Quite a bit of noise this week regarding the HPV vaccination programme. The latest seems to be in The Examiner with a leading public health researcher now claiming she is being misquoted and seeking a published apology from the reporter Today the Examiner published a news article being on a letter to the editor from a local priest calling for chastity and questioning the efficacy of the vaccine. Who needs the Daily Mail in scare story reporting?
In correspondence seen by me, Professor Diane Harper now claims that Jennifer Hough has misrepresented her work and only reported the risks associated with the vaccine in a second article published yesterday which reported on adverse reactions claimed by people and where the opinion of the journalist concluded that the HPV vaccine did not prevent cervical cancer – no research was contained in the article to back up this particular statement.
Professor Harper advocates that young women and their parents are educated about the vaccine, the possible rare risks and also that screening for all forms of cervical cancer will remain essential. She has addressed those who believe there are concerns with the vaccine and says they cannot be ignored.
An interview with Professor Harper (which alludes to frequent misrepresentations of her work) published on the Huffington Post last year is one of the easier to read which discusses issues pertaining to epidemiology, public health campaigns and research into the vaccine. It’s a pity that Jennifer Hough did not provide more information on the benefits of the programme and also report that Professor Harper believes in the efficacy of the vaccine up to the age of 26 and a protector against women having to undergo pre cancerous treatments and having smear tests misreported. Further reading on twisting science in this post by the excellent Ben Goldacre.
The article on the priest’s letter is the usual rubbish seized upon with no statistics or balance or fact checking. Fr. Eamonn McCarthy proceeded to get a lot of radio coverage today on Newstalk and Radio 1. In his letter to the Examiner Fr. McCarthy said that there was no evidence to show that vaccines worked (Psst Father heres only one bit – 60% reduction in genital warts in Australia reported last month.)
“A quick surf on the internet yields enough scary evidence to suggest that parents should think very carefully before allowing their young daughters to receive Gardasil, the HPV vaccine,” he said. “Thousands of adverse side-effects have been reported and, worldwide, up to 80 deaths among otherwise healthy young women have been allegedly linked to it. Two states in India have halted the vaccine.”
Fr McCarthy said HPV also gave a lie to claims that condoms are safe.
He also questioned what was being asked of secondary school boys.
[No i did not understand this either]
Mother nature is speaking to us through the bitter tears of rampant infection, sub-fertility, sterility and death. Like Mother Church, her cries are not being heeded,” he said. “There is a better way. Parents, do not be afraid to challenge your children to cherish the health and freedom of chastity. It has now become a matter of (eternal) life and death.”
Today the Irish Times published an article with one piece from a homeopath/therapeutic radiographer who is against the programme and a piece from two senior medics involved in public health and immunisation in favour of the programme.
I’m not a science reporter but an interested patient and reader of research and the reporting of research. A thought on medical treatments and risks – If I take a new medication there is a leaflet inside which outlines maybe a 1 in a 1000 risk or a 10 in a 10,000 risk or even a 1 in 100,000 risk associated with the medication and possible side effects. I am educated by the doctors prescribing it and the information provided on the disease and the treatment. There are side effects with all medications, there are also sudden deaths in populations, MS, early menopause and other illnesses – among those who have never taken the vaccine or any other medication.
If hundreds of thousands of women are vaccinated there will be reactions and there will be illnesses not related. We have medical review boards and agencies who will review the risks and reports and I think we have to put our trust in them, be informed about the risks of both the vaccine and also the disease being vaccinated against and also the fact that prevention in the form of safer sex and screening is also essential.
There are also issues with the way in which adverse effects are reported and recorded. Reports to the Vaccine Adverse Event Reporting System (VAERS) which Hough mentioned can be made by anyone, are often not followed up by a full report or evidence and many people could report a headache their daughter had 4 or 5 times over and it’s never checked up.
Facts are twisted to suit positions, religious groups have published all sorts of rubbish on this vaccine saying that it will make girls sexually permissive, there are anti big pharma groups, politicians who don’t want to pay for it, those who don’t believe women’s health is worth protecting. I would hope that all sides of the issue are covered in our national press and reported fairly and by people who actually know something on the issue – whatever I think about homeopathy (clue it’s sugary stuff) at least the Irish Times published both sides of the issue in today’s paper rather that the thoughts of a priest and delving into a list of scare stories and twisting research and data.
Cue loads of comments from anti vaccine types and other attention seekers. Tin hat on.
