A Few Thoughts on the "Cervical Cancer" Vaccine and HPV Eradication

So yesterday a government panel recommended that all young women and girls be vaccinated against the human papillomavirus. Here is a quote from the New York Times:

A federal vaccine advisory panel voted unanimously yesterday to recommend that all girls and women ages 11 to 26 receive a new vaccine that prevents most cases of cervical cancer.

The vote all but commits the federal government to spend as much as $2 billion alone on a program to buy the vaccine for the nation’s poorest girls from 11 to 18.

The vaccine, Gardasil, protects against cancer and genital warts by preventing infection from four strains of the human papillomavirus, the most common sexually transmitted disease, according to federal health officials. The virus is also a cause of other cancers in women.

The development and subsequent approval of this vaccine is very good news considering that HPV (aka-genital warts) is the most common sexually transmitted disease here in the US. (I should note that HVP is a group of several different viruses. The strains of HPV that cause visible warts seem to be less carcenogic than the strains that do not show visible symptoms.)

I thought it was interesting that this is being promoted as a “cervical cancer vaccine” because it really isn’t a cervical cancer vaccine, it’s a HPV vaccine. From what I have read the vaccine only works in people who do not have the strains of HPV it inoculates against and it decreases the risk of cervical cancer by preventing HVP infection. I suspect that framing this as cancer prevention is probably more acceptable to those parents who would reject the idea of a sexually transmitted infection (STI) vaccine, but there is something that bothers me about framing it in that way.

I’m also curious as to why the vaccine is being recommended for only girls and women. It seems to me that the best way to slow down the infection is to vaccinate everybody. One study indicated that vaccinating men would reduce the prevalence of HPV, but it would not be cost effective. Upon doing some further research, I found that there is a vaccine produced by Merk that can be used in men or women, but the vaccine was not universally recommended by the panel yesterday. I think even if it is more costly we should vaccinate everybody. In particular, vaccinating only women would not help men who have sex with men. This would be a non-issue if cervical cancer was the only type of cancer caused by this virus, but the HPV (which is really a group of several different viruses) viruses also can lead to cancer in the anus, penis, vagina, and vulva. The good news is that these cancers are less common than cervical cancer, but they are still costly and deadly cancers that we should try to eradicate. It seems to me that the vaccine should not be gender specific. I understand the practical reasons for calling it a “cancer vaccine” not a HPV vaccine, and I suppose it could still be called a cancer vaccine since HPV seems to increase the risk of several kinds of cancer.

I’m not trying to dampen the good news. I think the development of this vaccine is great, but I think it should be universally recommended without regard to gender. The current vaccination strategy seems to be modeled on heterosexist assumptions about sexual behavior, and it will not eradicate the disease. Universal vaccination would do this.

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80 Responses to A Few Thoughts on the "Cervical Cancer" Vaccine and HPV Eradication

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  4. 4
    Abyss2hope says:

    I also noted that some have insisted that this is not about curing a STD, but is only about cancer. If penis cancer killed as many people as cervical cancer kills, would the conservatives be as concerned about what message it would send to young boys?

  5. 5
    Lu says:

    From what I read, the vaccine has been through all the trials necessary to prove it safe and effective for girls, but not yet for boys. From this article:

    Several speakers also called for the immunization of boys, as soon as studies are completed on the vaccine’s safety and effectiveness for males. HPV has been linked to penile, anal, and head and neck cancers and a tumor-like condition of the respiratory tract.

    Merck officials said clinical effectiveness studies in males should be completed by 2008.

    That article also links to another article wherein one mother is quoted as saying that she won’t have her 13-year-old vaccinated because the girl is “too young” and doesn’t need it yet. Stuff like this just makes me want to scream. The whole point is to get the vaccine before you need it, doofus! (Preaching to the choir here, sorry. But geez.)

  6. 6
    Rachel S. says:

    Lu,
    Yeah, these parents don’t realize that they are sacrificing their children’s health. I should note that the info I got is from the medical journals, which tend to be a little ahead of the popular press, and it sounds like the Merk vaccine is safe for males and females.

    Abyss said, “If penis cancer killed as many people as cervical cancer kills, would the conservatives be as concerned about what message it would send to young boys?”

    No they’d be thrilled that they were saving their future Republicans. :) I am really tired of the whole “it’s gonna make girls ho around” attitude as well. These are the same people who think exposing kids to comprehensive sex education causes them to have sex earlier and no reputable study has found that.

  7. 7
    Sewere says:

    Hey people,

    My first time posting a comment on your weblog and I have to say it’s been an awesome inspiration to find people go beyond the superficial aspects of such important issues. But I digress. I find myself privileged to work in the field of family planning/sex health/reproductive health services. In an ideal world, it would be great that comprehensive sex education with infection prevention vaccines. Unfortunately, that is only a few of the cases some of the time. Nevertheless, I am excited that the HPV vaccine is available for women (it will soon be made available to men too). It is not as equitable as we would like it to be but it is quite significant.

    Under the current hetero male dominated world (I calls it like I sees it) we live in world that we live in, women bear the heaviest burden of disease when it comes to reproductive health. Something as specific as HPV affects women and gay/bisexual men far more than hetero-men. This risk ladder is such that women are mutliple times more likely develop cervical cancer than gay/bisexual men are to develop anal cancer and lastly than heterosexual men are to develop penile cancer. Trust me y’all this is quite a victory for women’s health. If you’re looking for more information, please check out the National Family Planning and Reproductive Health Association site NFPHRA.org.

  8. 8
    jr says:

    Let’s hope we can stamp out cervical cancer in our lifetimes

  9. 9
    Helen says:

    I’m copying this info. over from a journal I read regularly – this woman works in the field (it’s her area of specialist interest) and has some interesting stuff to say about the vaccine which I thought might interest people here:

    “First off, HPV vaccination is the future and it will be commonplace in the next few years. But at the moment, we are still in the early stages, despite the FDA approving this version of the vaccine. Note I said this version! This is the important point, as this specific vaccine covers a limited range of the sub-types of the HPV virus.

    HPV is indeed the cause of cervical carcinoma, but HPV is a family of viruses, and there are many different sub-types, which we divide into low-risk and high-risk depending on their ability to cause cervical cancer. Genital warts are also caused by HPV, but the low-risk types. Genital warts in themselves do not develop cancer, but if you have genital warts, you have a greater risk of having also been exposed to the high-risk types which do cause cancer.

    The most common high-risk types in the Western World associated with the development of cervical cancer are HPV 16, 18, 33 & 35. This vaccine protects against two of those, 16 & 18, but not the others. So in reality this vaccine does not eliminate your chance of getting cervical cancer, but reduces it, and it is a significant reduction.

    HPV is a sexually-transmitted disease. Early vaccination will reduce the incidence of transmission of the high-risk types through out the general population. That is why they suggest targeting the the preteens. Get them before they start having sex. There is little evidence to suggest that once you have been exposed to the virus that getting the vaccine will do any good.

    The way HPV causes cervical cancer is complicated, but basically DNA from the virus gets mixed in with the DNA in your cells, and it causes them to change and produces abnormalities in the cell nucleus, which MAY lead to cancer. However, not all people who get the virus will develop cancer, but their risk is increased.

    When you go for your annual smear in the US they are looking for evidence of changes in the cells to see if you are at risk of cancer, or if you have cancer. In the UK it is every 3-5 years as part of the cervical screening programme.

    They can also screen that sample for the presence of HPV, which is not routine, but will come in in the next few years. With that we should be able to identify those who have already been exposed to the high-risk virus and concentrate on them.

