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Next entry: Dobson’s crew prays for rain on Obama’s acceptance speech Previous entry: Always Striving, Improving

What’s worse: A two second shot or cervical cancer?

I hope this doesn’t come across too harshly, because I usually like Catherine Price’s blogging, but this blog post is irresponsible.  She buries the most important detail, perhaps for dramatic effect or perhaps because she didn’t realize how important it was.  The teaser on the front page of Salon says, “Do we need to guard against Gardasil? The controversial cervical cancer vaccine may carry serious health risks”.  That when I began to get that sinking feeling, because I’ve been carefully following how the right wing noise machine is trying to discourage people from getting their daughters vaccinated—-because sex should have “consequences” for women, even if the consequence is death—-and I was afraid that Catherine got snagged by right wing propaganda.  In fact, I have a segment for next Monday’s podcast (this week’s: is sex without condoms always a bad thing?) chronicling the success of getting the message out there to parents to refrain from protecting their daughters from HPV.


Sadly, I was somewhat right.  Catherine quotes far-right wing anti-woman group Judicial Watch* on the “dangers” of the HPV vaccine, and doesn’t note that they’re a far right anti-woman group until the end.  Nope, in the beginning of the post, she describes them as a public-interest group.  The only “public” whose interests they care about are virulent misogynists.  Believe you and me, in the crazy woman-hating arena, making sure that women still get cervical cancer for generations to come has become a big deal.  I searched YouTube for “gardasil”, and all but one of the front page videos were ye ol’ angry white men screaming out conspiracy theories about it.  If you’re up on the right wing code language, you should immediately realize that “Judicial Watch” is feeding the right wing belief that the courts need to be dismantled because liberal activist justices have this crazy idea that women and non-white people are citizens worthy of equal protection under the law. 

But Amanda, you might say, not every right winger who indulges in conspiracy theories about birth control and vaccinations against STDs actually wants to see women die terrible deaths from botched abortions and cervical cancer.  Agreed.  Some of them justify their misogyny with a thick coat of paternalism and the belief that female property is precious.  And they see contraception and STD protection as a plot by feminists to transfer the ownership of female bodies from fathers and husbands to the women themselves.  Actually, they’re not entirely wrong there.  But where we disagree is that they think women are so bone stupid that they simply can’t be trusted with the ownership of female bodies, and that the threat of STDs and unintended pregnancy is a critical part in keeping female property on the farm, where it can be safe.  This belief doesn’t even make sense in reference to HPV, which you’ll probably get even if you only sleep with one man your entire life. 

Judicial Watch isn’t remotely concerned about the potential of girls falling ill.  They aren’t mining the other reports that VAERS puts out, because then they’d discover that there’s a history of VAERS collecting data just like the reported adverse effects of Gardasil, which is to say a bunch of anecdotal cases that are evidence mostly of patients casting around for an explanation for an unexplained illness and latching onto the vaccine.  If they hadn’t gotten the vaccine, they might be blaming it on lack of sleep.  In some more serious cases, people have a collection of symptoms that are debilitating but have been around without explanation for a long time, like chronic fatigue syndrome.  There’s barely a correlation, much less causation.  The CDC has examined VAERS data, and you can read the results here. Catherine quotes the alarming number of over 9,000 adverse reactions reported.  And that does sound scary, coming from someone trying to scare you, like Judicial Watch is.  However, only 6,667 were in the U.S. out of 16 million shots.  That’s a complaint rate of 1 complaint in 2,400 cases.  Oh, and it’s not even as bad as that sounds:

VAERS received 9,749 reports after Gardasil vaccination (6,667 were U.S. reports, 3,082 were foreign reports). Among the U.S. reports, more than 94% were reported as non-serious adverse events such as brief soreness at the injection site and headache. Less than 6% were reports of serious adverse events, about half of the average for vaccines overall.

Emphasis mine.  Even if the number of adverse effects was 10 times the complaints, that means that we’re looking at 62,500-ish sore arms, which can be survived better than perhaps even your first Pap smear, and a scattershot of various different diseases that are best described as anecdotal evidence.  Someone’s** lying, and they’re lying because they want you daughter to be vulnerable to HPV, because who wants to live in a world where you can be a dirty slut without the fear of dying?*** 

I’ll be honest—-I actually expected the complaint rate attached to a diverse array of symptoms with no known cause to be much worse.  I remember being a teenage girl in the very-virginal years that you’re supposed to be giving your daughter this shot.  And I had more than one episode of feeling physically ill thinking about the future that lay ahead for the mysterious below the belt region.  And I don’t mean a little, but more like hearing about a friend going to get a pelvic exam made me dizzy, or hearing a doctor describe how they put in Norplant made me want to lay down for awhile.  I was skeptical that the vagina really was as big a hole as claimed, and the sheer amount of things that are supposed to go in and out of it—-penises, speculums, even tampons, and certainly babies—-made me nauseous.  I’m squeamish, of course, and then you have the medicalization of women’s anatomy that makes the routine aspects of vaginal interaction seem like medical procedures.  Obviously, I got over that, but to this day I can’t watch someone draw my own blood without wanting to barf.  I suspect that I’m not a complete weirdo, and a lot of girls have anxiety about sexual stuff that gets mixed in with squeamishness.  To make it worse, I’m sure a lot of parents have the exact same feelings when contemplating their own daughter’s sexuality.  So the psychological groundwork is laid to interpret every episode of poor health in the months after the HPV vaccine.  I’m somewhat surprised that the number of complaints blaming everything from autoimmune disorders to chronic fatigue on this shot haven’t been higher. 

Meanwhile, there’s 10,000 cases of cervical cancer every year in the United States, and it claims 3,700 lives every year.  But of course, the dead are not darling teenage virgins, and so don’t get the hysterical media attention that the sore arms out there do.

