Jul. 16, 2008 - Issue #665: Surviving the Industry
Well, Well, Well - Shot or not?
Merck has responded to the rash of stories calling into question the safety
of Gardasil, and announced they remain confident in the safety profile of
the drug. Public health educators have challenged my statement that
there’s nothing to be lost by postponing the shot. So I picked up my
phone to ask HPV vaccine developer Dr Diane Harper of Dartmouth Medical
School about it.
“The data we have is for 15 to 26 year-old-women ... the vaccine
works well for that age group. I have difficulty putting the emphasis on
10- to 12-year-olds,” she told me. And the pressure many are feeling,
to comply, is “not necessary ... the vaccine is still very effective
at a later age, even in those who’ve already had an HPV
infection.”
Which buys parents with reservations a little time, but still leaves them
with the question of what to do a few years down the road. The position of
public health workers, and of Merck, is of course that the benefits of
Gardasil outweigh the risks, but what isn’t very often taken into
account is the cumulative effect of all the vaccines our children are
getting.
Nor is there much room for opposition to a one-size-fits-all
approach—existing immune and autoimmune conditions play a key role in
how individuals respond to vaccination, and should be taken into account,
so while eradication of communicable disease is something to strive for,
it’s time we move to a more nuanced approach.
Honest discussion of risk/benefit balance is a good place to start, as is
an honest discussion of public health philosophy. Much like war casualties
are justified in the name of security, vaccine casualties are justified in
the name of the assumed greater health good delivered to the
public.
Some illnesses have been successfully eradicated with vaccines, but
cervical cancer isn’t going to be one of those. The HP virus is only
one of the risk factors for the disease—it comes with many that have
nothing to do with the virus. Smoking, inferior nutrition (which is why
cervical cancer is a much bigger problem in the developing world), other
sexually transmitted diseases, a suppressed immune system, multiple
pregnancies and synthetic hormone interference (which unfortunately
includes synthetic birth control pills) are key factors, and even those
pushing the vaccine are quick to admit that those should not be overlooked
or underestimated.
And Gardasil, which potentially protects from a disease that will strike
only a small number of women many decades down the road, is striking down
young women on the cusps of their lives. From the Vaccine Adverse Events
Reporting system (VAERS)—a previously healthy 12-year-old dies in her
sleep three weeks after her Gardasil shot. An 11-year-old dies of
anaphylactic shock three days after her Gardasil shot. A 17-year-old
suffers severe heart arythmia and dies two days after her third Gardasil
shot.
Brittany LeClaire, 13, is paralyzed within days of her third dose, then spends months learning to walk again with a walker. Jessica Vega, 14, is paralyzed after her second shot, now lives with the paralysis-causing autoimmune-system disorder Guillain-Barre Syndrome and has had to learn to walk again. Jesalee Parsons, 15, previously healthy, begins vomiting the day she gets her Gardasil shot, has been hospitalized on and off for more than a year and now lives with pancreatitis and chronic pain. Brooke Petkevicius, 19, a scholarship student at Berkeley, dies 14 days after her first Gardasil shot, of a pulmonary embolism. And that’s not a complete list.
It’s true that the majority of reactions reported have been minor,
but these are young women who wouldn’t likely, in hindsight, have
been willing to risk reactions that range from genital wart outbreaks to
seizures, paralysis, blood clots, treatment-resistant pain and death in
exchange for a reduced risk of cervical cancer many decades down the
road.
Nothing is risk-free, but we should be free to choose our risks, and we
should be fully informed, not managed into compliance. Given that the vast
majority of HPV infections clear spontaneously (90 per cent within two
years), given the severity of and numbers of adverse reactions, caution
with the vaccine is legitimate, not foolish.
An editorial in the New England Journal of Medicine in May of 2007 acknowledged the legitimacy of caution in light of “unanswered questions about overall vaccine effectiveness, duration of protection, and adverse effects that may emerge over time.”
Whether to vaccinate or not is a personal decision, and those who wish to opt out should be permitted to do so guilt-free. And they should be permitted to do so without having accusations of archaic sexual attitudes levelled their way. For many, choosing to postpone or pass on the shot is nothing more than a health decision. V
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