinated for other diseases and then sent to live in crowded, impoverished conditions while preparing for battle.

Dawn, you really can't read or comprehend writing. I was giving you the link to the "supposed" original unaltered report that you supposedly got by the FOIA but it is conveniently found on naturalnews.com. The whole point was that this whole "they changed the report" spiel was such a f'ing joke. This "original" report is the same as the "altered" one.
And by the way, you never linked to any FDA doc as your "proof." I went out and found it myself. So go out and find data showing that infection with either of 3 strains of HPV are associated with an increased risk of cervical cancer and 70% of all cervical cancers are associated with these 3 strains of HPV. I have a hint, look on PubMed. You won't find in on whale.to.

Dawn, where in the world did you get the idea that the only Americans who got Spanish flu were in the military? The disease was first observed at a military base, but many civilians were sickened and died in the United States and around the world.

Yes, Ozzy is quite lazy. Ozzy thinks "google" is the greatest gift to mankind - besides vaccines.

I really cannot read or comprehend writing Ozzy? Oh, please...isn't that what I said to you or someone else weeks ago? A little slow on the comeback - and not so original either.

Now, you are giving me links to my "evidence"? What kind of bullshit is that? Ozzy, again, my source is the FDA. Research "Gardasil" HPV Quadrivalent Vaccine, May 18, 2006 VRBPAC Meeting - Vaccines and Related Biological Products Advisory Committee Background Document.

For this discussion - let's leave PubMed OUT OF IT.

You're starting to crack up Ozzy.

There is nothing in the pdf that says anything about controlling for smoking. Merck and the FDA were desperately clutching at straws, so they looked for "potential imbalances" in the baseline demographics characteristics.

After looking really hard they found that 34.6% of the vaccine group were current smokers against 31.4 in the placebo group. Just like you did (with a little prodding), they realized that that 3% percent difference is hardly sufficient to explain a 44.6% (not 48%) difference in risk of precancerous lesions. So they looked even harder and found that

35.9 of the vaccinees had a history of cervicovaginal infection or STD vs. 32.1% in the placebo group.

In sum, they didn't "control" for anything; they looked hard and found nothing significant apart from the vaccine itself.

But of course, if in your learned opinion, these minute differences cancel out the 44.6% increased risk of precancerous lesions, I guess we antivaxers better defer.

But then you say "how about an potential 70% reduction in the risk of actual cervical cancer."

Well how about that word "potential"? Are you saying we are actually not sure if the vaccine will work in the long term?

By Undergrad-gal (not verified) on 14 Aug 2008 #permalink

Shit, this is what some of my fellow undergrads are these days?

I'd almost ask you to shoot me, Orac, except I have a future in actually furthering science and spreading good science and doing the right thing, as you are.

Look at study 015 where they used more balanced subgroups (controlled for) no increased risk. But then when they combined all of their subgroup analyses this supposed (not statistically significnat) increased risk of cervical cancer was gone.

Yeah it is potential. But I'm not about to wait around for 20 years to see if it works. You can.

Ozzy,

Yes, the other studies (conducted by Merck) had different outcomes. However, the reason suggested for the discrepancy
is purely speculative.

I think I would take my chances, stop smoking, try to boost my immunesystem and hope that would put me among the 90% who clear the infection without the help of Merck.

By Undergraduate-gal (not verified) on 14 Aug 2008 #permalink

Dawn: all those 'Special Ed teachers' you mention at that school; well, I'll give you a hint. If it says "IEP Aide" next to the name then that individual is not a teacher. How you link that to what you believe to be vaccine damage, I cannot imagine. All it says to me is that this school is doing a good job of a) providing quite intensive support to some presumably fairly severely disabled children and b) listing ALL of its staff, not just the qualified teachers. Most/many aides work part-time, some only a few hours a week, so one child with very high level support needs (eg profound physical impairment) could easily 'employ' three or four aides through the week on his/her own. Your 35 'teachers' might just account for comprehensive support for maybe a couple of dozen kids - hardly startling in a school of 450.

"What the maker of the product didn't tell you is that if you have been sexually active, exposed to one of the strains (there are over 100) you are then subsequently vaccinated against, you will INCREASE your risk of cervical cancer by roughly 48%."

Actually, I was told exactly that, which if it is true is a reason to do a blood test for evidence of HPV before giving children the shot. If my daughter was over the age of 12, I would certainly get them tested for HPV first and then consider the options with the doctor. I knew I was not sexually active and that my mother is negative for it, so even if there is maternal-child transmission, or diaper-changing transmission, there was no chance I was already infected. The nurse mentioned that there was some evidence to that extent to make sure I was truly making an informed decision, though I see that since then it was proven to have more to do with lifestyle factors like smoking.

"However, in this country alone - it strickly affected the military - military persons who were vaccinated for other diseases and then sent to live in crowded, impoverished conditions while preparing for battle."

Uh, so in other words, risk factors for Spanish flu are... living in crowded, impoverished conditions. Unvaccinated people in crowded, impoverished conditions and vaccinated people in crowded, impoverished conditions both died.

Dawn intoned "For this discussion - let's leave PubMed OUT OF IT."