PS: I got through this post without referring to the incredibly soft and dangerous interview that Fr. McCarthy had on Drivetime this evening with Philip Boucher Hayes – it was this which set me off digging and where I received information on the concerns of Professor Harper regarding the reports in The Irish Examiner.
Bonjour Maman… I agree with you about the priest’s ludicrous ‘contribution’ to this discussion, and thank you for the link to Dr Harper’s December interview in HuffPo. However, my understanding of that Harper interview, and of her interview on The Right Hook yesterday, is roughly the opposite of yours. Inasmuch as she complains of distortion of her views in either of those, it’s distortion by promoters of Gardasil as appropriate for all young teen girls, not by opponents. In the Goldacre piece she says “Merck was egregiously overmarketing Gardasil”. As a parent of daughters, I certainly came away from her carefully measured words with a largely negative assessment of the vaccine.
Harry is there a moral panic being created on this vaccine and it’s side effects? The mass vaccination against meningitis c has produced it’s own number of ‘reported’ side effects but we don’t see accompanying campaigns like gardisil girls or holy hormones? Gardasil and Cervatrix don’t protect against all forms of HPV and don’t eliminate the need for smear tests and that’s not said often enough
Being only mildly facetious but if Paula Byrna was true to her calling as a homoeopath won’t she be suggesting that we ensure that as many women as possible get vaccinated as that would be diluting the effect amongst the general population? Dilution is key right?
And let’s be honest, if this was a vaccine against testicular cancer would there be half the societal concern?
As for the Wii. B. Priestly argument that “A quick surf on the internet yields enough scary evidence to suggest that parents should think very carefully before allowing their young daughters to receive Gardasil, the HPV vaccine” a quick surf of the internet yields enough scary evidence of just about anything you want! Church conspiracies, alien invasion, the peculiar sexual practices of insects, you name it’s on the net. But not every voice on the net is meant to be equal, not is it in the real world either. They say a little knowledge is a dangerous thing, but so too can be too much scepticism.
Clearly some of the opposition has a ‘moral’ (i.e. sexually repressive) dimension, but I think we can wait at least a few more days before deciding if ‘moral panic’ applies to the coverage. I think you can argue, in fact, that there was a moral-panic-cum-political-s**tstorm over Mary Harney’s initial rejection of a vaccination programme a couple of years ago. When the U-turn came the media were initially hesitant to say, “But wait, was it a good idea after all…?” — having previously virtually accused Harney of being a child-killer for rejecting it.
Fr McCarthy, in his ignorance, focuses a lot on direct side-effects. The more sensible critique of Gardasil, in which I would include Dr Harper’s own views as well as Paula Byrne’s in the IT, is more about indirect, unintended and unknown longer-term consequences — especially in the context of extremely well-aired Merck-inspired PR that would make one think that, as you say, women will never need to worry about screening again.
It annoys me when priests get involved in these debates. It changes the whole debate from medical to ethical and it just ends up being yet another shouting match with the church trying to tell us what to do as usual.
Harry, there are potential side effects to everything, the question is one of relative risk. One of the most dangerous consequences of the demise of basic maths and numeracy in Ireland and other countries is that people appear to be utterly unable to assess relative risks.
The key facts have to be the rate of infection of what causes cervical cancer and the deaths that result from it, (and we have hard numbers on that) as compared to the likely side effects from taking the vaccine and we have numbers on that too, perhaps not as definitive as we might like but they look pretty good coupled with the upside.
We have been down this road before with whooping cough and MMR and any number of preventative measures and every time people who are modern day Luddite come forward to say that the upside is unproven while the downside is somehow more certain and definitely awful. All the while ignoring the reality of the actual disease or condition that the measures are seeking to prevent.
In this instance, we have people who are convinced in part by that the fact that women would almost certainly not get the disease if they didn’t have sex means we shouldn’t vaccinate on the basis that they think their daughters won’t ever have sex. Which is as far from responsible parenting as we can get. What next people arguing against seat belts because they will never drive dangerously?
Cervical cancer vaccine. - Page 2 // Sep 2, 2010 at 00:05
[...] Originally Posted by ComeLook Cervical Cancer vaccine will not help anyone..quite the opposite in fact Cancer vaccine warning | Irish Examiner Is the cervical cancer vaccine good to go? – The Irish Times – Tue, Aug 31, 2010 that Examiner piece was utter tripe….. Maman Poulet has it covered…Maman Poulet Bias and reporting on the Cervical Cancer Vaccine [...]
