CNN Spreads HPV Vaccination Doubts

I can’t decide if this is an example of careless reporting, or of intentional fear-mongering. While there is no solid evidence that Gardasil is dangerous, CNN’s article “Should parents worry about HPV vaccine?” seems to be written with the aim of confusing the public into believing otherwise:

Gardasil has been the subject of 7,802 “adverse event” reports from the time the Food and Drug Administration approved its use two years ago, according to the Centers for Disease Control and Prevention.

Girls and women have blamed the vaccine for causing ailments from nausea to paralysis — even death. Fifteen deaths were reported to the FDA, and 10 were confirmed, but the CDC says none of the 10 were linked to the vaccine. The CDC says it continues to study the reports of illness.

While the idea that the HPV vaccinations might be unsafe is scary, at this point in CNN’s article I’m most appalled by a major news organization’s apparent lack of interest in conveying any real information to readers about an issue that concerns the safety of women and girls, and that could impact people’s decisions on whether or not to get vaccinated.

Let’s start with the first statement – that 7,802 “adverse event” reports have been filed. The obvious follow-up question that should occur to any reporter is “well, how many of these adverse events have actually been linked to Gardasil?” One might also wonder what the average adverse event report rate is for any vaccine, and if those reports decline after the vaccination is proven to be safe. Readers naturally want to know, after such a sensational headline, well – should we be worried, or are people drawing connections between illnesses and the vaccine where none actually exist?

The article’s second sensational statement, that “[f]ifteen deaths were reported to the FDA,” immediately looses its steam when we realize that none of those deaths have been linked to Gardasil. At this point in my reading, I began to doubt CNN’s motives – they wouldn’t strum-up fear just because it’s good for ratings, would they?

Finally, CNN presents us with the terrifying story of a teenager who developed pancreatitis not long after taking the vaccine. While I am not insensible to how horrifying such a serious illness would be for a young girl and her family, it should be CNN’s responsibility to verify whether or not her fear that it was related to the vaccine could be founded – by researching how many of those incident reports dealt with pancreatitis, for example, or other autoimmune diseases. This type of reporting is important, after all, since it could impact women’s decisions and, consequently, their health.

Here is the sort of information that I would have expected CNN to include if they meant their article be read as a journalistic report that reflects a sense responsibility to the pubic, rather than a sensationalist rumor:

The Center for Disease Control (CDC) and the Food and Drug Administration (FDA) collect data on any health problem that occurs after any vaccine is administered, as part of the Vaccine Adverse Event Reporting System (VAERS). As the CDC explains, “Anyone can report a health problem in VAERS. Just because a health problem is reported to VAERS does not mean it was caused by a vaccine.” To be clear, what CNN reports as a possible cause for worry – that data about ‘adverse events’ following vaccination with Gardasil is being kept and monitored – is actually just part of routine procedure.

I asked above what the average ‘adverse event’ report rate is for any vaccine. For reports of adverse health events occurring after vaccination with Gardasil, less than 7% were ‘serious adverse events’ (“events involving hospitalization, death, permanent disability, and life-threatening illness“). As it turns out, this equates to “about half of the average for vaccines overall.”

To be fair, CNN does point out that “more than 26 million Gardasil vaccines” have been distributed since 2006, which provides a bit of context for the adverse event report number. Yet, the reporter fails to follow a claim that the vaccine should have been better tested with any description of how it actually was tested. This information isn’t hard to find – the same CDC page that lists the adverse event reports for Gardasil explains that studies included “…11,000 females 9 to 26 years of age… These studies found the HPV vaccine is safe and causes no serious side effects. The most common side effect is injection site pain.”

The CDC is looking into whether or not Gardasil could be related to 10 confirmed cases of Guillain-Barré syndrome, a rare autoimmune disease. Before CNN decides to run an exposé, however, I hope they’ll take the time to contact some of the researchers who work on Guillain-Barré and those studying a potential link. I also hope that they’ll write the piece with the aim to inform the public, not scare it.

Quite frankly, I’m not a doctor and I can’t recommend that anyone be vaccinated or not. If someone wants to read a blog that is run by doctors and medical researchers that frequently discusses vaccinations, I suggest Denialism Blog. Yet, before anyone decides not to vaccinate against HPV, they might want to consider that – as Jill points out – “HPV is a major risk factor for cervical cancer… genital warts, penile cancer and anal cancer.” In deciding whether or not to vaccinate girls and boys, the potential risks have to be weighed against the potential benefits. Considering that the American Cancer Association estimates that about “3,870 women will die from cervical cancer in the United States during 2008,” it is important to go into that decision with a cool head and an honest understanding of the risks.

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42 comments for “CNN Spreads HPV Vaccination Doubts

  1. July 8, 2008 at 11:36 am

    Yeah. I think they’re def. trying to spread fear.

    They can’t stand the fact that there are young females who are sexually active, and they feel threatened by it.

  2. Yuri K.
    July 8, 2008 at 11:50 am

    Or at least, they know that they can sell their product to people who are threatened. Not sure how much of a difference there is, but AOL Time Warner certainly has plenty of energy related to selling the idea of being exclusively sexual to younger and younger girls.

