HPV Vaccine again

[pegkerr]

By the end of today, both girls will have gotten their first dose of the HPV vaccine.

Like I said, it's a no brainer.

But then, some people don't have brains.

(Yeah, that's unusually harsh for me, I know. But I don't care. As far as I'm concerned, not letting your kids get the vaccine because "it might make them promiscuous" is criminal stupidity.)

And if you haven't read it yet (and you should), here once again is the link to rivka's essay on the vaccine at Respectful of Otters.

Edited to add: The Happy Catholic poster has replied to me, most politely. Our exchange is here. I have offered to cross-post one of the links she pointed to, 10 things you might not know about Gardasil, which originally posted at Evil Slutopia (a source, which she reasonably points out, cannot be dismissed on the grounds of religious bias). In return, I have asked her to read rivka's post. Edited to add, again: rivka has some reactions to the 10 things you might not know about Gardasil" list. See in comments below.

Comments

[dichroic.livejournal.com]

Gov. Rick Perry of Texas has apparently mandated the vaccine for all girls entering 6th grade in TX - and it will be free for lower income girls, and paid for by Medicaid for 18-21 years olds.

I'm flabbergasted, and very pleaased.

[heavenscalyx.livejournal.com]

Yay!

Yeah, and getting the flu vaccine makes people go out and let people SNEEZE on them! And, you know, the tetanus vaccine induced so many people to go out and get impaled on rusty nails. The ERs are still complaining about that one. Chock-FULL of rusty nail wounds. And people are so frustrated about not getting polio now that they're trying all SORTS of other ways to get paralyzed.

[/sarcasm]

[sundancekid.livejournal.com]

In part because the makers were campaign donors.

I mean, it's the right thing to do, but probably not for the right reasons.

[jbru.livejournal.com]

Hurrah for you, and your girls. I agree it's a no-brainer.

Good for you...

[dlandon.livejournal.com]

The argument that it will cause promiscuity just blows my mind. One shot will take away your daughter's ability to make healthy decisions and have good judgment? Not unless you've done a sh*tty job parenting. The underlying implication, to me, is that women are loose and flighty, and need a man to keep them from straying. I could be wrong, not being from that generation, but aren't these some of the same arguments used against the pill when it first came out?

At any rate, I'm glad you're taking them for it.

- Dena

[dichroic.livejournal.com]

I'll take it anyway.

[rachet.livejournal.com]

When I was 13, my periods went bonkers and my cramps put me to bed for at least a day. When my mom got me in to see her gyno he suggested going on the pill. We were both very much for it. Anything to keep them on a schedule and to get rid of the body twisting cramps I'd get (not to mention the pyschotic breaks I'd have if Chris (my brother) dared to ask me a question or act like a little brother).

Several months later my mom was talking to a friend of hers when I was in the other room. She was saying how happy we both were with the results. Her friend gasped and said "Wait...you put Rachel on the pill?"

"Well, yes."

"Aren't you afraid that was just a green light for her to have sex?"

"Uh...how so?"

I walked into the room, extremely confused and curious as to what the response was going to be. When she saw I was listening she was very flustered and stammered something about "making it easy" or something.

Then I looked at my mom and then back to her and said "I don't see how regulating my periods and reducing my cramps has anything to do with my judgment and morals."

She didn't say anything after that.

Idiot.

And what a low opinion she must have had of me!

[rachet.livejournal.com]

Oh..and GO YOU!!! That's great news. Wish we had it when we were of age.

[mrissa.livejournal.com]

Good. Good. Yes.

Someone close to me has cervical cancer that may have metastasized into lymphatic cancer. I wish I could implant her parents' emotional state into the parents who write blog posts like the one you linked, without actually harming their kids. Forcible empathy, dammit.

[julie-b-d.livejournal.com]

Hi Peg,

A good friend of mine also called me on the whole "promiscuity" issue. I was rather surprised that that issue is what jumped to her attention as there were three other issues mentioned first that I thought were much more important ... this may have been a problem with me formatting the post so I have tried to fix that. If you read through the entire post you would notice that I am worried more about the possible fast tracking by the FDA, inadequate testing on young girls as a control group, and the money trail from Merck to Governor Perry. (I also tried to clarify my comments in an addendum on the end ... sometimes "frame of mind" can lend understanding to what, on the face of it, looks like pure simple-minded religious prejudice ... which I also despise.

