Thursday, February 01, 2007

HPV Vaccine Debate

Sen. Connie Lawson (R-Danville) has one of the best legislative proposals this year. Lawson's SB 327 proposes to require vaccination of all girls entering the 6th grade against human papillomavirus (HPV), a sexually transmitted disease most commonly referred to as genital warts. HPV is perhaps the most commonly-transmitted STD. Until recently, it was thought the discomforting genital warts were the only thing an infected woman had to fear from HPV. We now know that it causes deadly cervical cancer in women. It is estimated about 6.2 million people become infected with the virus each year.

The Senate Health and Provider Services Committee, which is chaired by Sen. Pat Miller (R-Indianapolis) approved Lawson's bill unanimously, but not without watering it down considerably to assuage opponents. So who could possibly oppose Lawson's bill? Of course, the Christian right. Why? Because it will encourage young girls to be promiscuous if they don't have to fear getting the dreaded disease. And who are the legislators hearing from? Micah Clark of the AFA, of course. Clark offers this opinion on Lawson's bill as he discusses what he calls "a behaviorally spread disease":

The fact that HPV, unlike polio or measles, is a behaviorally spread disease makes this a hot-button issue among some parents. Unfortunately, as I mentioned last week following an interview I did, the opposition has been simplistically portrayed as a concern that the vaccine promotes sexual activity among teens. Again, that was not my concern. My contention is over a false message of safety. Condoms do not protect against HPV. The vaccine is only 70% effective, and the length of its effectiveness is not fully known. Therefore, without an accompanying abstinence message, and adequate information about the limitations of the vaccine, SB 327 is incomplete.

Putting that aside, there is still another problem. I believe that SB 327 is written incorrectly. SB 327 has a good objective - protecting women from a horrible disease - but it goes about achieving that goal in the wrong way. Rather than linking attendance language to the bill and requiring schools to track how many sixth grade girls have obtained the HPV vaccine, SB 327 should have schools simply provide accurate, written, information about the vaccine and its availability to all parents. The parents can then make the decision about vaccination, and when they believe it is appropriate for such discussions of an STD with their daughter. Another option would be for SB 327 to require doctors, instead of schools, to provide information about the vaccine to all parents. This approach recognizes the rights of parents, their values, and their responsibilities. It also removes the appearance of the heavy hand of government, as it seems to appear in SB 327’s introduced form. If SB 327 were modified in this manner, I believe it would sail through the Senate without much controversy.
To assuage the wing nuts like Clark, the Senate watered down Lawson's bill so that the vaccination is offered but not required of 6th grade girls as a condition of enrollment, even though a number of other vaccinations are already mandated, including diphtheria, pertussis (whooping cough), tetanus, measles, rubella, poliomyelitis, mumps, hepatitis B and chicken pox. Some of the opponents used the excuse that the vaccine hadn't been tested long enough, although 10 years of testing has found no adverse side effects according to medical experts. Many young girls who could be safely protected from the deadly disease will become infected, but as Clark puts it "the appearance of the heavy hand of government" is removed.

Contrast the religious right's reaction to news that HPV causes cervical cancer among women to its reaction to the discovery of HIV/AIDS in the 1980s. Because those at greatest risk of HIV/AIDS were gay men, a disfavored group by these folks, we enacted laws requiring health care providers to report the names of persons who tested positive for the disease, and we enacted laws to put people in jail who knowingly spread the disease to another person. Some of the zealots actually tried unsuccessfully to have people infected with the disease quarantined. For a short time, some states like Illinois, wouldn't issue you a marriage license unless you were tested for HIV/AIDS. There are about 45,000 new cases of HIV/AIDS reported in the U.S. each year compared to the more than 6 million who are infected with HPV. Each year, there are 16,000 cases of cervical cancer diagnosed, causing death to 5,000 women. Worldwide, nearly a half million women die each year from cervical cancer.

You will never see a legislative effort to crack down on people who are spreading HPV like you saw with the HIV/AIDS disease. Why? Because it involves such a significant portion of the heterosexual population, perhaps as many as one in four, you'll never see the legislature adopt the measures it enacted for HIV/AIDS for HPV. On the one hand, they don't want to punish heterosexuals for promiscuity, but at the same time they don't want to protect the population from the disease out of fear it will promote sexual promiscuity. Makes a lot of sense, doesn't it?