    And they include site pain as an adverse effect of a shot? Isn’t that, you know, what shots feel like?

  3. shah8
    July 8, 2008 at 12:09 pm

    CNN is just following the essential conclusion of a consumerist society…

    Impose a self-image, create a vulnerability/insufficiency, and sell a solution for the (oft-imaginary) vulnerability.

    CNN is merely selling the image of usefullness to readers by selling the information that HPV could be bad for you. It costs too much and may upset too many “important people” to actually do research. Also, almost everything that can be researched is ultimately ambiguous and a properly researched topic can leave the audience (that CNN wants) unsatisfied.

  4. C. Diane
    July 8, 2008 at 12:23 pm

    This reminds me of another recent fear-mongering bullshit CNN piece. The lead was about internet pharmacies being unregulated. Then, at one point, the reporter said that you can order “dangerous” drugs from internet pharmacies, but the DEA has no oversight!

    Of course not! It’s the FDA’s job to regulate prescription, non-narcotic drugs. Did CNN mention that? Of course not! But now they’ve got people worrying about their “dangerous” heart medications.

  5. William
    July 8, 2008 at 12:55 pm

    I’d guess that bad science, a slow news day, and the continued ignorant panic about vaccines in general are to blame for this story. I’m not so sure theres anything more sinister at work here than the average (and shocking) stupidity of many mainstream journalists. Just look at the way this story, like many, is constructed. You start with a basic premise (“X number of complaints have been made about thing Y”), dump in some human interest (“poor little Dick/Jane had A exposure to substance/circumstance/event B and now suffers from C”), then provide a point-counterpoint that gives equal weight to parties with radically different qualifications (“Dr. Smith and regulatory agency Q says there is no scientific evidence of a relationship, but emotionally involved non-expert #156742 disagrees”).

  6. July 8, 2008 at 12:57 pm

    I know this is hopelessly old-fashioned and stuffy of me, but when I was learning about journalism, I was taught that headlines must be statements and can never be questions. Because, you know, a news article — even a feature — is supposed to TELL US SOMETHING. It is NOT supposed to pose mysterious queries. Why are so many journalists afraid to explain the truth of a situation, and so many headline-writers afraid to summarize that truth in a statement? Oh, right, because they’re not interested in informing readers. They’re interested in generating revenue.

  7. July 8, 2008 at 12:59 pm

    And William, the shocking stupidity and sensationalism of mainstream journalists IS sinister. Media outlets could hire competent writers if they wanted to. They don’t see the point, however, and are happy to spread fear and misinformation if it increases their bottom line. Which it always, always will.

  8. July 8, 2008 at 1:12 pm

    I gave up on CNN as a respectable place for journalism and information a long time ago. Except for their Planet in Peril series I switch the channel. It is so odd that a liberal news organization would be promoting such fear. Who even reported this piece? Sanjay Gupta is their chief medical correspondent and I would not be shocked if he was left out of the report. This past year the NY Times had an article about if the HPV vaccine could be given to boys to prevent women from getting cervical cancer, would parents of boys get vaccinated.

    A few reason why I am not that surprised by this:
    1. CNN joined the news ranks to stir up controversy on the Mass. teen pregnancy pact.
    2. Their headlines for reporting on the DNC unity issues are all negative casting blame on Hillary, her fundraisers and supporters.

    They can be very anti-woman and an easy target is young girls. Whether it is Britney Spears or a unknown teenage girl, they will exploit anything for ratings. Through their stories, are they sending acceptable behavior standards for girls and women? I would think so. The HPV and the pregnancy pact stories all fit within young women having independence and contol over their own choices in life without restriction.

  9. July 8, 2008 at 1:22 pm

    I began to doubt CNN’s motives – they wouldn’t strum-up fear just because it’s good for ratings, would they?

    Have they stopped doing so, for more than ten minutes, at any time in the past seven years?

  10. Jenga
    July 8, 2008 at 1:35 pm

    “And they include site pain as an adverse effect of a shot? Isn’t that, you know, what shots feel like?”

    I assume that means for an extended period of time that would otherwise not be standard for a shot. But who knows?

  11. July 8, 2008 at 1:51 pm

    Yeah, my arm was unusually sore for several hours after I got the first Gardasil shot. I kept pausing throughout the day and saying, surprised, “Ow.”

  12. Allison Martell
    July 8, 2008 at 2:52 pm

    This is tricky, because there’s been so much nonsense in the media and elsewhere about Gardasil, so we are rightly skeptical of any claims against it. But at the same time, the pharmaceutical industry is completely out of control. I’m a big supporter of science and modern medicine, not prone to conspiracy theories, but with the outright corruption of medical research and treatment by drug companies, I’m increasingly suspicious of every prescription. What side effects were edited out of the ghost-written papers that got Gardasil approved? How many cases were cut out of trials after the fact? Can we ever take the drug company’s reports at face value?

