Why Governor Jerry Brown should veto pro-Gardasil AB 499

Presidential hopeful Rick Perry got into an awful lot of trouble for trying to mandate Gardasil, the HPV vaccine. But at least parents would have had the chance to opt out for religious or other reasons.

AB 499, which has been passed by California’s legislature and is now awaiting a yay or nay from Governor Brown, not only doesn’t offer an opt-out, it also ensures that parents may not even know if their son or daughter has had the vaccine. I’ve got to hand it to Merck; that’s an absolutely brilliant way to ensure that potential side effects and adverse events aren’t reported for study.

Here’s the thing that shocks the heck out of me. I’ve had tons of people try to badger me into getting Gardasil for my daughters, including pediatricians and gynecologists. And, frankly, it always turns out that I know more about the vaccine and HPV than they do.

“It’s almost 100 percent successful in preventing HPV infection,” they say. Sure—for the two oncogenic strains it contains, but not for those that currently cause some 34 percent of cervical cancers, nor for any that might fill the biological niche left by the vanquished strains. And the latest results show an overall 17-45 percent reduction in cervical abnormalities, not 100 percent. “Really?” they say.

Uh, yes.(Shouldn’t you KNOW this?)

Maybe I’m old-fashioned, but I believe that being fully informed means…being fully informed, both as the giver and as the receiver of the HPV vaccine, or any other healthcare choice. That’s the basis for intelligent decisions.

Yet if AB 499 becomes law, some spotty little twerp who doesn’t even know that smoking hugely ups the chances of getting a persistent HPV infection—or, for that matter, why the word ‘persistent’ is important—can pull the HPV vaccine trigger on a 12 year old. The kid won’t be considered smart enough to have a beer for another 9 years, mind you, but somehow he’s smart enough to completely understand, and consent to, the risks and rewards of a vaccine. Right now. Oh, and of course he’s confident enough to say ‘no’ to a doctor if he weighs the risks and rewards and decides against it.

Yeah, sure.

So I’m one of those 'crazy anti-vaxxers,' right?

I fully expected to get Gardasil for my kids when it came out. But I'm a parent. So I researched and thought carefully about our options. What I found was that there is a lot of anecdotal information about autoimmune disease being triggered, a plausible theory backed by a reputable study about why this might be so, pause for thought in Merck’s own studies; and strong evidence that Merck’s marketing machine has emphasized the risks of HPV, completely ignored the role of individual lifestyle choice, and minimized potential risks of the vaccine.

And as The Lancet puts it, autoimmune diseases “arise in genetically predisposed individuals but require an environmental trigger.”

My kids have a family history of autoimmune disease, specifically MS. One child has already been diagnosed with Raynaud’s disease, which could be something or nothing. We try to keep the environmental triggers to a minimum. So, as a parent, I made an informed choice to get the kids Menactra to avoid a rare but terrifying disease, but nixed the Gardasil, which seems largely unnecessary for our particular family. (We eat our veggies, don’t smoke, get the whole healthy immune system thing, and understand the importance of regular Pap smears.)

Our choice, and one that we have every right to make. Other families with different circumstances and habits might well, even SHOULD, make a different choice. This is America, right?

Governor Brown has already taken steps against a circumcision ban—ironically, circumcision is proven to help reduce the spread of HPV—and vetoed a ski-helmet law on the basis that parents have the right and the ability to make reasonable choices for their children. So let’s hope good things come in threes.

And Planned Parenthood should be ashamed of itself, too.

Me, I’m Planned Parenthood’s dream. I’m socially liberal. We have health insurance, so we don’t use their services, but I’ve always donated so that people who don’t have health insurance have options too.

I don’t run screaming at the very idea of my kids having sex, although I’ve given them The Lecture about rights and responsibilities, physical, emotional and spiritual.

I’ll talk to them about anything and frequently do, much to their horror. (Particularly, it must be said, after a large g & t. Yum—Hendricks or Cardinal gin. Eat your heart out, Big Brands!)

If they want to go to a gynecologist, I’ll drive them there, pay the bill, and stay out of the room while they’re talking. But again, I understand that some kids, maybe even mine, can’t discuss some things with their parents. Although it pains me to think it’s necessary, I do think PP needs to provide services to kids so that they can be marginally more intelligent about the choices teenagers are wont to make.