    The other problem is all this is relatively new, and no one has any idea how long the vaccine will last for. No one knows if this is lifetime coverage. As far as I can recall, the longest we have looked at vaccination coverage is 4 years. So it maybe a case that we need to get re-vaccinated for a regular basis.

    What am I saying here?

    Well before you rush out and demand that you be vaccinated, consider if it is actually of any use for you.

    If you have young kids and are thinking about it, yes it is probably a good idea to get them vaccinated before they start having sex, so that you can reduce their risk of cervical cancer significantly. However, remember, this only acts against TWO subtypes, so there is still a risk from all the other high-risk sub-types out there. The best way to prevent transmission of HPV is condoms. Even if your teen has been vaccinated, they are still at risk from the other sub-types.

    If you are considering it for yourself, you have to think will it be of any real benefit for me.

    If you have already been exposed to high-risk subtypes, it will be of little benefit, and you will still need your regular smears. There is a long time period between getting HPV and developing full blown cervical cancer, so for women already in the screening programme, you will still need to get those smears.

    Don’t get me wrong. HPV vaccination is the way forward, but let’s not get carried away here, we are still taking baby steps. This vaccine will not get rid of cervical cancer completely. It will reduce the risk of getting it significantly. What we really need is a more broad range vaccine covering all of the high-risk types.

    Yes, I think we should vaccinate all our 12 year olds, and not just the girls. Remember, men transmit and carry the virus. There is an argument for vaccinating the boys as well. For that generation, this will have a huge impact. However, for women from their mid-twenties onwards, the impact will be less. This will not eliminate the need for smears overnight. It will not erradicate CIN or cervical cancer.

    Cervical Cancer is still a sexually transmitted disease, and while HPV causes it beyond a doubt, HPV is a family of viral sun-types. The only sure way of not getting cervical cancer is NO SEX. However, the best practical way is the use of CONDOMS. Even once vaccinated, you will still need to remember that.

    My worry is that in the excitement over this, people will forget this is not a cure, this is another preventative measure,a good one and a hugely important, but it is NOT the cure for cervical cancer.”

  10. 10
    Dreama says:

    I must admit that when I look at the “women only” vaccine recommendation with the most jaundiced eye, it feels to me like it’s coming from the same kind of mindset as the most unpleasant motivation for being anti-choice: women ought not be having sex outside of marriage (which is, of course, the only time we get pregnant unintentionally or contract disease) and bad things happen when we do. The liberal mind says we need to be protected from our own sluttery and often in quite condescending ways, the misogynist mind says we have to be punished for it in universally condescending ways.

    That may just be me, at the deepest depths of resigned cynicism.

  11. 11
    Rivka says:

    The Merck vaccine hasn’t been FDA-approved yet. Yes, the scientific research shows that it’s effective, but policy is only based on approved vaccines.

  12. 12
    Rachel S. says:

    Helen, Your friend makes a good point. This doesn’t fight all of the HPV types.

  13. 13
    Rachel S. says:

    Yeah, Dreama I actually feel skiddish about both the liberal and conservative views on this subject.

  14. 14
    Sara says:

    They’re doing studies to determine the safety and efficacy of the HPV vaccine in boys. I mean, think about it: drug companies are probably going to choose to sell twice as much product over remaining loyal to an illogical sexist belief. I also think it’s totally fair to call this a cervical cancer vaccine – the vast majority of cervical cancer is caused by HPV. (There are also some studies that show a link between HPV and some penile, anal and head and neck cancers, so boys may not be in the clear anyway.) This vaccine doesn’t protect against all cancer-causing strains of HPV, but a flu shot doesn’t protect you against all strains of flu and no one has a problem with calling it a flu shot.

  15. 15
    Anono says:

    What happened to freedom of choice? The right to do what you want with your own body? If this were abortion we were talking about, no one would like the government telling schoolkids what to do. How come the government can mandate this kind of vaccination? (Because it will benefit the kids? Oh, but there are plenty of people who will swear that it would benefit girls if they have to consult their parents before getting an abortion.)

  16. 16
    Dan S. says:

    “How come the government can mandate this kind of vaccination?”

    As to whyHerd immunity. Which is also why boys should be vaccinated (if ~safe), and why parents who decide that their kids don’t need those ickle shots in general – for various childhood diseases – are risking more than just their child’s life.

    I haven’t followed this closely enough – is it in fact mandating, or recommending?

    “one mother is quoted as saying that she won’t have her 13-year-old vaccinated because the girl is “too young” and doesn’t need it yet. Stuff like this just makes me want to scream. ”

    Me too. Would it help, I wonder, if it was explained, via analogy, something like this:
    Let’s say they invented a drug that could prevent drunk driving (and therefore drunk driving accidents). You could drink – you just would sober up as soon as you got in the car (don’t ask how!)
    It’s recommended that everyone get this drug as soon as they get their driver’s license, and it lasts for at least several years. However, some people object out, worrying that this sends a message to kids that it’s ok to drink long before they are of legal age. It’s giving them license to get sloshed, they say!
    Now, would this make sense? Is this a good reason to oppose giving this drug to kids who are too young to drink?

  17. 17
    Robert says:

    Now, would this make sense? Is this a good reason to oppose giving this drug to kids who are too young to drink?

    Possibly.

    The issue at hand is a question of moral hazard. Removing one negative consequence of a behavior (and publicizing that removal) will generally lead to an increase in the behavior, as the disincentive to the behavior created by the negative consequence disappears. This isn’t controversial; it’s an axiom of social behavior. (I’m told that seatbelt laws provide a pretty good example of a homeostatic behavior change; people feel safer and so they take more risks and drive faster, and so forth.)

    Figuring out the real-world consequences of a particular change can be a fairly complex calculus. In the scenario of the magical de-drunking pill, we have a number of things to compare. On the positive side of the balance sheet, people aren’t going to die from drunk driving accidents. That’s a good thing – that’ll save 10, maybe 20 thousand deaths annually in the United States.

    On the other side of the ledger, to some extent, children are going to start drinking more. It’s more difficult to weigh the harm caused here. There are health consequences to early drinking, and there are life outcome consequences. It’s just very hard to measure some of those changes, mostly because they “hide” in a complex causal thicket.

    Even if you can measure them, it’s not always an apples and oranges comparison. Is it worth saving 10,000 lives a year if an additional 100,000 people a year are thrown into poverty (because their early drinking causes them to drop out of school or become chronic drunks or whatever)? 200,000? A million? Beats the hell out of me.

    A similar calculus is being expressed, although not always in an articulated fashion, by people taking exception to the HPV vaccine. It’s a good thing that people won’t die of cervical cancer. If that benefit comes at a cost of a million extra teen pregnancies a year, it might not be worth it. I’m inclined to think that, in our sex-obsessed culture, the net effect of “legitimizing” sex with an HPV vaccine is pretty minimal. Maybe if we were a community of Mennonites it would be difficult, but I’m thinking that this isn’t going to change people’s minds about sexual behavior. Accordingly, the benefit from the vaccine is almost certainly going to swamp any negatives caused by increased promiscuity, on a net basis. But I acknowledge that I could be wrong.

    Because of the difficulty in getting an empirical grip on these questions, it’s very tempting to simply demonize the opponents of HPV (or seatbelt laws, or de-drunking pills) as being hateful fanatics who want X number of people to die. (“Because they hate women/teenagers/people who drive too fast!”) This is an understandable temptation for people who don’t understand the complex web of factors that are at play; if I have no sense of smell, I’m going to be tempted to conclude that the mean people insisting I bathe every day simply want to torture me.