  13. Casmall
    July 8, 2008 at 3:49 pm

    Allison-Hold your horses on the conspiracy thing. For one, there is a big difference between epidemiological/drug safety reports, which the CDC records, and internal drug company research. We’re talking about 16 million patients here, each monitored by their own doctors.
    Frankly, there is no reason to suspect that Gardasil is anything but a great, life saving drug. CNN should be shamed for what appears to be bold-faced fear mongering.

  14. bfp
    July 8, 2008 at 4:23 pm

    So when CNN reports about the woman who died on the floor of the hospital what it’s *really* doing is trying to control women, I guess?

    I mean, I wonder why feminists of all people (the same people who claim to care about women) are so dismissive of potential problems that affect young women *exclusively*. Why are government statistics given privilege over the lived experiences of women? Why, after all these years of problems with the FDA approval standards (the first type of breast implants, Depo Provera, the most recent patch, etc) is the first thing we say when reports start leaking out about possible problems, that clearly those reports are anti-women?

    I hold no assumptions of goodness by CNN. I am the first to dismiss their reporting practices. But it seems to me that maybe if you center women in this the more appropriate response would be feminists banning together to demand a full accounting of what the hell is going on. Maybe it really is nothing. Or maybe, like countless times before, there is some serious shit going on and young women have a RIGHT to know about it.

    And it might do good to consider that maybe the reason CNN is reporting about this is because the the problems that are occurring are affecting white populations. Complications related to Depo provera, something pushed on women of color, prison populations and women outside the U.S., is never reported on ever.

  15. S
    July 8, 2008 at 4:56 pm

    bfp – exactly.

    I thought feminism was all about not dismissing women’s voices.

    It’s not as if the medical profession are champions of women at all. This isn’t the first I’ve heard about the HPV vaccine being rushed through untested.

    Are women’s lives that cheap?

  16. Habladora
    July 8, 2008 at 5:27 pm

    It was certainly not my intent to say that CNN should not have reported on this at all, but that they should have reported on it more thoroughly because this is an important issue. I’m so sorry that that is not the way it came across.

  17. Casmall
    July 8, 2008 at 6:27 pm

    bfp and S – This is why good reporting is important – This vaccine has been on the market for two years and been given to 16 million people. Imagine keeping track of 16 million people for in two years. A lot of them get sick. If you give the vaccine to the same number of people and MORE of them get sick, then you have a reason to look closely at the vaccine to see if it is the cause.
    This hasn’t happened, people taking this vaccine don’t get sicker them people who don’t get the vaccine.
    How do I know this? The center for disease control (CDC) keeps track of people when they get sick. They don’t talk to the FDA, they don’t talk to drug companies, they just talk to doctors to see what their patients are suffering from. The CDC then reports this data-that’s all.

  18. Chel
    July 8, 2008 at 8:26 pm

    Oh come on you guys, give them a break.

    After all, CNN’s got the World’s Best Political Team on Television. They can’t be all that bad…

  19. William
    July 8, 2008 at 10:45 pm

    Why are government statistics given privilege over the lived experiences of women?

    Because we aren’t just talking about government statistics. We’re talking about statistics from multiple government agencies, various civilian groups, doctors, and peer reviewed research. At the end of the day we’re talking about a vaccine that prevents cervical cancer that has been given to more than 16 million women. Ultimately, “the lived experiences of women” (which translates mostly to the experiences of parents trying to find someone to blame for a tragic event) in this case consists of the assertions of non-experts in the face of evidence. But hey, I’m sure its all part of a big conspiracy to kill ten women and make another few dozen sick by preventing cancer…

    Why, after all these years of problems with the FDA approval standards (the first type of breast implants, Depo Provera, the most recent patch, etc) is the first thing we say when reports start leaking out about possible problems, that clearly those reports are anti-women?

    Interesting piece of data: turns out the first generation of breast implants didn’t cause any of the problems people claimed. In fact, despite all the assertions of people with those implants and all the media scare mongering, once the longitudinal research was complete it was discovered that silicone didn’t cause the problems people claimed. Companies still don’t sell those implants because of incorrect public assumption, and they’ve already lost the lawsuits, so there really isn’t much of a reason to game the research. Incidentally, the exact thing that was thought to cause all those health problems (medical silicone entering the body when an implant ruptures) has become relatively common practice in the body modification and transgender communities through the practice of “pumping”.

    There are three reasons people are calling foul on this story. First is that the HPV vaccine has faced an uphill battle ever since it came on the market because there are hordes of fundamentalist assholes who think that taking away the threat of cervical cancer will somehow be damaging to women (I’m sure you can tease the horror out there yourself). Second, theres no science here. Bare assertion isn’t evidence, and the story seems more like fear mongering than anything else when there is a total lack of corroboration. Finally, stories like these (which give no information but stir up lots of anxiety) don’t advance the discussion or help people make informed decisions. All they do is create fear and reduce the likelihood that women will get a vaccine that might save their lives.

    practices. But it seems to me that maybe if you center women in this the more appropriate response would be feminists banning together to demand a full accounting of what the hell is going on. Maybe it really is nothing. Or maybe, like countless times before, there is some serious shit going on and young women have a RIGHT to know about it.

