Virigina considers mandatory HPV vaccination

I'm afraid Buck from Pensito Review is totally out to lunch on this one. Buck thinks that mandatory HPV vaccination is just another big pharma scam.

Buck writes:

Del. Phillip Hamilton, R-Newport News, has introduced a bill that would add the human papillomavirus vaccine to the list of immunizations needed for school attendance, and if it passes, it would go into effect in time for the 2008 school year. But when was the last time you heard of a Republican proposing a health measure for the greater good? Right, Hamilton makes a weasel’s excuse for volunteering to sponsor the bill:

"Hamilton said pharmaceutical company representatives approached him about submitting the bill, probably because he chairs the House Committee on Health, Welfare and Institutions. Drug companies have been among the largest contributors to Hamilton’s election campaigns." [VP]

“Probably?” You bet, Phil. And keep cashing those checks, buddy.

I don't care what Hamilton's motives are, mandatory HPV vaccination would serve the greater good. Gardasil has been shown to be safe and effective against the strains of HPV responsible for 70% of cervical cancer and 90% of genital warts.

Unfortunately, the Virginia bill also has a "conscience" clause for those parents who actually want their daughter to get HPV if she sleeps around. HPV is a communicable disease. By not vaccinating a child, they're putting others at risk as well. We don't allow opt-outs for other vaccinations like measles. Why should parents who are squeamish about HPV vaccination get special treatment? Still, if the exemption helps get the bill passed, it's an acceptable price to pay. The most important thing is to to protect as many kids as possible, as soon as possible.

Buck doesn't think cervical cancer is that big a deal, anyway:

Not to belittle the seriousness of cervical cancer, but there are apparently about 10,000 cases of it diagnosed in the United States every year, and about 3,700 women die of cervical cancer annually. And the papillomaviruses are so common (there are 100 strains) that 75 percent of all sexually active women will likely become infected at some point, and of those, only about 1 percent will develop cervical cancer.

To me, that does not indicate a pressing need to vaccinate milions of schoolgirls who may or may not engage in safe or unsafe sex.

But then, I don’t work for the pharmaceutical industry like Philip Hamilton does.

The FDA estimates that full Gardasil vaccination would prevent 70% of cervical cancers. Going by Buck's stats, that's 7,000 women who could be spared cervical cancer every year. That's not worth it? What if you add in the 1% of Americans who get genital warts each year? What about infants who are born with HPV because their mothers are carriers? Still not important enough, even if you throw in the misery of HPV-related infertility?

Sure, Hamilton has received about $1000-$1500 dollars per election cycle from Merck, the manufacturer of the Gardasil vaccine. That said, Merck's competitors actually give a lot more.

When you consider all the prescription drugs that are used to treat HPV-related infections and cancers, the vaccine is probably a net loss for Big Pharma. Remember that most people are infected young and carry the virus for many years.

A full course of Gardasil shots costs about $375. Consider that just one course of medication for genital warts cost $200 to $300 back in 2004. Remember that many HPV sufferers need more than one course of treatment. Even those costs are chump change compared to the cost of a course of (prescription) chemotherapy for just one cervical cancer patient.

It's good to be skeptical when Republicans and drug companies join forces--but let's not let healthy skepticism get in the way of good health. Mandatory HPV vaccination is a good idea, no matter who's proposing it.

Comments

[Lawrence Krubner]

Is there a level of indentation that is suppose to end with the sentence "I don't care what Hamilton's motives are"? I can't figure out who the author of that paragraph is.

[Cass]

I agree completely. We should all get down on our knees and thank Providence whenever corporate and the public interest happen to align; we all know Its not going to throw much else our way.

[Lindsay Beyerstein]

That should clear up mess I made of the blockquotes.

[Rob Helpy-Chalk]

Of course, you can opt out of all sorts of immunizations. In some areas you can still even send your kids to public schools. Around here (upstate New York) both the Amish and a sizable back-to-the-land hippie community refuse to vaccinate, making us ripe for all sorts of nasty outbreaks.

(The hippies should know better. They are generally communitarians who are open to scientific findings whenit comes to ecology. You'd think a science-driven public good like vaccination would be right up their alley. Instead, a lot of them wind up as free riders on group immunity.)

[Anacher Forester]

If Buck had a cervix there's no doubt that his position would be reversed.

