Quick Hit: The HPV vaccine for boys?

The Washington Post reports that Merck, the company that makes Gardasil, has asked the FDA to approve the HPV vaccine for boys and young men.

When a vaccine designed to protect girls against a sexually transmitted virus arrived three years ago, the debate centered on one question: Would the shots make young girls more likely to have sex?
Now the vaccine’s maker is trying to get approval to sell the vaccine for boys, and the debate is focusing on something else entirely: Is it worth the money, and is it safe and effective enough?

Shocking that the concern for young men isn’t about promiscuity.

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49 Comments

  1. Femgineer
    Posted March 26, 2009 at 2:19 pm | Permalink

    If you could prevent your partner from getting cancer for $300, wouldn’t you want to do it?

  2. Lilith Luffles
    Posted March 26, 2009 at 2:19 pm | Permalink

    Didn’t you know, Jessica? Boys are born at a 10 on the promiscuity scale, and nothing you can do will alter that, save maybe castration. So why care, am i rite?

  3. Joe
    Posted March 26, 2009 at 2:27 pm | Permalink

    It’s about time they try to get it approved for men. I intend on getting the vaccine, it’s not promoting sex, it’s about promoting health.

  4. Brianna G
    Posted March 26, 2009 at 2:36 pm | Permalink

    Yeah, well, I think it’s a lot like how most of the female BC issues centered around promiscuity and the ones about male BC are all about safety and efficiency. With women, we will want it even if it’s not 100% safe and not 100% effective, because both pregnancy and HPV primarily physically impact women, and we’ll take a lot more risk to protect ourselves than men will take to protect another person. The problem, of course, is that some drug companies seem to think that this means that they don’t have to continually improve the safety of their products, since women will buy it anyway, but for men, they have to get it 100% the first time.
    However, HPV, unlike pregnancy, is a public health concern similar to rubella. Just because little boys don’t give CRS to children, and rubella is mild in them, doesn’t mean we shouldn’t eradicate rubella. Same thing for HPV, except that HPV can potentially impact 50% of the population instead of just pregnant women in the right trimester. This needs to be framed in the public-health view.

  5. Caro
    Posted March 26, 2009 at 2:41 pm | Permalink

    Right, and how shocking that decreasing the spread of a sexually transmitted infection that can have serious health consequences for women isn’t considered important enough to bother men and boys with vaccination. Though I think if people mentioned more often that strains of HPV can occasionally cause penile cancer, maybe there would be more interest among men in getting vaccinated…

  6. Sigmund
    Posted March 26, 2009 at 2:59 pm | Permalink

    $300? I looked into Gardasil (for myself, obviously) and was told it would be around $600. Which I was pretty bummed about, since that’s way out of what I can afford right now.

  7. Femgineer
    Posted March 26, 2009 at 3:39 pm | Permalink

    Yes, I remembered wrong, but it seems like you completely missed the point.

  8. jjgirl23
    Posted March 26, 2009 at 3:56 pm | Permalink

    hahaha

  9. jjgirl23
    Posted March 26, 2009 at 3:59 pm | Permalink

    It makes me sad that the focus of the debate is only money & safety when the boys are effected. What about the girls’ safety? The only stuff I ever heard being debated about the vaccine’s “safety” the first time around was “Is it safe! Will it make them have sex!” Do people not care about women’s safety at all, or do they care but care more about preventing sex?