  18. 18
    Ampersand says:

    Robert, there is no policy, however malicious, that cannot somehow be rationalized as being for the greater good in some nebulous and “hidden in a complex causal thicket” manner. “Hidden in a complex causal thicket,” after all, is not distinguishable from “I have absolutely no evidence of such a connection but I strongly want to believe it exists.” It’s a good thing to give other people the benefit of the doubt, but taken to extremes it can lead to a refusal to acknowledge even obvious bigotry and irrational beliefs.

    Anyone who sincerely believes that the prospect of cervical cancer is currently providing a significant disincentive to having sex is an idiot; the argument you refer to stinks of after-the-fact rationalization, and does not deserve being taken seriously.

    I don’t think the opposition to HPV vaccine is fueled by a hatred of women, per se. I do think it’s fueled by a quasi-religious belief that women, as a matter of morality, should undergo the natural consequences of having sex, and that any policy that allows women to have sex without natural consequences is immoral.

  19. 19
    Jake Squid says:

    I’m told that seatbelt laws provide a pretty good example of a homeostatic behavior change; people feel safer and so they take more risks and drive faster, and so forth.

    Do you have any credible data to back this up? A quick search reveals only one article by a group in Ireland making this claim. All other relevant documents that I find indicate that people who engage in risky driving behaviours are less likely to wear seatbelts.

  20. 20
    Jake Squid says:

    A little further research shows that highway deaths have declined in the last 20 years – corresponding to the increase in seatbelt laws (as well as other safety measures like airbags).

    From http://virgil.azwestern.edu/~dag/lol/DriversCrazy.html (Adapted from Scott Sleek’s “Car wars: taming drivers’ aggression,” “When human behaviors offset safety mechanisms,” and “Experts have varied ideas on how to curb accidents,” APA Monitor, September, 1996, pages 1, 13-14.):

    Increased risky driving has not been noted with the availability of airbags or the mandatory requirement to use seatbelts. Both of these devices have lowered traffic death rates.

  21. 21
    Robert says:

    Wikipedia has a basic article on the subject, and there’s an online book by the guy who fleshed out the idea.

    Anyone who sincerely believes that the prospect of cervical cancer is currently providing a significant disincentive to having sex is an idiot;

    This seems to be an emotional position, rather than a rational one.

    The prospect of getting a disease currently provides a disincentive to sex for at least some people. (It certainly circumscribed my behavior when I was a single guy). What share of that disincentive goes to cervical cancer? A pretty small percentage, I imagine. But cervical cancer is a pretty serious thing; telling people “guess what, you’re now safe from cervical cancer!” is bound to produce some psychological relief in the population in question.

    As I said, I’m pretty sure that the calculus weighs heavily on the pro-vaccine side. But the psychology of disease for some people may be that a specific immunity carries a lot of mental weight, when compared to a nebulous bundle of fear. We know that there are “all these diseases out there” but very few people can list them and provide statistical information on the real risks. Couple that with the fears (reasonable and unreasonable) about vaccination in general, and I’m not sure I’d be comfortable calling people idiots for worrying about the issue.

  22. 22
    Mandolin says:

    Robert,

    I agree generally with what I think is the gist of your argument. I don’t see the arguments against HPV so much having to do with the idea that young people aren’t having sex because they fear cervical cancer as having to do with the idea that adults should send consistent messages to teenagers that they shouldn’t have sex. It seems to me that the objectors fear creating a philosophical atmosphere where teenage sex is legitimate. The objection to the HPV vaccine is for its symbollic value, not because the objectors see cervical cancer as a deterrent.

    I also agree with you that the HPV vaccine is a relatively small symbol in our culture, which is already pretty sex-obsessed.

    But I fail to make the next leap of logic with you. The assumption that teenage pregnancy will go up because teenage sex is more acceptable isn’t supported by data – last I checked, those countries most forthright and casual about teen sex also had the lowest teen pregnancy rates. So what exactly are these serious consequences that are supposed to arise that we liberals are too senseless to notice? What’s the equivalent of the body odor in your bathing metaphor?

  23. 23
    Robert says:

    The assumption that teenage pregnancy will go up because teenage sex is more acceptable isn’t supported by data – last I checked, those countries most forthright and casual about teen sex also had the lowest teen pregnancy rates.

    That doesn’t quite follow. There may not be a country-by-country correlation – but countries have different cultures. Given a fixed culture, more sex = more pregnancies. If the “more sex” causal factor also includes a “more contraception” causal factor, that might not happen – but in the case of HPV, the causal factor includes a disincentive for barrier contraception, not an incentive for more of it. (“You don’t need that condom! I’m on the pill and we don’t need to worry about HPV because we both got vaccinated!”)

  24. 24
    Sara says:

    Robert, isn’t pregnancy itself a disincentive? The HPV vaccine will not affect your chances of becoming pregnant. Your seatbelt analogy is kind of silly because in a car crash, you either get injured or don’t. When you’re having sex, you either get preganant or don’t…or you get HPV or don’t or you get HIV or don’t or you get herpes or don’t. If a seatbelt only prevented you from fracturing your ribs (for example) but left you open to other injuries, wouldn’t people still be worried about broken legs and collarbones? Or death? God knows the sex-related risk I was most afraid of as a teenager was pregnancy, so really my use of the pill was what was leading to less condom use and therefore more risk of contracting HPV.

    And finally, if we’re making sex less dangerous, we’re making it less dangerous. If all you can muster against the idea of kids having sex is that they might get HPV, but we have an HPV vaccine, then you really don’t have an argument against kids having sex at all. In the real world, of course, there are plenty of disease-related reasons for kids not to have sex, and parents everywhere can hide behind those instead of making a real moral argument against their kids doin’ it. The correct moral position in this situation is not that it is worth the spread of cancer to prevent pregnancy – pregancy can be prevented without the spectre of cervical cancer (hello condoms). Cancer is not an acceptable social engineering tool.

  25. 25
    Jake Squid says:

    It seems that Wikipedia comes to a conclusion regarding seat belts contrary to that of the clear majority of studies. Although they are correct that anti-lock brakes do seem to show the sort of behavior to which you refer. A simple online search will bear out what I am saying and what I have quoted.

    So, in conclusion, mandatory seat-belt laws do not encourage risky behavior. Or so the studies say. Although I’m sure that having “been told” outweighs all that.

  26. 26
    Robert says:

    I’m not married to the example, Jake. The phenomenon appears to exist; how it manifests itself in various areas is certainly going to vary. Maybe seat belts are an area where other factors override risk homeostasis; I don’t know.

  27. 27
    Jake Squid says:

    That is, more or less, my point. Although we can see that the phenomenom does exist, do we have the ability to predict where it will play out with any consistency?

    To quote from Wikipedia:
    It is likely to be least when an intervention is imperceptible and greatest when an intervention is intrusive or conspicuous.

    Do you view vaccination at an early age to be intrusive and conspicuous? Can you honestly remember for which diseases you were vaccinated at the age of 3 or 5 or 9? I can’t and neither can most people who I have asked (note: not a valid survey for either size or selection). Therefore, if we wish to follow the theory and can agree that the HPV vaccine is not highly intrusive nor conspicuous to the recipients, the HPV vaccine should have no noticeable effect on frequency of sex.

  28. 28
    nobody.really says:

    people who engage in risky driving behaviours are less likely to wear seatbelts.

    This may well be true, but would not contradict the idea that people engage in risk compensation.