[LukeD]

The HPV vaccine issue has resulted in some interesting bedfellows.

1. Anti-'Big Pharma'/biotech industry leftists
2. Anti-vaccination alt. medicine and greens
3. Cultural conservatives (Christian Right)

It's similar in composition to the coalition against human-animal chimera embryos, GMOs etc.

Alicia Priest: Say No To The HPV Vaccine
Published in organic online magazine 'Shared Vision.'

[Nicholas Beaudrot]

This works out to around $800M annually in vaccines. If you use the various actuarial estimate for a value of a year of life, this works out to a huge net win.

Moreover, when the patent on Gardasil expires, HPV vaccine will certainly be a net win.

[Lawrence Krubner]

"They are generally communitarians who are open to scientific findings whenit comes to ecology. "

I know that crowd well. I read this weblog post aloud to my friends when I first read it. I was asked if this vaccine had mercury in it. I've no idea if it has mercury in it, but it is interesting that that was the first thing I was asked. The issue of mercury in vaccines operates as disinformation, a grassroots campaign of disinformation that undercuts the legitimacy of the science that goes into verifying the benefits of these vaccines.

[cfrost]

Most people alive today have never seen a contemporary picture of a smallpox victim’s face or an iron lung ward, so they have no idea what mass immunization has done for them. I fear to think what it would take to wake folks up.

[Hawise]

It is frightening that there are people unwilling to vaccinate their children in safe ways because of a disinformation campaign. There is still ferocious debate in the autism community about mercury in vaccines and ongoing attempts to scare parents about vaccination. With the return of mumps and measles in some communities, we may finally get people to realize that vaccinations protect their children from serious dangers.

[Andrew J. Lazarus]

There was a dimwit back-to-nature couple at our preschool who didn't vaccinate their kid against measles. And he got it. Also his sister. Plus, it closed the school down for a day while the staff double-checked their OWN immunizations. (The measles vaccination from the 1950s and early 1960s appears to weaken with time: boomers at are some risk.)

This is indeed a classical free rider problem.

[Lindsay Beyerstein]

According to the CDC, there's no thimerosal in the HPV vaccine.

[Alon Levy]

The hippies should know better. They are generally communitarians who are open to scientific findings whenit comes to ecology.

Only when the scientific findings support their beliefs.

[Lindsay Beyerstein]

Alon, it's almost axiomatic that any person will challenge science when the verdicts of science conflict with their most deeply-held beliefs.

The point is that, generally speaking, most so-called hippies have beliefs and values that are generally consonant with modern science and medicine. It's remarkable when a fad like thimerosal anti-vacciantion sweeps an otherwise rational community. (Sure hippies have their metaphysical weirdness, but if you take a dispassionate view, their religious/mystical beliefs tend to be isolated from their day-to-day practice, much like most contemporary Christians, Jews, and others who inhabit the modern world but continue to profess ancient belief system.)

[mythago]

Of course, there's a less charitable view of the people falling for the 'fad'--they figure that everybody else is getting vaccinated, so it's safe for them not to vaccinate their kids.

Most states have opt-outs for vaccination, but I am pretty sure that you opt out of all vaccination if it's for other than health reasons, not "my religion approves of vaccination except for HPV".

[Heraldblog]

Great news. I remember when Republicans called Gardisil the Slut Vaccine. One more sign of the Republican Party slowly shedding its Cultural Conservative lizard skin.

[Hawise]

There are alot of reasons that people do not chose to vaccinate themselves or their children. In Quebec, the last great smallpox epidemic lasted longer than necessary because elements of the political class and the church convinced the majority French population that the vaccination program was an attempt to destroy them. In parts of Africa and Southeast Asia the polio eradication is slowed by similar fears.
New vaccines, new fears amd new people profitting from that fear.

For those interested- a blog dedicated to the subject.

http://vaccinethebook.typepad.com/mt/

[Richard]

I can understand why some people are skeptical of claims based on "scientific evidence" and backed by government. Government has a hstory of lying to the very people it supposedly serves. In the past, public science can and has been manipulated to support private economic objectives. The damage wrought by trans fats and rancid polyunsaturated vegetable oils in the diet are but two examples of how an alliance between government and science has done more harm than good.