*If you want to see how far right and obsessively misogynist they are, check out their issues page.  Seven projects, and one of them is just obsessively following around the woman who symbolizes, to the hard right, everything that’s gone wrong with this country since they untied women from the stove: Hillary Clinton.  So we already have one name on the list of people they’d like to see die of cervical cancer.
**Judicial Watch.
***I do.  Who’s with me?

 

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Posted by Amanda Marcotte on 01:32 PM • (68) Comments

To be fair, the antivax crowd in general comes just as much from the left as the right, and is just as irresponsible. That said, the specifically anti-HPV-vaccine people are transparent in their woman-hating.

Comment #1: Ginger Yellow  on  08/12  at  01:42 PM

So, why didn’t you comment there??

Comment #2: Eric, Rejector of Memes  on  08/12  at  01:50 PM

Listen, if you give a girl a Gardasil shot to a pre-teen girl, she will immediate run out into the street, tackle the first appropriately aged man she can find, and have sex with him BEFORE SHE GETS MARRIED.  Once she gets pregnant, she’ll run off and get an abortion inside six months.  Cervical Cancer takes years to kill you.  If anything, these Gardasil shots will be killing more people than they save.

My logic is infallible.  That’s why I’m voting for Mr. Buffalo Chip in 2008.

Comment #3: Zifnab25  on  08/12  at  02:05 PM

Catherine quotes far-right wing anti-woman group Judicial Watch* on the “dangers” of the HPV vaccine, and doesn’t note that they’re a far right anti-woman group until the end.

The first red flag, for me, is that even if Judicial Watch weren’t a far right antifeminist group, if you wanted to show a credible link to real research that actually shows that Gardasil might be dangerous, you might want to cite, oh, I dunno, some doctors or scientists or something? 

That’s getting to be the first thing I watch for in these sorts of articles, or really any sort of article that is trying to convince me of some sort of controversial fact.  Who, exactly, are they getting their quotes from?  If it’s medical, I want the AMA, the CDC, an article published in The Lancet, one of the more well known groups of specialists, or maybe some very well respected researcher in the relevant field (and I want a major university or research hospital after her name, Johns Hopkins or Columbia Presbyterian, not South Bumfuck U). 

I also like to watch the commentators on political “round table” shows and count how many come from conservative think tanks and/or small universities know only for their right-wing politics (it’s amazing how many talking heads come from Pepperdine and George Mason, considering how totally NOT influential those schools are in any capacity other than as right-wing recruiting centers).

Comment #4: The Opoponax  on  08/12  at  02:09 PM

Ha.  I got the third shot this morning.  Totally with you in getting it on without dying.  Well, not with you, but you know what I mean.  Also with you on the inability to watch someone take my blood.  Gotta look the other way.

Comment #5: rowmyboat  on  08/12  at  02:13 PM

To be fair, the antivax crowd in general comes just as much from the left as the right, and is just as irresponsible.

Yeah, and they may piss me off even more when they come from the left, because they’re giving us a bad name.

Comment #6: Amanda Marcotte  on  08/12  at  02:21 PM

Oh, and yes, Amanda, I was similarly squeamish about the obsessive medicalization and general big scary complexity that came hand in hand with owning a post-pubescent vulva.  Vestiges of this hung on until my early 20’s when I finally got my hands on a copy of Our Bodies Ourselves and started reading (outside that source) about the Women’s Health Movement of the 70’s. 

Which is generally painted as woo-filled and wishy-washy, but the idea that you didn’t have to hold a medical degree to look at what was going on “down there” was a huge load off.  I was like, “wait, this group of women invented a machine to perform abortions which was made out of, like a mason jar?  and they operated it without a single complication despite not being doctors?  for years?” 

*BOOM* (That was the sound of my 22 year old head fully exploding.)

Comment #7: The Opoponax  on  08/12  at  02:34 PM

I also like to watch the commentators on political “round table” shows and count how many come from conservative think tanks and/or small universities know only for their right-wing politics (it’s amazing how many talking heads come from Pepperdine and George Mason, considering how totally NOT influential those schools are in any capacity other than as right-wing recruiting centers).

PBS and NPR really are our last decent bastions of journalism in this country, and yet they repeatedly floor me when they insist on bringing out the AEI and Brookings Institute hacks to - time and again - peddle their “moderate” flavor of snake oil.

I’m amazed that some of these right-wing schools even manage to stay accredited.  What on God’s Earth do they even teach at those diploma mills?

Comment #8: Zifnab25  on  08/12  at  02:41 PM

Okay, I realize advertising is not put in place by the Pandagon crew, but the ad right below this post on the main page was “stop abortion on demand, 158 babies die every hour” and something about the disappearing unborn.

Comment #9: ohsohappy  on  08/12  at  02:43 PM

Hmmm good thesis, this may come as a shock from the “Right Wing” but we aren’t all just some monolithic block. I am really frustrated with the weirdness surrounding what should be a standard vaccine. I have a daughter and she’s grown but I think she absolutely should get this vaccine, why wouldn’t you.

I also normaly don’t think of Judicial Watch as right wing, I like some of their work but if they are against this vaccine that’s just weird and they need to re-think that.

I know that dust ups like this make for good blogs but I don’t think the opposition to this vaccine is very strong, carzy yes but not very strong. It’s like being against an AIDS or Polio vaccine. We aren’t in Nigeria you know. We do tolerate dissenting opinions as a nation but this is public health. What I think would be more effective for you Amanda is to feature (if you can find them out there) the sexual antics of some of the people opposing the vaccine.