  10. devin89
    Posted March 26, 2009 at 4:04 pm | Permalink

    Even if you do get the guardasil vaccine, it only protects against the strains of HPV that can lead to cervical cancer, it doesn’t protect against the strains that give you genital warts. (There are over 40 strains, and only a few that can lead to cervical cancer, the majority of them only give you the warts…but it won’t kill you. Greaaat)
    I think guys SHOULD get a vaccine against it though because when a guy carries HPV, he doesn’t get any symptoms so unless a guy has slept with a girl who already has HPV there is no way for him to know he has it. (If he gets tested, HPV doesn’t show up on the test as it is basically undetectable since it doesn’t really AFFECT guys.)
    I am particularly opinionated on this matter as I have the disease myself. (Decided to sleep with the guy I had been dating…only after I got sick did I find out he was a lying cheating bastard…but) I didn’t get the guardasil because I didn’t even really know about it until after I was sick. The doctors keep telling me to get it anyway but 1. I can’t afford it and 2. I’m not having SEX anymore so won’t GET another strain. BUT the idea that they are concerned that it won’t be safe for guys whereas they are only worried that girls will be having more sex is infuriating. What’s not SAFE is the fact that guys can carry the disease with absolutely no signs and can even get tested and not know they have it. What’s NOT safe is guys not CARING if they have the disease or not…because who cares if it isn’t going to hurt them…

  11. JudoJohn
    Posted March 26, 2009 at 4:16 pm | Permalink

    Hold on!
    Any man would pay $300 to avoid infecting his wife/girlfriend with a virus that causes cancer!
    Should men get vaccinated? Is it worth the cost, considering the balance of risks involved? I’m not so sure about that. Not all strains of HPV cause cancer.
    It seems fair to say that those who are at risk of catastrophic illness should be the ones getting the vaccine. Because of *deplorable* attitudes towards sex, some parents will not allow daughters to get the vaccine. Because of this, perhaps males should get vaccinated. Also, some women may not be able to afford the vaccine, and in that case it would be a benefit for males to be vaccinated.
    It does seem to be the case that all females should be vaccinated as a matter of course, as a public health policy.

  12. journolat
    Posted March 26, 2009 at 4:27 pm | Permalink

    Actually it guards against 4 types… 2 that cause genital warts and 2 that cause cervical cancer. but there are other less common strains that also cause cancer and genital warts that it doesn’t protect against.

  13. devin89
    Posted March 26, 2009 at 4:32 pm | Permalink

    Right. It’s hard to keep track, as every doctor I have spoken to has told me something different. *sigh*

  14. anteup
    Posted March 26, 2009 at 4:36 pm | Permalink

    “Any man would pay $300 to avoid infecting his wife/girlfriend with a virus that causes cancer!”
    What makes you so sure?
    Also, it only PREVENTS the virus it doesn’t cure it. If hes only getting it for someone he sees as worth ~the long haul~, he could already have it by then. And for (most) males to get it in time, their parents would also still be the ones in control of the money and the insurance. It needs to be administered before becoming sexually active.

  15. Velvet Acid Christ
    Posted March 26, 2009 at 4:51 pm | Permalink

    The HPV vaccine debate has always confused me. Many don’t want to make it available for girls out of fear they’ll become promiscuous.
    So whats the trade off? Lets not make it available and watch girls face a greater risk of cervical cancer? Its almost like they’re punishing girls for having sex.
    Whats worse, a woman having a one night stand, or 6 months of chemotherapy?
    Even though as a man I don’t face the cervical risk, I would still like to prevent warts. I had a wart on my hand once, believe me, I don’t want them ‘down there’. Knowing a vaccine could prevent me from spreading the virus to a woman is my moral responsibility.
    Make the damn vaccine available already.

  16. thegecko
    Posted March 26, 2009 at 5:05 pm | Permalink

    If that were the case, I suspect there would have been a mandatory vaccine rolling out about 10 years ago. Oh, and women would have been required to get it too.

  17. thegecko
    Posted March 26, 2009 at 5:13 pm | Permalink

    I’m confused by the debate as well…you’d think that parents would place a higher priority on protecting their daughters from a deadly disease than protecting their hymens from wandering penises.
    I’ve found one response that shuts ‘em down pretty quick whenever they start that “promoting promiscuity” bullshit: “Ok, but what if she is a virgin on her wedding night, but then she gets it from her husband? Or what if she gets raped by a man who is carrying it?” Then I also point out that certain strains of HPV (not the ones which are known to cause cancer, but other types) can actually be transmitted from an adult’s hands to an infant during diaper changes and the like. I mean seriously people, it’s a virus, who cares how it spreads? We should care more about getting under control…yesterday.