Daniel, I must say that is a classic straw-man argument (not to mention unfair to the good old Luddites as usual!). I’m the last person to say that my teenage daughters won’t have sex (gulp), and there’s nothing in Paula Byrne’s piece or Doc Harper’s interview pushing chastity-as-prophylactic either. My view would be exactly the opposite of your caricature: the upside of Gardasil is pretty certain and not as great as what’s it been cracked up to be; the downside is uncertain and, for a variety of reasons, as much social/commercial as they are medical, ‘awful’ can’t be ruled out. Read the links above again, especially the Huffington Post one. Gardasil has never been adequately tested on the age cohort that will get it in Ireland, and Harper herself raises serious questions about its utility for that group.
But I know it’s more fun to pretend the opposition are all progress-hating, sex-hating, science-hating right-wingers.
Harry, I’m not suggesting that all the opposition are “all progress-hating, sex-hating, science-hating right-wingers.” merely that amongst the concerns lie those who are.
Let me be clear, I don’t think I would place an Homeopath (who has researched Gardsil!, what this research involves we have no idea) on an equal footing in a scientific debate with almost anyone.
But just on Paula Byrne and the lack of pushing chastity, she says “Cervical cancer is relatively rare, with approximately 3.9 deaths per 100,000 people each year in Ireland. There is no epidemic to warrant the urgent introduction of this vaccine.” So it’s rare, it’s not a epidemic so we don’t need to rush into anything here. Let’s take our time. Of course, she uses a number here of 3.9 per 100,000 people but we’re not talking about something that affects all people. Men don’t get cervical cancer so that rate is actually double what she says it is. It might seem a small thing but if I was researching and writing an article about testicular cancer, I would confine my stats of the rate of infection to those who could actually get the infection. And it’s not the only factual error that she presents us with.
She also makes another basic mistake here “Serious reactions to the vaccine were estimated at 3.4 per 100,000 doses distributed. Each person receives three doses, so the serious adverse reaction rate is probably closer to 10 persons per 100,000 doses given.” See what she did there? she multiple the adverse reaction rate by 3, cos there are 3 doses. She decided that in each 100,000 doses given to the same women 3 times, that 3.4 different women would have adverse reactions.
She appears to ignore the fact that it is likely those who had an adverse reaction to the first dose are probably going to be the ones having a bad reaction again not some new 3.4 from the remaining 97,997. That’s the result of either bad maths and bad stats or perhaps a desire to big up the downside just as she was reducing the infection rate in the previous bit. Why would someone do that?
And one other thing, about the notion that dealing with one form of HPV simply allows another form to take its place so why bother. Reducing the number of types of infection can lead to cervical cancer is a good thing as it reduces the number of enemies the scientists have to focus on. The fewer the causes, the easier they are to target.
Harry, there are lots and lots of genuinely concerned parents who want concrete answers and scientific sceptics who think that product X is not as great as the PR folks make out. It is entirely possible that Gardsil is not as great as Merck & Co. make out, but it will be scientists that show that using the scientific method openly. Sadly in the real world of science, we don’t normally have an answer that says, this will 100% make you better and have absolutely no downside at all for anyone. It’s about probabilities and relative risk and in that mix there are people with agendas who will seek to confuse for their own ends. But let’s not confuse the two groups.
This is not a defence of vaccination over screening, as already said screening works and should be continued and increased. This doesn’t need to be a case of either/or despite what some have claimed.
Poor Paula Byrne: first her medical-science qualification was demoted to secondary status by Maman, now it’s been dropped entirely by Daniel, so she’s just a crazy ol’ homeopath. Still, she uses the scientifically standard mortality stat (annual deaths per 100,000) and knows enough about drug trials to understand how ‘per-dosage’ is used to minimise adverse-reaction statistics, so maybe she is pretty smart about medicine after all. (Whereas you apparently believe that someone getting a ‘serious adverse reaction’ — that’s a lot more than a sore arm, it’s death, disability, hospitalisation etc — from the first dosage would always still be given two more, to get another pair of serious adverse reactions for her collection.)
