velvetpage (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
velvetpage) wrote2008-05-14 07:05 am
velvetpage) wrote2008-05-14 07:05 am
Entry tags:
Hoax-busting
I came across The Great HPV Vaccine Hoax Exposed on a community, where its reception contained far too much of, "It's a shame this is written in such a National Enquirer tone, because it has some good information." Um, NO.
So I'm going to debunk it, bit by bit.
The first claim is that the FDA has known for several years that HPV has no direct link to cervical cancer. This is based on a petition to the FDA to reclassify a testing device as a device to locate HPV, instead of being a device to locate cervical cancer. This follows directly from some quotes of the FDA that state that most HPV infections clear up on their own in healthy women. The article interprets this as meaning that HPV has no direct link to cervical cancer, and the FDA knows it.
But that's not what the FDA information says. It says that most strands of the virus are harmless and eradicated by the body with no symptoms, and even the cancer-causing strands sometimes do not cause cancer; an HPV infection is most likely to lead to cancer or pre-cancerous lesions when it is a persistent and/or recurring infection. NOWHERE in that does it say that HPV is not linked to cervical cancer; it says that not all strands of HPV are linked to cervical cancer. The author of the article has exaggerated and overgeneralized a statement in order to discredit the FDA and eliminate the need for a vaccine.
Conclusion: SOME strands of HPV can and do cause pre-cancerous lesions and eventually, if untreated, cancer.
The second claim is that HPV vaccines actually increase the rate of lesions. The quotes make it quite clear that the subset of women who are likely to experience this are those who are already infected with one of the four strands, but the article then generalizes that to say that it's dangerous for many women. If you read the Gardisil literature, you find out that women should be either virgins or tested for these strands before getting the vaccine, and it's not recommended for these women for this exact reason. In other words, the article's claim that the marketing hasn't included this information is false. The entire reason it's given to young women, usually adolescents, is to hopefully get it to them before they become sexually active, so they won't be infected before they get it.
Conclusion: If you follow the Gardisil guidelines and get tested before getting the vaccine, the vaccine will prevent infections of those strands and will NOT cause new cancerous lesions. However, it is true that getting the vaccine when you are already infected is dangerous. The claim that Gardisil isn't making that clear is false.
The next claim is that, because Gardisil is only effective if administered to girls who are not already infected, and because "virtually all" sexually active women are infected, administering the vaccine safely requires interrogation of young virgins. Well, if you consider a doctor asking her patient, "If you've ever had sex, now is the time to tell me, because this vaccine could be dangerous for you if you have and I'd want to run a couple of tests before administering it," to be interrogation, then this is perfectly true. (This is probably a good place to put in the caveat that only 80% of sexually-active people get HPV - those who are active with people who were virgins until that time are at almost no risk - so the "virtually all" is an exaggeration.) However, the language is inflammatory. No one is holding a gun to these girls' heads. Just as with many medical procedures, it's important to get a bit of background information here. A girl would be asked the same thing when offered a pap smear, or any other time she saw her gynecologist. Even the use of the word "virgin" is inflammatory, because our associations with virginity are of innocence, and the idea is that asking the question of an innocent is going to destroy that innocence. That's hogwash. Girls who are old enough to get this vaccine have already had some pretty comprehensive sex education at school (at least in Ontario and any reasonable state.) Most have already started menstruating. They are not complete innocents, and asking a question like that is not going to destroy whatever innocence they still have.
Conclusion: People administering the vaccine do indeed need to ask a question or two, while maintaining their professionally-mandated confidentiality about the girls' responses, so that the vaccine is administered only to people who will not be harmed by it.
The last section deserves to be actually cut and pasted so you can see it in all its glory. Accordingly, here it is:
Quadrant I: Non-Sexually Active, No Gardasil Vaccine
Outcome: No risk of cervical cancer.
Quadrant II: Non-Sexually Active, Receives Gardasil Vaccine
Outcome: No medical benefit from vaccine.