I completely agree that concerns over promiscuity would be no reason not to take a drug proven effective without the above concerns. However, there are so many other issues that have nothing to do with any moral judgment and everything to do with concern for the medical safety of young girls.

If nothing else, I'd encourage you to take a look at the links to Evil Slutopia's list of 10 things you might not know about Gardasil ... just to get the POV of people who you can't possibly accuse of having any religious bias. Here's the link: http://evilslutopia.blogspot.com/2007/01/gardasil.html

Whatever choices anyone makes on this issue are perfectly justified either way ... I was just trying to make sure that everyone knew the issues that are not getting mentioned.

[shakespearechic.livejournal.com]

I, of course, am no fan of Perry and I know one of his main reasons for doing this is his connections to Merck, but I will give him a bit of respect for responding to criticism by saying:

"Providing the HPV vaccine doesn't promote sexual promiscuity any more than providing the Hepatitis B vaccine promotes drug use," Perry said in a statement. "If the medical community developed a vaccine for lung cancer, would the same critics oppose it claiming it would encourage smoking?"

[ame-chan.livejournal.com]

A no brainer indeed. Mine are getting it too. It seems inconceivable to me that any parent would not want this for their daughters.

[phoenixsong]

Wow. Do you have a link or other citation for that? Because I'd love to be able to quote that at people...

[shakespearechic.livejournal.com]

Definitely! It is HERE from Yahoo News. It's cited as a statement released by Perry but a Google search hasn't pulled up the original, only the actual executive order. Still... I'll give him credit for that rebuttal, even if he thinks I'm going to hell. :-D

[pegkerr.livejournal.com]

I have read the link you provided, thanks. I ask in return that you read the link I provided above, here.

My doctor took care to make sure that mine was an informed decision: she explained that the vaccine did not completely eliminate the chance of cervical cancer and it would not eliminate the necessity of pap smears.

The comment thread up above also mentioned the issue of Perry getting campaign donations from Merck. My reaction is still, yes I am perfectly well aware that the profit motive exists for America's drug manufacturers. This is not a surprise to me. I do not think, however, that precludes them from coming up with ideas or products that are in my or my family's best interests. I am not going to try to parse whether Perry's or Merck's motivations are pure as the new-driven snow: my girls will still get the vaccine.

I will edit my original post to include the link you provided me. Thanks for replying.

[julie-b-d.livejournal.com]

Hi Peg,

I do understand your position, perhaps better than you realize. This product may, indeed, be in everyone's best interests. However, as a doctor from Baylor interviewed on the local news commented yesterday: the vaccine has been tested for four years while the cancer usually takes 10 years to develop ... therefore, we don't have enough data yet.

With the ready availability of Pap smears which hold the US numbers very low and the lack of complete testing on the drug, I still think it's just about as risky to go with this drug as it is to do without it, perhaps riskier. This dates me terribly but I knew several people who were "Thalomide babies" and can't shake that desire for the FDA to slow down some and thoroughly test their drugs ... especially before recommending them for young girls.

However, this is something that we obviously could go around and around about. I will put the link to your source with my other resources as well. Cheers, Julie D.

[sundancekid.livejournal.com]

Wow. That's a lot of sense from Governor Goodhair.

[morganmalfoy.livejournal.com]

While I don't think an HPV vaccine will make promiscuity rise, I do think the facts aren't out there. I was discussing this with another teacher friend of mine whose students had asked her about this, worried that they could just spontaneously have cervical cancer. Obviously, cervical cancer is not ONLY caused by HPV, but the advertisements (at least in Florida) say nothing about cervical cancer and HPV being an STD, they focus solely on the fear of cancer.

And while I hope that this vaccine would be widely used, I do not plan on being vaccinated. Why? Because I'm not planning on having sex anytime soon, nor can I see any other situation where I would need it. If you and your kids want to be vaccinated, I'm glad you're being protected against cervical cancer, and HPV, which is alarmingly rampant. I also hope, however, that we are allowed to continue to have some autonomy over our bodies.

[darth-kittius.livejournal.com]

It's so wonderful that they have that now. I'm trying to decide if I should shell out the $400 to get it myself. I can't get it paid for since I'm out of the age-range. I'm thinking it's worth it!

[prunesnprisms.livejournal.com]

I think that link you posted to the Evil Slutopia blog really made sense to me. I am over 30 and have no children yet, and I don't think I'm eligible to take this vaccine. By the time I have a pre-teen child the information out there will be different, I expect--either more grounded or rejected.

