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Thread: Remark on HPV Vaccine Could Ripple for Years

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    Remark on HPV Vaccine Could Ripple for Years

    September 19, 2011
    Remark on HPV Vaccine Could Ripple for Years

    By DENISE GRADY


    During a debate last week for Republican presidential candidates and in interviews after it, Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Medical experts fired back quickly. Her statements were false, they said, emphasizing that the vaccine is safe and can save lives. Mrs. Bachmann was soon on the defensive, acknowledging that she was not a doctor or a scientist.

    But the harm to public health may have already been done. When politicians or celebrities raise alarms about vaccines, even false alarms, vaccination rates drop.
    “These things always set you back about three years, which is exactly what we can’t afford,” said Dr. Rodney E. Willoughby, a professor of pediatrics at the Medical College of Wisconsin and a member of the committee on infectious diseases of the American Academy of Pediatrics. The academy favors use of the vaccine, as do other medical groups and the Centers for Disease Control and Prevention.
    The vaccine, recommended by the medical groups for 11- and 12-year-olds, protects against the human papillomavirus, or HPV, a sexually transmitted infection that can cause cancer. Use of the vaccine was disturbingly low even before the Bachmann flap, health officials say. That is partly because of the recent climate of fear about vaccines in general, and partly because some parents feel that giving the vaccine somehow implies that they are accepting or even condoning the idea that their young daughters will soon start having sex.
    Allegations that vaccines could cause autism have frightened some parents away from giving them to children. But the question has been studied repeatedly, and there is no evidence for such a link; the research that first promoted the idea was subsequently proved fraudulent.
    Indeed, a report published last month by the Institute of Medicine, which advises the government, found that the HPV vaccine was safe.
    It did find “strong and generally suggestive” — though not conclusive — evidence that the vaccine could cause severe allergic reactions. But such reactions have been rare.
    Historically, Dr. Willoughby said, vaccine scares have caused vaccination rates to drop for three or four years, and have led to outbreaks of diseases that had previously been under control, like measles and whooping cough. Measles cases in the United States reached a 15-year high last spring, with more than 100 cases, most in people who had never been vaccinated.
    Once the disease begins to reappear, parents become worried and start vaccinating again. With cervical cancer, Dr. Willoughby said, “unfortunately, the outbreak is silent and will take 20 years to manifest.”
    This time, he said, there will be no symptoms to scare parents back into vaccinating their daughters until it is too late.
    HPV infection is extremely common — the most common sexually transmitted infection in the United States. More than a quarter of girls and women ages 14 to 49 have been infected, with the highest rate, 44 percent, in those ages 20 to 24.
    Millions of new infections occur each year, and researchers think that at least half of all adults have been infected at some point in their lives. The genital region is teeming with HPV, and any kind of intimate contact — not just intercourse — can transmit the virus. In most people, HPV is harmless: The immune system fights it off. But in some people, for unknown reasons, the viruses persist and can cause cancer.
    Although the HPV vaccine was initially approved in 2006 to prevent cervical cancer, more recent data has shown that HPV also causes cancers of the penis, anus, vagina, vulva and parts of the throat. Many scientists think that the vaccine can prevent those diseases as well.
    Last month, the Centers for Disease Control and Prevention published a report on vaccination rates in girls that was “a call to action” to do a better job with the HPV vaccine, according to Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases.
    “We’re not meeting our goals,” Dr. Wharton said. “Girls are not getting an important preventive measure that they need.”
    Nationwide, last year only 32 percent of teenage girls received all three shots needed to prevent HPV infection, the disease centers found. Rates of vaccination were much higher (at least 45 percent) in a few states — Massachusetts, Rhode Island, Washington and South Dakota. Those furthest below average (20 percent or less) included Idaho, Mississippi, Arkansas and Alabama.
    The report was particularly troubling, Dr. Wharton said, because it showed use of the HPV vaccine lagging far behind that of two other vaccines that were licensed around the same time, one for meningitis and a combination shot against tetanus, diphtheria and whooping cough.
    “This vaccine has been portrayed as ‘the sex vaccine,’ ” said Dr. Mary Anne Jackson, a professor of pediatrics at the University of Missouri-Kansas City and a member of the infectious disease committee of the American Academy of Pediatrics. “Talking about sexuality for pediatricians and other providers is often difficult.”
    Dr. William Schaffner, an infectious diseases expert at Vanderbilt University, acknowledged that 11 or 12 is “a pretty tender age, and parents are having a hard time getting used to this concept.”
