New at Reason

February 20, 2007

Jesse Walker wonders why the vaccine for cervical cancer is suddenly so hard to avoid.

Comments

|2.20.07 @ 7:51AM|#

Is it a vaccine for cervical cancer or a vaccine for HPV?

Guy Montag|2.20.07 @ 8:11AM|#

Apologies for this being too far off topic.

Caught a bit of Loveline on the radio last night and a caller, born with HIV, had a question for Dr. Drew about preventing further STDs when she becomes sexually active.

One thing that I noticed was that neither Dr. Drew nor the caller called HIV anything different than an STD, which was a marked departure from the "educated talk" about HIV from college over 20 years ago, i.e., that HIV was a [pick something besides sexual] disease.

The other thing was that Dr. Drew pointed out that the reason that folks like the caller live for decades now vs. being told they had six months to live after diagnosis, is because of all of the drug treatments that are used to keep the virus under control.

He went on to say that the people a few years ago who were denying that HIV was even related to AIDS and that using drug therapy was "dangerous" really need to be held responsible for the many deaths that occurred by the delay that they caused.

I tend to agree with Dr. Drew on that.

On this HPV vaccine, I am torn on the forced application. There have been times that mass vaccinations were necessary (and necessarily rubbed me the wrong way as being against government intrusion), like for smallpox, etc. But this seems to have gone too far.

jf|2.20.07 @ 8:38AM|#

This is just more proof that the far-right religious fundies run every aspect of this country.

|2.20.07 @ 8:41AM|#

My 13-year old daughter was going to vaccinated at her last physical (about a month ago) but her doctor hadn't yet gotten the vaccine shipment. The doc highly recommends it and will call us when it arrives.

That said, I don't think it should be mandatory - it's not contagious, as has been noted, under normal casual contact conditions - but I just can not, for the life of me, understand why any parent would not want their daughter to be protected against the possibility of HPV.

jf|2.20.07 @ 8:48AM|#

BTW, Pajamas Media has removed Ron Paul from their online presidential straw poll.

|2.20.07 @ 9:10AM|#

If this is "New at Reason", then why is the home page still sporting the medieval uberdweeb? I can't believe we had to endure his embarrassing mug this long. And what's with taking a bullshit government holiday off anyway. If anything there should have been a series of special 'President related' articles. Come on Reason staff, get off your collective (hee) ass.

|2.20.07 @ 9:12AM|#

Dear For Clarification: Read the first sentence of the article. If you are still confused, you might try reading the entire article.

I suspect that the states are moving to make this vaccine mandatory so that the parents are relieved of such a difficult decision. If the state requires the shots, it becomes a public health issue for all to deal with, it may become separated from the morality of sex because all girls are in the same boat, from little Miss Dorky-frump to Miss 12-going-on-25. The state makes the decision so you don't have to.

I suspect that parents will be relieved that they don't have to talk to their kids about sexually transmitted diseases.

|2.20.07 @ 9:26AM|#

|2.20.07 @ 9:29AM|#

????? my comment got sucked into the void. Try try again

I suspect that parents will be relieved that they don't have to talk to their kids about sexually transmitted diseases.

I suspect you are right. If there's one thing parents want the government to be put in charge of, it's parental responsibility.

|2.20.07 @ 9:54AM|#

Warren: I don't know if you're being sarcastic or not. Of course no parent wants to have less control over their children. But if you want your kid to be vaccinated, but you don't want them to think that you are given them the OK to screw around, then this type of government decision would relieve you of a lot of stress. I didn't say it was a good thing that parents would be relieved to cede parental responsibility, but I think (without any evidence other than my experience) a lot of parents secretly welcome this type of thing. If they didn't, this governor would be toast.

Bob|2.20.07 @ 10:02AM|#

but I just can not, for the life of me, understand why any parent would not want their daughter to be protected against the possibility of HPV.

Because not having the vaccine may discourage them from having imorral sex.

|2.20.07 @ 10:12AM|#

Bob's statement reminds me of something that a Reason editor said last year about the people who oppose this vaccine. Why would someone be discouraged from having sex by not getting a vaccine that prevents a virus from giving you cancer when you are 60 years old? For all of the reasons I didn't get laid in high school, "No wait, I don't want to get cancer after menopause" was never one of them.

