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Friday, April 25, 2014

Vaccination, Advocacy, Aquinas

Dear Fred,

Thanks for your email.

Ironically, I was searching for an Aquinas quotation (to include in a post I'm preparing about Michael Gerson's article on the conflict between science and religion) when your email arrived. 

"What Must Happen In The Apparent Conflict Between Religion And Science"

As it happens, the Aquinas quotation is embedded in an email I was writing to my friend Claiborne but, apparently, never sent.

It addresses your question about vaccination advocacy:

Dear Claiborne,


India on verge of wiping out polio - http://www.stltoday.com/news/science/article_4926b418-91eb-5c22-841b-5741d05e7156.html

Vaccines are the biggest health boon ever bestowed on human kind, doing more to prevent suffering and death than all the drugs in the pharmacopeia.

The lives and suffering that have been saved by vaccines dwarf the healing miracles of the Old and New Testaments combined. 

A relative of mine -- a fellow in his mid-40s -- is suffering his first attack of shingles and, due to its location, is concerned that it could spread slightly, blinding him in one eye. (There is a shingles vaccine. I STRONGLY recommend it to anyone who had chicken pox as a child.)

Political argument over vaccines epitomizes our political predicament - with Reason and Science allied on one side, and miraculous conviction on the other. 

The article about Michelle Bachmann that I've pasted below typifies the conflict. 

I also encourage you to contrast the following web pages for keener insight into the nature of this "debate": http://www.advancedhealthplan.com/donstalk.html  /// http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm (The first of these two articles is essential reading.)

In brief, America's scientific and technological society can not survive if the irrationalists prevail. Where anecdote is primary, exceptions to The Rule are posited as New Rules. This is, of course, absurd. So is the direction in which American irrationalists are taking us.  "Don't it always seem to go that you don't know what you've got til its' gone?")

I believe in miracles and am persuaded miracles happen more often when people are open to their manifestation.

I also believe that the methodical application of the human mind is primary. 

In the 13th century A.D., Thomas Aquinas (in whose tradition I was formed) asserted the primacy of Reason: "Arguing against those who said that natural philosophy was contrary to the Christian faith, (Aquinas) writes in his treatise "Faith, Reason and Theology that "even though the natural light of the human mind is inadequate to make known what is revealed by faith, nevertheless what is divinely taught to us by faith cannot be contrary to what we are endowed with by nature. One or the other would have to be false, and since we have both of them from God, he would be the cause of our error, which is impossible." "Aladdin's Lamp: How Greek Science Came to Europe Through the Islamic World" by John Freely - http://www.amazon.com/Aladdins-Lamp-Science-Through-Islamic/dp/030726534X

In a nutshell, sound scientific Reasoning can not lead us astray. And only at that juncture where Reason can no longer penetrate and illuminate does Faith properly fill the void. 

Aquinas Tantum Ergo - probably the hymn I have sung more than any other (excluding Christmas carols) puts it well: http://en.wikipedia.org/wiki/Tantum_Ergo 

A more revealing translation of the crucial couplet is this: "Give us supplemental faith where our senses cannot penetrate." 

Aquinas' gist is this: 'Sensory data first. Lacking sensory data, faith.'

As corollary: Wherever Faith contradicts the primary role of Reason, Faith itself does damage to human understanding by representing Falsehood as Truth.

I see essential selfishness, a selfishness so profound - and unconscious - that it flirts with solipsism, a selfishness that values it's own irrational (or sometimes non-rational) opinions over Truth.

It is emphatically insufficient to rely on any article of faith the same way biblical "literalists" justify their bibliolatry by saying: "The Bible says it. I believe it. That settles it."


If this is God speaking, I don't believe in "Him."

Pax on both houses,

Alan

PS Here's a new article entitled "Unvaccinated Behind Largest Measles Outbreak in Years" - http://yourlife.usatoday.com/health/story/2011-10-21/Unvaccinated-behind-largest-US-measles-outbreak-in-years/50852098/1



Remark on HPV Vaccine Could Ripple for Years


By 

Published: September 19, 2011

During a debate last week for Republican presidential candidates and in interviews after it, Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Medical experts fired back quickly. Her statements were false, they said, emphasizing that the vaccine is safe and can save lives. Mrs. Bachmann was soon on the defensive, acknowledging that she was not a doctor or a scientist.
Dan Wagner/Sarasota Herald-Tribune, via Associated Press
NO DEBATE Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Experts disagreed.
Multimedia

