Tuesday, February 20, 2007

The Religious Right's Crack Up Over HPV Vaccine

Indiana has witnessed a crack up on the part of religious right in reaction to the legislative effort of Sen. Connie Lawson and other female legislators to get young girls vaccinated against HPV, the virus which causes cervical cancer in women. They so far haven't succeeded in killing it, but their opposition has forced it to be watered down from required vaccination of sixth-grade girls to purely educational in nature. The religious right seems to think young girls will be more promiscuous if they face one less life-threatening, sexually-transmitted disease.

During third reading debate last week, Sen. Mike Delph (R-Carmel) impugned the integrity of Sen. Lawson and other female legislators who participate in Women In Government, suggesting they had been bought off by Merck, the only pharmaceutical company which manufactures the vaccine against HPV. Delph expressed outrage that a private company would use the legislative process to enact laws to improve its bottom-line revenues. Delph's protestations seem a little specious when you consider the fact he earns a living as Senior Director of Government Affairs for Comcast, a publicly-regulated utility. The last time I checked, the cable TV industry had a very active lobby at the federal and state level, which works hard to improve bottom-line revenues for their industry. Senate President Pro Tem David Long (R-Fort Wayne), according to eyewitnesses, wasn't amused by Delph's comments, who say Long gave Delph a little tongue-lashing when he concluded his comments on Lawson's legislation.

So who does Delph turned to for consolation after earning the wrath of his Republican leader? Why none other than the American Family Association's Micah Clark. As Clark explains in an item entitled, "Senator, You shouldn't say what others are saying":

I got a call from Senator Mike Delph on Monday evening on his drive home to tell me of the vote on Senate Bill 327. To no one’s surprise the HPV vaccine bill passed. It was a lopsided vote of 45-5.

The heated, hour-long debate focused on cervical cancer far more than the effectiveness of the new vaccine or the rights of parents to be provided the fullest amount of information and choices regarding an STD vaccine for 9-12 year old girls.

Senator Delph took a verbal beating from some very emotional legislators, just as Senator Jeff Drozda had a few days earlier when he tried to amend SB 327 to give parents more information. Senator Delph irritated the bill’s authors, and Senate leadership, by bringing up a topic that has been widely addressed in the media from publications like The Washington Post, The Wall Street Journal, The Houston Chronicle, The Indianapolis Star. Delph’s offense was citing the huge amounts of money that Merck not only stands to make with this STD vaccine, but also has been pouring into campaign coffers, and lobbying efforts. Senator Delph questioned the propriety of such efforts to quickly rush through bills like SB 327 in two dozen states.
Well, if Sen. Lawson and other female legislators were outraged by the antics of Delph, Drozda, Clark and other members of the religious right, they should get a load of what's happening next door in Illinois, where similar legislation is being debated. As State House reporter Rich Miller explains, opponents there went so far as to make an issue of the sex life of the bill's sponsor after she candidly admitted she had HPV. An anti-abortion lobbyist, Jill Stanek, had this to say about Sen. Debbie Halvorson (D) after she acknowledged she had HPV:

So when state Sen. Debbie Halvorson admitted she had HPV and worried others might get it, you would think she'd focus on her behavior that caused her to contract that sexually transmitted disease.

Halvorson would be most helpful by discussing the health consequences of pre- or extra-marital sex. Here are some potential topics:
  • Halvorson could discuss the number of sex partners she has had throughout her lifetime and how each one increased the likelihood of contracting HPV. If Halvorson even had only one sex partner aside from her husband, she could discuss how one can contract HPV from a sole encounter.
  • Halvorson could discuss whether she realized at the time her sex partner carried HPV, which most trusting, vulnerable women don't.
  • Halvorson could disclose whether it was her husband who passed HPV on to her after sleeping with other women, demonstrating another reason for chaste
    behavior outside the marriage bedroom.
  • More uncomfortably, if Halvorson contracted HPV through rape, she could discuss ways to avoid rape.
  • But no, Halvorson does not advocate avoiding a risky behavior that leads not only to HPV but to 20+ other STDs and their strains, along with unplanned pregnancy. Halvorson merely advocates trying to avoid the consequences of risky behavior. Shame on her.
Shame on Stanek. In reacting to Stanek's comments about Halverson, Miller said, "I’ve always liked Jill, but her remarks crossed the line of decency and could backfire." "The legislation could pass just because of the tactics used against it." "This slash and burn stuff might work in the national media (although its influence seems to be fading fast), but people here are a bit more reasonable than the DC gasbags." I would add to Miller's comments, do you think Stanek would ask those same questions of Marilyn Quayle, who is a cervical cancer survior, or suggest she acquired it because former Vice President Dan Quayle was sleeping around?