I generally vote center right but I am not a straight ticket voter and I do not much appreciate as the father of a daughter that any politician would try to legislate morality and put her at risk for a few votes. When they do that they deserve to be outed like Larry Craig (endlessly pursuing Clinton), or Johnny “Haircut” Edwards (who bankrupted 100’s of OBGYNs and tried to legislate a series of “moral” initiatives). Respectfully to you on his campaign you wouldn’t have known this and trusted him like a lot of peopel. I may be a babe in the woods but I expect them to be able to drop their political willies long enough to at least not make things worse.

At the end of the day I think just calling the offices, emailing and blogging against specific opponents of this vaccine will be effective. Right now the false moral crusaders are in a rout and are afraid. Their standard bearers of moral purity: Eliot Spitzer, Larry Craig, John Edwards and a number of Senatorial spouses (tawdry indeed) and a smattering of Congressmen are all being caught this year with their pants down around their ankles and that’s great news for public health. It means to me that nobody wants to take a chance in a climate like this. I mean who was that bigshot preacher who just got nailed for getting happy ending massages with his gay lover. Hahahaha!

JUst keep up the good work on this vaccine message here, you are doing a great public service! If you could give folks links or some sort of directions, or phone numbers for their representatives that would be cool too.

Good luck on this effort.

Comment #10: SPQR_US  on  08/12  at  02:57 PM

I recently had a long talk with my newly-pregnant primary partner about vaccinations.  She was largely unfamiliar with the vaccination-related concerns on the left (concerns ranging from legitimate caution to crazy conspiracy theories), and I tried hard to be fair to the people who are worried about vaccination while presenting my feelings, that vaccinations and herd immunity basically rock.

Comment #11: NBarnes  on  08/12  at  02:57 PM

I am “too old” to get the Gardasil (33) but if I could I would. :( Sadly I’m probably going to die a slut. wink

That said- many many many serious adverse event (SAE) & investigational new drug (IND) reports cannot be linked to any ONE drug that a patient has been taking or a syndrome they have.

Take it from me- I see hundreds of them every framdamn day- and I’ve seeen hundreds for (an) HPV vaccine.

Comment #12: Danica Lefse Queen  on  08/12  at  03:00 PM

Oh, the funny thing is that it’s not the hacks from Bob Jones and Liberty you have to watch out for on these shows (though I guess they probably show up on Fox News or even the other major cable news outlets—I’m talking mainly about PBS and the network Sunday Morning political shows).  It’s people from perfectly accredited schools that are simply only known for being right-wing affiliated. 

George Mason is a legitimate school, in fact the main reason this sort of thing first caught my eye is that my alma mater has reputation as left-aligned, and a similar level of national name recognition (and probably a similar level of academic rigor), but you will NEVER see an academic out of my school on a political roundtable show. 

Though one of my archaeology professors is apparently the world’s foremost expert on what the Vikings ate, so you will sometimes see him on the Discovery channel.  He’s not a leftist, though, I don’t think.

Comment #13: The Opoponax  on  08/12  at  03:02 PM

I have a daughter and she’s grown but I think she absolutely should get this vaccine, why wouldn’t you.

My doctor specifically recommended I not get it, as it’s not covered by my insurance and as a long-sexually-active woman in her late 20’s I’m in all likelihood already carrying a few strands of HPV.  She saw it as an expensive waste of my time, basically, and recommended that I have safe sex and continue my virtually free course of annual well woman exams w/ pap smear. 

It’s meant for young teens who are not yet sexually active.  Because 60% of sexually active adults already have the disease it prevents, there’s not much point in getting it after you’ve had multiple sexual partners.  It’s kind of like going to the doctor for a flu shot because you feel achy and nauseous. 

So, um, not to burst your bubble, but that’s why your grown daughter hasn’t dashed out and gotten vaccinated.

Comment #14: The Opoponax  on  08/12  at  03:08 PM

Not to worry opoponax you didn’t burst my bubble. I didn’t say she didn’t get it and she doesn’t currently have HPV. I should have done a better job with that paragraph. As you point out clearly there are several strains and I should have been more detailed.

I think your reasoned argument is what I would prefer to see as part of the national dialogue on this vaccine not the moral tempest on either side. This is how things used to work in this country with vaccines. Now it is a different world.

Oh well to hell with them all, I’ll just do whatever I want anyway. ;^)

Comment #15: SPQR_US  on  08/12  at  03:19 PM

Well, I can’t wholly* participate but

***I do.  Who’s with me?

but count me in , anyhow.
[Nice post…funny to see Salon get snookere’d, but then.. there IS Paglia.]
*italics, forsworn

Comment #16: has_te  on  08/12  at  03:25 PM

“my newly-pregnant primary partner”

Hey now, stop getting all lovey-dovey.

Comment #17: Dr T  on  08/12  at  03:29 PM

she doesn’t currently have HPV.

Unless she is 14 or a nun, that’s incredibly unlikely.  Seriously.  My doctor, who is BTW an officially recognized OB/GYN, medical school graduate and everything, was pretty much like, “you’re sexually active, you probably already have HPV.” 

AFAIK it’s rare to actually be officially tested - a pap smear is usually the de facto “test”, but you can have HPV and never have an abnormal pap smear.  In fact a minority of carriers ever have symptoms, and a very small minority of those people ever actually develop cervical cancer.

Comment #18: The Opoponax  on  08/12  at  03:30 PM

“my newly-pregnant primary partner”

Hey now, stop getting all lovey-dovey.

Seemed fairly obvious to me that the poster was describing a polyamorous arrangement. If so, odds are the person is more than a “girlfriend” but probably not legally a “wife.” Is there a better cutesy-ootsy term the poster should’ve used for “newly pregnant”? Perhaps “Woman Who Carries My Fresh Man Seed”?

Most people I know prefer the term “partner” anyhow. I know when my fella calls me his “partner” I get gooey inside. Whereas “girlfriend” or “wife” make me kind of ill.