But the organization’s arrogant support of AB 499 is going way too far for me. So Planned Parenthood is quite literally off MY Christmas list.

No perfect choices.

It’s quite possible that in 10, 20, 30 years one of my kids will be one of the tiny minority of women who suffer the effects of a persistent HPV infection, and I’ll bitterly regret my choice. It’s also quite possible that if I gave it to them I would be one of the tiny minority of parents who bitterly regret saying yes to Gardasil, like the Tetlocks or the Tarsells.

There’s no perfect choice. As a parent, I make lots of probably imperfect, but informed and thoughtful, choices. And guess what, Assemblywoman Toni Atkins and the policy makers of Planned Parenthood?

It’s none of your damn business.

Health Authorities May Ditch Gardasil and Cervarix

Gardasil and its rival Cervarix cost governmental health programs, insurance companies and individuals billions. Most governments have approved vaccination programs on the assumption that if an HPV jab guards against the two viruses that cause 70 percent of cases of cervical cancer, then the vaccine will eliminate roughly 70 percent of new cancer cases.

Oops. Real-life study results don’t bear out that assumption at all, and now that Gardasil has been found in two placebo-controlled studies to reduce pre-cancerous cells by just a meager 17 to 45 percent, both Scotland and Germany are reconsidering their hugely expensive HPV vaccination programs.

13 leading scientists in Germany have said that the vaccine is leaving women vulnerable to other strains of the virus and that information about its effectiveness is misleading. The Robert Koch institute, which makes recommendations about publicly-funded vaccination programs in Germany, is reassessing Gardasil and expects to issue a report within about two weeks. As one expert said, "The results of the studies clearly contradict many overly optimistic pronouncements. Women are entitled to be adequately informed."

Women in the US are apparently not as entitled to be informed, as recent news reports about Gardasil have focused primarily on information that the vaccine has proved to be extremely effective against HPV strain 16 for up to 8.5 years—a statistic that now appears to be rather beside the point.

Senior public health experts in Scotland also warned that HPV vaccines might not be as effective as expected after reviewing the two large-scale studies of Gardasil. Although the competing vaccine Cervarix is administered by the National Health program in Scotland, Cervarix uses the same VLP-type vaccine along with a novel adjuvant to target the same cancer-causing viruses. Specific data about Cervarix’s efficacy is not currently available.

The randomized, placebo-controlled trials of Gardasil followed 17,622 women who underwent Pap testing at the start of the trials and then every 6 to 12 months. All the women showed no exposure to 14 common HPV types and had normal Pap smears to begin with. After 3.6 years abnormal cells were reduced by between 17 and 45 percent, depending on the type.

Colposcopies were reduced by 20 percent, cervical biopsies by 22 percent and surgery and other invasive treatments by 42 percent.

Results Unsurprising

A study published earlier this year in the Journal of the National Cancer Institute (JNCI) looked at both early and invasive cervical cancers from 1980 to 1999 in a New Mexico population. The study found that HPV types 16 and 18 had caused 66.3 percent (not 70 percent) of cervical cancers and, more worryingly, that type 16 was already being replaced by types other than 16 or 18 (the two strains covered by both Gardasil and Cervarix).

Although this replacement was taking place pre-Gardasil, experts have long theorized that one or more of the many other strains of HPV could fill the biological niche left by elimination of 16 and 18. This kind of ‘replacement disease’ has already been seen with the pneumococcal vaccine Prevnar. It’s unclear at this point whether replacement diseases have been the cause of Gardasil’s disappointing results as Merck did not release an analysis of the types of HPV found to have caused the abnormalities in the study subjects.

Merck is having better luck with Gardasil’s efficacy against genital warts. Gardasil, unlike Cervarix, also guards against two wart-causing strains and reports from Australia show that new diagnoses of genital wart infections have dropped by 48 percent.

Meanwhile, women who are weighing the pros and cons of the Gardasil vaccine, now have more complete information, even if—distressingly—the results of the two studies have received little publicity. Reports have associated convulsions, paralysis, epilepsy, numbness etc. with the vaccine, although as yet no causal link has been established.