    Do you think that the act of refraining from putting on a seatbelt causes people to speed? Or rather, do you think that people have differing tolerances (or affinities) for risk, and that a higher tolerance (or affinity) leads some people BOTH to refrain from wearing seatbelts AND to drive in a more risky fashion? If you think the former, than you have grounds to dispute the risk compensation hypothesis. If you think the latter, then there is no contradiction with the risk compensation hypothesis.

    highway deaths have declined in the last 20 years – corresponding to the increase in seatbelt laws (as well as other safety measures like airbags).

    It is unclear to me how “highway deaths” are measured in this article. As noted in the Wikipedia article cited by Robert,

    The number of drivers killed and injured decreased, but at the same time there was a 75-year high increase in the numbers of pedestrians, cyclists and rear seat passengers killed, and this increase occurred only in collisions involving passenger cars, not goods vehicles and buses which were exempt from the seat belt law.

    Or as noted in the first chapter of The Armchair Economist, entitled “How Seat Belts Kill”:

    How many additional accidents were caused by the safety regulations of the 1960s…? Is the net effect of the regulations to decrease or to increase the number of driver deaths?

    This question cannot be answered by pure logic. One must look at actual numbers. In the middle 1970s, Sam Peltzman of the University of Chicago did just that. He found that …. [there] were more accidents and fewer driver deaths per accident, but the total number of driver deaths remained essentially unchanged. An interesting side effect appears to have been an increase in the number of pedestrian deaths; pedestrians, after all, gain no benefit from padded dashboards….

    If you find it hard to believe that people drive less carefully when their cars are safer, consider the proposition that people drive more carefully when their cars are more dangerous. This is, of course, just another way of saying the same thing, but somehow people find it easier to believe. If the seat belts were removed from your car, wouldn’t you be more cautious in driving? Carrying this observation to the extreme, Armen Alchian of the University of California at Los Angeles has suggested a way to bring about a major reduction in the accident rate: Require every car to have a spear mounted on the steering wheel, pointing directly at the driver’s heart. Alchian confidently predicts that we would see a lot less tailgating.

    Admittedly, proving the risk compensation hypothesis is challenging because DISproving it is so hard. The question is not whether total highway deaths decreased; the question is whether the number of highway deaths (or whatever variable you measure) decreased at the rate forecast to result from the change in seatbelt laws. If not, this result may suggest that people adopted more risky behaviors in response to the new seatbelt laws; alternatively, it may simply suggest that the initial forecast was screwed up. It’s an empirical challenge.

    I find it plausible that immunization might reduce people’s aversion to have sex. But, for the reasons cited by everyone besides Robert, I’d guess that the magnitude of the effect would be small.

  29. 29
    Robert says:

    “But, for the reasons cited by everyone besides including Robert…”

    Just to be picky.

  30. 30
    Jake Squid says:

    nobody,

    The bit you quote from Wikipedia regarding pedestrian deaths relates specifically to a study in the UK (the numbers match exactly). I had not yet found anything showing comparable stats for the USA – until the quote you provided from The Armchair Economist. But even there, without reference to a particular study, it may be referring to the UK study.

    I was just irritated about the seatbelt example since it seems not to really be what it’s been claimed. Anti-lock brakes, on the other hand…

  31. 31
    B says:

    When I was a kid a dentist assitant came to our class a couple of times each semester and made the entire class rinse our mouths with flour for five minutes. I don’t think this made us less likely to brush our teeth. Rather the opposite – it made us aware of the fact that our teeth migt get holes in them. Likewise one might argue that early vaccination will make children more viscerally aware of the danger of veneral diseases and make them more careful.

  32. 32
    Robert says:

    I wonder with the brakes if the difference isn’t that you can FEEL the performance. There’s a visceral difference between driving a car with and without ABS; stomp on the pedal with ABS and you STOP…and you think “wow, this thing will stop under any circumstances! Maybe I’ll go race that train…” Whereas with seatbelts, there’s no feedback until the decisions have already been made. (“Oh shit I should have buckled my SPLAT”)

  33. 33
    Jake Squid says:

    Robert,

    That is exactly what the studies I looked at conclude. Because people can feel & see the difference in stopping distance and skid they are more likely to follow closer at higher speed and brake later.

  34. 34
    Ampersand says:

    In the US, it’s my impression that homeostatic theory is more often referred to as “compensating behavior.”

    I realize the particular example isn’t essential to Rob’s case, but it’s worth noting that the Wikipedia article seems to be wrong. The best study I was able to find on this – “best” referring to both the quality of the data and the sophistication of the statistical model – is this 2003 study published in The Review of Economics and Statistics. The bottom line:

    Our findings indicate that seat belt use significantly reduces fatalities among car occupants, but does not appear to have any statistically significant effect on fatalities among nonoccupants. Thus, we do not find significant evidence for compensating behavior. In the course of our analysis, we replicate some of the findings of studies that concluded that such behavior exists, and we show that, once we allow for the endogeneity of usage, the effects of seat belt use on nonoccupant fatalities is insignificant.

    Overall, we find that seat belt legislation unambiguously reduces traffic fatalities.

    (Okay, Brad already said that, but I thought providing a link to a good study of US data might be useful).

    They also found (like virtually all studies do) that traffic fatalities go down when the economy is poor and go up when the economy is good. And, contrary to what some other studies have found, Black drivers are not more likely to be involved in fatal accidents than white drivers.

    Interestingly, one way to create a short-term decrease in accidents (and fatalities) would be to switch to driving on the left. That would make drivers more nervous and careful for a while, and lead to a drop in fatal traffic accidents. (There was a real-world example of this in Sweden in 1967, when they switched from left to right-side driving). But in a few years, the effect would disappear completely, as drivers got used to the new standard. What I’m wondering is, could we reduce accidents by switching sides to drive on every few years, or would people get used to that too?

  35. 35
    Jake Squid says:

    Hah! I saw that study from/about Sweden too.

    And, oh the pain it burnses it burnses. Jake! Do you hear me? Jake!

    BTW, what search terms did you use to find that study? Just curious as my meager search abilities didn’t turn up anything of the sort.

  36. 36
    Ampersand says:

    Actually, that one was really easy – I just searched for “seat belt laws.” But I searched for it on Google Scholar, rather than regular Google – so if that’s not what you did, that may have been the difference.

  37. 37
    Robert says:

    What I’m wondering is, could we reduce accidents by switching sides to drive on every few years, or would people get used to that too?

    We’d get used to that.

    What we could do that would never get old is this: assign every individual their own personal side of the road, left or right. Have it change every few years to keep the individuals on their toes. Since you’d never know where anyone else was going to be driving, however, you’d be at maximum hypervigilance at all times.

  38. 38
    RonF says:

    What we could do that would never get old is this: assign every individual their own personal side of the road, left or right. Have it change every few years to keep the individuals on their toes. Since you’d never know where anyone else was going to be driving, however, you’d be at maximum hypervigilance at all times.

    Amp and Robert, have you ever driven in Boston? Because they seem to have implemented this rule there for years. I used to drive a cab for Cambridge Yellow. Those who are familiar with the area are nodding their heads as they read this, but for those who have never driven in Boston, trust me; I’m now qualified to drive in military convoys in Iraq.

    “You never know where anyone else is going to be driving” pretty much defines traffic in Boston. The first time the light turns green at a major intersection with two lanes in all directions and someone in the left lane makes a right turn in front of you, you’ll learn.

  39. 39
    RonF says:

    As far as this vaccine goes, I think that the health benefits outweigh any risks in encouraging an increase in unhealthy behavior.