Comment #19: Well, what?  on  08/12  at  03:51 PM

People with some types of abnormal Pap (ASCUS = Atypical Squamous Cells of Unknown Significance) often get tested for type of HPV carried. “High risk” type HPV carriers get monitored more aggressively than “low risk” type carriers. (Risk is for developing invasive cancer).

Comment #20: NancyP  on  08/12  at  03:57 PM

Though one of my archaeology professors is apparently the world’s foremost expert on what the Vikings ate

This is why I love academia.

Comment #21: Loneoak  on  08/12  at  04:04 PM

I am all for vaccines that have been tested thoroughly and endured over time, and I am all for parents carefully weighing the benefits (which are many) against potential risks. I do have a problem though with the mindset that says if the FDA has approved it, it must be perfectly safe and therefore we should mandate it for all teen girls everywhere. Merck and the multiple lawsuits they had over Vioxx should tell us that all drug companies (just like all other companies) are amoral, care only about profit, and do the minimum amount of testing to get approval lest adverse effects arise in a pattern and hurt their profit. Maybe Gardasil will never be exposed like vioxx and it really is a wonder drug, but until there has been serious, large scale study about potential short and long term side effects any attempt to mandate its use moves girls from being potential cervical cancer victims to state mandated lab rats.

Comment #22: Robin Rhea  on  08/12  at  04:06 PM

For the record, my daughter is under one and if by the time she hits puberty Gardasil has been proven safe in the long run you can bet your ass she will get it, I’m just not convinced it is safe yet, so the real burden is on parents of current teenagers about whether or not to vaccinate their daughter given the lack of proof that it is either safe or unsafe in the long run.

Comment #23: Robin Rhea  on  08/12  at  04:11 PM

Yes, Nancy, but by the time you’re given that test, it’s already apparent that you do, in fact, have some strain of HPV.  Very few people are tested for HPV before showing any symptoms that they already carry it.  Unless SPQR_US’s daughter was involved in an HPV related study (where one assumes that, regardless of symptoms, one would need to know which subjects had HPV and which did not), it’s unlikely that she can know for sure that she does not have it.  Considering that a large majority of sexually active adults carry HPV, if she is sexually active, she probably has it.  That seemed to be the assumption of my (very talented, I might add) GYN*, anyway.

Thus my telling him that the reason his daughter hasn’t got the vaccine is that she’s already sexually active is probably bursting his bubble. 

* Though on the other hand the tinfoil hat prone part of me wonders if GYNs just don’t want to lose the annual pap smear business.  But that part of me is very, very small.  And either way, once the next generation of girls is vaccinated, the pap smear business is going to go down inevitably—eliminating a few twentysomethings is not really a long-range moneymaker for them.

Comment #24: The Opoponax  on  08/12  at  04:12 PM

Robin, please do remember that, in order to have access to Gardasil, one must consult with a physician.  A physician whose job it is to figure out whether X treatment is the right option for you (or your kid).  Considering the concept of herd immunity and the fact that vaccines tend to be a pretty permanent therapy (and often used on the very young), it is usually necessary to do a wide level of testing as to their safety in the long run across vast masses of the population. 

Unlike Vioxx, which was a chronic pain treatment taken orally. 

I think you can probably assume, if you have good access to medical care and generally trust your doctor, that if your pediatrician recommends that your daughter have Gardasil, that it’s perfectly safe and the right thing to do.

Comment #25: The Opoponax  on  08/12  at  04:19 PM

???  They’ll be a lot MORE certain it’s “perfectly safe” in ten years.  Give the kid a break.

(And it’s not PERFECTLY safe: it’s STATISTICALLY safe.)

Comment #26: Eric, Rejector of Memes  on  08/12  at  04:39 PM

Opoponax,

I appreciate your response and respectful tone, but I think the FDA testing and consequent revisions are lacking still. Vioxx passed all of its clinical trials, but when you move from clinical trials of 1,000-2,000 participants to patient populations in the millions side effects become much more apparent. Gardasil was only tested on around 4,000 individuals prior to approval and less than 1,200 under the age of 16.

When it was approved the only serious adverse reactions listed were headache, gastroenteritis, appendicitis, and pelvic inflammatory disease. In the short time it has been on the market they have had to add joint and muscle pain, fatigue, physical weakness and general malaise to the list of potential side effects because like I said, they become much more apparent when the list of people affected jumps from 4,000 to several million.

I still do not think that all or any of those conditions is a good reason to withhold the vaccine, but I think there is a possibility that more serious side effects will arise (become evident) as the vaccine use expands. If nothing more serious arises, I am in favor of making it part of the standard vaccination schedule. Until that point, I think mandating its use really is just making people part of an extended clinical trial.

I hope no more adverse reactions arise and I can give it to my daughter, I just don’t think we are at the point yet. As to the part about trusting doctors, I do for the most part and think they always have mine and my family’s best interest at heart, but I am not convinced that they always have the time to thoroughly study every pharmaceutical that comes down the pipe, consequently most of the information they have has been given to them by drug reps who may not exactly be enthusiastic to highlight all potential complications.

Comment #27: Robin Rhea  on  08/12  at  04:41 PM

Somehow I made it to my 30s as a sexually active adult and still have not gotten HPV. How do I know? I guess I lucked out there too because my GYN routinely tests for HPV as part of the annual exam. Of course, he may only be testing for the cancer-causing strains…but I’m a bit peeved I’ve aged out of the vaccine.

This is all to say that while it is not likely to reach my age and not have HPV, it isn’t impossible. Still, I’m thinking SPQR_US is talking out his ass when it comes to his daughter’s HPV status.  Assuming she has been tested for it (which is unlikely), why would she share that information with her dad? I have a very open relationship with my dad, but pap results and such are not the topic of discussion. Ever.