  18. Leeny
    Posted March 26, 2009 at 5:43 pm | Permalink

    I just gave a presentation on HPV today for a class, and another issue about vaccinating boys for HPV is that only vaccinating girls (i.e. only ~50% of the population) makes it essentially impossible to achieve the herd immunity required to truly reduce the transmission of the infection in a population (particularly because there is no way in reality that 100% of girls will be vaccinated). In Britain they had tried to just vaccinate females for rubella, and they only saw only a small decrease in prevalence of congenital rubella problems, and only after they started gender-neutral immunization were they able to achieve more complete and rapid reduction of infection.
    Another interesting facet of the male immunization debate is that the HPV vaccine for men has become associated with homosexuality, with the misconception that only gay males need the vaccine. A quote from a BBC article: “It is bad enough suggesting to people that their 12-year-old daughter might need a vaccine against a sexually transmitted infection. I would be interested to see the response of suggesting to parents that they should vaccinate their boys at 12 in case they become gay.”

  19. jouissens
    Posted March 26, 2009 at 6:19 pm | Permalink

    When Gardasil was in development, I sat screaming into a void of silence: Why aren’t you developing this vaccine for _men_ instead of women? It was, of course, a rhetorical question: they were making it for women instead of men for the same reason they made contraceptive pills for women, viz– the bankrupt, ideologically-inflected epistemology which shapes science as a whole, and which is responsible for the fact that women have, since the inception of even the _concept_ of biochemical interventions as birth control, always been the ones automatically chosen to bear the burden of (sometimes quite substantial) side effects and risks.
    As a scientist, I can tell you outright that there is, quite simply, not one single physiological reason to pursue hormonal manipulation of women instead of men (i.e. it isn’t in any way “easier” to alter female bichemistry such that reproduction is inhibited than it is male.) While the “novel” notion of “the pill for men” has occasionally arisen several times over the past decade, it’s never been pursued seriously, and researchers attempting it encounter a dearth of funding – if, however, you want to research yet ANOTHER birth control chemical for _women_, you will find staggering funds available to you.
    I’m not suggesting that Gardasil is “bad”, or that sexually active women shouldn’t take steps to protect themselves from HPV – what I am doing is noting the rather savage equation: men are the primary carriers and spreaders, but it’s on women’s bodies that science pinned the vaccine and the attendant risks – it is merely another repetition of the same uninterrogated masculinist biases that govern western medicine, which render female bodies as objects free to be tampered with. I suppose it’s “encouraging” to see that Merck is considering pursuing the male market (although that’s the only reason they’re doing it – more market revenue capture), but frankly I’d be surprised to see it come to fruition.

  20. SilverAeris
    Posted March 26, 2009 at 8:03 pm | Permalink

    “which render female bodies as objects free to be tampered with”
    It is exactly this issue here. The female body is seen as being okay to mess with. It’s the history of the female body being used to being subjected to. Subjected to public domain, to public consumption, etc.
    The male body isn’t seen as something to mess with. Important: but it can be when issues of race arise. It’s something that only belongs to the man.
    This issue was brought up in my science and technology studies class. The issue is one of operability a term Lawrence Cohen brings up.(his article on kidney transplants in India with regards to this term is good) “Cohen posits operability as the degree to which a person’s relationship with the state is mediated through invasive medical commitment.” Women have this history more so than men. The coerced sterilizations, the frightening effects of the pill when it first came out, and the whole “is it safe and effective?” question not being raised a whole lot when it comes to women, because does it really matter? Women are used to it.
    This operability of women is something that bothers me very much so. I am very protective of my body and if there’s an option where I don’t have to put anything in my body then I take it. (I’m not allergic to latex, so wow the condom is my best friend. and free in my area)
    It would be interesting to see the HPV vaccine approved for men as well. I doubt I’ll see a mass media campaign urging them to take it and I doubt it’ll take off. But, it also prevents 90% of the cases of genital warts, and I think most guys don’t want warts on their dick, so if this angle is emphasized I could see more guys going for it.