The claim that there's no mercury in the HPV vaccination should be received with skepticism in light of the fact that parent's were lied to about the existence of mercury in other childhood vaccinations. Have we forgotten about Vioxx, Phen-Fen, Zyprexa (causes diabetes) and other FDA approved drugs so quickly? What about the bird flu vaccine for which millions have been paid... all to protect us from a nonexistent pandemic.

I find it strange that the political left, which so ardently demands proof and accountability on political issues, so easily rolls over and accepts the claims of "sound science" from economically conflicted sources, without question. They fail to identify the same scaremongering tactics favored by the Bush administration when those same tactics are employed by the drug industry.

The truth is that you don't need to know much about medicine or science to understand the motives behind the push to make the HPV vaccination mandatory. Those motives are based on economic goals. If Gardasil were not a profitable venture, it probably would not exist.

The free market system is a disppasionate entity that cares not a wit about your health. It exists to make money... period. Are people at risk of cervical cancer? Of course, but the Soccratic question is, should we trust government and industry to protect us from it and other diseases. Heart disease mortality rates are much higher... perhaps we should add statin drugs to the growing list of state-mandated medications for our children.

Am I saying that Gardasil is another in a long line of medical frauds. No, but it does mean we should be very careful when government and industry attempt to take us further down the slippery slope of controlling every aspect of our lives.

This industry (PHARMA) has cried "wolf" enough times in the past it merits proceeding with great caution.

[Hawise]

I don't disagree that caution should be taken. I question whether Gardisil should be one of the mandatory vaccinations since it is not highly contagious outside of physical contact and it only protects against some forms of the virus. I would prefer to see meningitis taken more seriously since those vaccinations have a longer track record and the infection vector is more open.
What I do not care to see is the fear mongering that develops around a do you/don't you medical question. "Gardisil WILL turn your daughter into a slut!", "MMR will turn your child into a fecal matter throwing, head banging autistic with no hope of a normal life!", "The vaccination program is meant to make your men infertile and destroy your culture!" and so on.
Scepticism of large scale emergent technologies and medical treatments is fine, fear mongering is terrorism in a fancy disguise and a false veil of care.

[John P]

I have a 13-yr old daughter. She's getting the vaccine.

I'm a scientist. Thimerosal is irrelevant. Gardasil uses an aluminum adjuvant. Aluminum adjuvants are commonly used in vaccines.

Following the logic of some posts here, we can't really do much to protect ourselves from disease, can we? We have to trust the MDs and the scientists. What is the alternative? Are you going to give yourself an endoscopy or colonoscopy? Colonoscopies save lives (colon cancer kills about 50,000 each yr in the US). How about self-nephrectomy? Good luck with that. My sister had renal-cell carcinoma. Her doctor removed her kidney. She's in remission.

Cervical cancer kills about 3,700 women each year in the United States and some 200,000 worldwide. Dismissing this is cold-hearted, callous, and misogynistic. I daresay anyone dismissing these stats has not lost a loved one to cervical cancer.

I take umbrage at posters and activists who casually drag scientists and science through the mud. Have you read the paper or even the abstract of the study? Can you name anyone involved with the study? Do you know how many subjects were in the trial of the vaccine? Educate yourself and stop posting misinformation.

[SamChevre]

Just a facts correction--in most states, you can get an exemption to vaccination requirements for religious/conscientious reasons. (Intended to protect, for example, Christian Scientists.)

[herbert browne]