Comment #28: history_mom  on  08/12  at  04:45 PM

I think the FDA testing and consequent revisions are lacking still. Vioxx passed all of its clinical trials, but when you move from clinical trials of 1,000-2,000 participants to patient populations in the millions side effects become much more apparent. Gardasil was only tested on around 4,000 individuals prior to approval and less than 1,200 under the age of 16.

Are you an MD?

Yeah, I didn’t think so.

Also, seriously.  Vioxx was NOT a vaccine.  Getting a prescription-only pill used by a rather small minority of adults (and probably never by children who aren’t terminally ill anyway) on the market is a very different thing than getting a general-use vaccine on the market. 

I don’t blindly trust the FDA, and there are plenty of well known cases of a widely touted drug being pulled, but the likelihood that a vaccine meant for children would be so under-tested that your average lay-person would immediately see the danger is, ummm, unlikely, to put it politely.  Not to mention, what Eric said.  Your daughter won’t be remotely eligible for another decade.  There’s no real reason to get your panties in a twist about this*. 

*Which is one of the reasons all this anti-vac stuff gets to me.  It’s just something else for perfectly ordinary parents of perfectly ordinary children to get their knickers in a bunch over, generally without any good reason.  There is no reason you need to freak out ten years in advance over something like this.

Comment #29: The Opoponax  on  08/12  at  04:51 PM

Hopefully the last post, if you go to the link below you will see that 31 drugs have received FDA approval and then been withdrawn because they were proven dangerous once they went from clinical trials to use by patients. The average amount of time it took for these drugs to get taken off the market was 5.6 years, so once Gardasil makes it 5 or 6 more years I think we will be in the clear to add it to the standard vaccination schedule. 

http://www.consumerjusticegroup.com/drugrecall/drugrecalls.html

Comment #30: Robin Rhea  on  08/12  at  04:54 PM

Opoponax,

I’m not really trying to freak out over something that is ten years away, the thing that gets me is the push to mandate its use (Texas tried to last year). Knowing how 4,000 girls and women have reacted to it is much different than predicting how 50,000,000 girls will. No, I’m not an MD, but I’ve done enough work in statistics to make me skeptical of governmental approvals.

Comment #31: Robin Rhea  on  08/12  at  04:58 PM

The issue in Vioxx wasn’t whether it was “undertested”, but whether Merck deliberately misled the FDA and the public about adverse risks. Believe me, this is not a startling aberration in the world of Big Pharma.

Comment #32: mythago  on  08/12  at  05:01 PM

You know what else I don’t understand about the vaccine, and specifically Gardasil, nonsense?

OK, you go to your doctor for X complaint.  Your doctor says, “Oh, hey, let me prescribe you this lovely drug for that!”  You take the prescription to a pharmacy, they fill it, you take the drug, and more likely than not you get better (or at least, the drug in question does what it was supposed to do and doesn’t cause significant side effects). 

Most people don’t really question this process that intimately, and especially don’t do outside research on Every Little Thing their doctor prescribes, because well, you just know doctors don’t know shit about all these drugs and get most of their info from drug reps who are interested in hiding the bad parts…  Most people don’t leave their doctor’s office thinking, “OK, this prescription for Valtrex?  Bull shit!  I better go home and check out all the research on this stuff before I go fill it…”  In fact, if my father the pediatrician is to be believed, lots of people come into the office with heads full of ideas about all the totally awesome drugs he needs to prescribe their kid, or else he’s not doing his job as their pediatrician. 

Why is this process suddenly turned upside down when it comes to Gardasil?  Why do people feel like doctors aren’t to be trusted, are routinely misinformed, or are worse, are deliberately misleading their patients about this one particular drug?  When in all likelihood the same doctor could give them a prescription for crack (avec fancy name, of course) and they’d gobble it up like manna from heaven?

Comment #33: The Opoponax  on  08/12  at  05:03 PM

I’m thinking of asking for it for my sons, who could carry HPV as much as any woman.  HPV can adversely affect men as well as women, especially if the men aren’t circumcised (note: only mentioned because I enjoy being accused of making things “all about the menz” and because penile cancer really exists.)  Plus, why should only half the population fight a problematic virus?  Wouldn’t it be better if everyone did this?  If stopping a virus from flourishing on a cervix is a good thing, then it’s a good thing to keep it from flourishing on a glans or foreskin, right?  Especially when one considers the likelihood that they may come in to contact with each other or a mouth at some indeterminate time and duration.

I have no idea what their pediatrician would say, but with the oldest turning 10, it’s about time to at least look into this aspect of the sexual health of my sons.  On the other hand, I bet health insurance would only cover this for girls.  Time to do some research.

Comment #34: jon  on  08/12  at  05:17 PM

From what I understand, health insurance by and large doesn’t cover it at all.

Which is probably the main obstacle to things like Texas’s initiative to make it mandatory in schools.  The only vaccines that are mandatory are the ones they dole out for free, whether you have health insurance or not.

Comment #35: The Opoponax  on  08/12  at  05:20 PM

Are you an MD?

Yeah, I didn’t think so.

Uh, are YOU?

What the hell… like you said yourself, this question doesn’t concern her for another ten years at least; and the only person with any twisted knickers that I can see is Opo.

Comment #36: Well, what?  on  08/12  at  05:44 PM

Sorry, I don’t feed trolls.

Oh, OK, just this once…

I’m not an MD, but then my stance on Gardasil (and on most other vaccines and prescription-administered medications) is that the best course of action is probably to consult a doctor you trust, when the time comes, rather than getting whipped up about the possibility that a vaccine recommended for teenagers might be unsafe for your infant, who won’t be eligible until long after it has been proven safe (which it probably already is, otherwise it wouldn’t be widely available to the general public). 