In-Depth From A.D.A.M.Human Papillomavirus (HPV)

HPV is actually a group of 100 viruses, about 40 of which are sexually transmitted. Some HPV viruses can significantly increase the risks of cervical cancer, as well as cancers of the vulva, vagina, anus, and penis. HPV is very common; an estimated 20 million people in the U.S. have it. At least half of all sexually active men and women will eventually be exposed the virus.
Two vaccines have been approved and are now recommended for the prevention of some types of HPV.
  • The Gardasil vaccine is 100% effective against cervical, vaginal, and vulvar diseases caused by 4 types of HPV (HPV 6, 11, 16, and 18). Of note, Gardasil prevents cervical cancer caused by HPV strains 16 and 18, which account for 70% of cervical cancer cases in the United States. It is less effective in women who were exposed to the virus before they were vaccinated. The vaccine has been shown to be effective for 5 years after women receive the initial dose. In September 2008, the FDA also approved Gardasil for the prevention of vaginal and valvular cancers caused by HPV 16 and 18.
  • A new vaccine, Cervarix, was approved by the U.S. Food and Drug Administration on October 16 2009. This vaccine protects against HPV strains 16 and 18. As such, it will not prevent genital warts but would still protect against the strains that cause the majority of cervical cancers.

Who Should be Vaccinated for HPV?

Currently, two vaccines are approved by the FDA to prevent either human papillomavirus (HPV) or cervical cancer: Gardasil and Cervarix.
Gardasil is approved for:
  • Girls and women ages 9-26, for the protection against HPV-16 and HPV-18, the HPV strains that cause most cases of cervical cancer, and against HPV-6 and HPV-11, which cause 90% of cases of genital warts.
  • Boys and young men ages 9 - 26 years to prevent genital warts
Cervarix
  • Girls and women ages 10 - 26 for protection against HPV-16 and HPV-18, the HPV strains that cause most cases of cervical cancer.
  • Cervarix does not protect against genital warts.
  • Cervarix has not been approved for use in boys or men.
Current immunization guidelines recommend:
  • Routine vaccination for girls ages 11 - 12 years, before they are sexually active. The vaccine should be administered in 3 doses, with the second and third doses administered 2 and 6 months after the first dose. The HPV vaccine can be given at the same time as other vaccines. Either Gardasil or Cervarix may be used, and one vaccine can be substituted for another in the 3-dose series.
  • Girls as young as age 9 can receive the vaccine at their doctor's discretion.
  • Girls and women ages 13 - 26 who have not been previously immunized or who have not completed the full vaccine series should get vaccinated to catch up on missed doses. The American Cancer Society suggests that women ages 19 - 26 discuss with their doctors the relative risks and benefits of vaccination.
  • Women should not get the vaccine during pregnancy.
  • Gardasil can be used in boys aged 9 - 18 years to prevent genital warts. At this time, however, the CDC's immunization advisory committee does not recommend its routine use in boys. Rather, the committee is allowing individual physicians to decide whether to vaccinate their male patients.
Currently there is no research to confirm the vaccine's effectiveness in women over 26, so there is no recommendation yet for this age group. Gardasil is not recommended for pregnant women.

Side Effects

Studies have shown no significant side effects from the HPV vaccine. The most common side effect was soreness at the injection site.