The simple (or not-so-simple) act of skepticism is part of any scientific enquiry... and, despite the assurances from the CDC, or the postulations of a self-proclaimed "doctor" or "scientist" that the preservatives (and other "inert ingredients") have "no appreciable affect on health or" blablabla have pretty much worn out their believability, in my case. If anyone wants studies to "prove" something, (ANYthing) well, they're out there- somewhere- eg the recent study that, in some cases, SMALLER amounts of certain toxins are more deleterious to certain subjects in certain common conditions than larger amounts may be.
Re: .."The issue of mercury in vaccines operates as disinformation, a grassroots campaign of disinformation that undercuts the legitimacy of the science that goes into verifying the benefits of these vaccines.." - HOGWASH. The science is only as "legitimate" as it is honest & well-thought-out. The efficacy of its immediate application may be undercut- but that's a socio-political issue, not a scientific one.
Re: .."Gardasil uses an aluminum adjuvant. Aluminum adjuvants are commonly used in vaccines.."- AND it's routinely wrapped around cola drinks. THERE, by God... THAT makes it solid- it's OK, America! forget about those false implications re Alzheimer's- just grass-roots hysteria, probably a whisper-campaign started by the glass container mfrs and the enormous off-shore stainless Steel lobby...
Re: .."How about self-nephrectomy? Good luck with that. My sister had renal-cell carcinoma. Her doctor removed her kidney. She's in remission.."- That's great!.. she's still numbered among the 6 billion... but if we're reduced to making policy based upon 2nd & 3rd-hand narrative ("The cops caught a known pedophile smoking something a block from an elementary school. We need a law that will send anyone caught smoking within 1000 yards of a school UP THE RIVER!") then all the Science in the world isn't going to save us. But, if you'd like an anecdote of mine, relating to the rationality and humanity of doctors, gov't employees, etc here's mine. I delivered a child at home (Oregon). When the facts became known to the Children's Services Division, I was threatened with arrest & 30 days in the slammer, for failing to treat the eyes of the newborn with silver nitrate (as was the prevailing legally mandated custom)- even though the child was born with a caul (pure luck, in my defense). When the next member of my growing family made an appearance, I took our daughter, the new mother and the newborn babe to the nearest hospital, about 20 miles from home. They refused to administer the Ag solution, on the grounds that "the baby wasn't born here". When I asked if that meant they wouldn't treat my broken leg if I were to show up with one because I wasn't born there, either, they forcibly showed us the door- and offered to call the police, to make sure we stayed out. (A trip of 65 miles, to the next County, finally produced the silver solution... something that I'm not even sure is required, these days).
In defense of a good number of the MDs in my old home, I will say that they shrugged off a "grass-roots whisper campaign" besmirching them locally (by timber companies) when the majority of them signed a letter demanding that someone study the possible link between the routine spraying of 2,4,5-T in the local watersheds and the rate of spina bifida in the County (which was in excess of a 1000% of a national average). I'd rather see policy made from a basis of scientific enquiry than from my personal narrative... even though it may be the collective narratives that ultimately lead to the application of science to the questions at hand. ^..^

[Njorl]

It seems a bit odd to me to make the vaccinations mandatory. While I think the state should offer convenient and free HPV vaccinations for the greater good, I would not mandate them. The point of the other mandatory vaccinations is not so that a greater good will be served, but so that the state can perform its duty to provide an education without unduly exposing children to danger. Measels and chicken pox are easily communicable via standard classroom behaviour. Having children in school without their immunizations is an unnecessary risk. The same is not true about HPV. I could be wrong. Maybe it is seen as unavoidable that most students will screw several times per day with multiple partners during school hours, but that isn't how I remember it.

[mhatrw]

This is a complicated issue. The vaccine has been shown to be effective against HPV associated infections. However, there is NO DATA available about whether this actually translates into effectiveness against cervical cancer and certainly no data about how it effects cervical cancer mortality rates. NONE OF THE CONTROL SUBJECTS CONTRACTED CERVICAL CANCER! Furthermore, the control "placebo" was an aluminum adjuvant that has been shown to cause neural death.

Of course, the vaccine DID show health benefits in a clinical study. The study showed that GARDACIL reduced observable HPV infections significantly over the period observed in comparison to the the alum adjuvant only "placebo."

However, what I dispute is that:

1) an aluminum adjuvant injection was a good placebo control for analyzing short term side effects,

2) sufficient tests have been done on amorphous aluminum hydroxyphosphate sulfate, L-histidine and polysorbate 80 (other GARDACIL ingredients) injections in mammals to determine that there are no long term health effects associated with these adjuvant and "filler" ingedients,

3) we are certain that there are no long term health problems that associated with this vaccine in general,

4) we have determined the long term efficacy of this vaccine,

5) we understand how the reduced rates of observable HPV infections of the vaccinated subjects quantitatively relate to reduced instances of cervical cancer and/or cervical cancer mortality, and

6) that a non-infectious, sexually communicable virus that we THINK may cause a generally treatable form of cancer is a good candidate for mandatory vaccination in any case.

[nacho]

mhatrw -
Just to clarify:
L-histidine, one of the ingredients of GARDASIL that you cite as a potential danger, is an essential amino acid. One of the building blocks of life. It's not a danger - I hope you didn't spend too much time looking up studies of its safety.