    That would be a appropriate response if there was any evidence whatsoever. Unfortunately, what we’re talking about is a death rate (with absolutely no pattern) lower than one in a million and reports of “adverse events” for something the the neighborhood of 1 in every 2000 vaccinations. Now maybe theres something there, but the reporter didn’t report anything. In fact, if you read the story, it appears that they did research and couldn’t find any evidence of a problem. So, rather than spiking a story they’d already spent time on, they ran a headline with a question mark that took up a few inches worth of screen space without actually saying anything. Bad science, bad journalism, bad logic, bad writing.

  20. ACM
    July 9, 2008 at 2:29 am

    I agree that it’s important to look at both sides, yet I’ve noticed an appalling trend to simply say “Yay government! If they say it’s great it must be.” It’s not always as cut and dry as that, especially when lobbyists and politics get in the way.

    Care to look at another side?

  21. ACM
    July 9, 2008 at 2:48 am

    OK, not trying to sound rude but I just wanted to make this point. Gardisol does not = vaccine for cancer. According to the American Cancer Society (

    Of the more than 100 strains of HPV, about 60 HPV types cause warts on non-genital skin, such as on the hands and feet. These are the common warts.

    The other 40 HPV types are mucosal types of HPV. “Mucosal” refers to the body’s mucous membranes, or the moist skin-like layers that line organs and cavities of the body that open to the outside. For example, the vagina and anus have a moist skin-like layer. The mucosal HPV types are also called the genital (or anogenital) type HPVs because they typically affect the anal and genital area. The mucosal HPVs prefer the moist squamous cells found in this area. They do not prefer the skin of the hands and feet.

    Some types of genital HPVs can cause cauliflower-shaped warts to appear on or around the genitals and anus of both men and women. In women, visible warts may also appear on the cervix and vagina. This type of “genital wart” is known technically as condyloma acuminatum and is most often caused by HPV-6 or HPV-11. Because these genital warts rarely develop into cancer, HPV-6 and HPV-11 are called “low-risk” viruses. These low-risk types can also cause low-grade cervix cell changes that do not develop into cancer.

    Other genital type HPVs have been linked with genital or anal cancers in both men and women. They also cause low and high-grade cervix cell changes and pre-cancers. These are called “high-risk” HPV types and include HPV-16, HPV-18, HPV-31, HPV -35, HPV-39, HPV-45, HPV-51, HPV-52, and HPV-58, as well as some others.

    So starting off not all, not even most strains of HPV cause cancer.

    Although nearly all cervical cancers are related to HPV, most genital HPV infections do not cause cervical cancer. Most people who test positive for genital HPV DNA in research studies eventually test negative, often within 6 to 12 months.

    I hate the fear mongering, and yes that’s what it feels like, from some that seem to be saying “OMG You’re gonna get HPV then cancer! Quick take this vaccine!” Failure to vaccinate does not automatically mean you’re going to get cancer. Even then timely treatments and health checkups play a major part.

    Pre-cancer cells are not cancer. Although some pre-cancer changes may return to normal on their own, most cases of CIN 3 are likely to progress to cervical cancer over a period of time that probably takes about 10 years if not detected and treated. But very few HPV infections lead to cervical cancer. Pre-cancer cells are found by having regular Pap tests

    I’m not saying don’t get vaccinated. By all means if you feel more comfortable, then please do. I’m just asking that those of us who don’t aren’t written off as quacks or given scare tactics about getting cancer. I wish more money was put into better sex-ed and on health care so that women could afford the regular check ups that are important to preventing and treating cervical cancer.

    And please, don’t label us all as anti-sex. Some of us love sex, a lot. We just think a healthy sex life is more than just getting a shot and going on about your way.

  22. ACM
    July 9, 2008 at 2:52 am

    Uh oh, my first comment went through and my second was sent to moderation. I hope that doesn’t mean I’ve been blacklisted, because that would make me cry. I’m really not trying to fight, I just hate when after the 98% of the time I love reading here I find that 2% that makes me uncomfortable.

    I’ll stop commenting. Sorry.

  23. Dianne
    July 9, 2008 at 4:00 am

    Before taking the reports to VAERS too seriously, remember that anyone can report anything to VAERS. There is no screening whatsoever. As an experiment, a person sent a report that a vaccine had caused muscle hypertrophy, skin discoloration, and emotional disinhibition–in short, that the vaccine had turned him into the Incredibe Hulk. It was accepted. He later withdrew the claim, but he did not have to: If he had not agreed to the removal it would still be listed under a possible adverse effect of (I think) the influenza vaccine.

    GBS is a real risk with any infection or vaccination. However, its occurrance is rare and it is usually completely reversible. Plus natural HPV infection can probably cause it as well. So while working on ways to reduce the risk of GBS with vaccination seems like a very good idea, not vaccinating for fear of GBS seems like not such a good idea.

  24. Dianne
    July 9, 2008 at 4:03 am

    Uh oh, my first comment went through and my second was sent to moderation. I hope that doesn’t mean I’ve been blacklisted, because that would make me cry.