The controversial nature of Gardasil means that it’s unlikely that pediatricians and OBGYNs are not aware of it, the recommendations, the kinds of research done, the possible side effects, the chances that it’s unsafe, the circumstances under which it was approved, and the like.  It’s not just some random drug your doctor is unlikely to have the straight dope on (and if your doctor is anything more than a quack, she probably doesn’t go around prescribing drugs she doesn’t know anything about, anyway).  Knowing about this stuff is part of a doctor’s job.  It’s why the whole institution of prescriptions exists in the US in the first place.

My panties are not in a twist, at all.

Comment #37: The Opoponax  on  08/12  at  05:55 PM

I know some women who were reluctant about getting their daughters the vaccine because their daughters weren’t sexually active yet, and wouldn’t be for some time. All I could think of was how many of my friends were raped and/or sexually assaulted, and the subset of them for whom that was their first experience.

Comment #38: maurinsky  on  08/12  at  05:59 PM

“I have no idea what their pediatrician would say, but with the oldest turning 10, it’s about time to at least look into this aspect of the sexual health of my sons.  On the other hand, I bet health insurance would only cover this for girls.  Time to do some research.”

It depends on the pediatrician.  There have been a few pieces on parents who want to vaccinate their boys are well are their girls.  It seems some pediatricians are all for it on the grounds that treating genital warts isn’t exactly a walk in the park for the patient, it will prevent the boys from acting as reservoirs for a potentially devastating virus, that if early research is any indication, HPV-related oral cancers are equal-opportunity offenders, or any combination thereof.  Other pediatricians are adamantly opposed because they’d be treating a patient for someone else’s benefit, or the FDA hasn’t approved it yet, or they don’t see genital warts as a big enough deal to recommend vaccinating against.  As far as health insurance goes, it probably won’t be covered for boys until the FDA approves it for use in boys, but it’s hardly a given that it will be covered for girls since most states don’t require it; whether that will have changed by the time it’s approved for boys is kind of up in the air.

Personally, if I had sons, I’d get them vaccinated for it for their own sakes.  The fact that they wouldn’t be passing a cancer-linked strain of HPV to any future partners would just be a bonus.

Comment #39: preying mantis  on  08/12  at  06:21 PM

Okay, I realize advertising is not put in place by the Pandagon crew, but the ad right below this post on the main page was “stop abortion on demand, 158 babies die every hour” and something about the disappearing unborn.

That’s a good thing! You should click on the link too!  Let them waste their money advertising here.

As to the topic, we got the vaccine for my daughter.  Our health insurance paid for it.  I couldn’t think of a reason not to get it.

And even if I was some kind of anti-sex right-winger, would I really want my daughter to die because she made a “mistake”?

Comment #40: Tom  on  08/12  at  06:39 PM

Even if you don’t frame it as “a mistake” (I certainly don’t think any of my sexual relationships were mistakes, OK, well there were one or two but mainly not), the bottom line is why suffer needlessly from a disease which can be easily prevented? 

Nobody got all pearl clutchy about the polio vaccine, thinking, “well how will I keep little Jimmy from going to that dirty public pool now?  We’ve got to stop this Salk thing!  Think of all the drowning, stomach cramps, swimmer’s ear, and urine exposure polio prevents every year!”

Comment #41: The Opoponax  on  08/12  at  06:57 PM

I like that I’m a troll simply because I thought your response to her was beyond the pale of unnecessarily condescending.

(and if your doctor is anything more than a quack, she probably doesn’t go around prescribing drugs she doesn’t know anything about, anyway).

you seem to think that quacks are somehow in the minority. and yet look at who we elected President…

I had to educate my doctor on four—FOUR—different drugs he’d prescribed for me. Yeah, he was a quack, and also the only doc my insurance covered within 20 miles. I got rid of him when I could afford it. It took awhile.

I followed the Journalist’s Code: if your mother says she loves you, Check it out. I did my homework on everything he told me, and yeah. He was often right, but those four times (and one could have had life-threatening consequences) he was wrong. He was either too busy or too dumb (someone has to barely scrape by in med school, right?) to fully read through my medical history and see where those medications would have had negative interactions.

I don’t think he’s a bad dude. But doctors are human, and it never hurts to approach other humans with an idea of Trust, but Verify.

Comment #42: Well, what?  on  08/12  at  06:58 PM

you seem to think that quacks are somehow in the minority. and yet look at who we elected President…

Funny, I didn’t think that Bush held an MD?

I had to educate my doctor on four—FOUR—different drugs he’d prescribed for me. Yeah, he was a quack, and also the only doc my insurance covered within 20 miles. I got rid of him when I could afford it. It took awhile.

Well, OK, that’s what I meant when I referred to “a doctor you trust”.  If you don’t trust your doctor to prescribe you things or give you medical advice, then of course you should make the call for yourself in the best way you can.  But if you’d trust your doctor in general, and don’t generally question their advice, then if your doctor tells you Gardasil is safe and recommended in your case, there is no real reason to be suspicious. 

This is not really that hard.

Comment #43: The Opoponax  on  08/12  at  07:07 PM

I don’t think “quack” is a term restricted solely to those with MDs. If I’m wrong, and only a doc can be a quack, I apologize. I should simply have said that idiots abound.

I just think you presume too much when you presume that MOST people trust their doctors. Or even that most people SHOULD. It sounds like something you’d say if you lived in a nation with decent health care.

Which, possibly you do. I don’t, and neither do most of the posters here. A little skepticism re: trendy new medications that earn their patentholders bazillions of dollars seems more than merited.
Note that I said “skepticism,” which would apply to Robin’s position of being glad she has 10+ years to watch the research, before injecting her daughter. Not, “blind paranoia and refusal to acknowledge science.”

Comment #44: Well, what?  on  08/12  at  07:13 PM

Sorry, that should read “trendy new medical advances,” not medications…

Comment #45: Well, what?  on  08/12  at  07:15 PM

Catherine is welcome to visit the oncology clinic where i work and ask some of the women being treated for advanced stage cervical cancer whether they needed to be protected from Gardasil.