Readers’ Comments

But the harm to public health may have already been done. When politicians or celebrities raise alarms about vaccines, even false alarms, vaccination rates drop.
“These things always set you back about three years, which is exactly what we can’t afford,” said Dr. Rodney E. Willoughby, a professor of pediatrics at the Medical College of Wisconsin and a member of the committee on infectious diseases of the American Academy of Pediatrics. The academy favors use of the vaccine, as do other medical groups and the Centers for Disease Control and Prevention.
The vaccine, recommended by the medical groups for 11- and 12-year-olds, protects against the human papillomavirus, or HPV, a sexually transmitted infection that can cause cancer. Use of the vaccine was disturbingly low even before the Bachmann flap, health officials say. That is partly because of the recent climate of fear about vaccines in general, and partly because some parents feel that giving the vaccine somehow implies that they are accepting or even condoning the idea that their young daughters will soon start having sex.
Allegations that vaccines could cause autism have frightened some parents away from giving them to children. But the question has been studied repeatedly, and there is no evidence for such a link; the research that first promoted the idea was subsequently proved fraudulent.
Indeed, a report published last month by the Institute of Medicine, which advises the government, found that the HPV vaccine was safe.
It did find “strong and generally suggestive” — though not conclusive — evidence that the vaccine could cause severeallergic reactions. But such reactions have been rare.
Historically, Dr. Willoughby said, vaccine scares have caused vaccination rates to drop for three or four years, and have led to outbreaks of diseases that had previously been under control, like measles and whooping cough. Measles cases in the United States reached a 15-year high last spring, with more than 100 cases, most in people who had never been vaccinated.
Once the disease begins to reappear, parents become worried and start vaccinating again. With cervical cancer, Dr. Willoughby said, “unfortunately, the outbreak is silent and will take 20 years to manifest.”
This time, he said, there will be no symptoms to scare parents back into vaccinating their daughters until it is too late.
HPV infection is extremely common — the most common sexually transmitted infection in the United States. More than a quarter of girls and women ages 14 to 49 have been infected, with the highest rate, 44 percent, in those ages 20 to 24.
Millions of new infections occur each year, and researchers think that at least half of all adults have been infected at some point in their lives. The genital region is teeming with HPV, and any kind of intimate contact — not just intercourse — can transmit the virus. In most people, HPV is harmless: The immune system fights it off. But in some people, for unknown reasons, the viruses persist and can cause cancer.
Although the HPV vaccine was initially approved in 2006 to prevent cervical cancer, more recent data has shown that HPV also causes cancers of the penis, anus, vagina, vulva and parts of the throat. Many scientists think that the vaccine can prevent those diseases as well.
Last month, the Centers for Disease Control and Prevention published a report on vaccination rates in girls that was “a call to action” to do a better job with the HPV vaccine, according to Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases.
“We’re not meeting our goals,” Dr. Wharton said. “Girls are not getting an important preventive measure that they need.”
Nationwide, last year only 32 percent of teenage girls received all three shots needed to prevent HPV infection, the disease centers found. Rates of vaccination were much higher (at least 45 percent) in a few states — Massachusetts, Rhode Island, Washington and South Dakota. Those furthest below average (20 percent or less) included Idaho, Mississippi, Arkansas and Alabama.
The report was particularly troubling, Dr. Wharton said, because it showed use of the HPV vaccine lagging far behind that of two other vaccines that were licensed around the same time, one for meningitis and a combination shot against tetanusdiphtheria and whooping cough.
“This vaccine has been portrayed as ‘the sex vaccine,’ ” said Dr. Mary Anne Jackson, a professor of pediatrics at the University of Missouri-Kansas City and a member of the infectious disease committee of the American Academy of Pediatrics. “Talking about sexuality for pediatricians and other providers is often difficult.”
Dr. William Schaffner, an infectious diseases expert at Vanderbilt University, acknowledged that 11 or 12 is “a pretty tender age, and parents are having a hard time getting used to this concept.”
But like the measles vaccine and others, this one must be given before a person is exposed to the virus or it will not work.
“Here we’d like to get it completed before the young woman initiates her sex life,” Dr. Schaffner said. “Of course parents, particularly fathers, think that’s going to happen at around age 34.”
The average age of first intercourse in the United States is about 17 for both boys and girls, according to the Kinsey Institute. About 25 percent have had sex by age 15.
Even before Mrs. Bachmann’s comments, family doctors were negotiating with reluctant, confused parents. Dr. Schaffner said he knew a pediatrician who postponed the HPV shots until most patients turned 15 specifically to avoid parents’ objections at the younger age.
“He thinks he can pick out the early adventurers because he knows them so well,” Dr. Schaffner said. “Those, he vaccinates earlier. Personally, I’m dubious about the success of this strategy. He may be no better than the parents figuring out who is doing what when.”
Dr. Willoughby said he thought the HPV vaccine might be more acceptable to parents if it were recommended even earlier in life, at a less fraught time than the cusp of puberty. Then it could be given, as most vaccines are, without parents’ or doctors’ feeling a need to give the child a detailed explanation. And there would not be the unspoken implication that sex was imminent.
“There’s probably no reason why it should be 11 or 12, as opposed to 5 or 6 or even birth,” Dr. Willoughby said. “If it were being given in kindergarten, I don’t think would be an adherence problem.”
So far, there is no evidence that the vaccine wears off over time, but if that does occur, Dr. Willoughby said, booster shots could be given.
There are many strains of HPV, but two of them, known as Type 16 and Type 18, cause 70 percent of all cervical cancers. Other strains can cause genital warts.
One version of the vaccine, Gardasil, made by Merck, works against the two cancer-causing strains and two other strains that are the most common causes of genital warts. Gardasil was approved for use in boys in 2009 to prevent genital warts, but medical groups like the pediatrics academy have not recommended it; that could change within the next few months.
Another version, Cervarix, made by GlaxoSmithKline, protects against only the cancer-causing strains, and is approved only for girls and women.
In studies comparing women who were vaccinated with those who were not, the vaccines were 93 to 100 percent effective at preventing infection with HPV Type 16 and Type 18, according to Dr. Deborah Saslow, the director for breast and gynecological cancer at the American Cancer Society.
Some critics of the vaccine have said it is not needed in the United States, arguing that cervical cancer is no longer common here: Pap tests are finding precancerous growths early enough to remove them before they turn into cancer. There are about 12,000 cases of cervical cancer and 4,000 deaths a year in the United States. (In developing countries, infection rates are much higher, and the disease is a leading cause of death in women.)
But deaths are only a small part of the trouble caused by HPV. Several hundred thousand women a year in the United States need surgery for precancerous lesions caused by the virus, and many more are treated for other cervical abnormalities linked to the infection.
The vaccines could prevent many of those cases and spare women the surgery, which can be painful and nerve-racking, and may impair a woman’s ability to carry a pregnancy to full term, Dr. Saslow said.
By June 2011, more than 35 million doses of the two cervical cancer vaccines had been distributed in the United States, according to the Centers for Disease Control and Prevention. The most common side effect is a sore arm from the shot. Though faintinghas been reported, Dr. Jackson said that teenagers were more likely than younger children to faint after any injection.
When pediatricians recommend the vaccine, many parents still hesitate. Michele Boettiger, the mother of three daughters in Missouri City, Tex., said she struggled with the decision about whether to vaccinate them against HPV. She worried about whether the vaccine was safe.
As a Roman Catholic who believes in abstinence until marriage, she also wondered whether the vaccine would somehow send the wrong message, and act as “a gateway for young women to think they have sexual freedom.”
Ms. Boettiger, a nursing student, found reassurance in the endorsement of the vaccine by the disease centers and other medical groups, and in its acceptance by the National Catholic Bioethics Center.
Her father and her husband, the girls’ father, both died of cancer. “Our family suffered a loss from cancer,” she said. “It is not a battle I want to fight anytime soon.”
She has had her two older daughters vaccinated, and will do the same for the youngest.



