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Mainstream scaremongering over Gardasil

Posted in Bad Astronomy by Skepdude on August 20, 2009

READ THE FULL ENTRY AT BAD ASTRONOMY

Gardasil is the brand name of a vaccination that protects young girls and women against the human papillomavirus (HPV), a virus that has been positively linked with cervical cancer along with other horrible diseases. It also can trigger cancers in men as well.

I’ve written about this topic before; 4000 women in the United States die every year alone from cervical cancer, an appalling 1/3 fatality rate for those diagnosed with the disease. Tens of millions of people — both men and women — carry HPV.

Gardasil protects young women from ever getting HPV. These women have a substantially lower chance of contracting the virus and getting cervical cancer. I consider that a very, very good thing.

But you wouldn’t think so if you read the New York Times, or the (Australian) ABC News. Both posted articles playing up the dangers of Gardasil as revealed by a new government study of the vaccine. That would be fine if it were true, but both reports, in my opinion, unfairly inflate the apparent danger. The ABC article is particularly egregious, with a headline saying “US doctors question Gardasil side effects” when it’s clear from the article that this isn’t really the case.

What are the dangers? The worst one would of course be death. In a study of the vaccine, there were 20 deaths of young girls at some time after they got the shot. Twenty! That sounds like a lot! However, there are two MAJOR problems with that statement:

1) There is no obvious link between the deaths and the vaccination other than in time. One girl died from drug abuse. Another from hepatitis, and others from embolisms, cardiac failure, and other problems. While these are all very sad — and as a father of a young girl at the age to get Gardasil, my heart aches for those families — none of these can be directly tied to the vaccination.

2) There were 20 deaths out of 7 million girls who received the vaccine. Those odds are 1 in 350,000. That’s roughly the same odds as dying from falling off a bed, chair, or other furniture.

READ THE FULL ENTRY AT BAD ASTRONOMY

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5 Responses

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  1. redrabbitslife said, on August 24, 2009 at 10:18 AM

    I think your attitude to gardasil might also be described as insufficiently skeptical.

    Gardasil is a three-step vaccine, with each dose costing between $120 and $150. It’s publicly funded for girls in eighth grade here, which I’m kind of okay with. It’s not mandatory.

    In your country you state 4000 women a year die of cervical cancer. Here, it’s just under 400. Granted, that’s still too many, but to put it into context you’re looking at numbers that are just over double the number of people struck by lightning every year.

    We have a comprehensive public health programme which encourages women to get free, widely available, easy to access Papanocolou (Pap) testing for cervical cancer every 1-2 years. Cervical cancer takes in general >10 years to develop, so even if a woman is really noncompliant and only goes every five years or so, she is still likely to discover and be able to treat the precancerous lesions. And treatment is not painful, invasive, or onerous, it’s seriously a one-off doctor’s visit. The people who get cervical cancer almost uniformly have been avoiding this. I’m sure you heard about that horrid English girl, Jade Goody.

    So the issue here is, who needs gardasil? And who is least likely to get it?

    The kids with the least sex ed need it, which are the kids in the religious schools or who are home schooled. These kids are unlikely to be allowed to have it.

    The kids whose parents are crazy and irresponsible and who are likely to become crazy and irresponsible (not getting regular paps) themselves need it. They’re not likely to show up for it at school. They’ll not come for paps. They’ll not come back if called for an irregular pap. This is Jade Goody.

    Your average, middle of the road, promiscuous teenager who worries about STIs, visits her doctor for every sneeze and gets pap tests, she’ll be fine without Gardasil. But she’s most likely to get it. It’s a waste of her money.

    The place where it’s really needed is the place where paps are just not available. If they’d send my three doses to Africa, I’d be freaking thrilled. There it’ll save lives.

    • Skepdude said, on August 24, 2009 at 11:19 AM

      Red,

      You should have left this comment on the Bad Astonomer’s website. I was only linking. I personally do not know enough about this issue to make a strong comment either way.

      I am not sure what to say except that you can make the reverse argument too. PAP testing probably costs a few hundreed dollars anyway (a 5 min doctors visit shows up as hundreeds of dollars on my insurance website!), and if anyone is vaccinated there would be no need for PAP testing.

      If the vaccine is effective I would think that it would be a better preventative measure than testing, which by definition will catch the problem after it has occurred no?

      I guess the bottom line is whatever is more efficient in reducing the number of deaths, so if Gardasil turns out to not be more efficient or to be worse, then I would advocate the testing over it.

  2. redrabbitslife said, on August 24, 2009 at 6:59 PM

    Yeah, I thought about it and left a similar comment there. It’s an effective vaccine as far as it goes, but 90% protection against 70% of the more dangerous versions of HPV in circulation isn’t good enough in my book for all this fuss. These women still need screening, the same as before vaccination. Personally, I’m jumping up and down for getting better screening and awareness.

    I like gardasil, but I’m not in love with it, and I think a lot of the economic arguments have been incomplete at best and disingenuous at worst.

    A 5 min doc’s visit will be billed depending on what the visit is for. Consultation about $30-50. Pap testing billing usually amounts to about $15-30, but it’s the sort of thing that can be safely delegated to properly trained nurses, to save cost to the patient (not an issue here, but still).

    • Skepdude said, on August 25, 2009 at 10:41 AM

      So then I guess that a combination of vaccination (regardless if its Gardasil or something else) is the best, most desired way to proceed right?

      • redrabbitslife said, on August 25, 2009 at 5:40 PM

        Yup. You got it. The thing that I try to impress upon my patients is that it’s good but not perfect and they still need safer sex and Pap testing. I’m just bothered by the hype that it’s “the answer,” and by the price, which is pretty extravagant.


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