Imagine. You brush up against your daughter and she winces; you pull up her sleeve and see the telltale needle mark. She’s what, perhaps 12 years old.
It was Gardasil, not heroin, duh, she says. The nurse said it was safe and now I will never get cervical cancer. Don’t you want me to stay healthy, Mom?
Well, yes. And so, because you know that she has a strong family history of autoimmune disease on both sides, you’ve deliberately chosen to protect her health by avoiding getting her extra shots. Particularly Gardasil, because it’s a novel type of genetically engineered vaccine, as yet unproven, and of questionable value. You’re cautious because it has anecdotally been associated with autoimmune diseases—which are triggered in susceptible individuals by environmental factors—and your doctor has advised you, dammit, to be cautious with shots.
But now your informed decision has been overridden by a complete stranger.
Ridiculous?
If the scenario of a minor child—as young as nine—being given a shot without a parent’s knowledge or consent seems absurd, think again. New York Senate bill S4779, sponsored by Senator Liz Krueger and co-sponsored by Senators Adams and Parker, provided for exactly that. And although S4779 has been held in the Senate Codes Committee for improvement and clarification of the bill's language, Ms. Krueger is reportedly determined to get it through at some point. Meanwhile, Assemblywoman Amy Paulin has sponsored New York Assembly bill A06702, which is almost identical apart from an attempt to make vaccination with Gardasil mandatory for school attendance.
The bills seek to ensure “that a health care practitioner may provide medical care related to the prevention of a sexually transmissible disease, including administering vaccines, to a person under age eighteen without the consent or knowledge of his or her parents or guardians, provided such person has capacity to consent to the care, without regard to the person's age, and the person consents. The section provides further that any release of patient information regarding vaccines provided under this section shall be consistent with sections 17 and 18 of the public health law.”
Wonderful. Not only could a nurse shoot up my kid with Gardasil or Cervarix even if I’ve specifically decided against it, I couldn’t find out for sure what those needle marks are. I’d have no clue as to why my child might have started convulsing, as did two girls in Spain right after getting their shots.
The whys and wherefores
Although some bloggers have speculated about the motives of these zealous legislators, particularly with regards to campaign contributions by Merck, I don’t doubt that they think they’re doing the right thing—even if they’re in fact being preposterously over-reaching. Merck has done a fantastic job of persuading the public, including (apparently) some legislators, that if our kids don’t get the three Gardasil shots at a total cost of around $400 per child, they’re gonna get cervical cancer. Why bother to research the real facts?
Merck, of course, has notoriously been highly unscrupulous about its sales jobs—from concocting an entire fake medical journal and deliberately discrediting doctors and researchers who questioned Vioxx to paying off professional medical associations (PMAs) to promote Gardasil to other health professionals, without any appropriate transparency and discussion of risks and benefits. Not to mention its participation in the skewing of reporting drug trials endemic in professional journals.
The company is not going to spend a whole lot of effort on educating anyone about the full pros and cons of Gardasil and the truth about HPV. Particularly when its Gardasil sales have just plummeted by almost 80 percent in Australia, where a massive HPV vaccination campaign has ended.
Nor can we rely on doctors to educate themselves and us. In the context of Gardasil, Newsweek even quoted Susan Wood, former head of the FDA’s Office of Women’s Health, as believing that there was no relationship between a healthy diet and a strong immune system that could fight off HPV on its own and leave a natural immunity in its wake—totally contrary to solid scientific evidence.
And so we have legislators falling for the quick fix. Kids are having sex, their theory goes, and indulging in risky behavior. They already come to us to get birth control and treat STDs, so let’s PREVENT the STDs with a very expensive shot that must be safe because the government says so (Vioxx, anyone? BPA? Tambocor? Thalidomide?). It must be effective because Merck says so. Parents, of course, are just naïve, uncaring, and/or prudish and should have no say in the matter.
Never mind that kids who are already having sex have a heightened risk of developing a high-grade cervical abnormality if they are infected with vaccine-type HPV when they get Gardasil—particularly if they smoke.
The capacity to consent
But wait. The target kids have to have the “capacity to consent,” right? They can make decisions for themselves, especially if they’re already having sex, a supposedly adult activity. Gardasil is recommended for kids as young as nine, and kids as young as nine have been known to have sex ‘willingly.’
The capacity to consent implies the ability to understand and weigh all the pros and cons of Gardasil. Frankly, I’ve been giving my DOCTOR info that she, as an overworked professional, didn’t have previously. And yet Ms. Krueger and friends think that a nine year old—hell, a sixteen year old—can sit there and figure it all out before making an informed decision?
I’d think a lot better of Ms. Krueger if she initiated healthier foods in schools. Or campaigns that educated kids about the behaviors that cause persistent HPV infections and, potentially, cancers. I’d be good with efforts to teach parents about Gardasil, honestly cataloging the risks and benefits. I’m not necessarily against Gardasil for the right, most at-risk population as long as their family history is taken into consideration.