Gays are used to these kinds of tactics. The religious right has been saying from the very beginning of the HIV/AIDS epidemic that people who get it are to blame and deserve to die because they engaged in "immoral" and "risky sexual behavior." The tactic is frought with problems, though, with respect to HPV because of the sheer numbers of people infected with it. Unless Stanek lives under a rock, most of the people she associates with on a daily basis are either infected or have a close family member or friend who is infected. Can you imagine what their reaction will be if researchers ever develop a vaccine against HIV? Wouldn't you want your children vaccinated? You can bet the religious right will oppose it on the basis it would encourage people to engage in "homosexual sex."

6 comments:

Anonymous said...

HPV vaccine
Questions surround advocacy group's connection to drug firms
BY CINDY BEVINGTON
cindyb@kpcnews.net (Created: Sunday, February 11, 2007)

A controversial vaccine that has divided legislators, parents and the medical community across the country was a hotbed topic in the Indiana Senate this past week, with a Senate version of a bill requiring the vaccine in Hoosier schoolgirls changing drastically by week's end.

SB 327 would have required all Indiana girls to be vaccinated against human papilloma virus (HPV) by sixth grade by the start of school in 2008. HPV is a virus spread through sexual contact in both males and females. Scientists have identified over 100 forms of HPV, a few of which can cause cervical cancer and genital warts. Two pharmaceuticals, Merck & Co. and GlaxoSmithKline, have been working on an HPV vaccine. Merck's was tested over a 3 1/2-year period and approved by the FDA in June. Glaxo officials anticipate their drug being approved within the next few months.

The vaccine is supposed to protect against two HPVs that researchers believe can cause about 70 percent of cervical cancers, and against two that can cause about 90 percent of genital warts. An important note is that the vaccine does not protect against the other 30 percent of viruses that also can cause cancer. It also does not protect against any other cancers of the genital regions in males or females.

A common misconception about the vaccine that has been voiced by legislators and repeated in major media is that it is a cancer vaccine. But it is not a cancer vaccine. Rather, it is a vaccine for a virus that can cause cancer. Another misconception about HPV itself is in the numbers that vaccine supporters use regarding the prevalence of the infection: They say that 20 million people at any given time are infected with HPV, which is true. However, they fail to explain that the 20 million includes ALL kinds of HPV, not just the ones that cause cancer.

Also, most cases of HPV clear up on their own, without any kind of intervention at all. Of those that do cause problems this year, the CDC estimates that about 11,000 women in the U.S. will be diagnosed with cervical cancer, and that 3,700 will die from it. Most of these cases will be in women who have not undergone regular Pap tests for cell dysplasia, a precursor of cervical cancer. In comparison, 70,000 U.S. women die of lung cancer (the No. 3 cause of death in women) each year. Compared to colon cancer — the No. 10 cause of death in U.S. women — cervical cancer is 1/8 of colon deaths in U.S. women.
Worldwide, cervical cancer is the second leading cause of death in women, mainly because cervical cancer — as well as AIDS — is so prevalent in third world countries, where Pap screenings are not available and where cultural traditions or taboos may prevent women from knowing about, seeking or having access to Pap tests.

Indiana backs down
Across the country, at least 18 states have been debating legislation to mandate the HPV vaccine in American girls. Wednesday, Utah killed their legislation in committee. On the flip side, last week Texas Governor Rick Perry sidestepped his legislature and mandated the vaccine through executive order, causing a flurry of protests around the country, with opponents accusing him of having too many connections to Merck to be nonbiased.
According to Texas-based news reports, Perry accepted $6,000 from Merck's political action committee during his campaign for governor. He also has ties to Merck through his former chief of staff, Mike Toomey, who now is one of Merck's three lobbyists in Texas.

Additionally, Perry's current chief of staff's mother-in-law, Texas Republican state Rep. Dianne White Delisi, is a state director for Women In Government, which has been actively promoting the vaccine's legislation, and which also accepts money from Merck.
This week in Indiana SB 327 became a shadow of its former self when, in the face of strong opposition to legislating the vaccine, the bill's author, state Sen. Connie Lawson, R-Danville, wrote changes into it that basically makes it an HPV education bill. In its present form, parents would simply receive information about HPV, cervical cancer and the availability of the vaccine. But even with the changes, the Indiana House would still have to approve it — and could change it substantially, perhaps even back to its original form — before it could become law.

Links to drug companies

In the meantime, some people are questioning links between the vaccine's manufacturer, Merck & Co., and Women in Government (WIG), an advocacy group of 136 women legislators across the country who have been introducing HPV vaccine bills in their home states for the past couple years. No one is questioning the member legislators individually; it is the group as a whole.

