I’m not anti-vaccine. My concern is that as far as I understand it there hasn’t been terribly much independently-funded research done about the potential side effects, be they immediate or long-term, of this vaccine.
I know that no vaccine is 100% effective, but most are very highly effective. I’m not saying that means we shouldn’t use them. Of course we should. Polio is bad; eliminating it is something we should continue striving towards. I wasn’t trying to say that Garadisil doesn’t work or anything like that.
My point was this: the vaccine only blocks a few strains of the virus. The virus itself is only a factor in developing cervical cancer: the overwhelming majority of cases of HPV are wholly benign or lead to a relatively harmless condition (warts). Very occasionally HPV can lead to development of abnormal cells, which sometimes turn cancerous. Cervical cancer is only barely within the ten most prevalent cancers. So to say that this vaccine “prevents cancer” isn’t really true in the common interpretation, since the risk is already quite small. The vaccine will reduce your risk of getting a particular strain of a virus, which in turn reduces the chances of developing cancer, but it’s not some miraculous anti-cancer drug.
My main concern on the topic is that it’s a really expensive drug. A nurse tried to pressure me into getting it at Planned Parenthood a while ago. I told her that I wasn’t interested because even if getting HPV was a risk for me (which it’s not), I don’t think that making the already-tiny risk a little bit tinier is worth nearly $400.
And as for the efficacy, it’s not a particularly good cite, but according to Wikipedia, there’s well over 100 strains of HPV. Eight of them are known to cause cancer. The vaccine protects against two of them. Again, it doesn’t prevent cancer; it slightly reduces the risk of possibly developing cancer.
When I was going for my OFA (Occupational First Aid) ticket we were instructed on the same point (though I work in a warehouse and not a school). We cannot give out anything of the sort. The reason provided by the instructor was that Tylenol, Aspirin, etc may have unexpected side-effects if combined with other medications which the patient is taking and which we may or may not be aware of. I don’t think zero-tolerance has anything to do with it, it sounds like someone clued into the fact that there may be a health risk involved, and made a ruling.
We really like a link to the article so we can see the source, as well. Not saying your source is suspect, Mumio, but they can be.
My sister was recently diagnosed with cervical cancer, after years of suspicious paps with pre-cancerous cells and LEEPs (a form of cervical biopsy). Now she has to deal with repeated biopsies, surgery, chemotherapy, and sterility (at 37). If you are of the mistaken impression that because cervical cancer usually grows slowly (but not always) that going through years of these procedures and the uncertainty of what is to come is easy on a woman, let me disabuse you of that notion right now.
As for the safety of the vaccination, from this site:
{Bolding mine}
Yes, there is aluminum in the vaccination. From this site:
Say your daughter is 80 pounds (40kg) - that would make her daily RDI 40 milligrams per day. The aluminum content of Gardasil is 225 micrograms, which is 0.225 milligrams. The aluminum content of Gardasil is not an issue. The fact that the article you quoted is so inaccurate on such a simple point throws the accuracy of the rest of the article into strong doubt for me, Mumio.
Maybe, maybe not. I had normal Paps every year of my adult life until 2002, when I had an abnormal one. It was followed by a colposcopy, which indicated microinvasive cervical cancer. So it had apparently popped up between annual exams. It was just becoming invasive, and as it was apparently rather fast-developing as these things go, if I’d even followed current U.S recommendations for women with a history of normal Paps and gone 2 - 3 years until my next one, I could have needed a hysterectomy - or worse.
I got off relatively easy with a LEEP, but let me tell you, if I had a daughter, I’d be marching her in for her vaccine as soon as recommended. Why do most people not think twice about vaccinating their kids against something like polio that they will likely never, ever be exposed to, but not against something that they will almost certainly be exposed to, given the extremely high rate of HPV infection in the U.S.? Let’s face it, the vast majority of kids will have sex at some point in their lives.
Well, part of it is probably because four hundred dollars is quite a bit of money for a vaccine that protects against a disease that protects against a disease which, statistically speaking, is almost always harmless. I’m sure that if Merck stops charging quite so much it’s popularity will go up.
:smack: Sorry I was snarky. I lost track of who I was replying to, and thought that you were one of the ones bitching about how we would do it in our country. (And your location field was blank at the time I replied.)
Wikipedia is not a great cite, no. And “well, eight strains of HPV cause cancer and Gardasil protects against two, so therefore, the risk reduction must be slight” is I guess not an unreasonable inference, but its contrary to the data that exists. Particularly given that two of the strains of HPV covered by the vaccine account for almost three-quarters of the cervical cancer cases in the United States.
There have been four very large Phase 3 studies of this vaccine in women (generally age 16-26). All are multicenter studies. The two big ones were FUTURE I and FUTURE II; there were 5500 women enrolled in the former (about half received study drug and half received placebo) and more than 12,000 in the latter (same basic study design).
In FUTURE I, the vaccine was associated with a 34% reduction in the incidence of anogenital lesions and a 20% reduction in the risk of cervical lesions (the risk reduction in cancers specifically caused by strains of HPV covered by the vaccine was obviously much better). Patients were followed for an “average” (can’t tell if it’s median or mean) of 3 years following first dose of vaccine, which of course means that a proportion of this group was followed for longer than 3 years. While there were minor injection site reactions in the treatment group vs. the placebo group, on the whole the serious adverse event profile was not different between Gardasil and placebo.