    Don’t take it personally. I think the spam filter sometimes gets overexcited about links and starts putting people who post links into automatic moderation.

    I’m really not trying to fight, I just hate when after the 98% of the time I love reading here I find that 2% that makes me uncomfortable.

    I’m not an author or a guest author of Feministe, but as a regular reader, I don’t think that anyone here would be annoyed at you for polite disagreement. Or even snippy and sarcastic disagreement. True banning seems to be reserved for the over-the-top obnoxious.

  25. July 9, 2008 at 4:29 am

    I’m sorry William, did you just put scare quotes around the lived experiences of women?

    Riiiiiight. You MUST know better eh. Tell us more *bats eyelashes*

    For instance, tell us about how there have been questions raised by Dr Diane Harper, one of the researchers who worked on Gardasil, about whether it’s been properly tested yet for that large a scale usage.

    But I mean, pharmaceutical companies and the FDA wouldn’t rush anything through for commercial reasons, would they?


    (link via bfp)

  26. estraven
    July 9, 2008 at 6:45 am

    If this can cheer up you americans, there was a very similar article on “Le Monde” recently. Except there it was an interview with a (male) professor discussing how come France shouldn’t pay for the vaccine. Arguments: 1) we can control the disease with pap smears; 2) the vaccine offers only partial protection, so the pap smear would still be needed; 3) it’s so expensive, and only about 1000 french women die of cervical cancer every year anyway.

    What can I say? 1) I would rather not have cancer than have cancer and be cured; 2) I would rather have some protection (we’re talking 70% here) than none; 3) I am sure if I die of cancer, I (and my family and friends) will be charmed to know it’s only me and another 999 examples of sheer bad luck.

    BTW, the interview also contained a (scientifically very shaky) argument that the vaccine only made sense for virgins. The sluts deserve what they get anyway?

  27. Dianne
    July 9, 2008 at 7:40 am

    Estraven: No, I can’t say it cheers me much to know that the French are vulnerable to this sort of inanity too. If you need a cold-blooded counterargument to the only 1000 French women die argument you could point out that that means that 1000 French women are dying very expensively, after massively expensive treatment with chemotherapy, surgery, and/or radiation. Also, since cervical cancer is about 65-70% curable, another 1200 or so French women are being successfully, but very expensively, treated for cervical cancer. The cost of the treatment of those 2200 or so women probably outweighs the cost of vaccinating, even vaccinating millions. Also, other cancers, including head and neck cancers, penile cancer, anal cancer, and possibly some skin cancers, have been linked to HPV. So vaccinating the next generation–boys included–could decrease the rates of a number of cancers.

  28. July 9, 2008 at 9:03 am

    The problem I have with this story– and any like it really– is that new drugs ALWAYS have problems because it’s damn near impossible to make something perfect before putting it on the market (and, by impossible, I mean inconvenient and expensive for the drug companies, so something that will never happen in America in our lifetime).

    Anybody who takes a drug, even a tested and approved drug, within the first few years that it comes out has to understand that there will be unexpected reactions.

    Of course, it doesn’t help at all that African Americans are already hesitant to try new drugs, and that women in particular can never be guaranteed that things for them will be completely safe (think lack of clinical trials using women, the first wave of birth control pills, forced sterilization, etc.).

    But for people to be so surprised and outraged that this drug has side effects such as *gasp* nausea is sorta ridiculous. And reports of this story need to stop it with the we-hate-things-that-help-women side and give us the whole picture.

  29. bfp
    July 9, 2008 at 10:39 am

    Because we aren’t just talking about government statistics. We’re talking about statistics from multiple government agencies, various civilian groups, doctors, and peer reviewed research.

    Oh, it’s not just one branch of government, it’s LOTS of branches! You’re right, when the government has oversight over itself, there’s no reason to worry! And again, since when were doctors or researchers ever grand advocates for women’s rights? (Maybe the same time corporate media was?)

    But hey, I’m sure its all part of a big conspiracy to kill ten women and make another few dozen sick by preventing cancer…

    just like I’m sure it’s a big conspiracy on the part of national and international press, “fundamentalist assholes,” etc. to get women to stop having sex.

    because there are hordes of fundamentalist assholes who think that taking away the threat of cervical cancer will somehow be damaging to women

    Actually, there’s also hordes of women of color who have no uterus, have been medically or surgically sterilized, have been tested on unknowingly and/or without their consent by doctors (and no, this is not a thing of the past, try talking to various native women’s health groups who have conducted extensive interviews with native women on reservations who only have access to health care through government hospitals), etc etc–and are wondering if they could possibly get more information about this shot, but are being told that ‘fundamentalist assholes’ are trying to shame them out of having sex. Feminists patting women on the head and telling them to not worry is not any better than ‘fundamentalist assholes’ patting women on the head and telling them not to worry.