I also don't think it can encourage promiscuity, myself, but I do have some sympathy with those that think it might be under-tested.

[rivka.livejournal.com]

Looks like she thinks I'm too mean to listen to, but she did edit to add a link to my post.

I'm so glad that your girls will be protected, Peg. When I was pregnant with Alex, I was tested for HPV and found to have one of the cancer-causing strains. Now that will be hanging over my head for the rest of my life. Not for my daughter!

[aome.livejournal.com]

We had already given some pretty hefty financial aid to family last year, or I would have demanded we give the vaccine as our "Christmas present" for our three nieces (9, 10 and 13 - all perfect ages). Maybe next year; their parents will never be able to afford it, otherwise. So - go you! I think it's worth the risk. Any chance you could also be part of an initial long-term study? That could be interesting, too.

[pegkerr.livejournal.com]

I was going to e-mail you to give you a heads up about the exchange when I got home tonight if you hadn't seen it. I started to reply to her post, addressing her off-the-cuff remark about your "baggage," informing her that your work at an HIV clinic gave you a seat front and center learning about what havoc the religious right could make in people's lives and so it was no wonder you felt the way you did. I erased the comment, thinking you'd prefer to be the one to respond, if anyone should--that was why I was going to e-mail you. But perhaps it is just best to let sleeping dogs lie. She was pretty polite to me and I was pretty polite to her, but it is clear we see things differently.

Ugh, I'm sorry to hear about the news you got when you were pregnant with Alex. (Yep, yep, I'm making the right decision.)

(Any thoughts re: her Evil Slutopia link?)

[rivka.livejournal.com]

Obviously, cervical cancer is not ONLY caused by HPV, but the advertisements (at least in Florida) say nothing about cervical cancer and HPV being an STD, they focus solely on the fear of cancer.

Cervical cancer is only caused by HPV. A woman who has never been exposed to HPV will never get cervical cancer.

There are good reasons for not marketing Gardasil as an STD vaccine. Most people, regardless of their level of sexual activity, don't consider themselves to be at risk for contracting an STD. (It's crazy, but there you go.) People think they know how to choose a "clean" partner, or think that you can only get an STD if you have a lot of sexual partners, or that you can only get an STD from sex with a relative stranger. Those are the dumb reasons - people who are making major errors in logic about their STD risk.

But smart people can also underestimate their risk of HPV. They might believe that they're not at risk because they always use condoms, because they get regularly screened for STDs and require screening from their partners too, or because they are committed to being a virgin until marriage. But condoms don't offer full protection against HPV. It's not included in a standard battery of STD tests. And plenty of women who were virgins on their wedding night have been subsequently infected by their husbands, who weren't. The possibility of rape must also be considered.

About 90% of sexually experienced adults, even monogamously married ones, wind up exposed to HPV. What percentage of them do you think would describe themselves as being "at risk for an STD?" My experience, from working in the public health and health psychology fields, suggests that the number would be well under 25%.

So Gardasil isn't marketed or presented to the public as an STD vaccine, because from a public health standpoint it's a bad idea for people to be thinking about the HPV vaccine as something that they only need if they have a risky sex life.

Also, think about the ramifications of recommending vaccination "before sexual activity," rather than having a standard age for vaccination somewhere in early puberty. How many teenage girls do you think would go to their parents and say "I think I'm ready to get the HPV shot now"? How many girls wind up having sex when they didn't plan to, or didn't want to? And once they've been exposed to HPV, they can't ever get the vaccine in the future.

Vaccination for HPV needs to be taken out of the context of sexual activity, from a public health standpoint, or not everyone who needs it will get it.

[rivka.livejournal.com]

However, as a doctor from Baylor interviewed on the local news commented yesterday: the vaccine has been tested for four years while the cancer usually takes 10 years to develop ... therefore, we don't have enough data yet.

That's a little bit disingenuous of the doctor from Baylor. It typically takes 10 years or so for carcinoma in situ to develop, but precancerous cervical lesions show up much, much sooner. And it's also possible to test for HPV antibodies, and determine whether the antibodies show that the person has been exposed to one of the cancer-causing strains.

With the ready availability of Pap smears which hold the US numbers very low

Pap smears are readily available to people with health insurance and conscientous health habits. That's why cervical cancer is increasingly a disease of the poor, and especially of poor people with difficult and chaotic lives. A single mother of three kids probably finds it very difficult to spend four hours (or more) waiting in a public health clinic to get a free Pap smear, when there are so many more pressing demands on her energy and time.