Lawson is the chair of WIG's board of directors. A former Indiana legislator, Susan Crosby, serves as the board's president, and Merck & Co., as well as Merck Vaccine, are, or have been funding sponsors for WIG.

WIG also has a business council, described on the group's Web site as “comprised of a small, select group of industry leaders. ... (who) ... play an integral role in planning our future growth, have the ability to attend our regional conferences and support the financial stability of the organization." The 2006 list of business council members include Merck Vaccine Division's executive director of health policy and external affairs; GlaxoSmithKline's director of public policy; and Digene Corporation's vice president of women's health. Digene manufactures screening tests for the presence of HPV in the body.

A list of WIG's current sponsors appears on its Web site at womeningovernment.org. Many of them are drug companies, including Merck and GlaxoSmithKline, which has its own HPV vaccine pending. While Merck Vaccine is listed as a 2006 corporate sponsor in WIG's Summer 2006 newsletter, The Legislative Voice, it is not on the 2007 list. A month ago WIG's Web site included WIG's 2005 sponsors — and Merck Vaccine Division was among them then, along with its parent Merck & Co. That list has since disappeared from the WIG site, as have other pages that show some of the group's past activities.

However, Internet caches of WIG sites dating back to 2001 are available at web.archive.org., and those caches list dozens of sponsors who historically have had a stake in various legislative issues over the past few years, both nationally and in individual states. Besides Merck Vaccine Division and other drug comanies — including PhRMA — some of those groups include telecommunications giants such as Verizon, Sprint, MCI and different cable companies; energy and utility suppliers; and numerous insurance giants such as BlueCross BlueShield and Humana.

Follow the money

In an interview with this newspaper two weeks ago, Lawson said that Merck had given WIG "some money" toward WIG scholarships, but she declined to say how much — a right she has under federal law. WIG is a 501(c)(3) nonprofit agency and, under federal law, 501(c)(3)s don't have to reveal who funds them, or how much they receive from their sponsors, unless they choose to divulge that information. They do have to file Form 990s with the Internal Revenue Service, though.

According to WIG's 2005 Form 990 — available with thousands of other nonprofit agencies' tax forms at guidestar.org — WIG's income was just under $2.4 million. And, again, although it does file attachments with sponsors' names on them for the IRS, those sponsor forms are not public. Lump-sum expenses are listed, though, and in 2005, WIG reported monetary compensation payments of $167,603 for its officers and directors — Crosby was paid $117,417 and Lawson, $5 per hour (number of hours not reported). The group also reimburses officers and directors for "organization expenses," the form reports. For other expenses, WIG reported $739,677 for conferences, conventions and meetings; and $224,815 for travel.

In the cached versions of WIG's Web site, WIG explains that its sponsors fund its activities: "Women in Government is the only organization that consistently provides full scholarships for current women state legislators and first-term women state legislators (to the group's) legislative business roundtables," a 2002 Web page explains.
It goes on to say that WIG sponsors up to 16 roundtables each year across the country. "Funding for Women in Government educational programs and scholarship awards comes from grants made by corporations and philanthropic foundations, and supplemented by donations, membership dues and registration fees," the site says. At last viewing, WIG's current site listed membership dues as $100 per year.

From California to Europe

According to information on WIG's cached Web pages, the conferences and roundtables WIG members have attended on sponsors' scholarship monies have crisscrossed the world and nation, from seminars in California to summits in Europe. And, the group's newsletters mention WIG's gratitude for the sponsorship that made these educational meetings possible. For example, in 2004, then-chair of the board Beverly Hammerstrom (a Michigan state senator) writes, " ... at a time when travel is limited because of difficult budgets, WIG's scholarship awards to women state legislators (thanks to our many wonderful sponsors) are especially appreciated in helping legislators stay at the top of their games."

Other places on WIG's Web site also indicate that many of the sponsors' executives also are speakers at these meetings. Friday, Crosby was not available for comment, and WIG's communications director, Tracy Morris, said she was not authorized to be a spokesperson for the group. However, Morris did e-mail a prepared statement from Crosby, who has issued the same statement to other news media. "We leave it up to our supporters if they wish to share specific funding information," the statement said. "For us, I can simply say that Women In Government receives unrestricted educational grants from a variety of corporate, governmental, individual and foundation sources and we are grateful for the support."

Merck has not returned repeated requests for interviews with this paper, although Merck spokespersons have been quoted in Associated Press stories that the company was declining to state how much Merck gives to WIG. A communications director did not return phone calls requesting comment. However, in other news, Lawson was quoted in an AP story Friday that Merck's contributions had no impact whatsoever on her legislative agenda.