    Everybody told a bunch of poor women in the U.S. that Norplant was “perfectly fine” and ‘liberating’ and medically safe because it had been tested and implanted in millions of women world wide. oh, but look at that, Norplant was taken off the market because…? Even after government agencies, doctors and feminists all said everything was A-ok. Funny what happens when you center women’s voices and experiences.

    there are SO many instances of the reproductive health of women being set aside in favor of corporate profits (the big conspiracy is not that they want to kill women or that they want to stop women from having sex, but that they really don’t give a shit about women one way or another). Demanding more information is not the same thing as saying I agree with fundamentalist assholes who don’t want me to have sex. It’s demanding more information. And given the horrible track record the medical establishment has with so many groups of women (disabled women, women of color, poor women, non-citizens, etc), I’m wondering why any woman should be mocked for doing so.

  30. Older
    July 9, 2008 at 8:55 pm

    “Why are government statistics given privilege over the lived experiences of women?”

    So, where do you think “statistics” come from, exactly? Some kind of statistics mine? Statistics *are* lived experience, carefully recorded and carefully analyzed. Without the care, the recording, and the analysis, “lived experience” = anecdote, not evidence.

  31. NancyP
    July 10, 2008 at 12:49 am

    Most of the comments here are from people who are not even moderately knowledgeable on a professional basis (M.D., D.O., Ph.D. level virologist) about HPV-related disease.

    1. Most people have sex more than once in their life. Therefore, even if they shed an HPV infection at timepoint A, they are very likely to acquire another HPV infection in a short period of sexual activity. Yes, initially virgin couples who stay monogamous for life aren’t likely to get “genital” HPV types (BTW, “virgin” includes no oral sex for purposes of this statement). How many of those couples do you know? HPV is common. Multiple infections are common. Infections with high-risk HPV types are common. Integration of the high-risk HPV genome into the cell’s genome is common. Therefore high-grade intraepithelial neoplasia is common. Some of these high-grade in situ lesions progress to invasive carcinoma. The potential value of an HPV vaccine is high, whatever the concerns are about a particular version of an HPV vaccine.

    2. “Screening catches most of the intraepithelial neoplasia before it has a chance to invade. ” True – IF screening is done on a regular basis, by a competent screener viewing a properly obtained sample (Pap cytology), supplemented by a DNA HPV typing test for certain categories of Pap cytology abnormalities. Identifying the invasive vs non-invasive character of an HPV lesion in the (non-visualized) endocervical canal requires biopsies, and establishing the extent of a high grade lesion requires a large biopsy called a “LEEP conization” or “cold knife conization”. Each divot of tissue you take out of a cervix weakens the cervix a little bit for purposes of childbearing – if a large percent of the cervix is gone, the remainder may need to be stitched shut at about 14 weeks gestation in order to ensure that the pregnancy can last to near-term.

    3. Not everyone gets screened, or screened competently, or screened at the appropriate intervals for their clinical situation. The incidence of invasive cervical cancer is not zero in any country. Poor, minority, institutionalized, or rural women, and women with mental illness or addiction, tend to have the lowest rates of screening and the highest rates of invasive cervical cancer and death from same. On the international scene, in developing countries, cervical cancer is the number one cause of cancer deaths for women (even before HIV!). Screening just doesn’t happen for the majority of the women in these countries.

    4. The utility of the vaccine is highest in medically underserved populations. Countries with minimal health care resources could have a significant decrease in women’s cancer with minimal cost (given an ideal vaccine, appropriately cheap). Yes, the obvious answer in the developed world is to try to fix the level of medical service – but that still won’t reach everyone, absent compulsory coercive examinations. If you leave the decision to seek care up to the patient, some will be too preoccupied or incompetent to seek care, some will refuse care.

    The real world question is “Is this the ideal safe and effective HPV vaccine?”, not, “Could we benefit from the properly implemented HPV vaccine?”

    The concerns about Guillain-Barre syndrome make sense – a known complication of some viral infections (mostly respiratory) and anti-viral vaccines. Another concern would be anaphylactic reaction to vaccine components (remember those flu shot screening questions about egg allergy?). Then you look at the other serious events, and ascertain which can be easily explained by known pathophysiologic processes of a concurrent disease occuring in the vaccine population at the same frequency as in the general population. Statistically significantly increased serious events not otherwise explained are the ones that should be investigated further.

    Inherent problems with the vaccine concept:

    1. Current vaccines cover the most common high-risk HPV types in North America. Other populations have different frequencies of the known high risk HPV types. No population will be 100% protected. Also not known is the long-term efficacy, need for booster shots, percent of population unable to provide immune recognition for the vaccine antigens. Therefore, no current vaccine makes other screening entirely redundant.

    2. It is likely that the frequency of HPV types not covered by the vaccine will increase in a population with high vaccination rates. For example, type 55 (not covered) may come to occupy the ecological niche once owned by type 18 (covered). Entirely new HPV types might emerge. Both events would require redesign of vaccines.

  32. NancyP
    July 10, 2008 at 12:52 am

    I’d be seriously happy never to see another woman with advanced cervical cancer.

  33. RPS
    July 10, 2008 at 2:22 am

    One month ago, my 14-year old daughter, a competitive swimmer with no prior medical history of neurological issues, suffered two generalized tonic-clonic seizures, of 20-30 minute duration, within 10 and 16 hours, respectively, of receiving her second dose of Gardasil.