  21. Brandi
    Posted March 26, 2009 at 8:15 pm | Permalink

    Actually it’s not something I want to see mandated. My daughter will have the option to get it when she’s old enough to make that decision (probably not at 9, which is the age our pediatrician recommends), but I view it as a reproductive health issue. I’m adamently opposed to making any reproductive decisions for my children.
    In our state, the debate has focused not on it encouraging promiscuity, but on requiring it as a public health issue. We’re really seeing the other side of the debate.

  22. Brandi
    Posted March 26, 2009 at 8:17 pm | Permalink

    It also should be noted that getting the vacccine and/or not having HPV does not mean you will not get cervical cancer. I’m sure many know that, but it seems to be a common misperception I see.

  23. czarnick
    Posted March 26, 2009 at 8:19 pm | Permalink

    I think this is a good example of someone claiming credentials online they don’t actually possess. If you really understand the history of “the pill,” you’d know serendipity permitted its development and not some focused, patriarchal effort.
    Biochemically, it’s much easier to alter the course of one egg a month than the constant development of sperm. As for funding, there are significant non-scientific barriers to development of any new contraceptive.
    Nice rhetoric though…

  24. orgostrich
    Posted March 26, 2009 at 9:11 pm | Permalink

    The female body provides a mechanism for preventing menstruation- pregnancy and lactation. There is no natural equivalent in men. Actually, to prevent spermatogenesis in men requires removing FSH and testorone, which would be difficult to do and have severe side effects.
    Also, safety might be discussed more in men because there is equal risk of side effects but fewer direct benefits. And since men aren’t affected by the virus, conservatives might think that they are less likely to change their behavior because of the vaccine. However, I don’t believe anyone would actually change their behavior because of the vaccine.

  25. thegecko
    Posted March 26, 2009 at 9:52 pm | Permalink

    The majority of the debate surrounding this vaccine is whether it’s “moral and proper” to make it available at all; the question of mandating it has been a more recent issue.
    I do disagree with your line of thinking on this issue though; the reason this vaccine is recommended for girls of such a young age is that the point is to give them immunity before they are exposed to the virus. As you stated in another comment above, by the time you are infected, it’s too late for the vaccine to help you.
    As long as the vaccine is safe and effective, it is no different from any other vaccine. Making the decision to immunize you daughter against one more pathogen is not the same as putting her on birth control pills, having an iud implanted, or signing her up for sterilization without her consent. 1 in 4 females ages 14-59 are thought to be infected (http://www.medicalnewstoday.com/articles/64137.php) and 50% of sexually active adults in this country will have some strain of HPV at some point in their lives (http://www.cdc.gov/std/HPV/STDFact-HPV.htm) so this is very much a public health issue. HPV causes warts and strains 16 and 18 (which are covered by the vaccine) are thought to be the culprits in 70% of cervical cancer cases.
    A virus is a virus is a virus…regardless of the mode of transmission. As long as this vaccine is safe, making the decision to have a child immunized for HPV is conceptually no different from getting them MMR, tetanus, or Hepatitis B vaccines. The difference only exists in our minds because we are socialized to view sexually transmitted diseases as consequences of indiscriminate behavior.

  26. mikeymikemike
    Posted March 26, 2009 at 10:05 pm | Permalink

    Gardasil was first approved for women 12-26(through the FDA’s quick testing for cancer and AIDS related drugs). Men, who do not have the cancer risk, have a longer trial period. Also Gardasil is being tested in women over 26. Why did they choose 26 as the cut off? I don’t know, but as women (and men) side effects of medications increase. (More likely to have health problems, being on other medications etc.) Hopefully within vaccines for all women and men (and maybe young children or infants). The overall incidence of HPV should drastically decrease, as long as the vaccine is cheap and widely available.