Quadrant III: Sexually Active, No Gardasil Vaccine
Outcome: HPV presence is self-limiting and does not lead to cervical cancer.
Quadrant IV: Sexually Active, Receives Gardasil Vaccine
Outcome: 44.6% Increased risk of precancerous lesions. No reduction in cancer risk.
For Quadrant I, they're absolutely correct. Quadrant II is only true as long as the person in question remains non-sexually active, which means at some point, that person will move to Quadrant V, the one where someone becomes sexually active AFTER receiving the vaccine, and Quadrant II is therefore irrelevant. (Quadrant V is actually the spot where doctors want women to end up - it's the whole point of the vaccine.) Quadrant III is just plain not true, and I can point you to several people who can attest that it's not true - the people in my circle of family and friends who get pap smears every couple of months and are regularly treated for pre-cancerous lesions in an effort to keep cervical cancer at bay. Quadrant IV shouldn't happen at all, because doctors are supposed to be asking questions of their patients to make sure it doesn't happen.
Conclusion: Maybe the author should actually look at all FIVE possible outcomes, rather than four, and accept that women are going to move between them? Of course, that would require him to go back on his main premise, that the vaccine does no good.
The next section is headlined, "Gardisil shown to be useless." It cites a study which looked at rates of lesions in women who got the vaccine when they were already infected. This guy is bugging me big-time by this point. He refuses to recognize that there's a difference in outcome for women who get the vaccine PRIOR to becoming sexually active, or prior to contracting HPV (which are not always the same thing.) We've already established that women who are positive for HPV should not get the vaccine; but he uses this as a reason why women shouldn't get it to begin with, and that's totally false. I say it again: THE VACCINE IS DESIGNED for women who are NOT YET SEXUALLY ACTIVE. He hasn't cited any studies about women who got the vaccine before sexual activity and then went on to be sexually active - because those studies wouldn't support his premise, of course.
Conclusion: he's overgeneralizing, using adverse effects in a non-target population to scare those within the target population off of getting the vaccine. He's taken all kinds of good information and twisted it so that it means something totally different from what it said, and it makes me sick to think that people might believe him.
So I'm going to debunk it, bit by bit.
The first claim is that the FDA has known for several years that HPV has no direct link to cervical cancer. This is based on a petition to the FDA to reclassify a testing device as a device to locate HPV, instead of being a device to locate cervical cancer. This follows directly from some quotes of the FDA that state that most HPV infections clear up on their own in healthy women. The article interprets this as meaning that HPV has no direct link to cervical cancer, and the FDA knows it.
But that's not what the FDA information says. It says that most strands of the virus are harmless and eradicated by the body with no symptoms, and even the cancer-causing strands sometimes do not cause cancer; an HPV infection is most likely to lead to cancer or pre-cancerous lesions when it is a persistent and/or recurring infection. NOWHERE in that does it say that HPV is not linked to cervical cancer; it says that not all strands of HPV are linked to cervical cancer. The author of the article has exaggerated and overgeneralized a statement in order to discredit the FDA and eliminate the need for a vaccine.
Conclusion: SOME strands of HPV can and do cause pre-cancerous lesions and eventually, if untreated, cancer.
The second claim is that HPV vaccines actually increase the rate of lesions. The quotes make it quite clear that the subset of women who are likely to experience this are those who are already infected with one of the four strands, but the article then generalizes that to say that it's dangerous for many women. If you read the Gardisil literature, you find out that women should be either virgins or tested for these strands before getting the vaccine, and it's not recommended for these women for this exact reason. In other words, the article's claim that the marketing hasn't included this information is false. The entire reason it's given to young women, usually adolescents, is to hopefully get it to them before they become sexually active, so they won't be infected before they get it.
Conclusion: If you follow the Gardisil guidelines and get tested before getting the vaccine, the vaccine will prevent infections of those strands and will NOT cause new cancerous lesions. However, it is true that getting the vaccine when you are already infected is dangerous. The claim that Gardisil isn't making that clear is false.