On Mon, Oct 24, 2011 at 2:57 AM, Mr. Claiborne Clark <claiborne.clark@gmail.com> wrote:


On Fri, Apr 25, 2014 at 11:33 AM, Fred Owens <froghospital911@gmail.com> wrote:

the epidemic centers in California. It will be interesting to see how -- or if -- social pressure combined with law enforcement can effectively stop this.
The issue transcends left-right boundaries.
we have leftie loonies, and rightie crazies both against vaccination
can common sense prevail  ---- and how does one apply "social pressure" to a fellow parent who refuses vaccination?

--
Fred Owens
cell: 360-739-0214

My gardening blog is  Fred Owens
My writing blog is Frog Hospital

send mail to:

Fred Owens
35 West Main St Suite B #391
Ventura CA 93001

Dear Fred,

Thanks for your email.

I do not think there are any easy ways out.

To the extent possible, I suggest we give vaccine resisters what they want, simultaneously enforcing reasonable consequences.

Reasonable Consequences:

1.) If you do not vaccinate your kids, they will not be allowed to attend public schools. Furthermore, private schools (up to and including university) have the right to deny entrance to "the unvaccinated." "The unvaccinated" may, of course, home-school.

2.) Any family that does not vaccinate children will have those children quarantined according to state specifications in the event those children become ill. Breach of home-based quarantine will result in government-enforced quarantine at parental expense. (U.S. law already enforces quarantine at owner expense for unvaccinated pets with expired rabies vaccinations whenever they are suspected for being in the proximity of rabid animals. Such quarantine is a VERY expensive proposition - easily costing $10,000.00.)