  27. aftercancer
    Posted March 26, 2009 at 10:35 pm | Permalink

    I have to say that as a Mom of both a boy and a girl I don’t really care why this conversation is going on, I’m just glad it is. There has been research coming out lately that not only does HPV cause cervical cancer but oral cancers as well (for the reason you expect). This virus may never be completely eradicated but it could certainly be much better contained. A few hundred dollars for a shot is nothing compared to the costs of treating cancer. Believe me, I know.
    Kate @http://aftercancernowwhat.blogspot.com

  28. Sigmund
    Posted March 26, 2009 at 11:48 pm | Permalink

    …?
    I was replying to your comment because I was curious if I had overlooked or misunderstood something about the HPV vaccine, specifically the one for women, which seems relevant enough. It was not intended as an attack on your memory.

  29. Rowan
    Posted March 26, 2009 at 11:55 pm | Permalink

    The conversation about the HPV vaccine usually balances between the conservative religious sect of anti-sex-ers and the pro-woman and feminist section that doesn’t think that a medicine or education causes sex (pssst…being a human causes sex!) and has been told the vaccine is a great thing. I think we should be talking about the motives of the pharmaceutical industry and if this vaccine is actually safe or helpful. They don’t know if it’s really going to last past 4 years. Cervical cancer usually takes years to develop, and they know that it vaccinates for those 2 strains of HPV, but not really if it prevents cancer. I’ve read a joke that the HPV Vaccine actually stands for the Help Pay for Vioxx Vaccine, being the most expensive vaccine ever put out on the market. Pharmaceutical companies are not benevolent beings, creating products because they care. They exist to make money and we should never forget that.
    Good stats to know:
    92% of women who have an abnormal pap smear will have a normal one within a span of 2 years. There are about 3,000 women who die from cervical cancer per year, compared to the 40,000 women who die from breast cancer every year. I’m not diminishing those women’s deaths in any way. But pap smears have made that number as low as it is. Between 1955 and 1992, cervical cancer deaths in American women dropped by 74 percent due to routine pap smears.
    There have definitely been adverse effects reported due to the HPV vaccine, and interestingly enough, there have 32 deaths reported as of 12/08, according to the CDC. Imagine if 32 women would have died from RU-486 by now? There would be an uproar. Cancer is always easier to stand up for than abortion.
    I’m not diminishing the risk of HPV, but I really dislike scare tactic sex education. It’s disrespectful. But long term effects of Gardisil won’t been known for years and years. I just don’t know. I really distrust it. And I don’t agree with mandatory vaccination; health care should be self-determined. There’s this Public Health vaccine-lovin’ bandwagon that feels good to jump on, but I think putting possibly dangerous medications into young girls’ bodies deserves more analysis and thought than that.
    I do absolutely agree that of course this medicine was directed at women. OF COURSE. Bleh. Nothing more to say about that except for a continuing theme of devaluing women in our society.
    Just some alternative veins of thought to work out your brains a little bit! Have a nice night. Check out these links:
    http://www.nvic.org/
    http://www.nvic.org/vaccines-and-diseases/HPV/infectionfacts.aspx
    http://www.cdc.gov/vaccinesafety/vaers/gardasil.htm
    http://abcnews.go.com/Health/story?id=5620282&page=1

  30. jouissens
    Posted March 27, 2009 at 8:38 am | Permalink

    “focused, patriarchal effort”
    I’m well aware (in great detail, actually) of the history of the development of oral contraceptives, and there is nothing remotely serendipitous about how it came to be that _women_ were (and still are) the sole focus of such intervention. Interpellation is precisely that which operates culturally beneath the realm of the conscious; the piece in no way suggests that the guiding epistemological assumptions that have shaped science in the west are “deliberate,” and therefore this sentiment is misplaced.
    “Biochemically, it’s much easier to alter the course of one egg a month than the constant development of sperm.”
    This has been disproven widely enough that I need not recapitulate. It’s nothing short of amazing how often and how widely I hear that particular myth parroted verbatim, and it’s one of the best examples of just how deeply interpellation shapes most people’s consciousness. The history of western science is replete with examples of precisely this type of fallacy, “facts” which are vehemently argued to be objectively true that are later shown to have been merely the result of deep-set ideological biases. But it is the tenor of your response that I find the most distressing. While many of my colleagues pay lip service to bridging the gap between academia and the wider culture, I seem to be one of the few who actually _tries_; when I do and see what it prompts, I understand why they don’t.