Jesse Walker|2.20.07 @ 10:18AM|#

Is it a vaccine for cervical cancer or a vaccine for HPV?

It's a vaccine for HPV.

|2.20.07 @ 10:19AM|#

"Because not having the vaccine may discourage them from having immoral sex."

...and it's just another example of the right-wing's commitment to erring on the side of life. Except, in this case, they are risking death to teach their kids a lesson.

Jesse Walker|2.20.07 @ 10:27AM|#

If you're curious to see what those Christian conservatives are actually telling parents about the HPV vaccine, here's a Focus on the Family factsheet:

http://www.family.org/socialissues/A000001086.cfm

I suspect this will do more to persuade parents to accept the shots -- and to inform their children about other cancer and STI risks -- than to turn them away.

|2.20.07 @ 10:38AM|#

Warren: I don't know if you're being sarcastic or not.

To tell you the truth Lamar, I don't know myself. I just find the ease at which people hand their kids over to the state (and otherwise forfeit their liberty) unsettling.

|2.20.07 @ 11:57AM|#

The weird thing is, HPV is only linked to cervical cancer, and only one strain at that (I think). It's not as if all women (or even most women) infected with that particular strain get cervical cancer. The vaccine is a good idea, but the hype surrounding this issue is, as usual, over the top.

(My info may be out of date. If someone has a good link, I'd like to see it.)

biologist|2.20.07 @ 12:35PM|#

first two sentences of Jesse's article:

"Gardasil isn't exactly an anti-cancer vaccine, but it comes close. It protects girls and women against four sexually transmitted strains of the human papillomavirus (HPV), two of which cause about 70 percent of all cervical cancer."

|2.20.07 @ 12:44PM|#

For those who are wondering, the vaccine protects against two strains of HPV that cause roughly 70% of the cases of cervical cancer, and two strains that cause 90% of the cases of genital warts.

The problem is, there are some 30 strains of HPV that are sexually transmitted, and many of the carcinogenic ones are mild and self-limiting, so it's not obvious that you are infected. So you have the real possibility that even though your daughter gets vaccinated, she can still get HPV, genital warts, and cervical cancer.

Which is why girls who get the vaccine will still be required to get yearly pap smears, still be required to be careful about whom they sleep with, and still be required to practice safe sex. All of which can prevent HPV infection or cervical cancer in the first place.

When one also considers that for middle-class, non-smoking white women the risk for getting cervical cancer is already quite low, the policy of lining every teenaged girl up and vaccinating her seems rather wasteful and excessive.

wayne|2.20.07 @ 2:06PM|#

I have a teen age daughter and I plan to have her vaccinated. She and I have talked about it and she agrees that it is a good idea. It's a pricey vaccine, about $400.00, but I can't understand why a young woman would forego the vaccine.

|2.20.07 @ 2:29PM|#

Er, duh!

Thanks, biologist.

Captain Holly, thanks for the info. I knew the hype surrounding the vaccine was BS. Also, I've read that some huge proportion, more than half, of all sexually active women have HPV. Is there going to be a cervical cancer epidemic? I doubt it. Here's my question for the medically inclined: Why don't these particular strains of HPV cause cervical cancer in all, or even a majority, of infected women? Seriously, does anyone know? Or is it the case that the "bad" strains do cause cervical cancer in most cases, but these strains are actually rare?