I think many people in the GLBT community are frustrated by the fact that the medical community was able to quickly develop a vaccine for HPV, but scientists are no closer to developing a vaccine for HIV/AIDS than they were 20 years ago. If such a vaccine were available, you can bet people would be racing to the doctor to get vaccinated. The idea that some parents would choose not to protect their daughters from HPV is difficult to understand knowing the potential health consequences. But then every thing about the debate with the religious right on this issue is difficult to understand.

UPDATE: Texas Gov. Rick Perry (R) has bypassed the legislature and signed an executive order requiring all Texas schoolgirls to be administered the vaccination against HPV, making Texas the first state in the country to require the vaccine. As with Indiana, opposition in the Texas legislature came from the religious right who claimed it amounted to tacit approval of sexual activity among young girls. "If there are diseases in our society that are going to cost us large amounts of money, it just makes good economic sense, not to mention the health and well being of these individuals to have those vaccines available," Gov. Perry said. The order does contain an opt-out provision, which allows parents to sign an affidavit saying they object to the vaccine on religious or philosophical grounds.


Anonymous said...

Somehow, I suspect Sen. Miller's subtle hand here.

For instance, she felt "compelled" to report to the newspaper, that Sen. Simpson was not present for the vote.

Catty and overly protective of here turf.

And she is blatantly homophobic to boot.

All under the Lord's name, of course.

Anonymous said...

"We now know that it causes deadly cervical cancer in women. It is estimated about 6.2 million people become infected with the virus each year."

Nice spin here. Seriously, are we going for the scare tactic or something? Using your words, the female part of the 6.2 million people all ended up with cervical cancer. HPV _can_ cause cervical cancer, but it is not always the case.

Considering how so many new drugs end up being pulled, I do not want the government demanding my kid be injected with this stuff. Maybe the first kids to be good test subjects should be those of elected lawmakers. Lets wait 20 years to see the _real_ results of long term clinical trials.

Gary R. Welsh said...

Anon, I did not say all 6.2 million are women or they wind up with cervical cancer. I did say, "Each year, there are 16,000 cases of cervical cancer diagnosed, causing death to 5,000 women."

Anonymous said...

Another sad indication of how frightened and appalled these people are about sex. They are willing to let people die to prevent us living pleasurable, fully human lives.

Anonymous said...

"They are willing to let people die to prevent us living pleasurable, fully human lives."

Letting people die? Where does this ban others from getting this drug? Are you telling me we have been dumbed down so much, that everything requires a government mandate? Give me a break!

There are 300M people in this country. Say half are female. Cervical cancer kills 5,000 women. Just say that all 5,000 got cervical cancer from HPV. 5,000 out of 150,000,000 people. The risk just isn't there in my opinion. You want the drug, get the drug. My guess is that if in five years, this drug is yanked off the shelf for various problems, you will be here complaining about that as well.

Anonymous said...

"Cervical cancer kills 5,000 women. Just say that all 5,000 got cervical cancer from HPV. 5,000 out of 150,000,000 people. The risk just isn't there in my opinion."

It is to those 5,000 women and their families.

Anonymous said...

Keep in mind that even if the HPV doesn't progress to cervical cancer, it can act as a conduit for the transmission of other STDs.

Anonymous said...

"It is to those 5,000 women and their families."

Obviously, but what was stopping them from getting it? Again, why a government mandate for this brand new drug?

Wilson46201 said...

I suspect most of the folk here arguing against the vaccine are males - interestingly enough, this legislation was supported unanimously by all the female Senators in the General Assembly.

Gary R. Welsh said...

Remember, Sen. Pat Miller chairs the committee and dictates the state's health care policy based on her rigid, religious right views. She's responsible for watering it down.

Anonymous said...

To understand the "religious right" you have to be a Christian. Since you say that you can't understand us you obviously are not a Christian.

I for one will absolutely oppose this vaccine. I have 2 daughters and I completely agree with the idea that vaccinating my daughters for this implements the idea that it is OK for you to be sexually active. To me it is like saying "here, have some birth control pills just in case you mess up, at least it will protect you from pregnancy."