  31. MissKittyFantastico
    Posted March 27, 2009 at 8:43 am | Permalink

    I got it through student health at my university when it first came out and I dont’ remember exactly how much I paid but I think it was between $100 and $300. I’m pretty sure I would remember if it were $600! But maybe student health had a special deal (hopefully now that its been around longer, they have a deal where its free for students).

  32. jouissens
    Posted March 27, 2009 at 8:48 am | Permalink

    Just a note in passing, on the chemistry here: It’s simply untrue on its face that altering men’s hormones is somehow more “difficult” or “dangerous” than altering women’s (and, of course, it wouldn’t require “removing” FSH and testosterone in toto). It’s also perfectly possible that spermatogenesis could be interrupted in a variety of non-hormonal chemical ways.

  33. czarnick
    Posted March 27, 2009 at 9:12 am | Permalink

    There’s a big gap between knowing in principle that you can inhibit some enzyme or block some receptor and developing a safe, effective and efficient drug. They are not perfect, but beating the standard set by female contraceptives would be a difficult academic exercise, much less an industrial excursion.
    I still think it would be interesting to question all the successful female natural and medical scientists in the world about how warped their epistemological base is. Certainly, organized academic science has long wrongly been an old boy’s club. I’ll concede also that in medicine specifically very odd ideological strains (racist, sexist etc.) of thought have influenced decision making in the past, but by and large the “western” scientific method is sound. Yes, in science former truths are often overturned, but the basic molecular biology and medicinal chemistry of oral contraceptives are sound. A good natural scientist would certainly acknowledge the limit of our collective knowledge of biochemistry, but I think this is one area we’ve worked it out pretty well.

  34. Brandi
    Posted March 27, 2009 at 9:15 am | Permalink

    We selectively vaccinate, so the “it’s just like MMR” isn’t as effective a line of reasoning with me as it may be with other parents.
    Regardless of that, I don’t believe that Gardasil is the same as any other vaccine. The bottom line is that there is an action involved in getting exposed to HPV that isn’t there with polio. I believe if something is related to my children’s reproductive health, then it ultimately is their decision to make. If my daughter at 9 believed she should get it after we’d discussed it, then I would be happy to pay for it. I’m just not going to choose for her to get it.
    I feel the same about any hormonal birth control. If she wants to use it, I will happily pay for the prescription. As soon as I believe sex could be an issue for either of my children, we will make a stash of condoms available to them. I’m not making the Gardasil decision hers because I don’t believe it’s important but because I believe it’s more important to help her take control of her reproductive health.
    I’ve honestly not heard much of the idea that Gardasil promotes promiscuity. I’m sure the argument is there – it’s the same as the idea that making condoms available will encourage teens to have sex. The argument where I am has been consistent in that it’s about requiring the vaccine for girls to continue to go to school past 6th grade.

  35. alixana
    Posted March 27, 2009 at 9:53 am | Permalink

    As far as the age cut-off, my obgyn said that there wasn’t some well-thought-out medical/health reason for choosing 26 when they did the initial trials. If someone has information to confirm/refute this, I’d be interested to hear.

  36. everybodyever
    Posted March 27, 2009 at 10:00 am | Permalink

    I agree, and I’m surprised so few people have brought this up. (Above, I read comments like: “As long as the vaccine is safe and effective, it is no different from any other vaccine.” But its safety is far from established.)
    Of course a vaccine that can be summed up as a miracle drug as easily as Gardasil can be will be approved by the FDA as quickly as possible. And we know the FDA is far from infallible. I’m really uncomfortable with the idea of making junior high school girls both guinea pigs and mandatory paying customers for Merck. I’m really, really skeptical of the state lawmakers who want to require it for public school students and have assumed any who wants to is in the pocket of the company.
    I hadn’t heard the “help pay for Vioxx” acronym, but I wouldn’t be surprised. I don’t know how much Merck itself makes off of each Gardasil sale — I’m assuming a good chunk — but $4.85 billion requires a lot of vaccines…