(I'm sorry, but after being told my entire life that margarine was healthier than butter; then to be told that transfats are killers... well, I have little faith in the accuracy of medical science. If it's science, it shouldn't be turned on its head after a few years, or ever! E.g., Newton's theories still work even after Einstein, it just turns out that they are only approximately correct. It didn't turn out that they were TOTALLY WRONG like so many "factual" pronouncements from the medical community.)

bill|2.20.07 @ 2:38PM|#

I don't think the shot should be mandatory, but I'm concerned that boys are being left out of the equation. It's rare but HPV can cause penile cancers too.

|2.20.07 @ 2:58PM|#

Now, if we let congress know that it can cause dick cancer, they'll mandate it for all newborns!

biologist|2.20.07 @ 3:09PM|#

The Real Bill:

I don't know, but I'll guess wildly (IANAVOO = I am not a virologist or oncologist).

certain strains of HPV can induce cancerous growth only in women who are already genetically predisposed to have cervical cancer.

iow,

certain types of HPV + certain DNA sequences predisposing one to cervical cancer = higher probability of cervical cancer

other types of HPV + certain DNA sequences predisposing one to cervical cancer = baseline probability of cervical cancer

certain types of HPV + other DNA sequences not predisposing one to cervical cancer = baseline probability of cervical cancer

bill|2.20.07 @ 3:15PM|#

Plus, if boys are vaccinated so they don't contract it then they can't spread it. It actually makes more sense to vaccinate boys than girls. I doubt many women have gotten HPV from lesbian sex (yes it probably can be contracted that way somehow).

|2.20.07 @ 3:41PM|#

Thanks, biologist.

IANAVOO, too!

|2.20.07 @ 4:03PM|#

Here's my question for the medically inclined: Why don't these particular strains of HPV cause cervical cancer in all, or even a majority, of infected women? Seriously, does anyone know? Or is it the case that the "bad" strains do cause cervical cancer in most cases, but these strains are actually rare?

Here's my semi-informed answer (IUTBAVBNAO = I used to be a virologist but not an oncologist)

There are several reasons for this. Most sexually-transmitted strains do not cause cancer, and as biologist pointed out, even if you do get infected with a carcinogenic strain it's not an automatic death sentence.

Whether or not a woman develops cervical cancer depends on her age, habits, income and race (although the racial factor may be due more to lack of access to medical care than any significant genetic differences).

As I alluded before, one of the major factors associated with the development of cervical cancer is smoking. Black, Hispanic, and Asian women are more likely to both develop and die from cervical cancer, although both the incidence rate and death rates have been declining for all racial groups for the past 30 years or so. And the risk for cervical cancer also increases with the number of children a woman has.

In short, there are a multitude of factors that determine whether or not a woman gets cervical cancer, and most of them are lifestyle-based. Forcing every girl to get the vaccine is simply not justified given the current trends and nature of the disease; I can't help but associate it with the idea that forcing all gun owners to register their guns will significantly lower the homicide rate.

ellipsis|2.20.07 @ 5:33PM|#

If Focus on the Family supports the vaccine, something fishy is going on.

|2.20.07 @ 5:40PM|#

Thanks, Captain Holly.

It looks like human genetic diversity doesn't make the job of medical researchers any easier (but it does make for variety, which I love).

|2.20.07 @ 7:04PM|#

Seems like the discussion has been drifting towards the merits of the vaccine, without too much thought about the government's violent imposition of the vaccine upon 13 year old girls (I say "violent", because that is what "mandatory" means, and not "voluntary").

Have any of you ever thought about the implications this issue has on the principle of Equality Before the Law? The question is: Why are not BOYS being vaccinated?

Reason this: If the idea behind mandatory vaccionation is to protect women from cervical cancer AND being the HPV a sexually trasnmitted organism, then why are not BOYS being vaccinated as well, since it does require a boy (or a man) to sexually transmit ANYTHING to a woman?

The issue here is that the mandate DISCRIMINATES women, by innaculating only THEM, leaving boys to continue having their skin un-pricked. THAT violates the basic principle of equality before the law. Of course, Big Media will not see this problem, prefering to defend Big Nanny State, but neither have the vaccination opponents! Is it not this a case of civil rights violation?

Look at this incredible statement:

I suspect that the states are moving to make this vaccine mandatory so that the parents are relieved of such a difficult decision.

Talk about missing the point. The issue here is that there is big business to be made with vaccinations, especially with the added value of patent laws - those Letters of Marque that government issues to people that "invent" something. The big winner here is, of course, the supplier of the vaccine. Whatever deal that company struck with Mr. Perry, it will amount to a hefty sum indeed.

|2.20.07 @ 7:19PM|#

Gardasil isn't exactly an anti-cancer vaccine, but it comes close.