We live in a free country where we are able to raise our children the way in which we believe. We are free to raise our children with high moral standards and maybe more of you should think of doing the same.

There would be an outcry of people protesting if states were madating prayer (God forbid) in schools but it's OK to protect a young girl against a sexual decision!!

Ideas have consequences, good and bad. The way in which you behave has consequences good and bad. Maybe those of you who say we are trying to stop people from living a pleasurable human life never had consequences for making bad choices and if you did you didn't learn from them!

Anonymous said...

Maybe you would allow me to shed some light on this from the perspective of a medical doctor.

Why did Governor Rick Perry of Texas reverse his pre–election position and issue an outrageous executive order mandating that all girls in the sixth grade receive the HPV vaccine? He says that it is about saving the lives of women. If this were his true motives, then why did he issue his press release late on the Friday afternoon preceding the Super Bowl? Why didn’t he hold a huge news conference with fanfare, boasting of his efforts?

Perry’s action took place without a single word of public debate. It appears to be a corporate welfare program for Merck, the creator of the vaccine, and will be paid for at the expense of school girls who will be the guinea pigs for this unproven treatment. That’s right, unproven treatment.

This is not a vaccine against cervical cancer; rather it is a vaccine against HPV which is contracted through sexual relations. Merck admits in its own literature that it did not prove that the vaccine would prevent cancer. The HPV vaccine only protects against 4 of the 127 strains of HPV. According to the British medical journal, The Lancet, the vaccine is only effective for 4-1/2 years. A booster injection will be needed every five years. This has not even been discussed. You can count on Merck to lobby to have this booster shot mandated and paid for with tax dollars.

The vaccine was approved by the Food and Drug Administration (FDA) in mid 2006. Remember the FDA does not perform studies on drugs or vaccines prior to approval. The FDA relies solely on studies performed by drug companies. Only one drug company study is required for approval of a product. Merck performed a five year study of its vaccine using 25,000 women, mostly in third world countries. Only 1184 were pre-teenagers.

The average age of a woman with cervical cancer is 48. The effectiveness or dangers of this vaccine will not be known for at least a decade. Cervical cancer results in just 3,700 deaths nationally every year compared to heart disease which kills over 300,000 women annually.

Pharmaceutical companies spend hundreds of millions of dollars to lobby politicians for legislation which will give them financial benefits. Merck’s lobbying efforts on Governor Perry have paid off handsomely. The HPV vaccine has been coined Merck’s “How to Pay for Vioxx.” Merck manufactured Vioxx, an anti-arthritic drug, which was pulled from the market in 2004 because it had caused 125,000 heart attacks. In lawsuits, Merck was found to have withheld information about the cardiac dangers of Vioxx from the FDA, physicians and patients. In the first of many trials, the jury found Merck guilty of knowingly causing harm and awarded punitive damages amounting to $254 million. Merck lost billions in profits when their corrupt behavior was exposed.

Merck developed a plan to recoup their losses. They organized a strategy to have state governments mandate their HPV vaccine. They contributed to medical organizations and to a group, called Women in Government, to buy support for the mandatory vaccination program, and hired lobbyists to swarm the state capitols across the nation, pushing this legislation. Until now, Merck’s efforts had been rejected, but with the help of Governor Perry’s unprecedented executive order, Merck bypassed the Texas Legislature.

The cost of each vaccination is $360. Perry’s mandate will generate over one hundred million dollars every year for Merck in Texas and, if adopted nationwide, would generate billions of dollars more for Merck every year. It is unethical to bail Merck out of its financial troubles by forcing Texans to buy their product.

The Texas Medical Association opposes mandatory HPV vaccination.

All these facts make the credibility and motivation of Merck highly suspect. Relying on Merck’s studies for approval of this vaccine is like letting the fox to guard the hen house. Merck has already been proven to operate dishonestly.

Perry’s unilateral decision is not based on science but upon personal power, profit and politics. Perry has been trying to position himself as a potential Republican Vice-Presidential candidate.

Hoosiers need to think twice before having this vaccine administered to their daughters.

No public emergency existed for Governor Perry to have assumed dictatorial powers and mandated this vaccine. Perry’s tyrannical actions set a dangerous precedent.