3.) Although the following suggestion is probably not advisable in the light of compassion, it would be politically wise to prevent insurance agencies -- at least government-sponsored insurance agencies -- from covering the cost of treating unvaccinated diseases. Why should insurance companies pay for the treatment of diseases whose preventive vaccines are offered free of charge?

If you are in the mood, wee what vaccine resisters think of them - and how they argue against them. 

Pax tecum

Alan

On Fri, Apr 25, 2014 at 12:34 PM, Fred Owens <froghospital911@gmail.com> wrote:
I'm with you and Thom Aq -- all the way.
But my specific question is social pressure -- which can be an effective tool or an instrument of oppression.
In California, where I hang out, in community gardens, we have Leftie Loonie moms who will not vaccinate their children -- do we shun them? or throw sticks at them?  ---- it seems that something a little stronger than persuasive argument is called for


On Fri, Apr 25, 2014 at 9:24 AM, Alan Archibald <alanarchibaldo@gmail.com> wrote:
Dear Fred,

Thanks for your email.

Ironically, I was looking for an Aquinas quotation (to include in a post about Michael Gerson's article on the conflict between science and religion) when your email arrived. 

"What Must Happen In The Apparent Conflict Between Religion And Science"

As it happens, the Aquinas quotation was found in an email I'd been writing to friend Claiborne but, apparently, never sent.

That email goes to the heart of your question about vaccination advocacy:

Dear Claiborne,


Vaccines are the biggest health boon ever bestowed on human kind, doing more to prevent suffering and death than all the drugs in the pharmacopeia.

The lives and suffering that have been saved by vaccines dwarf the healing miracles of the Old and New Testaments combined. 

A relative of mine -- a fellow in his mid-40s -- is suffering his first attack of shingles and, due to its location, is concerned that it could spread slightly, blinding him in one eye. (I STRONGLY recommend the shingles vaccine you mention to anyone who had chicken pox as a child.)

Political argument over vaccines epitomizes our political predicament - with Reason and Science allied on one side, and miraculous conviction on the other. 

The article about Michelle Bachmann that I've pasted below typifies the conflict. 

I also encourage you to contrast the following web pages for keener insight into the nature of this "debate": http://www.advancedhealthplan.com/donstalk.html  /// http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm (The first of these two articles is essential reading.)

In brief, America's scientific and technological society can not survive if the irrationalists prevail. Where anecdote is primary, exceptions to The Rule are posited as New Rules. This is, of course, absurd. So is the direction in which American irrationalists are taking us.  "Don't it always seem to go that you don't know what you've got til its' gone?")

I believe in miracles and am persuaded miracles happen more often when people are open to their manifestation.

I also believe that the methodical application of the human mind is primary. 

In the 13th century A.D., Thomas Aquinas (in whose tradition I was formed) asserted the primacy of Reason: "Arguing against those who said that natural philosophy was contrary to the Christian faith, (Aquinas) writes in his treatise "Faith, Reason and Theology that "even though the natural light of the human mind is inadequate to make known what is revealed by faith, nevertheless what is divinely taught to us by faith cannot be contrary to what we are endowed with by nature. One or the other would have to be false, and since we have both of them from God, he would be the cause of our error, which is impossible." "Aladdin's Lamp: How Greek Science Came to Europe Through the Islamic World" by John Freely - http://www.amazon.com/Aladdins-Lamp-Science-Through-Islamic/dp/030726534X

In a nutshell, sound scientific Reasoning can not lead us astray. And only at that juncture where Reason can no longer penetrate and illuminate does Faith properly fill the void. 

Aquinas Tantum Ergo - probably the hymn I have sung more than any other (excluding Christmas carols) puts it well: http://en.wikipedia.org/wiki/Tantum_Ergo 

A more revealing translation of the crucial couplet is this: "Give us supplemental faith where our senses cannot penetrate." 

Aquinas' gist is this: 'Sensory data first. Lacking sensory data, faith.'

As corollary: Wherever Faith contradicts the primary role of Reason, Faith itself does damage to human understanding by representing Falsehood as Truth.

I see essential selfishness, a selfishness so profound - and unconscious - that it flirts with solipsism, a selfishness that values it's own irrational (or sometimes non-rational) opinions over Truth.