Err, this vaccine protects against a viral disease, 7% of the strains of which cause one type of cancer in some of those who contract it. Unless this is some new definition of "close" I'm not aware of, that's nowhere close to an "anti-cancer vaccine".

Hopefully for Merck, they've hired the same people who did up the propaganda for embryonic stem cell research...how are those miracle therapies coming along anyway?

|2.20.07 @ 7:23PM|#

On a positive note, I applaud Mr. Walker for opposing making the vaccine mandatory even though he thinks it's a good idea. It is refreshing to see libertarians who uphold liberty even if it means agreeing with religious conservatives.

|2.20.07 @ 8:41PM|#

Gamito,

You've got it exactly wrong. It's meant to protect women and heterosexual men. They want gay men to get it. The fundies probably hope that they'll get anal cancer or something. As usual though, there are many flaws in their plan. For example, bisexuals.

|2.20.07 @ 8:43PM|#

For the sarcasm impaired, the above comment wasn't serious.


Or was it?

Jesse Walker|2.20.07 @ 9:22PM|#

I didn't say it was a vaccine against all cancers, Crimethink. It isn't even a vaccine against every variety of HPV.

biologist|2.21.07 @ 9:50AM|#

I'd just like to say I think that crimethink is a real idiot.

VikingMoose|2.21.07 @ 10:23AM|#

Biologist:

Agreed. A total fucking idiot. Always has been.

dhex|2.21.07 @ 10:31AM|#

"since it does require a boy (or a man) to sexually transmit ANYTHING to a woman?"

you may not be totally up on how hpv is spread, but the above is simply not true.

lunchstealer|2.21.07 @ 12:15PM|#

Unless this is some new definition of "close" I'm not aware of, that's nowhere close to an "anti-cancer vaccine".

Actually, it's a very old and common definition of the word 'close' that you appear to be unaware of.

|2.21.07 @ 4:16PM|#

[Y]ou may not be totally up on how hpv is spread, but the above [statement, that a boy is required to sexually transmit a disease to a woman] is simply not true.

You must be jesting. Do you read what you write?

biologist|2.21.07 @ 4:24PM|#

he's not jesting, you're just wrong, Gamito.

|2.21.07 @ 6:14PM|#

Two girls can't spread this thing to each other? Is that what we're getting at? Too many people are trying to win their particular arguments that not a lot of truth or common sense is happening today.

|2.22.07 @ 11:44AM|#

he's not jesting, you're just wrong, Gamito.

Kindly explain why. It is one thing to say "You're wrong!" and then ride towards the sunset, and another thing to back up such assertions with an explanation. I would love to hear it.

|2.22.07 @ 12:22PM|#

From todays Pharma Newletter- 2/22/07

Texas Governor's Cervical Cancer Vaccine Meeting Coincides with Donation, Article Says Texas Gov. Rick Perry's chief of staff met with key aides about the new vaccine Gardasil to prevent cervical cancer on the same day Merck donated $5,000 to his campaign, according to documents obtained by The Associated Press. Perry's spokesman said the timing of the meeting and the donation was a coincidence, while Merck had no immediate comment. Texas became the first state to require the vaccine against human papillomavirus earlier this month, but state lawmakers are considering overriding the measure. END

golly gee I wonder what the big rush is all about? Politicians voted in by the people while being bought and paid for by the Corporations at the same time. Which do you think they listen to the most, a vote caster or a cash caster?

Ask your Dr. if its right for you!

biologist|2.22.07 @ 2:03PM|#

from: here

"HPV is usually transmitted through direct skin-to-skin contact, most often during penetrative genital contact (vaginal or anal sex). Other types of genital contact in the absence of penetration(oral-genital, manual-genital, and genital-genital contact) can lead to HPV infection, but those routes of transmission are much less common than sexual intercourse"

biologist|2.22.07 @ 2:07PM|#

btw, Gamito, the vaccine hasn't been tested in males, to my knowledge, so that's another good reason to not attempt to vaccinate them right now.