Comment #46: pablo  on  08/12  at  07:29 PM

HPV can adversely affect men as well as women, especially if the men aren’t circumcised

Or gay.

Comment #47: rea  on  08/12  at  07:49 PM

Nobody got all pearl clutchy about the polio vaccine, thinking, “well how will I keep little Jimmy from going to that dirty public pool now?  We’ve got to stop this Salk thing!  Think of all the drowning, stomach cramps, swimmer’s ear, and urine exposure polio prevents every year!”

There might be some psuedo-scientific woo involved on the side of parents. HPV is related to cervical cancer, so maybe they see it as some sort of magic cervix drug instead of seeing the vaccine as just a standard anti-viral measure. Cue the subconscious fears of Virgin Wombs crumbling into dust like a TV vampire.

Other pediatricians are adamantly opposed because they’d be treating a patient for someone else’s benefit

Meanwhile, an epidemiologist dies inside.

Comment #48: Juan Stoppable  on  08/12  at  08:03 PM

Ohsohappy: Okay, I realize advertising is not put in place by the Pandagon crew, but the ad right below this post on the main page was “stop abortion on demand, 158 babies die every hour” and something about the disappearing unborn.

Advertising on pandagon seems to be done by someone from The Onion. Fun in it’s ironic non-appropriateness, but getting a little predictable.

Comment #49: inge  on  08/12  at  08:42 PM

From what I understand, health insurance by and large doesn’t cover it at all.

Which is probably the main obstacle to things like Texas’s initiative to make it mandatory in schools.  The only vaccines that are mandatory are the ones they dole out for free, whether you have health insurance or not.

IIRC, this actually was the main reason behind the push for making it mandatory.  If it’s mandatory, then insurance companies (and, most importantly, Medicaid) have to cover it.  If not, the girls who are most at-risk are the least likely to get the shot.

Comment #50: Lee  on  08/12  at  08:51 PM

“Other pediatricians are adamantly opposed because they’d be treating a patient for someone else’s benefit”

Meanwhile, an epidemiologist dies inside.

Mind, they tend to also be of the opinion that getting warts frozen, lasered, sliced, etc. off one’s genitals is less onerous than getting three shots.  I don’t think the opposing pediatricians tended to have thought the issue through as thoroughly as they might have.

Comment #51: preying mantis  on  08/12  at  08:55 PM

Mind, they tend to also be of the opinion that getting warts frozen, lasered, sliced, etc. off one’s genitals is less onerous than getting three shots.  I don’t think the opposing pediatricians tended to have thought the issue through as thoroughly as they might have.

Not to mention, it can often take YEARS of that treatment before they finally disappear “for good”—and, of course, since you still have the virus they could come back at any time.

I submit that no man has truly lived until he’s had a doctor take a laser to the head of his penis.

Comment #52: Dr. Shrinker  on  08/12  at  09:25 PM

All right, I’m going to pretend this question is purely hypothetical: but does anyone know if Gardasil would be effective or appropriate for a couple that has technically “aged” out of the recommended range, yet have neither of them had any outside partners in their lifetime?  We’ve had a good track record so far, but a friend has recently come down with a pretty life wrecking case of HPV induced genital warts due to an infidelity and it makes one think.  I’d rather throw plates and sob like a baby if one of us has an affair than die of cancer or discover my partner is infected with something that will eventually shift to me if we stay together.

We have the world’s best doctor, he has sat down with us and explained in detail why he recommends this vaccine but not that vaccine for our child.  I’m sure we could talk this over with him, but it’s some time till we see him again.

Comment #53: AnnaArcturus  on  08/12  at  09:29 PM

The anti-side is all “Well, in a proper sex life: virginal until marriage monogamous until death, there is no problem with HPV.” My standard response is a snort and a “yeah, right.”

I’m on the close-watch list for cervical cancer, having lesions and dysplasia. If I can spare my kids what I’ve been through the last two years, I’m going to.

My oldest has had her shots. She had a sore arm. As opposed to the mandatory DPT shots, which made her bazooka-barf.

My youngest will be getting them in a year or two. She’s 8.

Comment #54: Angelia Sparrow  on  08/12  at  09:32 PM

I will probably get it for my boys too.  Even if it turns out that there is no direct benefit for males (highly unlikely), assuming straightness on their behalf, giving them the vaccine would prevent them from being carriers and passing it on to any female partners they may have.  And if the insurance doesn’t pay for it, then I suppose I’ll save up and pay out of pocket.

However, as my oldest is only six, I still have a few more years yet before that’s something that we need to worry about.

Comment #55: ks  on  08/12  at  09:35 PM

I think we should get the women who come into my clinic for LEEP procedures (where you get part of your cervix LASERED OFF because you have bad cells growing there) crying start doing PSAs about how fucking stupid you are if you think some pain with the shot is a good reason to skip it.

Comment #56: Jasmine  on  08/12  at  11:09 PM

“but does anyone know if Gardasil would be effective or appropriate for a couple that has technically “aged” out of the recommended range, yet have neither of them had any outside partners in their lifetime?”

There’s no reason it shouldn’t be; 26 isn’t a magical cut-off point, it’s just the top of the age-group the US tests were done on for FDA approval.  You might check the Gardasil applications in European countries where it’s offered.  They seem to be doing it less conservatively than we are (boys included, higher age range, etc), so they’ve probably got some research available.

Comment #57: preying mantis  on  08/12  at  11:19 PM

The Gardasil strategy by Merck is brilliant!  They train ABCCNNCBSMSNBCFOX to call
Gardasil the “cervical cancer vaccine”, and then they further peddle it as preventing cancer in our
young daughters.