  40. 40
    Sailorman says:

    I’ve a post on this in my blog, BTW, titled “hpv insanity” which you might enjoy:
    http://moderatelyinsane.blogspot.com/2006/05/hpv-insanity.html

    The main reason not to give it to boys (to my knowledge from what I”ve read) is simple: Boys don’t suffer as much from HPV, and the cost/benefit ratio simply isn’t there. This is a fairly expensive vaccine.

    If you give it to both sexes, it’s really expensive.
    If you give it only to boys, you’ll protect everyone IN THEORY so long as you vaccinate all boys. BUT there are problems. The most obvious problem, of course, is that we have a constant influx (from outside the US) of unvaccinated folks, some of whom have HPV. So women will still be at risk.

    If you give it only to girls, you won’t protect boys as much. But boys don’t NEED as much protection, because they don’t get cancer from HPV. (From a public health perspective, there are probably better ways to spend $300 on ‘male health’). But you WILL protect the girls.

    I am positive that if there were an equivalent hard-to-detect cancer in boys which was known to be caused almost entirely by HPV, we’d be giving it to everyone.

  41. 41
    Mandolin says:

    But boys don’t NEED as much protection, because they don’t get cancer from HPV.

    Except for penile or anal cancer.

    From Rachel’s post:

    HPV (which is really a group of several different viruses) viruses also can lead to cancer in the anus, penis, vagina, and vulva. The good news is that these cancers are less common than cervical cancer, but they are still costly and deadly cancers that we should try to eradicate.

  42. 42
    Mendy says:

    RonF, isn’t the motto of Bostonian drivers (most not all) – “If you don’t like my driving stay off my sidewalk”?

    The few times I’ve visted Boston, I refused to drive, and I found being a pedestrian to be nearly as nerve wracking.

    On the subject of the post, I will be having my children vaccinated. My son will be as well as soon as a vaccine is approved for use in males. My question is this: if it seems onerous to some to vaccinate their preteens then why can’t we lump that vaccine in with the others that children already receive. Boosters could then be given when MMR, tetnus, and other boosters are given. This seems to make the most sense to me in a practical way. Most first graders will not appreciate the supposed “moral implications” of their school vaccines.

  43. 43
    Moral anti-police says:

    I wonder why would a 13 year old boy or girl need protection against STDs? They are not supposed to be having sex, if they think they are smart enough to take decisions blatantly against parents will, they should face the consequences of their decision.

    A parent who decides against it is responsible for the safety of their kids, but they have no right to enforce chastity on them? You need to decide whether the parents are ‘responsible and in control’ or ‘NOT responsible cause they are not in control’ of their kids sexual activity.

    Yes, both sexes should be vaccinated, but why should the entire society get on board with helping you live while you are defying them? If you want to vaccinate your kids for anything and everything under the sun, please do so, but why try to force it on people who dont intend to live your way?

    My guess – To have more of ‘you’ than ‘them’. If everyone starts behaving like you, then that would be considered “Normal”. Isnt that exactly what you are claiming to fight?

  44. 44
    Rachel S. says:

    m.a.p said, “I wonder why would a 13 year old boy or girl need protection against STDs?”

    First of all everybody deserves protections from disease whether they are sexually active or not.

    Second, this is not just connected to sexual activity that is chosen by 13 years. One very important reason to protect very young kids it that it is not uncommon for children to be sexually assaulted or molested. I personally know of cases where is was discovered that a child was being molested because they had STDs. Obviously, doing that to a child is wrong, but people deserve as much protection as possible for as long as possible because you never know what might happen to you or your child.

    Third, it is practical to give this vaccine when other vaccines are given.

    Fourth, not getting the vaccine is not going to prevent your daughter from having sex.

    Moral anti-police said, “If you want to vaccinate your kids for anything and everything under the sun, please do so, but why try to force it on people who dont intend to live your way?”
    I guess you haven’t heard of the Muslim fundamentalist in Nigeria who arrived at the same sort of conclusion as you. They chose not to vaccinate their daughters for polio and now a disease that was once eradicated has come back.

  45. 45
    Jake Squid says:

    That’s great, Moral. So, if your kids don’t listen to you they deserve death by cancer? I imagine that at some point you disobeyed your parents rules – should you be put to death? Will you be offing yourself?

    And people wonder why I hate them…

  46. 46
    Moral anti-police says:

    What is more damaging? Cancer or Sexual molestation? I am sure if you are a concerned parent, you will protect them from the later and not take a ‘if it happens’ approach with the first one. Or is it simply easier to vaccinate and forget, only going back to being a protective parent when something bad happens?

    Sure, if you are as distant with your kids that they would hide sexual assualt on them from you, I think my ways dont apply to you. I never implied on what you should or should not be doing.

    As for the Muslim fundamentalists in Nigeria, I think they already appreciate you telling them how they should live, still that is very interesting coming from a self-proclaimed liberal. Jake, I dont think anyone wonders why you or anyone else hates them, the feeling is very mutual.

  47. 47
    odanu says:

    Moral anti-police: Concerned parents miss sexual assaults on their children all the time. That, and it does no good to vaccinate the child against the cancer after the molestation has occured. All too often, the offender is the other parent, or step-parent, or other close and trusted adult. And abusers are extremely good at ensuring that the victim believes that if s/he tells, something horrible will happen, either to hirself or to hir loved ones.

    Tell me, after you vaccinate your child from tetanus, do you then “forget” and leave them to play with a can full of rusty nails? Why then would a parent concerned enough to vaccinate a child against a deadly cancer then fail to teach other self protective behaviors that augment said vaccination? Why do you assume that parents that seek to protect their child from sexually transmitted cancers would not also wish to protect their children from other sexually transmitted diseases and the consequences of too early or too immature sexual activity?

    Oh, and by the way, cervical cancer is deadly. When all five stages of CC are included, as many as 25% of people who contract it die from it within five years. Sexual molestation, most commonly, is not. So on the face of it, cancer is, in fact, the more damaging of your two examples. That and the fact that one in three women or thereabouts (many more in some populations) have experienced sexual molestation — not with no ill effects, but surviveably and often thriveably over time.

    Oh, and public health is certainly an area where international interests come into play…non-vaccination of children in one part of the world eventually (and sooner than later) affects children in other parts of the world…so yeah, like other issues that affect the entire human population, or the entire globe, nationalist and religious issues must be subsumed to the greater good of the human species. No one has a civil right to spread typhoid, fex.

  48. 48
    Rachel S. says:

    My view is that it is proper to try to protect children from diseases whether they are sexually transmitted or not. HPV is extremely common in this country, most American women and a lot of men) will get it unless this vaccine is given to as many people as possible. I would say to anyone who doesn’t want to give their kids this vaccination–Do you really care about your children?

    Let’s say you think premarital sex is evil or sinful for whatever reason (I don’t agree, but let’s go with that view.) Many people currently have premarial sex. Do you think the appropriate price to pay for this sin is cancer or death? Because when you say that your children shouldn’t be vaccinated against this infection, what you are saying is “I don’t mind my child paying the ultimate price (death) for what in the scheme of things is a very minor sin. My children should potentially suffer death or serious disease if they make youthful mistakes.” Do you really believe that? If so then, we may need to get some parenting classes.

    PS–I think sexual assault and cancer both wreak havoc on our society, and a know many people who have been victims of both.

  49. 49
    Moral anti-police says:

    Whether premarital sex is good or bad is a personal belief. Whether family should be sharing a belief is family based. If an individual belongs to and wants to belong to a family, he/she should participate and share in the belief system. If not, he/she should part ways. Is that simple enough for you to understand? I do believe that sexual molestation is worse than cancer cause you cannot make it go away, ever! As for child molestation victims, it is sad that parents (so called concerned parents) will “miss” the fact that their children have been victimized. If you dont understand your kids to miss out something as traumatic as that, maybe I should be the one suggesting parenting lessons. Its not as if the kids are capable of masking their feelings, given they are (assumed) naive enough to be threatened by any attacker.