Anyway, the point against Gardasil and a universal vaccination campaign is not mainly about these figures. One more time I’m going to say, read the HuffPo piece (http://www.huffingtonpost.com/marcia-g-yerman/an-interview-with-dr-dian_b_405472.html) — skip right to the last section if you must — and listen to Dr Harper on Tuesday’s Right Hook, toward the end of part 2, and then tell me why we’re vaccinating 12-year-old girls. And beyond the screening versus vaccination divide (which is, as you say, not a necessary one), the truth is: drug-company research is so thoroughly corrupt that the first trustworthy trial of this drug is the one we’re doing with our kids.
Harry, it is Paula Byrne who was recycling women from the first 100,000 dosage back into the population for the 2nd and 3rd dose when she was claiming that the real figure must be really 3 times that reported of 3.4. 3.4 per 100,000 remains 3.4 per 100,000 it does not become 10 per 100,000 women simply because the same 100,000 women are given 3 doses. That’s not down to her being crazy.
If you give 300,000 women one dose each then the 3.4 rate scales up to roughly 10.2 who would have adverse reactions. But if you give the same dose to the same 100,000 women 3 times that does not mean 10.2 would have an adverse reaction.
As for the use of mortality rate of 3.9 I would suggest you look here, which lists numbers twice that of hers
http://seer.cancer.gov/statfacts/html/cervix.html
because they use mortality amongst the potential population who could get it. That would be women. We also tend not to include the elderly when reporting mortality rates for childhood diseases either.
As for your final assertion “the truth is: drug-company research is so thoroughly corrupt that the first trustworthy trial of this drug is the one we’re doing with our kids.” It amazes me that someone could tar the reputations not simply of large corporations (which is par for the course these days and not entirely without reason) but also the many hundreds and thousands of professionals who work in them. Do some companies cut corners? Absolutely, but when they are caught doing so and they usual are, they are caught because of the professional integrity of those people you seem to think are all colluding in a deliberate effort to harm young girls.
Re mortality rate: there’s nothing wrong with your preference for a ‘female only’ rate, but you described Paula Byrne’s use of the standard population formula as a ‘factual error’ and a ‘basic mistake’, which of course it isn’t.
Re serious-adverse-effects rate: reading back over your last two posts, Daniel, it appears you’re contradicting yourself and tying yourself in statistical knots. To avoid the risk of doing the same myself, I’ll let that rest!
Re drug companies: I’ve never suggested a deliberate conspiracy to harm (another straw-man); but corporations have a single overriding purpose, and believe it or not it doesn’t involve the health and well-being of young girls or anyone else. The integrity of some, or even most, individuals has unfortunately little to do with it. (Come on, Merck’s shameful history with Vioxx is hardly ancient history.) I suggest a dip in the writings of Dr Marcia Angell — a noted critic of homeopathy, by the way! http://www.nybooks.com/contributors/marcia-angell/
My 12 year old daughter was disabled by Gardasil. I am in no way anti-vaccine, but there is something wrong with this vaccine. It cost my family thousands of dollars in medical bills and it cost my daugher her quality of life.
Just google gardasil side effects or go to http://WWW.SANEVAX.ORG and read the stories of injury and death. The examiner and the priest are doing the right thing exposing this vaccine because you will soon hear of young Irish girls who will be taken down in their young teenage years because of this vaccine.
Parents, please Investigate Before You Vaccinate. I wish I had. Watch this young girls for side effects and report them. Here are the current Stats in the US System VAERS.
According to VAERS as of 9/2/2010
Adverse Reactions
Gardasil – 18,461
Cervarix – 426
HPV Vaccines – 137
TOTAL – 19,024
Deaths
Gardasil 77
Cervarix 4
TOTAL – 81
In March of this year the number of reactions reported stood at 16,000. That means 3,000 more reports were made over the last 6 months – or approx. 125 reports a week. That is what went wrong with Gardasil.
It is not about numbers and marketing strategies – it is about destroying the lives of those it was supposed to save.
As the mother of a 15 year old daughter who is now injured and an 18 year old son, I can assure you I will NEVER ALLOW my son to receive this Vaccine.
I read up the research reportage on HPV vaccines when their introduction here was first proposed.
The Church sees anything that makes sex less scary as a bad thing as a matter of course. The Church has plenty of track record in lying about the science involved.
The pharmaceutical companies on the other hand stand to make fortunes from these vaccines if they can be extended across the entire female population. They have marketed these vaccines very heavily to parents and GPs.
We should always be particularly careful about impacts of drugs that are intended for such general use.
Additionally, the vaccine is not permanent in its effect, is expensive(may displace other spending) and doesn’t work for all types of HPV. It’s no substitute for condoms and regular smear tests.