A higher standard

As individuals, public officials are required to declare gifts and contributions they receive from entities like Merck Vaccine Division and WIG's other sponsors. But, the 501(c)(3) status of the group protects WIG members from having to disclose anything they accept under the group's name, for purposes under which the group acts as a nonprofit, including "educational" trips and travel, conventions, seminars, meetings and roundtables.
Even so, northeast Indiana's elected officials believe that WIG members, including Lawson, should be held to a higher standard — meaning she and her WIG colleagues should fully disclose how much they receive from each of WIG's sponsors.
Describing Lawson as honest and above-board with an impeccable reputation, as a legislator who is concerned only for the best interests of children, state Rep. Matt Bell, R-Avilla, said he considers her a tremendous public servant who always has her heart in the right place.

"Not one bit of her can be bought or sold," Bell said. "But as a legislator, I believe Women In Government should disclose in a very transparent way anything they got from Merck, so the people can look at it and make their own decisions." Sen. Dennis Kruse, R-Auburn, was just as adamant that WIG disclose what Merck has given WIG, as were Reps. Phyllis Pond, R-New Haven, Dick Dodge, R-Pleasant Lake and Marlin Stutzman, R-Howe. (See accompanying story, "What local legislators think").
But, Tufts University political science professor Jefferey M. Perry was a little tougher. On his university Web site, Perry's specialties are listed as being in the areas of interest groups, citizen participation, nonprofits and public policymaking. He has written several books on these topics, and has been quoted heavily in major newspapers' investigations of lobbyists' influence on elected officials.

"As a nonprofit, WIG is clearly contravening the spirit of the law, which is transparency for donations for lawmakers," Perry said in an interview last week. "The law makes nonprofit tax forms public because 501(c)(3)s provide for a subsidy from all taxpayers to the nonprofit — all taxpayers have to pay more because of the non-taxability of the nonprofit."

Both lobbying and "education" expenses like those claimed by WIG are legal under a nonprofit status. But, the very nature of lawmakers' debt of accountability to their tax-paying constituents should make this non-taxpaying group feel like they ought to disclose any money they use under the nonprofit's umbrella, Perry said. It's a fine line the group may be toeing, he added: "This nonprofit apparently is doing things that educate; where education can be a dodge is by calling lobbying education — but lobbying is still permitted under a 501(c)(3)."

In the case of a legislator or a nonprofit that takes money from a manufacturer that can gain from legislation that lawmaker later introduces, or the nonprofit supports, "It certainly raises questions," Perry said. "In a perverse way it's more of a conflict of interest than if the money went directly to the legislators. "That's because if you're part of an organization that depends on that donor's largesse, you may feel more of a pressure to do things that they want — and, I do think (WIG's connection to Merck) is unusual, due to the large number of bills that have been filed. It seems set up to affect advocacy to help legislators in their own states."

More than 1 million nonprofits are registered in the U.S., and a vast majority of them are providing philanthropic activity, Perry said."So, this kind of nonprofit really stands out because it sounds more like an advocacy group than philanthropic. And, when it comes to revealing what they're receiving from their sponsors, there should be complete transparency, including the amounts they receive."

Anonymous said...

Direct quote from Merck's website

http://www.merck.com/newsroom/press_releases/product/2006_1113.html

"For most people, HPV goes away on its own; however in some, certain high-risk types of HPV, if unrecognized and untreated, can lead to cervical cancer."

Anonymous said...