    If you’ve never witnessed your previously healthy child suffer an unprecedented tonic-clonic seizure, believe me, it is horrifying. There wasn’t much I could do except call 911 and feel powerless.

    While she was subsequently hospitalized for testing and observation, I googled +Gardasil +seizure at a friend’s suggestion, and began an awakening to this whole issue. My daughter is not out of the woods yet – she’s still undergoing evaluation by pediatric neurologists, and still possibly suffering simple partial seizures centered in her motor cortex.

    If anything, the CNN article is too watered down. It tamely mentions Gardasil being blamed for “ailments” and making girls “sick”, without exposing or elaborating the serious neurological effects, such as seizures and Guillain-Barre Syndrome (which causes paralysis), suffered by some recipients of the vaccine. I’m disappointed that “Habladora”, the author of the Feminste blog entry (there titled “CNN Spreads HPV Vaccination Doubts”, reproduced on Alternet with title “CNN Spreading Inaccurate Info on Cervical Cancer Vaccine”, chooses to suggest that the CNN article might be “fear-mongering” on CNN’s part. From my perspective as a progressive-minded parent of a victim of this vaccine’s side-effects, I applaud any exposure given to this issue by the mainstream media.

    Why does Alternet assert, through its chosen title for the reproduced blog entry, that the information CNN has reported is “inaccurate”? The fact of the matter is that the reported information is not inaccurate. Gardasil *is* to blame for “ailments”, and it *is* making girls “sick”. My daughter is a prime example. And if you want more examples, all you have to do is peruse the websites of a couple of watchdog organizations monitoring the issue by making Freedom of Information Act requests against the national Vaccine Adverse Events Reporting System (VAERS) database. Here are the links:

    Further, I take issue with Habladora’s supposition that “there is no solid evidence that Gardasil is dangerous”, which she makes by citing a CDC webpage that attempts to explain away the deaths and paralyses reported to VAERS in connection with Gardasil, and which fails to even mention seizures and other reported effects. So what constitutes “solid evidence that Gardasil is dangerous”? Absent some formal technical argument, understandable only to medical professionals, that conclusively links cause and effect at a molecular biology level or something, all we have is statistical correlation. I’m a believer in statistical correlation. When people who have received a vaccine soon die, become paralyzed, have seizures, and suffer other effects, more prevalently than in the general population, then that constitutes evidence of danger, in my estimation.

    Habladora also inexplicably characterizes the CNN report as a “sensationalist rumor”. That adverse events associated with Gardasil vaccinations have occurred is not a rumor – it is a fact, supported by 7802 reports to VAERS between June 8, 2006 and April 30, 2008. Nor is CNN’s reporting of it “sensationalist”. Again I view it as appreciable journalism, and it is surprising that Habladora, an apparent feminist and therefore progressive, would cast aspersions on such reporting (perhaps she suspects CNN of raising fears about HPV vaccine on behalf of the religious right, who oppose it for the same reason they oppose contraception – they view it as encouraging teen sex). After all, we’re talking about Big Pharma pushing a vaccine through the FDA’s approval process and lobbying state and local governments to make it mandatory for public school attendance by teenage girls. What is Merck’s motive – altruism, or profit?

    Even Dr. Diane Harper, the leading scientist for the clinical trials of Merck’s and GlaxoSmithKline’s HPV vaccines, has doubts about the adequacy of their clinical trials, their efficacy, and the sensibility of mandating them for school girls – you can watch an investigative reporting team’s interview with her here.

    To me this whole saga has the appearance of Merck strong-arming compliant governments in the pursuit of profit, while simultaneously performing a drug safety experiment on the population at large. I’m wary of Gardasil not for religious reasons, but because of concerns about its safety, and about the integrity of Merck and the current governments’ processes for approving and mandating drugs. In general I’m a freethinker and a believer in science, and not opposed to vaccination. But this whole experience has awakened me to the need to think about the vaccines I give my children, and their necessity, instead of just “going with the flow” of the CDC’s recommendations (the latest one of which, added only two years ago, is Gardasil). In the particular case of HPV, cervical cancer, and Gardasil, I found this analysis, of the prevalence and treatability of HPV-related disease in American women, to be pretty clarifying and thought-provoking.

    The bottom line for me is that, in my family’s experience, Gardasil is dangerous, and we won’t be having any more of it.

  34. Blackamazon
    July 10, 2008 at 9:41 am

    SO which women you talking bout NAncy P?

    BEcause I’d be seriously happy to never see another woman unnecessarily hysterectomied, scarred or generally destroyed internally ” for her own good”

    I’d be super happy if women of color were you know BELIEVED when they said hi I wasn’t having seizures/ massic internal problems before x and now after x I am what teh hell is going on?

    and in a feminist space not essentially be told their degrees arent good enough to talk about teh amazing cramps and bleeding they got ( HEY NORPLANT)

    You know what would be even better for me is that if WOC weren’t deemed acceptable risk collaterral so youd be seriously happy some women weren’t getting cervcical cancer

    because if another women never gets cervical cancer ( which any person with basic medical reading training knows is not happening has HPV is a multifaceted disease and this vaccine covers five of those strians)

    and ONCE AGAIN too many WOC end up sterile , bleeding and dying

    YEah for me not with the happy making.