Why? It is an index of medical journals from around the world, including some of questionable quality (like "Medical Hypothesis"). What makes it less desirable than the commercial sites you list?

Oh, and I would recommend the following two books on the 1918 influenza pandemic:
http://www.amazon.com/Flu-Story-Great-Influenza-Pandemic/dp/0743203984/
and
http://www.amazon.com/Great-Influenza-Deadliest-Plague-History/dp/B0007…

They should be available at your local library. Read carefully about the effort to get samples from graves in arctic areas. Those people were more than likely not vaccinated nor in the military. Also, pay close attention to the stories of the people in the first book, many were NOT in crowded impoverished conditions, like my step-mother's brother who was about five years old when he died(the second book is more scholarly, it has a good description of the development of medicine and medical education).

Rebecca you are a total idiot. I guess you have no clue how the public school system works.

Basiorana YOU are an even bigger idiot because if you knew anything about the Gardasil shot you would know that girls who had NEVER had sex before had reported contracting genital warts and vaginal legions. Oh, what am I thinking? Vaers is a joke? Never mind.

Yes, this "new" pandemic..will be affecting the morons such as yourself that eat GM foods, chemically alter their hormones by way of health & beauty products, take medications, drink flouridated water, and get VACCINATED for everything, etc, etc. etc.

Has anyone ever figured out why their grandmother/great grandmother is in BETTER shape than their own mother?? Shit, I see through the bullshit...do you?

Well, like I said earlier, if your vaccinated theory plays out...good for you. However, if I am right, My side will live through the pandemic. I guess we shall see.

Dawn: Oh no!! It is a (communist: big pharma: big government: alien: reptilian: illuminati) conspiracy to sap and impurificate all of our precious bodily fluids don't ya know.

Uh, so in other words, risk factors for Spanish flu are... living in crowded, impoverished conditions. Unvaccinated people in crowded, impoverished conditions and vaccinated people in crowded, impoverished conditions both died.

This is true, but Spanish flu was widespread enough that not just poor people died. One example is the mother of William Randolph Hearst, who was obviously quite well off. She died in 1919 of the flu. Dawn's point is actually wrong on many levels.

"Gardasil shot you would know that girls who had NEVER had sex before had reported contracting genital warts and vaginal legions."

And young girls would never lie to their parents about never having sex before. Especially, to parents who would consider it a serious sin.

"Has anyone ever figured out why their grandmother/great grandmother is in BETTER shape than their own mother??"

Actually, my mother is in better shape than my grandmother was at my mother's age. Seriously Dawn, do you think that the current generation (my children's generation) is exposed to greater levels of toxic chemicals than two generations ago (my parent's generation). You fail to realize the ubiquitous use of large quantities of pesticides, heavy metals, etc that occured during that generation.

"Basiorana YOU are an even bigger idiot because if you knew anything about the Gardasil shot you would know that girls who had NEVER had sex before had reported contracting genital warts and vaginal legions [sic]"

Yes. I mentioned in my post maternal-child and diaper-changing transmission. Not having sex doesn't mean you can't possibly have HPV< but not having sex and knowing your parents are both clear and your daycare providers always wore gloves when they changed your diapers is a pretty good indication.

"Has anyone ever figured out why their grandmother/great grandmother is in BETTER shape than their own mother?? "

Because my mother is depressed and obese, whereas my grandmother takes psychiatric medication when she needs it? My other grandmother is a bad comparison, though, she smoked and was riddled with tumors when she died. Ignoring the obesity, though, most of my friends' parents are healthier than their grandparents were at that age.

My side will live through the pandemic. I guess we shall see.

Holy fucking shit, that just went from amusingly brain-dead to full-on, dangerous batshit crazy.

Where, approximately, do you live Dawn? I inquire merely so I can stay the hell away from you.

My grandmother's first child died when an HiB infection (now vaccine preventable) caused her epiglottis to swell shut. Mary lived for three days. My grandmother was 21 or so at the time. Considering that she was upset about that until the day she died, I'd say I'm much better off. If I have children, chances are the same thing won't happen to them.

Natalie: the impression I get is that u-g gleefully throws around terms she's heard without really understanding them, its all very silly!

StuV: If you look at the hours Dawn posts and then look at a world map, I think its not that hard to guess where "she" is from (assuming "she" doesn't work night-shift). I say "she" as it strikes me that its usually guys who hit out for beers...

By Heraclides (not verified) on 15 Aug 2008 #permalink

affecting the morons such as yourself that eat GM foods, chemically alter their hormones by way of health & beauty products, take medications, drink flouridated water

Shorter Dawn:
Our precious bodily fluids!
POE - OPE - EOP!
Wing attack plan R!

Oh noes, Dawn has worked out Teh Truth!

[surreptitiously phones for the black helicopters]

Well, that's *my* evil conspiracy pay-cheque earnt for today.

Dawn said: "However, in this country alone - it strickly affected the military - military persons who were vaccinated for other diseases and then sent to live in crowded, impoverished conditions while preparing for battle.

You are absolutely WRONG (and so is whale.to which claims that the Spanish flu was caused by vaccines). The first reported outbreaks were in, Fort Riley Kansas and simultaneously in the borough of Queens, NY.