    You know many people who have been victims of both, so that gives you moral authority to tell others how to live their life? Does that mean any other person who knows more victims than you can tell you what you should be doing? No one has the civil right (is there anything like ‘civil rights’ in global context?) to do anything, including telling others what to do – specially against their individual and collective beliefs.

  50. 50
    Moral anti-police says:

    BTW, I see no one enforcing malaria or flu vaccines on Americans. That inspite of mosquitoes and birds being not controlled by any code of conduct. Interesting that you would consider vaccinating the entire populace of a different continent to protect ‘your’ children, yet you would not consider enforcing a vaccination on your own populace even in face of grave danger. Why not suggest enforcing a hepatitis vaccination also? Isnt it easier to contract and much more contagious than HPV? It doesnt even need a sexual contact! So why focus on something that will reduce risk only in unprotected sexual activity?

  51. 51
    Jake Squid says:

    MAP asks: Isnt it easier to contract and much more contagious than HPV?

    No. From the CDC:
    Genital human papillomavirus (HPV) infection is the most common sexually transmitted disease (STD) in the United States…

    Certain HPV types cause abnormal Pap smears and are etiologically related to cervical, vulvar, anal, and penile cancers; other types cause genital warts, recurrent respiratory papillomatosis…

    From Canadian Medical Associates Journal:
    As the recent paper by Winer and associates2 highlighted, sexual contact is not necessary for the transmission of HPV. Although these authors showed that the cumulative incidence of HPV over the first 4 years after first sexual intercourse was about 50%, they also showed that HPV infection was acquired by virginal women at a cumulative rate of 7.9% over 2 years. According to these authors, abstaining from penetrative sex did not protect women from HPV transmission, and they proposed that skin-to-skin contact during nonpenetrative sexual contact may be a primary mode of genital HPV transmission.

    …I see no one enforcing malaria or flu vaccines on Americans.

    Measles, mumps, rubella, chicken pox, TB, tetanus, smallpox (in days gone by), polio. All of these are cases where herd immunity is necessary in order to supress the disease. But I’m sure you’ve never heard of anybody enforcing those vaccinations.

    LALALALALA I’m not listening! If kids disobey their parents they deserve to die!

    Lovely specimen of humanity there.

  52. 52
    Robert says:

    Just FYI, Jake, we don’t enforce those vaccines. We do strongly recommend them to parents, and in most states they won’t let you come to school if there’s been an epidemic and your kid isn’t vaccinated, and compliance is pretty high. But it’s voluntary.

    Didn’t we already that conversation?

  53. 53
    Abyss2hope says:

    Moral anti-police,

    I find your assumption about parents who don’t know what happened to their child dangerously naive. Many times the perps are people trusted by the victim and the parents, as such they often spend considerable effort manipulating everyone involved. One of the key factors that led me to say nothing to my parents was the belief that I should save myself for marriage. I saw what happened at 15 as my failure rather than seeing it for what it was.

    Rape.

    The fallout of that could have been deadly. It was only a free screening that resulted in the discovery of pre-cancerous cells when I was in my early 20s and before it could become cervical cancer.

  54. 54
    Lee says:

    And, Moral Anti-Police, the statistics on child molestation and sex abuse are as follows:

    Child Abuse & Child Sexual Abuse ~ Substantiated

    Composition of substantiated child abuse in 2000:
    879,000 children were victims of child maltreatment.
    Neglect ~ 63%
    Physical ~ 19%
    Sexual ~ 10%
    Psychological ~ 8%

    Victimization rates declined as age increased.
    Rate of victimization per 1,000 children of the same age group:
    Birth to 3 years old = 15.7 victims per 1,000.
    Ages 16 and 17 = 5.7 victims per 1,000.

    Except for victims of sexual abuse, rates
    were similar for male and female victimization:
    11.2 and 12.8 per 1,000 children respectively.
    Rate of sexual abuse by gender:
    1.7 victims per 1,000 female children
    0.4 victims per 1,000 male children.

    Rate of child abuse by race:
    White = 51%
    African American = 25%
    Hispanic = 15%
    American Indian/Alaska Natives = 2%
    Asian/Pacific Islanders = 1%

    The comparative annual rate of child victims:
    decreased steadily from 15.3 victims per 1,000 children in 1993
    to 11.8 victims per 1,000 children in 1999;
    then increased to 12.2 per 1,000 children in 2000.
    Whether this is a trend cannot be determined until additional data are collected.

    Source: US Dept of Health and Human Services,
    Administration for Children & Families,
    National Clearinghouse on Child Abuse and Neglect, 2000.

    This means that roughly one out of every six children in the U.S. will have been sexually molested or abused by the time they turn 18. From elsewhere in the report, half of all female rape victims are under the age of 18.

    I think these numbers are a pretty clear argument for giving the vaccine to your children some very serious consideration.

  55. 55
    Sailorman says:

    Can I make a suggestion that we not sidetrack too much into abuse? Not that it’s an uninteresting topic, but the argument for the HPV vaccine really does not depend much on the abuse angle, and abuse threads can sometimes go downhill fast.

    Moral anti-police is merely operating on an incorrect assumption about two things:

    1) how we perceive, and classify, risk, and
    2) How we react and change behavior in response to increased or decreased risk.

    Theoretically, if we were entirely rational actors, MAP might have a reasonable point. And it is tempting to consider yourself to be rational (who wants to think they’re not rational?) but in fact, we’re not rational.

    Hmm. I did write a long post about this, which goes into the rationality issue in more detail. But to explain it better to MAP, since s/he apparently didn’t read my post (on my blog) called “HPV Insanity”:

    I will use a simple example.

    Sex exposes you to:
    Unwanted pregnancy
    Sexually transmitted, uncurable and possibly fatal diseases (AIDS)
    Sexually transmitted, uncurable, unpleasant, and nonfatal diseases (herpes)
    Sexually transmitted, curable, diseases (gonorrhea)
    Contact transmitted parasites (crabs)

    and the like.

    Sex also carries with it a certain emotional risk.

    All of the above issues share two crucial characteristic, among others:
    1) They are well known and widely publicized; and
    2) They are relatively immediate. E.g. if you “get” something, you have “gotten” it pretty much right after you have sex.

    Let’s ONLY focus on immediacy.

    We know that people do not rationally assess and adjust behavior for non-immediate risk. How do we know this? Well, studies aside, one easy and common sense way is to see how many people act in a manner which is harmful in the long term (or in the unknown future) but beneficial in the short term.

    You can, for example, look at issues whcih are not especially beneficial in the short term (having an ice cream cone twice a week even if you know you have high cholesterol) but which have a significant long term effect (significantly increasing your risk of heart attack and death).

    We eat the ice cream. This increases our risk of death by, let’s say, 1 in 10,000. Small, right? But the truth is that if–every time we ate an ice cream–we had to play Russian Roulette with a 10,000 chamber handgun, we would probably skip the ice cream. Even if we could eat anything we wanted for a week–and some people do–we would probably not risk a 1/10,000 chance of IMMEDIATE CERTAIN death for that right to eat.

    Similarly, many people will have unprotected sex with a stranger. But they would not be willing to play “STD roulette” or “pregnancy roulette” first. They just don’t process the risks rationally.

    OK, now back to HPV for a moment.

    What does HPV do?