    But like the measles vaccine and others, this one must be given before a person is exposed to the virus or it will not work.
    “Here we’d like to get it completed before the young woman initiates her sex life,” Dr. Schaffner said. “Of course parents, particularly fathers, think that’s going to happen at around age 34.”
    The average age of first intercourse in the United States is about 17 for both boys and girls, according to the Kinsey Institute. About 25 percent have had sex by age 15.
    Even before Mrs. Bachmann’s comments, family doctors were negotiating with reluctant, confused parents. Dr. Schaffner said he knew a pediatrician who postponed the HPV shots until most patients turned 15 specifically to avoid parents’ objections at the younger age.
    “He thinks he can pick out the early adventurers because he knows them so well,” Dr. Schaffner said. “Those, he vaccinates earlier. Personally, I’m dubious about the success of this strategy. He may be no better than the parents figuring out who is doing what when.”
    Dr. Willoughby said he thought the HPV vaccine might be more acceptable to parents if it were recommended even earlier in life, at a less fraught time than the cusp of puberty. Then it could be given, as most vaccines are, without parents’ or doctors’ feeling a need to give the child a detailed explanation. And there would not be the unspoken implication that sex was imminent.
    “There’s probably no reason why it should be 11 or 12, as opposed to 5 or 6 or even birth,” Dr. Willoughby said. “If it were being given in kindergarten, I don’t think would be an adherence problem.”
    So far, there is no evidence that the vaccine wears off over time, but if that does occur, Dr. Willoughby said, booster shots could be given.
    There are many strains of HPV, but two of them, known as Type 16 and Type 18, cause 70 percent of all cervical cancers. Other strains can cause genital warts.
    One version of the vaccine, Gardasil, made by Merck, works against the two cancer-causing strains and two other strains that are the most common causes of genital warts. Gardasil was approved for use in boys in 2009 to prevent genital warts, but medical groups like the pediatrics academy have not recommended it; that could change within the next few months.
    Another version, Cervarix, made by GlaxoSmithKline, protects against only the cancer-causing strains, and is approved only for girls and women.
    In studies comparing women who were vaccinated with those who were not, the vaccines were 93 to 100 percent effective at preventing infection with HPV Type 16 and Type 18, according to Dr. Deborah Saslow, the director for breast and gynecological cancer at the American Cancer Society.
    Some critics of the vaccine have said it is not needed in the United States, arguing that cervical cancer is no longer common here: Pap tests are finding precancerous growths early enough to remove them before they turn into cancer. There are about 12,000 cases of cervical cancer and 4,000 deaths a year in the United States. (In developing countries, infection rates are much higher, and the disease is a leading cause of death in women.)
    But deaths are only a small part of the trouble caused by HPV. Several hundred thousand women a year in the United States need surgery for precancerous lesions caused by the virus, and many more are treated for other cervical abnormalities linked to the infection.
    The vaccines could prevent many of those cases and spare women the surgery, which can be painful and nerve-racking, and may impair a woman’s ability to carry a pregnancy to full term, Dr. Saslow said.
    By June 2011, more than 35 million doses of the two cervical cancer vaccines had been distributed in the United States, according to the Centers for Disease Control and Prevention. The most common side effect is a sore arm from the shot. Though fainting has been reported, Dr. Jackson said that teenagers were more likely than younger children to faint after any injection.
    When pediatricians recommend the vaccine, many parents still hesitate. Michele Boettiger, the mother of three daughters in Missouri City, Tex., said she struggled with the decision about whether to vaccinate them against HPV. She worried about whether the vaccine was safe.
    As a Roman Catholic who believes in abstinence until marriage, she also wondered whether the vaccine would somehow send the wrong message, and act as “a gateway for young women to think they have sexual freedom.”
    Ms. Boettiger, a nursing student, found reassurance in the endorsement of the vaccine by the disease centers and other medical groups, and in its acceptance by the National Catholic Bioethics Center.
    Her father and her husband, the girls’ father, both died of cancer. “Our family suffered a loss from cancer,” she said. “It is not a battle I want to fight anytime soon.”
    She has had her two older daughters vaccinated, and will do the same for the youngest.
    Thank you, Rep Bachmann for raising the spotlight on this. Still wish she would have done for circumcision, etc along those lines because they deserve to be in the spotlight. At the same time I'm still appalled to the reaction from the experts and etc. Especially, with Ms. Boettiger, a nursing student, etc whom ultimate decided to vaccinate her two oldest daughters and she will the same with her youngest when reaches the recommended age. Now onto my comment regarding all of this.