    And please in your rush to listen to how bad the media is versus how disturbed WOC are by little things like non pre occuring SEIZURES and DEATH

    do ignore the research captain of teh drug herself

    going pump the brakes

    cause them uneducated WOC cant’s be trusted

  35. NancyP
    July 10, 2008 at 10:34 pm

    bfp, the point is that medically underserved women, including WOC all over the world as well as plenty of rural or poor white women, will benefit most from a properly designed and tested vaccine. NOWHERE DID I CLAIM THAT GARDASIL IS FULLY TESTED AND UNDERSTOOD FOR WIDESPREAD DISTRIBUTION AT THIS POINT IN TIME. Personally, I would have been reluctant to have widespread unmonitored distribution this early in the Gardasil vaccine’s history, and would not advocate for opt-out whole-population vaccination strategy for at least a few years, until the data from early users is more mature. I would advocate that strenuous efforts to investigate each serious adverse event should be made (records review, interviews, collection of blood samples for appropriate testing and for storage for possible future tests, autopsies for any deaths). But I’d advocate that for any serious adverse event for any class of drug. The hard cold reality is that most drugs reach market before rare complications appear, simply because sample sizes of 1000 users are not going to demonstrate rare events. There is an unknown degree of risk in being an early user of a drug. Later users have an established degree of risk. I have had an adverse drug interaction event myself from being an early user (effective overdose due to competition of two drugs for one particular cytochrome P450 type).

    I DO claim that a properly designed and tested HPV vaccine is an effective strategy for significant risk reduction for development of invasive cervical cancer in the sexually active population. (It would be useless for the 1 % of the population who expect to be lifelong virgins).

    In our university oncology practice, about half of the women with high-stage or lymph node-positive cervical carcinoma are WOC, although our practice catchment area has 20% WOC. The major reason for the disparity is reduced health care access, lack of health knowledge, lack of practical support and time to pursue preventative care, and increased rate of HIV positivity in the WOC population as compared with the white population. If a good quality vaccine can reduce the incidence of high-risk type HPV infection, it represents a simple and more readily achievable intervention in the short term. Yes, it would be great to get ideal health care access, education, convenience, and effective HIV prevention to every woman, but it will take time to achieve political will among the voters and the politicians – and even with the best implemented universal health care system, some will fall through the cracks and be lost to screening until too late (eg, in British Columbia CA, with one of the best screening rates in the world). I’ll take every safe and effective tool available to reduce the incidence of invasive cervical cancer.

    I admit, I probably wouldn’t be supporting the HPV vaccine concept as strongly as if I had no direct knowledge of the effects of cervical cancer on specific individuals. In the same way, liver doctors look forward to a possible vaccine for HCV viral hepatitis, and all family members of people with dementia look forward to possible ameliorative drugs to slow progress of the disease.

  36. NancyP
    July 11, 2008 at 2:05 am

    I know when my car is not working well, and can often describe a particular issue (unusual noise on the left of the car that gets louder with increased speed), but I don’t know why and I don’t know how to fix it.

    I rely on the Natl Transportation Safety Administration to collect my complaint and those of other car users, determine if a problem is occuring in a particular car model at a rate not typical of cars as a whole, and issue a recall. If my car problem is not due to a glaringly bad design defect, I must rely on the judgement or the computer diagnostics of the mechanic to identify the problem and fix it. I don’t have a detailed knowledge of car transmissions, engines, etc. I don’t have an issue with consulting with people who do have expertise in car repair. The “sounds funny” symptom above turned out to be a bad bearing – but I couldn’t make that diagnosis on my own.

    Individual patients know their symptoms. They may not identify the actual cause of their symptoms, and they may not have the experience or technical knowledge to know how to treat it.

  37. Tsu Dho Nimh
    July 11, 2008 at 5:09 pm

    Here’s one of the 11 reported Guillain-barre cases: Information has been received from a physician concerning a 14 year old female who was vaccinated IM with a dose of Gardasil. Subsequently the patient “came down with some syndrome”, may have been Guillain-Barre syndrome. Medical attention was sought and the patient recovered. The consumer noted in this report was not one of the physician’s patients. Upon internal review, Guillain-Barre syndrome was considered to be an “other important medical event”. This is a hearsay report in the absence of an identifiable patient. Attempts are being made to identify the existence of a patient.

    Some others were clear-cut, classic GB, showing up a week or so after a mild viral illness.

    I read all of the “severe” and “death” event reports. It’s about what you would expect to see in a group of females of that age, vaccinated or not.

  38. July 12, 2008 at 4:38 pm

    What I’ve always been a bit curious about is why it’s only women who are strongly encouraged to get the vaccine, or are the only ones covered in any media at least. The point of vaccines is to eliminate the possibility of the disease developing (or being carried) in the vast majority of the population, so why ignore 50% of the population who can contract it or pass it on? Is it because it’s an STD and therefore somehow the woman’s responsibility?

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