    Well, it has an effect on you which radically increases your chances of getting cervical cancer. Because it doesn’t have much of an immediate effect, it’s not as widely publicized. It does NOT ‘guarantee’ you will get cancer. it does NOT mean your cancer won’t be discovered. it does NOT mean your cancer won’t be treatable.

    In other words, HPV is
    1) Not widely publicized;
    2) Not guaranteed to have any real effect on you, even if you get it;
    3) Not immediate in any way.

    So if you think youths will change their behavior based on a HPV vaccine, you have a lot of explaining to do first, mostly why they don’t change their behavior like you would expect based on about everything else.

  56. 56
    Jake Squid says:

    Robert,

    Yes, we had that conversation. Although it is true that there are no laws that enforce the requirement, the vaccines are de facto enforced. For a large number of people, they showed up at school one day & their entire class was innoculated (Los Angeles, CA – in the 60s, at least – is an example). For a large number of people, it is accepted (if incorrect) knowledge that their kids must be innoculated for them to attend school.

    So, although not technically, legally enforced by government we do seem to have de facto enforcement via the mistaken belief of the (I believe, large) majority that the standard innoculations are required.

  57. 57
    Moral anti-police says:

    Jake, So HPV was exclusively transferred through sexual contact, penetrative or not, its still sexual contact. On the other hand, hepatitis can be transferred even by using contaminated everyday items. It is not classified as STD as there are other means to spread it. It still kills more people than AIDs, so stop putting a twist on words. If you have to advocate for a vaccine it should be hepatitis and flu! The simple matter of fact that it is not, makes me question the “safety” motive you are purporting. Try proving that sexually inactive people and responsible sexually non-promiscuous people can also get HPV, it kills and is not curable. Until you do that, there is no moral ground in enforcing any such vaccination.

    All you are arming people by vaccinating people is to be a little bit less careful with their kids and their sexual habits. Also, the enforcement of vaccination among americans by americans is an American problem. It is not the same with Nigerian, Sudanese, Indian or Chinese problem, similarly polio in Nigeria is not an American and hence you have no authority to enforce vaccination on them. Its a choice they (Non-Americans) have to make. It is sad that some kids had to suffer from an avoidable disease (Non-STD), however, that does not mean you get the right to vaccinate all american kids to a STD. There is no relevance or connection!

    Sailorman, Yes, we are not entirely rational all the time. Should unprotected promiscous sex be considered an offense similar to drunk driving? What should be considered promiscuous? Is it safe/responsible to have sex with someone who has not presented his current sexual health report to you (and you to them)?

    Why punish a drunk driver, using force to stop him/her, if necessary, but allow/engage/support uncontrolled-irresponsible sexual contacts? It seems so called rational people want a double standard depending on kind of irresponsible behavior. Why not provide armoured cars to all people who MAY engage in police chase? Make them safe!

    As for should my children suffer from a disease because they were attacked? I am sure they will be treated in time (because it will found WAY before time). But I would want to find out and get the culprit prosecuted before he/she hurts other innocent kids. This whole vaccination of kids simply helps cover up the heinous crime, incase parents “miss” it. Even worse the child will live without help for rest of his/her life, thanks to the early vaccination.

  58. 58
    Sailorman says:

    MAP, you are really not making much sense here. If you actually lack understanding of the issues I would be happy to explain them to you. But if you are going to change the subject to drunk driving and criminals (???) I can’t bear to waste the time.

  59. 59
    Jake Squid says:

    If you have to advocate for a vaccine it should be hepatitis and flu!

    Why can’t I advocate for vaccinations against hepatitis and flu and advocate for vaccinations against HPV, MMR, polio, etc?

    Also, the answer is still a resounding “no” to your question about hepatitis vs HPV. Many, many more people have HPV than have or have ever had hepatitis. Also, you beg to be asked, “which hepatitis?” Isn’t there one strain that is a sexually transmitted disease that differs from the strain sometimes passed via food handled by infected people?

    Hey, if you want to expose your kids to the preventable risk of death by cervical cancer I can’t stop you. But you can’t stop me from feeling sorry for your daughters or thinking that, if only there were a god or gods, that you would undoubtedly suffer eternal punishment for wishing death (or preventable risk thereof) on children who break their parents’ rules.

    You and Barbara Bush can say, “We need to teach the children that sex is death,” all you want. It doesn’t make you sane or humane or correct.

  60. 60
    Lee says:

    Maybe, MAP, you’re entirely missing the info that an HPV infection isn’t treatable? Or many times isn’t even readily detectable?

  61. 61
    Moral anti-police says:

    Lee, HPV isnt as dangerous as HIV or Hepatitis (Cancer is curable! atleast in early stages). No it is not hard to detect HPV or Cervical cancer, it needs appropriate tests, thats all.

    There are strains of Hepatitis (A- D) with some difference in the virus DNA structure. The contagiousness of each of these vary of which B is considered lethal, none is completely curable and D can only exist if other kinds already exist.

    Sailorman, I understand your view point about the immediacy of the effects and general caution by actors involved. My point is not that it will not be safer to protect against damages that will be visible after a prolonged period of time. To simply advocate vaccinations to protect those who fail to acknowledge these dangers will only protect irresponsible people that are inherently careless about the long term effects of their actions. Obviously these people will not take measures to protect others around themselves from dangers they themselves choose to ignore. This puts them into the likes of drunk drivers (not only risking their own lives but those of others around them as well).

    PS: Vaccinations will allow people to carry the virus, but be immune to its affects! That is what vaccines do! How dangerous is that? Arming up for a biological war are we?

  62. 62
    Sailorman says:

    # Moral anti-police Writes:
    July 12th, 2006 at 12:06 pm

    Lee, HPV isnt as dangerous as HIV or Hepatitis (Cancer is curable! atleast in early stages). No it is not hard to detect HPV or Cervical cancer, it needs appropriate tests, thats all.

    Ah. So those women out there dying of cervical cancer just need TESTS. Why didn’t someone see that? Oh, wait… I know! It’s because (contrary to popular belief) you CAN’T accurately test for many things in a manner which is both effective and affordable–and CC is one of them. it’s easy to miss.

    Not to mention the obvious: Barring your cheerful “cancer is curable” comment…. you’re wrong. it’s curable–sometimes. But curing cancer is no fun, not cheap, and a whole lot more dangerous than vaccinating.

    Sailorman, I understand your view point about the immediacy of the effects and general caution by actors involved.

    Great! Can you explain why you think it is wrong, then?

    My point is not that it will not be safer to protect against damages that will be visible after a prolonged period of time.
    OK. This is not entirely clear but let’s keep going.

    To simply advocate vaccinations to protect those who fail to acknowledge these dangers will only protect irresponsible people that are inherently careless about the long term effects of their actions.

    But…. the vaccine IS safer. You’re protecting them. Protection is safety. Are you only trying to protect people who adhere to a certain moral code? Is “overprotection” bad?

    If so, you need to change your initial “my point is” statement. You need to change it a LOT.

    Obviously these people will not take measures to protect others around themselves from dangers they themselves choose to ignore.

    You may be right! That’s why the vaccine is so important. They won’t protect others around themselves, so we can protect for them, by vaccinating.

    This puts them into the likes of drunk drivers (not only risking their own lives but those of others around them as well).

    ooh, this is a really atrocious analogy. Can’t you compare them to Nazis or something instead? Sex (voluntary sex) requires the assent of both people. If one is UNKNOWINGLY infected then the other will get HPV. If one is vaccinated transmission cannot occur.

    PS: Vaccinations will allow people to carry the virus, but be immune to its affects! That is what vaccines do! How dangerous is that? Arming up for a biological war are we?