But I am totally against usurping parents’ rights, making uninformed decisions, and encouraging kids to make uninformed decisions. Especially when there’s a financial motive on the part of clinics and drug companies.
That’s what cigarette companies do. Is Senator Krueger the new face of the Marlboro Man?
Here’s the straight talk for your kids, just in case legislators nationwide are daft enough to jump on the Krueger bandwagon. What you need to know about Gardasil
Thursday, February 18, 2010
Gardasil pros and cons
Gardasil has been hailed as the first vaccine against cancer, protecting women against some of the strains of human papillomavirus. HPV can, in a tiny percentage of cases, cause cervical cancer. Gardasil also been reviled as oversold and potentially dangerous. Here’s what you need to know:
• Up to 80 percent of people will get HPV, a virus akin to the common cold, in their lifetime. There are more than 100 strains of HPV, multiple strains of which COULD cause cancer in limited circumstances.
• 95 percent of those infections are self-limiting—they’ll be beaten off by your immune system, leaving you immune to further infection with the same strain.
• Only if an infection becomes persistent could it cause pre-cancerous lesions.
• Your behavior dramatically affects the chances of an infection becoming persistent.
• If you smoke, you have up to a 2,700 percent greater chance of getting a persistent HPV infection. (Anthony Gunnell, M.A.Sc., Karolinska Institutet, Stockholm; November 2006, Cancer Epidemiology, Biomarkers & Prevention)
• If you don’t eat vegetables and fruit regularly, you are 50 percent more likely to get a persistent HPV infection. (Rebecca L. Sedjo, MSPH, et al: University of Arizona, US; Cancer Epidemiology, Biomarkers & Prevention)
• If you have multiple sexual partners, you will exponentially increase your chances of getting a persistent HPV infection.
• Oral birth control and having sex at a young age may increase HPV risks.
• Being uncircumcised or having an uncircumcised partner increases HPV risks.
• Insufficient sleep on a regular basis, drug use—anything, in fact, that depresses your immune system—will increase your chances of getting a persistent HPV infection.
• With all that, if you get regular Pap smears, the chances of an infection progressing to pre-cancerous lesions and then cervical cancer are very small, and if it does, it is extremely curable when caught early. About 4000 women, some 60 percent of whom have not had smear tests, will die of cervical cancer in the US this year. It is twice as likely to affect Hispanic women and 50 percent more likely to affect African American women, probably because of economic factors. The number of cases drops by about 4 percent annually.
Gardasil
• Gardasil protects against the two strains of HPV, 16 and 18, that currently cause close to 70 percent of cervical cancer, plus two wart-causing strains. There are more than 100 strains of HPV. Merck’s research shows a small degree of cross-protection against strains not covered by the vaccine.
• Gardasil is a novel type of genetically engineered vaccine.
• Although ads imply that you will not get cervical cancer if you get Gardasil, Gardasil does not protect against many oncogenic strains of HPV. So far, Merck’s research has shown a rather meager 17-45 percent reduction in all cervical abnormalities in vaccinated girls. Recent figures of 89 percent reduction refer only to abnormalities and persistent infections caused by the four vaccine-type strains and do not include abnormalities caused by other strains.
• Although HPV16 and 18 caused the majority of invasive cervical cancer in a sample of women in New Mexico, the overall proportion attributable to HPV16 has dropped over 20 years, giving way to non-18 types. (C.M.Wheeler, PhD, University of New Mexico; Journal of the National Cancer Institute 2009).
• There is some concern that non-vaccine HPV types will fill the biological niche, an effect known as replacement disease. Merck does not think this likely, although it has happened with the vaccine Prevnar.
• The effect on natural immunity and duration of protection is currently unknown. Nor is the effect of new HPV infection in older adults when immunity has worn off.
• Merck’s research showed initially that Gardasil caused a 44.6 percent increase in the highest grade of pre-cancerous lesions in women who were already infected with vaccine-type HPV. Merck determined that the study was unbalanced and that those women also had high risk factors such as smoking. After ‘balancing’ the study, the combined figure for subgroup studies showed an enhanced risk of disease of 11.7 percent for females who had vaccine-type HPV at the start of the study.
• If you are already sexually active, get an HPV test prior to vaccination, particularly if you smoke or are otherwise high-risk.
• A neurologist has expressed concern about unusual immune response-mediated inflammation in the spine of a girl who died from an unusually rapid onset ALS-type disease and believes it may be associated with Gardasil.
• The FDA associates Gardasil with heightened risks of syncope and blood clots.
• Gardasil has also been associated anecdotally with Graves Disease, paralysis, Guillaine-Barré syndrome, seizures, chronic headache, and various autoimmune diseases although not at statistically extraordinary levels. Merck’s studies showed a slightly elevated risk of various types of arthritis. Incidence of autoimmune disease, which is triggered in susceptible people by environmental factors, is rising rapidly and an ever-increasing lifetime burden of vaccines and accompanying adjuvants may be a factor. This has not been proven, however. In trials of Gardasil, placebo vaccinations used an aluminum-containing adjuvant, something that could mask sideeffects.