It is emphatically insufficient to rely on any article of faith the same way biblical "literalists" justify their bibliolatry by saying: "The Bible says it. I believe it. That settles it."


If this is God speaking, I don't believe in "Him."

Pax on both houses,

Alan

PS Here's a new article entitled "Unvaccinated Behind Largest Measles Outbreak in Years" - http://yourlife.usatoday.com/health/story/2011-10-21/Unvaccinated-behind-largest-US-measles-outbreak-in-years/50852098/1




Remark on HPV Vaccine Could Ripple for Years

By 
Published: September 19, 2011

During a debate last week for Republican presidential candidates and in interviews after it, Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Medical experts fired back quickly. Her statements were false, they said, emphasizing that the vaccine is safe and can save lives. Mrs. Bachmann was soon on the defensive, acknowledging that she was not a doctor or a scientist.
Dan Wagner/Sarasota Herald-Tribune, via Associated Press
NO DEBATE Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Experts disagreed.
Multimedia

In-Depth From A.D.A.M.Human Papillomavirus (HPV)

HPV is actually a group of 100 viruses, about 40 of which are sexually transmitted. Some HPV viruses can significantly increase the risks of cervical cancer, as well as cancers of the vulva, vagina, anus, and penis. HPV is very common; an estimated 20 million people in the U.S. have it. At least half of all sexually active men and women will eventually be exposed the virus.
Two vaccines have been approved and are now recommended for the prevention of some types of HPV.
  • The Gardasil vaccine is 100% effective against cervical, vaginal, and vulvar diseases caused by 4 types of HPV (HPV 6, 11, 16, and 18). Of note, Gardasil prevents cervical cancer caused by HPV strains 16 and 18, which account for 70% of cervical cancer cases in the United States. It is less effective in women who were exposed to the virus before they were vaccinated. The vaccine has been shown to be effective for 5 years after women receive the initial dose. In September 2008, the FDA also approved Gardasil for the prevention of vaginal and valvular cancers caused by HPV 16 and 18.
  • A new vaccine, Cervarix, was approved by the U.S. Food and Drug Administration on October 16 2009. This vaccine protects against HPV strains 16 and 18. As such, it will not prevent genital warts but would still protect against the strains that cause the majority of cervical cancers.

Who Should be Vaccinated for HPV?

Currently, two vaccines are approved by the FDA to prevent either human papillomavirus (HPV) or cervical cancer: Gardasil and Cervarix.
Gardasil is approved for:
  • Girls and women ages 9-26, for the protection against HPV-16 and HPV-18, the HPV strains that cause most cases of cervical cancer, and against HPV-6 and HPV-11, which cause 90% of cases of genital warts.
  • Boys and young men ages 9 - 26 years to prevent genital warts
Cervarix
  • Girls and women ages 10 - 26 for protection against HPV-16 and HPV-18, the HPV strains that cause most cases of cervical cancer.
  • Cervarix does not protect against genital warts.
  • Cervarix has not been approved for use in boys or men.
Current immunization guidelines recommend:
  • Routine vaccination for girls ages 11 - 12 years, before they are sexually active. The vaccine should be administered in 3 doses, with the second and third doses administered 2 and 6 months after the first dose. The HPV vaccine can be given at the same time as other vaccines. Either Gardasil or Cervarix may be used, and one vaccine can be substituted for another in the 3-dose series.
  • Girls as young as age 9 can receive the vaccine at their doctor's discretion.
  • Girls and women ages 13 - 26 who have not been previously immunized or who have not completed the full vaccine series should get vaccinated to catch up on missed doses. The American Cancer Society suggests that women ages 19 - 26 discuss with their doctors the relative risks and benefits of vaccination.
  • Women should not get the vaccine during pregnancy.
  • Gardasil can be used in boys aged 9 - 18 years to prevent genital warts. At this time, however, the CDC's immunization advisory committee does not recommend its routine use in boys. Rather, the committee is allowing individual physicians to decide whether to vaccinate their male patients.
Currently there is no research to confirm the vaccine's effectiveness in women over 26, so there is no recommendation yet for this age group. Gardasil is not recommended for pregnant women.

Side Effects

Studies have shown no significant side effects from the HPV vaccine. The most common side effect was soreness at the injection site.