    What the #$%#!! are you talking about? I’m really wasting my time with you, aren’t i.

  63. 63
    Rachel S. says:

    Sailorman said, “I’m really wasting my time with you, aren’t i.”

    Me thinks so. Unfortunately, MAP doesn’t even understand what a vaccine is.

  64. 64
    Mandolin says:

    Does anyone else think MAP might be a joke? I mean, there’s even something a little silly about the name. I suspect someone of trying to pull our chains.

  65. 65
    ptera says:

    MAP-
    Arguing that we should advocate for Hepatitis and flu because it kills more people is a bit irrelevant. As I understood this thread it was about advocating HPV vaccination in the US as a response to its approval by the FDA. Hepatitis is not endemic to the US and is not a large health concern here. There is no single vaccine for the flu merely a yearly guess at what will be the prevalent strain for that flu season. This is very different from HPV which has specifically targeted the most virulent strains and has a long term efficacy.

    Are you advocating for Hepatitis A vaccination or B? Hepatitis A is primarily water related and is not a concern where water treatment is widespread though it is a problem in the third world. Hepatitis B is more problematic in the US but it is primarily transferred by blood to blood transfer not incidental contact as you state. Strains C-G do not have vaccines.

    I’m very careful about when and with whom I will have sex. Testing is a prerequisite but as I found HPV is not included in sexual health history or testing. I always use condoms. I also have high risk HPV. It may some day progress into cervical cancer (I’ve already had two close calls) and we all know that cancer kills (despite your ! cancer is NOT curable). Please send me the deed to my moral high ground.

    A few more things about HPV. It is incredibly widespread. Estimates are that 80% or more of the population have some strain and many have multiple. Because of its prevalence it is not an STD that is traced. When I was diagnosed and I subsequently freaked out my doctor informed me that it wasn’t worth trying to figure out who I got it from or notifying any subsequent partners. Because so many people have it it is nearly impossible to trace. A three hundred dollar series of vaccines would have saved me (thankfully my insurance) over two thousand dollars thus far. Because this is a life time infection this amount will only go up. I am thrilled that my daughters will not have to deal with this.

  66. 66
    jma says:

    In 1990, a graduate student working on her Ph.D. thesis at the School of Public Health at the University of California, Berkeley, detected in 100% of the fresh tissue specimens of prostate cancer analyzed, oligonucleotides specifically identical to those found in the E7 regions of sexually transmitted viruses HPV-16 and HPV-18.
    For convoluted reasons this discovery was never published. However the findings can be witnessed on pages 106, 108 and 111 of the Ph.D. dissertation “Detection of Human Papillomavirus Type 16 and 18 DNA in Human Prostatic Adenocarcinomas” archived at the Main Library of the University of California, Berkeley. (Published: Dec. 1991; Location: MAIN STACK: 308t 1991 877)

  67. 67
    sylphhead says:

    “The simple matter of fact that it is not, makes me question the “safety” motive you are purporting. Try proving that sexually inactive people and responsible sexually non-promiscuous people can also get HPV, it kills and is not curable. Until you do that, there is no moral ground in enforcing any such vaccination.”

    How about providing a rational ground for assuming that sexual activity is inherently bad? Outside of thousand-year old Hebrew folktales involving evil apples and a flatass Earth, if you please.

    “To simply advocate vaccinations to protect those who fail to acknowledge these dangers will only protect irresponsible people that are inherently careless about the long term effects of their actions.”

    Nah, sexual puritans, I’d say, are more careless about the long terms effects of their actions. They have a tendency to invade the wrong country and shoot lawyers in the face.

  68. 68
    mythago says:

    What thousand-year-old Hebrew folktale refers to apples? Or sex being inherently evil? I’m deeply curious.

    And yeah, I’m guessing MAP is a troll, given its ability to spell long words and at length when convenient, then suddenly having trouble using the apostrophe properly.

  69. 69
    sylphhead says:

    “What thousand-year-old Hebrew folktale refers to apples? Or sex being inherently evil? I’m deeply curious.”

    Just a general reference to that coin-operated relic in your local Marriot suite whose misogyny and anti-sex weirdness is taken by some to be authoritative. As long as we’re talking about apples here, there’s so much that’s wrong with the Adam and Eve story. (Particularly relevant on a feminist site, as it has been the excuse for much sexism over the centuries, what with wily females causing all sorts of trouble like the damnation of man and all. Though if you want wily, you can’t go wrong with Lilith, who must have been a pretty groovy chick.) Why was the tree placed smack dab in the centre of the Garden of Eden, with the four rivers placed around it? How could God condemn Adam and Eve when at the time they decided to eat the fruit of the tree of the knowledge of good and evil, they [b]hadn’t eaten it yet[/b] and thus had no moral agency? But I digress.

  70. 70
    FurryCatHerder says:

    Much of the misogyny wrapped up in that thousand-year-old Hebrew folk tale doesn’t come from the Hebs, it comes from those whacky Christians.

    Not sure what anyone here knows midrashically about Lilith, but I have to agree she was a pretty groovy chick.

  71. 71
    mythago says:

    Not sure what anyone here knows midrashically about Lilith

    Very little, apparently.

  72. 72
    FurryCatHerder says:

    Very little, apparently.

    This is also probably the Jews fault.

    As for being sex-negative, if we could just get those whacky Christians to read Shir Hashirim maybe they’d get over their sexual hangups and stop blaming us for them as well …

  73. 73
    sylphhead says:

    “Much of the misogyny wrapped up in that thousand-year-old Hebrew folk tale doesn’t come from the Hebs, it comes from those whacky Christians.”

    My editorial choice of the word ‘Hebrew’ came from the fact that the word just sounds archaic, hence emphasizing the thousands year old part. That Judaism is by far the healthiest view of sexuality and women among the Abrahamic religions is well known, the occasional beating of old women in buses notwithstanding. It wasn’t my attention to randomly assign blame to Jews, when we’ve got a perfectly healthy Mel Gibson around to do that.

    “This is also probably the Jews fault.”

    My impression was that the Jews popularized the notion of Lilith – Christian writings, I believe, make little reference to her. Really, they needn’t have, because they’re perfectly capable of demonizing the normal woman in Eve without resorting to actual demons.

  74. 74
    jjf says:

    Like penicillin doesn’t make it worse over time?

  75. 75
    tim1534 says:

    The fda also approved oxycontin?

  76. 76
    Susan says:

    1. If it can be established that this vaccination protects most/all vaccinated persons from infection with HPV, and
    2. If it can be established that there is no substantial health risk to the persons so vaccinated,

    it would be interesting, but maybe not too interesting, to hear arguments why all persons eligible should not be vaccinated immediately.

  77. 77
    Suzanne says:

    What’s your point, Tim? Oxycontin works for people with chronic, severe pain. The fact that some people get addicted doesn’t change that.

  78. 78
    Stage 2B says:

    Why would anyone not want to have their child vaccinated against HPV?
    This vaccine can potentially save many lives and perhaps reduce the cancer rates for other oral (head and neck) cancers that are currently being studied and linked to HPV just like cervical cancer.
    Having been diagnosed less than one year ago with Stage 2B cervical cancer – advanced invasive cancer – I can attest to the fact that developing cervical cancer is something you would prevent through a vaccine, if posible. We are talking about giving millions of people something that can save their life. If chemotherapy, radiation (internal and external) sound like a better alternative, then by all mean – don’t vaccinate.

  79. 79
    trillian says:

    Stage 2B – all the best of luck to you, and please read that as an understatement. And you are absolutely right.

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