By marketing it as an “anti cancer” vaccine, focusing on young girls as the recipient, portraying it as protecting our pure young daughters (only virgins, ok?) from that horrible dirty unspeakable HPV virus and evoking visions of wart covered daughters.

Sheer genius.

Oh, and by marketing it as keeping our rope jumping happy sing song chanting little girls, and because it is for STDs, then further guilt trip and major coup for Merck - anyone who is skeptical of Gardasil is a - gasp - MISOGYNIST! 

Eeeek! You either are one of those anti vac kooks or you are one of those right wingers.
You can’t be someone who remembers all the vaccines and meds that EVENTUALLY were proven to be more harm than good

Perfect Merck, you’ve done well, keep up with the head games.  Genius. Anyone who questions this vaccine must hate little girls.

Comment #58: Laura  on  08/13  at  12:49 AM

Uhh, yeah, Laura.  If they come out with a vaccine that prevents you from getting a virus that causes cervical cancer, then yup, that’s a vaccine against cervical cancer.  If you’d rather have bits of your cervix trimmed off every few years, with pretty scary results for your future fertility (if this is something you care about, of course), then by my guest, don’t get vaccinated. 

I wonder how many wackjobs flounced around the 19th century version of a blog comments thread freaking about Ohnoes!  The Horror!  Smallpox could be eradicated!  Can you believe they have the nerve to call this crazy new treatment a vaccine “against smallpox!”

Comment #59: The Opoponax  on  08/13  at  01:42 AM

Luckily I escaped with the one time acid burn rather than the repeted penis-lasering. But what about my future, and my potential partners? I care enough about myself that I would prefer to have been protected, and I sure care about any random potentially deadly viruses I might spread to others even if the risk is fairly low.

Comment #60: Bacopa  on  08/13  at  02:11 AM

The Gardasil strategy by Merck is brilliant!

Except I heard it first and most often from research epidemiologists, several years ago. (I mean, some of us here DO talk with working scientists)(and not all of them are in private industry).

Comment #61: gwangung  on  08/13  at  02:19 AM

“Until that point, I think mandating its use really is just making people part of an extended clinical trial.”

Welcome to the real world, where we still call it the practice of medicine, and as patients still take risks for not only our own health but for the betterment of society.  Here’s to the brave women in those structured clinical trials, and to all those who follow in their footsteps by their early adoption of this vaccine.

Comment #62: chimpyissatan  on  08/13  at  03:02 AM

AnnaArcturus
I had exactly that conversation with my gynocologist last week.
Apparently the vaccine is only 1% effective in patients over 26 due to the way your immune system ages not due to prior exposure.
So it might work for you but the odds are against it.

Here in Australia they have been immunising girls for the past year or so but are about to start on boys next year I believe, to eliminate the reserve.

Comment #63: emi  on  08/13  at  09:09 AM

As someone who was first diagonosed as having atypical squamous cells, and then a high-risk strain of HPV, I would have loved to have Gardasil available. My GYN (whom I think is fabulous) told me that he currently used Gardasil as part of the treatment in cases like mine—or he would if I were under 27. I was 29 when diagnosed.

Fortunately I had health insurance, and was able to have 2 surgeries—the first 4 months after diagnosis, and the second 3 months after that. Then my health insurance ran out, and even though I’m supposed to get a PAP every 4-6 months, I haven’t been able to afford these critical follow-ups.

(A bit of a digression, but as a Mass resident, I had health care. When I lost my job, and couldn’t find another, I had 2 options (1) keep my health care, but become homeless, or (2) lose my health care, and move in with family out of state until I chould get my feet back under me).

I push every young woman I know toward the Gardasil vaccine—and I wish I’d had the option.

I’m also a single-issue voter this election—health care.

Comment #64: Jicklet  on  08/13  at  10:30 AM

Jicklet - are you familiar with the National Breast and Cervical Cancer Early Detection Program? 
http://www.cdc.gov/cancer/nbccedp/

Access will vary depending on where you’re living, of course, but there are a lot of programs for low-income women to get Pap screens.

Comment #65: burgundy  on  08/13  at  11:33 AM

I wonder how many wackjobs flounced around the 19th century version of a blog comments thread freaking about Ohnoes!  The Horror!  Smallpox could be eradicated!  Can you believe they have the nerve to call this crazy new treatment a vaccine “against smallpox!”

Funnily enough [woo site, but never mind]:

In the late nineteenth century, a British homeopathic physician, Dr. J. Compton Burnett, published a treatise that asserted smallpox vaccination caused a chronic nervous system and skin disease. He named this chronic disease “vaccinosis,” distinguishing it from the immediate adverse reactions to vaccination.

[...]

Opposition to smallpox vaccination has been vocal and vehement since the first Anti-Compulsory Vaccination League was formed in England in 1866. Newspapers during the early twentieth century were filled with accounts of disease and death following vaccination. The anti-compulsory associations doubted the safety of vaccination and often asserted that vaccination caused more brain damage and deaths than smallpox itself.

Comment #66: Dunc  on  08/13  at  12:01 PM

Thanks Burgundy, I hadn’t been aware of that.

Of course, after checking in to it, in my state, you have to be over 50, or high-risk and over 40, to be eligible.

Comment #67: Jicklet  on  08/13  at  07:16 PM

Jicklet, what state are you in?  That sounds more like a mammogram requirement than a Pap smear requirement.  (Which is not to say that I don’t believe you.  At some point I will stop being surprised at the way people manage to fuck up really good programs.)  You might give the American Cancer Society a call - they have all kinds of great information about free and low-cost screening programs.  (I used to work there, and calls about Pap smears and mammograms were nice to get, because I could almost always hook them up with something useful.  As opposed to “I have cancer but no insurance” which was generally just tragic.)  1-800-ACS-2345

Comment #68: burgundy  on  08/14  at  12:17 PM
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