Readers’ Comments

But the harm to public health may have already been done. When politicians or celebrities raise alarms about vaccines, even false alarms, vaccination rates drop.
“These things always set you back about three years, which is exactly what we can’t afford,” said Dr. Rodney E. Willoughby, a professor of pediatrics at the Medical College of Wisconsin and a member of the committee on infectious diseases of the American Academy of Pediatrics. The academy favors use of the vaccine, as do other medical groups and the Centers for Disease Control and Prevention.
The vaccine, recommended by the medical groups for 11- and 12-year-olds, protects against the human papillomavirus, or HPV, a sexually transmitted infection that can cause cancer. Use of the vaccine was disturbingly low even before the Bachmann flap, health officials say. That is partly because of the recent climate of fear about vaccines in general, and partly because some parents feel that giving the vaccine somehow implies that they are accepting or even condoning the idea that their young daughters will soon start having sex.
Allegations that vaccines could cause autism have frightened some parents away from giving them to children. But the question has been studied repeatedly, and there is no evidence for such a link; the research that first promoted the idea was subsequently proved fraudulent.
Indeed, a report published last month by the Institute of Medicine, which advises the government, found that the HPV vaccine was safe.
It did find “strong and generally suggestive” — though not conclusive — evidence that the vaccine could cause severeallergic reactions. But such reactions have been rare.
Historically, Dr. Willoughby said, vaccine scares have caused vaccination rates to drop for three or four years, and have led to outbreaks of diseases that had previously been under control, like measles and whooping cough. Measles cases in the United States reached a 15-year high last spring, with more than 100 cases, most in people who had never been vaccinated.
Once the disease begins to reappear, parents become worried and start vaccinating again. With cervical cancer, Dr. Willoughby said, “unfortunately, the outbreak is silent and will take 20 years to manifest.”
This time, he said, there will be no symptoms to scare parents back into vaccinating their daughters until it is too late.
HPV infection is extremely common — the most common sexually transmitted infection in the United States. More than a quarter of girls and women ages 14 to 49 have been infected, with the highest rate, 44 percent, in those ages 20 to 24.
Millions of new infections occur each year, and researchers think that at least half of all adults have been infected at some point in their lives. The genital region is teeming with HPV, and any kind of intimate contact — not just intercourse — can transmit the virus. In most people, HPV is harmless: The immune system fights it off. But in some people, for unknown reasons, the viruses persist and can cause cancer.
Although the HPV vaccine was initially approved in 2006 to prevent cervical cancer, more recent data has shown that HPV also causes cancers of the penis, anus, vagina, vulva and parts of the throat. Many scientists think that the vaccine can prevent those diseases as well.
Last month, the Centers for Disease Control and Prevention published a report on vaccination rates in girls that was “a call to action” to do a better job with the HPV vaccine, according to Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases.
“We’re not meeting our goals,” Dr. Wharton said. “Girls are not getting an important preventive measure that they need.”
Nationwide, last year only 32 percent of teenage girls received all three shots needed to prevent HPV infection, the disease centers found. Rates of vaccination were much higher (at least 45 percent) in a few states — Massachusetts, Rhode Island, Washington and South Dakota. Those furthest below average (20 percent or less) included Idaho, Mississippi, Arkansas and Alabama.
The report was particularly troubling, Dr. Wharton said, because it showed use of the HPV vaccine lagging far behind that of two other vaccines that were licensed around the same time, one for meningitis and a combination shot against tetanusdiphtheria and whooping cough.
“This vaccine has been portrayed as ‘the sex vaccine,’ ” said Dr. Mary Anne Jackson, a professor of pediatrics at the University of Missouri-Kansas City and a member of the infectious disease committee of the American Academy of Pediatrics. “Talking about sexuality for pediatricians and other providers is often difficult.”
Dr. William Schaffner, an infectious diseases expert at Vanderbilt University, acknowledged that 11 or 12 is “a pretty tender age, and parents are having a hard time getting used to this concept.”
But like the measles vaccine and others, this one must be given before a person is exposed to the virus or it will not work.
“Here we’d like to get it completed before the young woman initiates her sex life,” Dr. Schaffner said. “Of course parents, particularly fathers, think that’s going to happen at around age 34.”
The average age of first intercourse in the United States is about 17 for both boys and girls, according to the Kinsey Institute. About 25 percent have had sex by age 15.
