Written November 4, 2010
[Apropos to Vaccine Awareness Week, I replied to an article by Jennifer Margulis on Mothering Magazine’s blog regarding the Gardasil vaccine. Jennifer Margulis is a talented, prolific writer with a PhD in American Literature who previously authored a lengthy vaccine-critical article for Mothering Magazine and was prominently featured on PBS’s Frontline documentary, “Vaccine War,” as the chief voice representing the high rate of vaccination refusal in Ashland, Oregon. I was briefly presented on the same Frontline program representing an Ashland parent favoring vaccinations. Ashland has one of the lowest vaccination rates in the nation.]
Jennifer, I’m not a Gardasil expert by any means, but I find your article alarmist and misleading:
1. Your source, Judicial Watch, appears to promote a conservative political/social agenda, and is not a scientific evidence-based source of vaccine information. Their anti-Gardasil stance is likely motivated by the fear that Gardasil will encourage teens to have sex.
2. Gardasil (or any other vaccine) is certainly not promoted as side-effect free. I know of no medicine or medical practice, conventional or alternative, that can make that declaration.
3. VAERS (vaccine adverse event reporting system) reports are completely transparent to the public, with an online searchable database. Anyone can order full reports. In fact, it is VAERS’ transparency that, while commendable on the one hand, makes it easy for people to misinterpret or misuse the information. A bank of passively collected, largely unverified reports of a temporal (time) connection between two events is not causation data. “Post hoc ergo proctor hoc” (after an event, therefore caused by it) is a logical fallacy. Every reporter should understand this before declaring things like: Gardasil is “killing young girls.”
4. Your citing the Natalie Morton case as evidence of a high-profile Gardasil death actually *exemplifies* this fallacy. A few minutes of Googling would have revealed this article: “Cervical cancer jab girl Natalie Morton died from large chest tumour.” Quote: “There is no indication that the HPV vaccine, which she had received shortly before her death, was a contributing factor to the death, which could have arisen at any point.” And: “…Evidence from the coroner is absolutely clear that the vaccine did not cause Natalie’s death.”
5. The CDC says that as of 9/30/2010 VAERS included 56 reports of deaths (only 30 confirmable) occurring at some point following a Gardasil vaccination. After 32 millions vaccine doses, it would be bizarre (or indicative of amazing protective properties) if a number of deaths/serious disorders did not coincidentally occur within months of the shot.
6. Public health officials closely investigated and analyzed all the confirmable reports of death and serious conditions, finding little to no difference compared to background rates, and no patterns or clusters indicating severe vaccine reaction. This vaccine is regarded as remarkably safe, overall. (Read article.)
7. You suggest Gardasil wasn’t tested on 9 year olds. Safety studies and immunogenicity tests included ages 9. At this time, the CDC recommends Gardasil just for girls starting at ages 11-12, optional for girls and boys as young as 9 years old. Some believe that the strong immune response observed in 9 year old could make the vaccine last longer and be more effective. So, we can ask why so young, or we can ask why wait.
8. You said: “I’d like to find out how many teen girls die from genital warts or cervical cancer.” The answer is probably zero, but a child’s risk of dying from an HPV-related cancer is irrelevant; cancer can take decades to develop. [12/22/2012 update: Cervical cancer caused by HPV is occuring more frequently in teens and young adults than formerly believed.]
A better question is: How many teen girls are sexually active and/or become infected with HPV? In a 2005 survey, 3.5% of participants said they were sexually active before age 13. By 13-19 years old, an estimated 35% of teens are HPV infected, and it increases from there. In most cases the virus disappears naturally, but can be ruining when it doesn‘t. (HPV transmission doesn‘t require sexual intercourse, and condoms aren‘t fully protective.) The idea is to get kids vaccinated before sexually active because if any of the four vaccine-types HPV is acquired before vaccination, the vaccine isn’t protective against that type.
9. You said: “I am wondering if the death rates for these illnesses are high enough to make this vaccine warranted in any way.” In the US, cervical cancer strikes about 12,000 (I read 15,000 also) women yearly, with about 4000 deaths/year. But, vaccines are not just about death rates. Gardasil may be protective against 70% of cervical (and genital) cancers — mostly curable, but cervical and genital cancer and cancer treatments cause suffering, carry risks (e.g. of hysterectomy), and are very expensive.
Significant too is that Gardasil can help prevent the distress, discomfort, risks, and financial burden of treating most serious (HPV related) pre-cancerous lesions (dysphasia).
The bonus is that Gardasil could help prevent 90% of genital warts cases that currently afflict millions –usually transient, painless, and mild, but some cases are debilitating and relentless, and it is highly contagious.
Inoculating boys/men could reduce most HPV-related male cancers and warts, as well as reduce transmission of HPV to their female partners for whom it is most dangerous.
So, is Gardasil worth the risk? I’m not completely sure myself, but only armed with facts rather than distortions can we begin to answer this question. I hope you correct your misleading statements, not just in a footnote or buried among the comments, but right up front.
“Gardasil Vaccine Safety
Information from FDA And CDC on the Safety of Gardasil Vaccine,” FDA (Federal Drug Administration), August, 2009.
“Reports of Health Concerns Following HPV Vaccination,” CDC (Center for Disease Control), as of October 26, 2010.