Deaths were - contrary to the usual pattern - mostly in the 20 to 40 age group, but they were not confined to adult male members of the military. Women died, farm hands died, railroad workers died.

By Tsu Dho Nimh (not verified) on 16 Aug 2008 #permalink

Alternative history goes along with alternative medicine - If the actual historical events don't support their wacky hypothesis they make something up that does. I am convinced they live in an alternative reality.

By Militant Agnostic (not verified) on 16 Aug 2008 #permalink

Dawn ... here's a job description for an IEP AIDE.

Our nonpublic level 5 school needs IEP Aides to work with severely emotionally disabled or autistic students. This person will serve, on an individualized basis and with a specific student, as an aide to the classroom teacher in assisting with academic instruction and in managing behaviors.

Requirements: AA degree preferred, High School diploma or equivalent required. Experience working with severely emotionally disturbed students and with crisis intervention highly preferred.

By Tsu Dho Nimh (not verified) on 16 Aug 2008 #permalink

By God how are many people so damned CERTAIN that there was a flu pandemic in 1919 caused by a flu virus?

Many of us morons are wondering how the virus was even seen under the electron microscope before it was invented.

For the PCR is everything crowd, it is now well established that "viral genomes", or 200-600 bp fragments of viral genomes, may not be specific to viruses at all, al all.

These PCR tests are never checked against "authentic virions" and thus could be measuring DNA originating within eukaryotic or prokaryotic cells based on the well documented "promiscuity" or habits-of-gene-swapping possessed by these little critters.

By Dr Von Frankenmundt (not verified) on 16 Aug 2008 #permalink

BTW, in case I've missed it since the last time, can any of you Guardisil cheerleaders direct me to the paper that tells us about the HPV strains and how many encode their very own polymerase? You know, the way a real virus like smallpox does.

By Dr Von Frankenmundt (not verified) on 16 Aug 2008 #permalink

"Dawn said: 'What do you think is in that vial? A cultered STD!'

"Sorry Dawn, that comment has disqualified you from participating in any further discussions, though the words uncultured STD keep floating through my mind."

And this little gem from notmercury is simply irresistible. I mean duuuhhh, if a virus is said to be an STD, say a herpes family member, and it can be cultured, than what do we wind up with class?

Pssstt a hint - float some other things through your mind: remember the gene swapping and recombination parts in your virology textbooks ... what are the possibilities of all these viral fragments from so many vaccinations in a living organism ... for God's sake - THINK!

By Dr Von Frankenmundt (not verified) on 16 Aug 2008 #permalink

"You are absolutely WRONG (and so is whale.to which claims that the Spanish flu was caused by vaccines). The first reported outbreaks were in, Fort Riley Kansas and simultaneously in the borough of Queens, NY.'

"Deaths were - contrary to the usual pattern - mostly in the 20 to 40 age group, but they were not confined to adult male members of the military. Women died, farm hands died, railroad workers died."

Tsu, perhaps you've heard of Gulf War Syndrome and the reports of contagions associated with the veterans' illnesses. There is strong evidence for this "syndrome" to be recognized as a complex (meaning cases, not all, where contagious agents are produced*) of "environmental" diseases meaning not a single cause other than war itself.

The question that begs itself: can such a set of phenomena that has been far better scrutinized than the diseases from World War I be ruled out for the case of 1919 Spanish Flu?

*of course there are many who believe in a "special creation" of viruses, thus an endogenous origin becomes "unthinkable".

By Dr Von Frankenmundt (not verified) on 16 Aug 2008 #permalink

Dr. VF said "By God how are many people so damned CERTAIN that there was a flu pandemic in 1919 caused by a flu virus?

Many of us morons are wondering how the virus was even seen under the electron microscope before it was invented."

Perhaps you should read a couple of books ("Flu" by Gina Kolata and "Influenza" by John Barry... the latter has some detail about the history of medicine in that era), because viable material from arctic graves of victims were recovered and analyzed. Here is an article on it:
http://findarticles.com/p/articles/mi_m1571/is_3_15/ai_53677543 ...and one paper on the subject (munged URL):
cdc.gov/ncidod/EID/vol12no01/05-0979.htm

And what is interesting is that people who survived the 1918 influenza pandemic are still producing antibodies:
http://www.reuters.com/article/healthNews/idUSN1647217720080817

Dr Von Frankenmundt:

"And this little gem from notmercury is simply irresistible. I mean duuuhhh, if a virus is said to be an STD, say a herpes family member, and it can be cultured, than what do we wind up with class?"

So you agree with Dawn that the vaccine contains a "cultured STD"?

By notmercury (not verified) on 17 Aug 2008 #permalink

Has anyone ever figured out why their grandmother/great grandmother is in BETTER shape than their own mother?? Shit, I see through the bullshit...do you?

They're not. They're all dead, while my mother is alive, and her current occupations include mountain biking.

Though my whole family medical history is complicated by my grandfathers both being heavy smokers.

HCN ... Great link.

I would have missed that about the antibodies.

By Tsu Dho Nimh (not verified) on 18 Aug 2008 #permalink