The next claim is that, because Gardisil is only effective if administered to girls who are not already infected, and because "virtually all" sexually active women are infected, administering the vaccine safely requires interrogation of young virgins. Well, if you consider a doctor asking her patient, "If you've ever had sex, now is the time to tell me, because this vaccine could be dangerous for you if you have and I'd want to run a couple of tests before administering it," to be interrogation, then this is perfectly true. (This is probably a good place to put in the caveat that only 80% of sexually-active people get HPV - those who are active with people who were virgins until that time are at almost no risk - so the "virtually all" is an exaggeration.) However, the language is inflammatory. No one is holding a gun to these girls' heads. Just as with many medical procedures, it's important to get a bit of background information here. A girl would be asked the same thing when offered a pap smear, or any other time she saw her gynecologist. Even the use of the word "virgin" is inflammatory, because our associations with virginity are of innocence, and the idea is that asking the question of an innocent is going to destroy that innocence. That's hogwash. Girls who are old enough to get this vaccine have already had some pretty comprehensive sex education at school (at least in Ontario and any reasonable state.) Most have already started menstruating. They are not complete innocents, and asking a question like that is not going to destroy whatever innocence they still have.
Conclusion: People administering the vaccine do indeed need to ask a question or two, while maintaining their professionally-mandated confidentiality about the girls' responses, so that the vaccine is administered only to people who will not be harmed by it.
The last section deserves to be actually cut and pasted so you can see it in all its glory. Accordingly, here it is:
Quadrant I: Non-Sexually Active, No Gardasil Vaccine
Outcome: No risk of cervical cancer.
Quadrant II: Non-Sexually Active, Receives Gardasil Vaccine
Outcome: No medical benefit from vaccine.
Quadrant III: Sexually Active, No Gardasil Vaccine
Outcome: HPV presence is self-limiting and does not lead to cervical cancer.
Quadrant IV: Sexually Active, Receives Gardasil Vaccine
Outcome: 44.6% Increased risk of precancerous lesions. No reduction in cancer risk.
For Quadrant I, they're absolutely correct. Quadrant II is only true as long as the person in question remains non-sexually active, which means at some point, that person will move to Quadrant V, the one where someone becomes sexually active AFTER receiving the vaccine, and Quadrant II is therefore irrelevant. (Quadrant V is actually the spot where doctors want women to end up - it's the whole point of the vaccine.) Quadrant III is just plain not true, and I can point you to several people who can attest that it's not true - the people in my circle of family and friends who get pap smears every couple of months and are regularly treated for pre-cancerous lesions in an effort to keep cervical cancer at bay. Quadrant IV shouldn't happen at all, because doctors are supposed to be asking questions of their patients to make sure it doesn't happen.
Conclusion: Maybe the author should actually look at all FIVE possible outcomes, rather than four, and accept that women are going to move between them? Of course, that would require him to go back on his main premise, that the vaccine does no good.
The next section is headlined, "Gardisil shown to be useless." It cites a study which looked at rates of lesions in women who got the vaccine when they were already infected. This guy is bugging me big-time by this point. He refuses to recognize that there's a difference in outcome for women who get the vaccine PRIOR to becoming sexually active, or prior to contracting HPV (which are not always the same thing.) We've already established that women who are positive for HPV should not get the vaccine; but he uses this as a reason why women shouldn't get it to begin with, and that's totally false. I say it again: THE VACCINE IS DESIGNED for women who are NOT YET SEXUALLY ACTIVE. He hasn't cited any studies about women who got the vaccine before sexual activity and then went on to be sexually active - because those studies wouldn't support his premise, of course.
Conclusion: he's overgeneralizing, using adverse effects in a non-target population to scare those within the target population off of getting the vaccine. He's taken all kinds of good information and twisted it so that it means something totally different from what it said, and it makes me sick to think that people might believe him.