Even before Mrs. Bachmann’s comments, family doctors were negotiating with reluctant, confused parents. Dr. Schaffner said he knew a pediatrician who postponed the HPV shots until most patients turned 15 specifically to avoid parents’ objections at the younger age.
“He thinks he can pick out the early adventurers because he knows them so well,” Dr. Schaffner said. “Those, he vaccinates earlier. Personally, I’m dubious about the success of this strategy. He may be no better than the parents figuring out who is doing what when.”
Dr. Willoughby said he thought the HPV vaccine might be more acceptable to parents if it were recommended even earlier in life, at a less fraught time than the cusp of puberty. Then it could be given, as most vaccines are, without parents’ or doctors’ feeling a need to give the child a detailed explanation. And there would not be the unspoken implication that sex was imminent.
“There’s probably no reason why it should be 11 or 12, as opposed to 5 or 6 or even birth,” Dr. Willoughby said. “If it were being given in kindergarten, I don’t think would be an adherence problem.”
So far, there is no evidence that the vaccine wears off over time, but if that does occur, Dr. Willoughby said, booster shots could be given.
There are many strains of HPV, but two of them, known as Type 16 and Type 18, cause 70 percent of all cervical cancers. Other strains can cause genital warts.
One version of the vaccine, Gardasil, made by Merck, works against the two cancer-causing strains and two other strains that are the most common causes of genital warts. Gardasil was approved for use in boys in 2009 to prevent genital warts, but medical groups like the pediatrics academy have not recommended it; that could change within the next few months.
Another version, Cervarix, made by GlaxoSmithKline, protects against only the cancer-causing strains, and is approved only for girls and women.
In studies comparing women who were vaccinated with those who were not, the vaccines were 93 to 100 percent effective at preventing infection with HPV Type 16 and Type 18, according to Dr. Deborah Saslow, the director for breast and gynecological cancer at the American Cancer Society.
Some critics of the vaccine have said it is not needed in the United States, arguing that cervical cancer is no longer common here: Pap tests are finding precancerous growths early enough to remove them before they turn into cancer. There are about 12,000 cases of cervical cancer and 4,000 deaths a year in the United States. (In developing countries, infection rates are much higher, and the disease is a leading cause of death in women.)
But deaths are only a small part of the trouble caused by HPV. Several hundred thousand women a year in the United States need surgery for precancerous lesions caused by the virus, and many more are treated for other cervical abnormalities linked to the infection.
The vaccines could prevent many of those cases and spare women the surgery, which can be painful and nerve-racking, and may impair a woman’s ability to carry a pregnancy to full term, Dr. Saslow said.
By June 2011, more than 35 million doses of the two cervical cancer vaccines had been distributed in the United States, according to the Centers for Disease Control and Prevention. The most common side effect is a sore arm from the shot. Though faintinghas been reported, Dr. Jackson said that teenagers were more likely than younger children to faint after any injection.
When pediatricians recommend the vaccine, many parents still hesitate. Michele Boettiger, the mother of three daughters in Missouri City, Tex., said she struggled with the decision about whether to vaccinate them against HPV. She worried about whether the vaccine was safe.
As a Roman Catholic who believes in abstinence until marriage, she also wondered whether the vaccine would somehow send the wrong message, and act as “a gateway for young women to think they have sexual freedom.”
Ms. Boettiger, a nursing student, found reassurance in the endorsement of the vaccine by the disease centers and other medical groups, and in its acceptance by the National Catholic Bioethics Center.
Her father and her husband, the girls’ father, both died of cancer. “Our family suffered a loss from cancer,” she said. “It is not a battle I want to fight anytime soon.”
She has had her two older daughters vaccinated, and will do the same for the youngest.


On Mon, Oct 24, 2011 at 2:57 AM, Mr. Claiborne Clark <claiborne.clark@gmail.com> wrote:


On Fri, Apr 25, 2014 at 11:33 AM, Fred Owens <froghospital911@gmail.com> wrote:
the epidemic centers in California. It will be interesting to see how -- or if -- social pressure combined with law enforcement can effectively stop this.
The issue transcends left-right boundaries.
we have leftie loonies, and rightie crazies both against vaccination
can common sense prevail  ---- and how does one apply "social pressure" to a fellow parent who refuses vaccination?

-- 

Fred Owens
cell: 360-739-0214

My gardening blog is  Fred Owens
My writing blog is Frog Hospital

send mail to:

Fred Owens
35 West Main St Suite B #391
Ventura CA 93001


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