just in

TheIndyChannel.com
Merck Halts Cervical Cancer Drug
Lobbying
POSTED: 6:21 pm EST February 20, 2007
UPDATED: 6:33 pm EST February 20, 2007
TRENTON, N.J. -- Merck & Co. is immediately
suspending its lobbying campaign to persuade state
legislatures to mandate that adolescent girls get the
company's new vaccine against cervical cancer as a
requirement for school attendance, the company said late
Tuesday.
The drugmaker had been criticized by parents and doctors'
groups for quietly funding the campaign via a third party to
require 11- and 12-year-old girls get the three-dose vaccine
in order to attend school.
Some had objected because the vaccine protects against a
sexually transmitted disease, human papilloma virus, which
causes cervical cancer. Vaccines mandated for school
attendance usually are for diseases easily spread through
casual contact.
"Our goal is about cervical cancer prevention and we want
to reach as many females as possible with Gardasil," Dr.
Richard M. Haupt, Merck's medical director for vaccines, told The Associated Press.
"We're concerned that our role in supporting school requirements is a distraction from that goal, and as such
have suspended our lobbying efforts," Haupt said, adding the company will continue providing information
about the vaccine if requested by government officials.
Merck launched Gardasil, the first vaccine to prevent cervical cancer, in June.
Sales totaled $255 million through the end of 2006, according to Merck.
Last month, The Associated Press reported that Merck was channeling money for its state-mandate
campaign through Women in Government, an advocacy group made up of female state legislators across the
country.
Conservative groups opposed the campaign, saying it would encourage premarital sex, and parents' rights
groups said it interfered with their control over their children.
Even two of the prominent medical groups that supported broad use of the vaccine, the American Academy
of Pediatricians and the American Academy of Family Practitioners, questioned Merck's timing, Haupt said
Related To Story
CERVICAL CANCER
l Encyclopedia: Cervical Cancer | Genital
Warts
l Overview: MedlinePlus.gov
l The Basics: 4woman.gov
l Guide: American Cancer Society
l In Depth: National Cancer Institute
HEALTH LIBRARY
l Pap Smears And Cervical Cancer
l Finding Cervical Cancer
l Early Diagnosis Best
AP Image
Merck & Co. said Tuesday it is suspending its
state-by-state lobbying efforts for its cervical
cancer vaccine.
Merck Halts Cervical Cancer Drug Lobbying - Print This Story Page 1 of 2
http://www.theindychannel.com/print/11066240/detail.html 2/20/2007
Tuesday.
"They, along with some other folks in the public health community, believe there needs to be more time," he
said, to ensure government funding for the vaccine for uninsured girls is in place and that families and
government officials have enough information about it.
Legislatures in roughly 20 states have introduced measures that would mandate girls have the vaccine to
attend school, but none has passed so far. However, Texas Gov. Rick Perry on Feb. 2 issued an executive
order requiring that schoolgirls get the vaccinations, triggering protests from lawmakers in that state.
The vaccine also is controversial because it is the most expensive ever - $360 for the three doses required
over a six-month stretch. Because of that cost and what pediatricians and gynecologists say is in adequate
reimbursement by insurers, many are choosing not to stock the vaccine or requiring surcharges to administer
it, adding to parents' difficulties.
Merck shares were down in after-hours trading on the New York Stock Exchange, falling 35 cents to
$44.15, after rising 22 cents in regular trading to close at $44.50.
Copyright 2007 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or
redistributed.
Merck Halts Cervical Cancer Drug Lobbying - Print This Story Page 2 of 2
http://www.theindychannel.com/print/11066240/detail.html 2/20/2007

Jill Stanek said...

You said, "During third reading debate last week, Sen. Mike Delph (R-Carmel) impugned the integrity of Sen. Lawson and other female legislators who participate in Women In Government, suggesting they had been bought off by Merck..."

Well, it turns out Delph was right:

http://illinoisreview.typepad.com/illinoisreview/2007/02/merck_admits_ma.html#more.

And Halvorson? She decided not to call her bill today in committee. Oh, yes, she's a board member of Women in Government.

Advance Indiana said...

Jill, You could make the same argument about all the other businesses and organizations which fund Women In Government, NCSL or any of the other legislative organizations for that matter. Connie Lawson did not introduce this bill because Merck contributed money to the organization. She did it because she believes in protecting women from this deadly form of cancer. I dare you to pose the same questions you posed to Debbie Halvorson to Marilyn Quayle, a cervical cancer survivor. A decent person wouldn't, but after your Halvorson post, I wouldn't put anything past you.

Jill Stanek said...

If you read all my blogs posts on this (links here: http://illinoisreview.typepad.com/illinoisreview/2007/02/wsj_news_alert_.html#more) my theme is always this: What causes cervical cancer, and what causes what causes cervical cancer?

If you read how proponents of the mandated HPV vaccines promote it, it is always to avoid discussing the fact HPV is a sexually transmitted disease, and the REAL prevention of HPV - and cervical cancer - is abstinence until marriage and then fidelity within marriage.

That was the rationale for my asking rhetorical questions of Halvorson - to draw out that point, which she to this day avoids. She said as recently as Monday in the press, "This has nothing to do with sex."

That is flat out wrong.

Halvorson (and actress Marissa Winokur) put themselves out there as Exhibits A to push mandated HPV vaccines. They erred when they said, basically, "We have a history of a disease. Here is our idea for the cure. But our idea for the cure disallows talking about the cause of our disease."

That is philosophically illogical and medicinaly dangerous.


As for Marilyn Quayle, has she taken a position on mandated HPV vaccines? I'm not on a witchhunt. But I will call those out who try to force this vaccination on all our daughters, particularly without discussing sexually destructive behaviors that lead to it.