In FUTURE II, the relative risk reduction of high grade cervical cancer was about 17%. Again, there was a mean/median follow-up of 3 years, and again the adverse event profile of this vaccine vs. placebo was not significant.
There were two more large Phase 3 studies, that I don’t have time to research here, but just on the basis of the two studies above (and ignoring Phase 2 trials and clinical experience now that the vaccine is available), that’s more than 8,000 patients who received this vaccine and were followed for an average of 3 years for safety. These studies were sponsored by the maker of Gardasil, but carried out by independent researchers at a variety of academic institutions, then published in exhaustively peer-reviewed publications (both FUTURE I and FUTURE II were published in The New England Journal of Medicine. So I take issue with your contention that “there hasn’t been terribly much independently-funded research done about the potential side effects, be they immediate or long-term, of this vaccine.”
Now, to the size of the risk reduction. You describe the reduction as “slight,” and later say this:
On a relative scale, the risk of any individual cancer is quite small, compared to, say, the risk of getting injured in a car crash. That doesn’t mean the risks are minor, nor that we should avoid an opportunity to reduce them.
There will be a bit over 11,000 cases of invasive (vs. pre-invasive) cervical cancer diagnosed in 2008. That’s quite a few. It’s the eighth most common type of cancer to affect women, not “barely within the ten most prevalent cancers.” The incidence rate is low, I guess, but it’s not as vanishingly small as you are portraying above (and, of course, for sexually active women, it’s a bit higher). And again, you can reduce the risk by somewhere in the neighborhood of 20% using the vaccine. That’s a not insignificant reduction to a not insignificant risk. Painting it as a tiny reduction to an already-negligible risk, and glossing over tons of research suggesting that the vaccine is safe, is incredibly irresponsible.
(DISCLOSURE - I work for a drug company, but not for the one that manufactures Gardasil).
I went to school in Oklahoma from 19778 to 1983, when we moved to Texas. Things I remember from school which would be considered odd today…
We said the Lords Prayer every day, right after (or before?) the Pledge of Allegiance.
I remember the guys who came to check and see if our spines were straight.
Both the teacher and the principal had paddles. I got paddled by teachers more than principals. First day of school they would send home a note for your parents to sign so they couldn’t paddle you. My Mom never did. There were rumors of an “electric paddle” but nobody could agree whether it shocked you or if it had an electric motor that made it hit you really really quick.
We would have head lice checks every year, which was basically the teacher going through our hair carefully with a pencil. The kids with the lightest color hair would get sent to the principals office for a more thorough examination. I was one of the platinum blond kids until around 4th grade, when it started darkening and I could get lice checked in my classroom.
We had an art project where we painted some kind of ceramic figurines of kids playing as presents for our parents. The white kids were all given one color of paint, the Indians another. The black kids got to sit with the teacher while they mixed colors to try to match their individual skin tone as closely as possible.
We frequently had pow-wows in the auditorium, that was an Oklahoma thing I guess.
I won’t, nor did I argue with any of the facts. My primary problem is the combination of the absolutely unreasonable cost and the distortion of facts surrounding what it does. If you say “Get this shot and you won’t get cancer!” then obviously people will pay obscene amounts of money for it.
If you’re honest and say “This series of injections will greatly reduce your risk of getting a couple strains of a virus that can, but doesn’t always, lead to pre-cancerous abnormalities,” then people on both sides will be much less hysterical about it. Cut out the drama and (gasp!) we’ll be able as a society to have a reasonable conversation about this - and hopefully the calmer heads will prevail and convince the others that reducing that risk is a good thing, which is of course what I believe.
The cost of the shot is not the only cost factor around HPV and cervical cancer. One of the public health considerations in recommending the vaccine was that if women are even partially protected against HPV, it may make sense in some circumstances to increase the interval between Pap tests, which would reduce medical expenses overall. So yes, it’s an expensive vaccine, but the expense of the vaccine isn’t the only figure to be taken into account.
There’s also the issue of herd immunity; the more people who are immune to the most common strains of HPV and genital warts (let’s not forget those little gems in this discussion, too), the fewer people who are running around spreading them. If (generic) you can’t afford the pricetag on the vaccine, that’s one thing, but I think it is somewhat immoral to depend on herd immunity to benefit your own health when you aren’t willing to pitch in to increase that immunity. Maybe the Calgary Catholic School Board hasn’t heard of this concept. Of course, it doesn’t matter to them, since all their good little girls and boys are only going to have sex with one person in their lifetime (their spouse, on their wedding night), and only to make babies. :rolleyes:
And nobody’s spouse ever dies or abandons them, and nobody is ever forced to have sex against their will, and all Catholics are 100% observant and only ever have sex with Catholics…
Yeah, don’t start me down that road unless you have a lot of spare time on your hands.
There were rumors of an “electric paddle” but nobody could agree whether it shocked you or if it had an electric motor that made it hit you really really quick.