• You should still get regular Pap tests, even if you have been inoculated with Gardasil.
It’s important to honestly assess your family medical history and lifestyle prior to getting the course of vaccinations. Read up on the facts. Gardasil may well be right for you, but it is not 100 percent effective or safe. Know its limitations—and yours.
• Up to 80 percent of people will get HPV, a virus akin to the common cold, in their lifetime. There are more than 100 strains of HPV, multiple strains of which COULD cause cancer in limited circumstances.
• 95 percent of those infections are self-limiting—they’ll be beaten off by your immune system, leaving you immune to further infection with the same strain.
• Only if an infection becomes persistent could it cause pre-cancerous lesions.
• Your behavior dramatically affects the chances of an infection becoming persistent.
• If you smoke, you have up to a 2,700 percent greater chance of getting a persistent HPV infection. (Anthony Gunnell, M.A.Sc., Karolinska Institutet, Stockholm; November 2006, Cancer Epidemiology, Biomarkers & Prevention)
• If you don’t eat vegetables and fruit regularly, you are 50 percent more likely to get a persistent HPV infection. (Rebecca L. Sedjo, MSPH, et al: University of Arizona, US; Cancer Epidemiology, Biomarkers & Prevention)
• If you have multiple sexual partners, you will exponentially increase your chances of getting a persistent HPV infection.
• Oral birth control and having sex at a young age may increase HPV risks.
• Being uncircumcised or having an uncircumcised partner increases HPV risks.
• Insufficient sleep on a regular basis, drug use—anything, in fact, that depresses your immune system—will increase your chances of getting a persistent HPV infection.
• With all that, if you get regular Pap smears, the chances of an infection progressing to pre-cancerous lesions and then cervical cancer are very small, and if it does, it is extremely curable when caught early. About 4000 women, some 60 percent of whom have not had smear tests, will die of cervical cancer in the US this year. It is twice as likely to affect Hispanic women and 50 percent more likely to affect African American women, probably because of economic factors. The number of cases drops by about 4 percent annually.
Gardasil
• Gardasil protects against the two strains of HPV, 16 and 18, that currently cause close to 70 percent of cervical cancer, plus two wart-causing strains. There are more than 100 strains of HPV. Merck’s research shows a small degree of cross-protection against strains not covered by the vaccine.
• Gardasil is a novel type of genetically engineered vaccine.
• Although ads imply that you will not get cervical cancer if you get Gardasil, Gardasil does not protect against many oncogenic strains of HPV. So far, Merck’s research has shown a rather meager 17-45 percent reduction in all cervical abnormalities in vaccinated girls. Recent figures of 89 percent reduction refer only to abnormalities and persistent infections caused by the four vaccine-type strains and do not include abnormalities caused by other strains.
• Although HPV16 and 18 caused the majority of invasive cervical cancer in a sample of women in New Mexico, the overall proportion attributable to HPV16 has dropped over 20 years, giving way to non-18 types. (C.M.Wheeler, PhD, University of New Mexico; Journal of the National Cancer Institute 2009).
• There is some concern that non-vaccine HPV types will fill the biological niche, an effect known as replacement disease. Merck does not think this likely, although it has happened with the vaccine Prevnar.
• The effect on natural immunity and duration of protection is currently unknown. Nor is the effect of new HPV infection in older adults when immunity has worn off.
• Merck’s research showed initially that Gardasil caused a 44.6 percent increase in the highest grade of pre-cancerous lesions in women who were already infected with vaccine-type HPV. Merck determined that the study was unbalanced and that those women also had high risk factors such as smoking. After ‘balancing’ the study, the combined figure for subgroup studies showed an enhanced risk of disease of 11.7 percent for females who had vaccine-type HPV at the start of the study.
• If you are already sexually active, get an HPV test prior to vaccination, particularly if you smoke or are otherwise high-risk.
• A neurologist has expressed concern about unusual immune response-mediated inflammation in the spine of a girl who died from an unusually rapid onset ALS-type disease and believes it may be associated with Gardasil.
• The FDA associates Gardasil with heightened risks of syncope and blood clots.
• Gardasil has also been associated anecdotally with Graves Disease, paralysis, Guillaine-Barré syndrome, seizures, chronic headache, and various autoimmune diseases although not at statistically extraordinary levels. Merck’s studies showed a slightly elevated risk of various types of arthritis. Incidence of autoimmune disease, which is triggered in susceptible people by environmental factors, is rising rapidly and an ever-increasing lifetime burden of vaccines and accompanying adjuvants may be a factor. This has not been proven, however. In trials of Gardasil, placebo vaccinations used an aluminum-containing adjuvant, something that could mask sideeffects.
• You should still get regular Pap tests, even if you have been inoculated with Gardasil.
It’s important to honestly assess your family medical history and lifestyle prior to getting the course of vaccinations. Read up on the facts. Gardasil may well be right for you, but it is not 100 percent effective or safe. Know its limitations—and yours.
Subscribe to:
Posts (Atom)
