FOR IMMEDIATE RELEASE
HPV Vaccine: More Politics than Fact?
You may have heard or read of the vaccine recently approved for the prevention of viral infection called Gardisil. This drug and the vaccination of school girls is the subject of Indiana Senate bill SB327. In its original form, the senate bill would have mandated that Indiana’s public schools require the immunization of school age girls for the human papillomavirus virus (HPV). In its current amended form, the senate bill still requires the school to provide medical information to all parents of girls entering the sixth grade regarding the HPV virus and the Gardisil vaccine, and to report to the state and local Departments of Health the number of “required female students who:(A) have; and (B) have not; been immunized against human papillomavirus (HPV) infection.” The Gardisil vaccine inoculates against four strains of the HPV virus identifiable with 70% of the cervical cancer occurrences in women. That’s the percentages listed in the Gardisil product insert literature. What is at issue here?
The HPV virus is an STD, responsible for various disease states including genital warts, penile cancer in males, and cervical cancer in females. There are many strains, or subtypes, of the virus tracked by the medical community, which estimates that anywhere from a hundred to many thousands of subtypes of the virus exist. According to the Federal Center for Disease Control (CDC) that figure is “more than a hundred”. There have been 17 subtypes of the virus which are attributable to the development of cervical cancer. 2004 estimates of infection in the adult female population of one or more strains of the HPV virus range from fifty to eighty percent. The CDC again reports that figure at eighty percent (80%) of the adult females in the U.S. by the time they reach fifty. About 6.2 million Americans get a new genital HPV infection each year. In 2004, the American Cancer Society estimated that about 10,520 women developed invasive cervical cancer and about 3,900 women will die annually.
How could anyone have concerns about this bill becoming law? Advocates say this is an information only bill, notifying parents about health risks to their children. Yet please consider the following facts before you casually accept this account at face value.
Women in Government President Susan Crosby, a former Indiana State legislator, said the vaccine could “eliminate a cancer”. Yet Gardisil is NOT a cancer vaccine. There is a relationship between HPV and cancer, again from the CDC: “All types of HPV can cause mild Pap test abnormalities which do not have serious consequences. Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to development of cervical cancer. Research has shown that for most women (90 percent), cervical HPV infection becomes undetectable within two years.”
I heard for myself in Statehouse discussions how this was the first vaccine against cancer. But the medical community requires for recipients of Gardisil to continue to receive regular PAP testing. In fact, the 3,900 annual fatalities are mostly in women who, according to the New England Journal of Medicine had never or rarely had a PAP test (March 16, 2006). Early detection and intervention greatly reduces the fatality rate of this horrible disease. The odds of pre-cancerous cells existing in the general population of 10 million women currently infected are 1 in 950. The vaccine could reduce those odds to 1 in 1360 in a fully vaccinated population. The National Cancer Institute reports it can take twenty or more years for the pre-cancerous cells to develop into cervical cancer. The odds of pre-cancer cell development are accurate, assuming the vaccine remains effective. At the present time, no one knows, including Merck and Co., the manufacturer of the drug, if and when a booster may be required. If the number of PAP tests were to decrease because of a false sense of confidence in the vaccine, the instances of cervical cancer would potentially increase.
Will the proposed information be distributed to Hoosiers talk about the risks of any new vaccine? What of the long term affects yet unknown? What affects on women already infected with the virus? The fact that much of the clinical testing was performed on an adult population, not the nine to fifteen year old girls for which the vaccine is to be administered? Merck infers the efficacy of the drug based on “immunugencity bridging”, or, an educated guess derived from the testing on young women sixteen to twenty six years of age. Will it include information on the cases of grand mal seizure resulting from the vaccine? When and if to obtain a booster vaccine? I do not know what information will be provided to parents, because the proposed Indiana law says the state Department of Health needs to come up with the language based on best information available.
So what has made all of this information so political? This illness, although treacherous and sinister, has a lower mortality rate than many illnesses. But there has been extreme political interest in mandating this vaccine, to the point where Texas Governor Rick Perry issued an Executive Order this month requiring childhood Gardisil vaccinations. In response, the Texas Medical Association, representing more than 41,000 physicians and students of medicine, issued a statement Feb 7 condemning the mandate.
Merck and Co. has contributed money, lots of money, to promote this product in mass media and among political associations of state legislators. This advocacy has led to proposed legislation in seventeen states attempting to hurry this new vaccine to market. There is no evil in honestly making profits; it is the only way in a market economy to see effective pharmaceutical therapies be developed by the best and brightest researchers in the world. Yet Merck stands to make billions if the widespread use of Gardisil catches on. Each dose of the vaccine could cost $360 (a battery of three shots over six months) plus “labor”.
How political is this issue? In December 2004, the U.S. House of Representatives issued a Minority (Democrat) Report, entitled The Content of Federally Funded Abstinence – Only Education Programs, attempts to discredit abstinence only education by challenging claims made in the materials used in classrooms. The report says, “…some of the curricula provide distorted information on cervical cancer, suggesting that it is common consequence of premarital sex. For example, the teaching manual of one curriculum explicitly state: “It is critical that students understand that if they choose to be sexually active, they are at risk for cervical cancer.” Another curriculum asks, “What is the leading medical complication form HPV? Cervical cancer.” Neither of these curricula mentions that human papillomavirus (HPV), though associated with most cases of cervical cancer, rarely leads to the disease, nor that cervical cancer is highly preventable when women get regular Pap smears.”
So, in December of 2004, some feds practically shrug off the risk to females of a serious life threatening disease, but in 2007 we are fully prepared to spend BILLIONS nationally to fight it?
Is this the best use of our limited resources in safeguarding the health of young women? I wonder why the schools are being put upon to do one more thing that takes them away from their role in educating children. Why are they counting doses? The Health departments and family physicians should be our primary resource for health related information for adults with children.
I have three daughters. Medical experts claim they can contract the HPV virus only through sexual contact with an infected partner. Even if they were to have one sexual partner their entire life, their future husband could be a carrier of the virus subtype that could develop over twenty years into cervical cancer. Please understand I am not anti vaccine, or anti women’s health. My pharmacist advises me on issues such as this, and always cautions that ANY new medication needs time to shake out. Will my children receive Gardisil? I do not think so, not at this time. Would I mandate as an Indiana legislator that your child should take this vaccine? Not at this time. If you have any questions please ask your doctor or medical professional. I hope you have questions.
Your opinion matters to me and I would like to hear your thoughts on this or any other issue of importance to you. You can write me at: Sen. Greg Walker, Senate Chamber, 200 W. Washington St., Indianapolis, IN 46208; or e-mail me at S41@IN.gov; or call my office at 1-800-382-9467.
Sen. Greg Walker
Indiana Senate District 41
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