    Here we go again with this and etc. Know that I'm just a student of life, who's yet to reach this stage of life. Found that this article is no different from other ones on these subjects. Unsure if theres more benefit/s and/or risk/s to this and etc. I'm hoping that my future partner and me are on the same page regarding all of this. Not really sure how to explain the why part of this at the moment.

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    Member Extraordinaire hppygr8ful's Avatar
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    Huh?

    Not sure if you are advocating for or against the vaccine? Unfortunately Ms. Bachmann is a nut who makes Sarah Palin look like a genius. I don't know where these women come from. There are so many bright articulate educated women who could represent the Republican Party. Anyway If I had a girl I would most likely have her vaccinated to protect her against future health risks. Even if said daughter remained celibate until marriage she would be protected if her intended was not celibate prior to that relationship. The evidence is in and Vaccines are 99% safe and effective with few side effects.

    Peace and Namaste

    Hppy

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    Quote Originally Posted by hppygr8ful View Post
    Not sure if you are advocating for or against the vaccine? Unfortunately Ms. Bachmann is a nut who makes Sarah Palin look like a genius. I don't know where these women come from. There are so many bright articulate educated women who could represent the Republican Party. Anyway If I had a girl I would most likely have her vaccinated to protect her against future health risks. Even if said daughter remained celibate until marriage she would be protected if her intended was not celibate prior to that relationship. The evidence is in and Vaccines are 99% safe and effective with few side effects.

    Peace and Namaste

    Hppy
    hppy,

    Have to say that I'm totally against your response because I found that both women are genius to a degree. Highly recommend that you do more of learning and researching on all of this. Since I think theres more risk involve when you don't do your own learning and researching. This also applies to the general mainstream population as well.


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    Super Moderator cougarnurse's Avatar
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    Whereas I am staying out of the polotical debates right now, I will say I am not too happy about more vaccines.

    Personally, I think it should not be mandatory. Oh, I believe that the MMR, etc. are important, but would refuse the chicken pox and HPV. Mom and I discussed this well before she died, too, and she'd have backed me up as a kid/used parental rights.

    No, I never did have chicken pox, either. Mom knew what the heck to look for, having had measles twice and dealing with her siblings going through stuff.

  5. #5
    Member Extraordinaire hppygr8ful's Avatar
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    I have done the research

    Quote Originally Posted by mybodymyself View Post
    hppy,

    Have to say that I'm totally against your response because I found that both women are genius to a degree. Highly recommend that you do more of learning and researching on all of this. Since I think theres more risk involve when you don't do your own learning and researching. This also applies to the general mainstream population as well.
    I have looked at you profile and am not sure what you credentials are to making a broad statement on the safety and efficacy of vaccines.

    I have read through hundreds of pages of independent research on the safety of vaccines and while there is always some risk - the remark made by Bachmann that the HPV vaccine had caused autism in a person is rediculous and unfounded. Also the original study on the MMR vaccine and Austism was found to be the result of fraudulent data and the Dr. who did the study has since lost his medical license. I do no believe that the HPV should be mandatory but we have had a marked increase in preventable disease Measels and Whooping Cough to name just two that are a direct result of people not vaccinating their children. People can make the choice not to vaccinate their children it's their right but they have to realize that they are putting other people at risk with their irresponsibility. We are only a generation removed from a time when children died and were severely affected for life with developmental diseases due to contracting preventable dissease such as Polio, Measals and Rubella. If my son or daughter contracted a disease that could have been prevented with a vaccine that I choose not to get - I would never be able to forgive myself.

    As for the intelligence of Bachmann and Palin - Both are obviously educated smart women. I even actually like Sarah Palin as a person - but as a Vice President I did not because of her lack of real world experience. Bachmans's world view seems to be fomulated on religious indoctrination and a reliance of "Evidence" that is anecdotal and unproven at best. When Bachmann makes comments about homosexuality being a disease or stating what she did about HPV she is showing her ignorance and the fact that she has not done any research to support her claims. I am a hard core conservative as many people here know. I support small government. I can't stand President Obama or his policies but my opinions are formed by independent reasearch of facts not anecdotal stories told on the internet.

    So please cite your evidence to support that vaccines are dangerous and I will look into it.


    Peace

    Hppy

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    Quote Originally Posted by hppygr8ful View Post
    I have looked at you profile and am not sure what you credentials are to making a broad statement on the safety and efficacy of vaccines.

    I have read through hundreds of pages of independent research on the safety of vaccines and while there is always some risk - the remark made by Bachmann that the HPV vaccine had caused autism in a person is rediculous and unfounded. Also the original study on the MMR vaccine and Austism was found to be the result of fraudulent data and the Dr. who did the study has since lost his medical license. I do no believe that the HPV should be mandatory but we have had a marked increase in preventable disease Measels and Whooping Cough to name just two that are a direct result of people not vaccinating their children. People can make the choice not to vaccinate their children it's their right but they have to realize that they are putting other people at risk with their irresponsibility. We are only a generation removed from a time when children died and were severely affected for life with developmental diseases due to contracting preventable dissease such as Polio, Measals and Rubella. If my son or daughter contracted a disease that could have been prevented with a vaccine that I choose not to get - I would never be able to forgive myself.

    As for the intelligence of Bachmann and Palin - Both are obviously educated smart women. I even actually like Sarah Palin as a person - but as a Vice President I did not because of her lack of real world experience. Bachmans's world view seems to be fomulated on religious indoctrination and a reliance of "Evidence" that is anecdotal and unproven at best. When Bachmann makes comments about homosexuality being a disease or stating what she did about HPV she is showing her ignorance and the fact that she has not done any research to support her claims. I am a hard core conservative as many people here know. I support small government. I can't stand President Obama or his policies but my opinions are formed by independent reasearch of facts not anecdotal stories told on the internet.

    So please cite your evidence to support that vaccines are dangerous and I will look into it.


    Peace

    Hppy
    hppygr8ful,

    Yeah I'm aware of this and understand were you are coming from on this. Nope I'm not one or have any medical credentials and have no intention to do. Still I'm a student of life and this is many of my passions.

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