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my sis has HPV. She had precancerous lesions. She's had multiple partners.
I have had one partner who was also a virgin, I do not HPV but I had precancerous lesions.
I always follow the advice of my physicians with the occassional question to the pharmacist because they keep up with these new drugs and vaccines faster than the docs do. My OB/GYN at my last annual did NOT recommend Guardisil for me. However, one of my students is sexually active/multiple partners and her pediatrician gave her the shot anyway.
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I believe in education. I believe in people learning all they can about something before they do it, because your doctor won't necessarily take the time to make sure it's right for you. But sooner or later, you have to decide who to trust with your (and your children's) health, and when it comes to that decision, I'm going to go with the solution that has the most research behind it.
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DC public schools are thinking of requiring it just like the chicken pox vax and WOW are people up in arms.
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edited to add verbs and clauses. I rite good.
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On the whole I agree with you, though. Anti-vaccination propaganda really annoys me.
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ETA: Also, good job on the debunking.
My only trouble* with the vaccine is that it doesn't cover a larger number of strains. Given so many peoples purposeful cluelessness** (IMO ), I can see them as taking this as a "I can't get HPV!" get out of jail free card, when it's not.
*I'm all in favor of the vaccine, I just wish it covered more strains.
** Actual conversation with my then GF's roommate back in college ( circa '88, but I've since encountered this elsewhere ).
I'd told her that her BF had been bragging to me that he was rather promiscious(sp?) and not taking any precautions.
"I can't get AIDS, or any STD, I'm on the pill."
After 45 minutes of trying to explain to her that the pill didn't protect from AIDS or any STD, and that's it's not a 100% surefire as birth control either ( which 2 of my friends learned the hard way ), I gave up. Some people just don't want to know the truth.
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I'm hopeful that by the time my daughters are old enough for it, there will be a new version that covers more strands, and since there will be ten years of use behind it by that point, we should be starting to see proper long-term studies done by then.
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Thank you so much for taking the time and effort to dissect that "article" so thoroughly.
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Wow, what a hobby! I guess that makes me just an occasional anti-vaccination propaganda ranter. Like, for 5 years, I've been arguing with my friend (who is not stupid and has a college-education) over her anti-vaccination views.
Basically, she says she'll eventually get her kids vaccinated, but she wants them to be old enough to be able to tell her if they experience side-effects(?!?!) Like, wasn't a thermometer enough to diagnose/treat their ailments in infancy and toddlerhood? And when I told her that it isn't fair that parents like me have to assume the (albeit) small risk of adverse effects so that her kids can benefit from the herd immunity from measles, polio, diptheria, she said, "Aha, so you admit these vaccinations have adverse effects!"
Yes, of course they do! But even a rudimentary knowledge of statistics and epidemiology would show you that the risk of exposure to these potentially deadly pathogens in an unvaccinated population is much greater than the risk of side effects! Studies in Britain have shown that when the immunization rate has gone below a certain percentage level in the population (I forget what the percentage is), epidemics have broken out.
And as a student of the history of medicine, I can tell you that until about 1950, children regularly died of epidemics of diptheria, polio and measles -- a horror our generation has never experienced.
Rant, Rant, Rant!
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So, how old are her kids? Is she putting them in public school? My school is in the process of sending out suspension letters to kids who haven't had their most recent round of vaccinations. Have you mentioned to her that even if she has some kind of exemption from the school board, if there is an outbreak, her kids won't be allowed to go to school?
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Whether he is repeating lies that someone else fed him, lies that he told himself, or lies that he came up with because he does not want to believe the science behind the vaccine, or most likely lies that he came up with because he has some sort of broken, stupid fixation on controlling the bodies of women whether they like it or not, the under-lying point: he is lying.
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That said, I certainly don't believe in that theological interpretation of women, and my daughter is in the process of getting the shots, which I'm paying for.