  37. MissKittyFantastico
    Posted March 27, 2009 at 11:06 am | Permalink

    What 32 deaths are you talking about? I’ve read about cases where someone got Guillan-Barre syndrome after being vaccinated, but the study concluded that there was no higher rate of people getting that after teh vaccine than there was in the general population, ie, it was just a coincidence. I would’t be at all surprsied that 32 girls died of some disease after getting the vaccine– the point is has someone shown a clear causal link between them?

  38. pepper
    Posted March 27, 2009 at 11:20 am | Permalink

    the vaccines are targeted toward the hpv strains that cause most cancer and genital warts. men get genital warts. men infect women with hpv. how is this only a female issue?

  39. thegecko
    Posted March 27, 2009 at 11:26 am | Permalink

    We selectively vaccinate
    As someone else pointed out in another comment, selective vaccination is not an effective way to gain control of and/or eliminate a virus. Vaccines work through herd immunity; we may be selectively vaccinating right now, but in the long run this really isn’t the most effective strategy if we truely want to eliminate the virus. If you want an example, see the comments on Rubella-the initial strategy there was to only vaccinate the women as well, and there was no significant decrease in infection rates until it became universal (for any who may not know, MMR stands for Measles-Mumps-Rubella).
    The bottom line is that there is an action involved in getting exposed to HPV that isn’t there with polio.
    I’m sorry, but I just can’t see why that should matter. Obviously it’s none of my business how you choose to rear your children, but I don’t see why parents get so hung up on the idea of their children becoming sexual beings someday. Realistically, most people will become sexually active before they reach the age of majority, and most people will have more than one partner over the course of their lives. For me, the only question I would want answered would be: “Is this vaccine safe?” Now, there has been some legitimate debate about that, and I could completely understand if you were hesitant because you wanted to see more data on safety and effectiveness, because you thought this was released to the public too soon, or because you were concerned by some of the examples Rowan points out below. However, at the end of the day, it’s just another virus with a socially controversial mode of transmission.
    I’m all for letting young women and girls take control of their reproductive health, but I also believe that if you’re going to make her a part of the decision, you need to broach the subject with her before she’s at risk of being infected.

  40. thegecko
    Posted March 27, 2009 at 11:44 am | Permalink

    Based on what I’ve been able to dig up, there’s been some disconcerting incidents but not enough investigation to determine a causal link. For example, I heard a story from a family friend (who is a gynocologist) several months ago about a young woman who passed out after receiving the vaccine…however it was later determined that she had not eaten anything that day prior to coming to the doctor’s office in the afternoon, and was apparently not feeling well before she even stepped into the examining room. There probably needs to be some rigorous investigation to rule out any dangerous side effects since the question has been raised.
    There are dangers with some vaccines (i.e., you don’t want to be injecting live attenuated types into someone who is immunocompromised) and it’s a good idea to police them for safety, but a lot of the historical scares revolving around them don’t seem to hold up to investigation.
    My biggest gripe is the societal attitude Jessica highlighted in the OP: “We can’t give it to the girls! They’ll take it as a license to have sex!” vs. “We can’t give it to the boys! It might not be safe!”

  41. wyo_cowgirl
    Posted March 27, 2009 at 11:58 am | Permalink

    RE: Deaths from HPV vaccine . . .I have done some reading on this in the past, and if I recall correctly, found information supporting what MissKittyFantastico suspects: 32 deaths of individuals who had received the Gardasil vaccine at some point in the recent past were recorded, but had NOT been causally linked to the vaccine. I realize it’s kind of obnoxious to make that statement without providing a link . . . so I’ll have to look this up again and have it ready for the next time this topic arises!
    On another note, one thing I’m surprised hasn’t been touched on more frequently in discussions of HPV and public health: the cost of treating the damn virus in individuals who develop symptoms short of actual cervical cancer. Warts in both genders, and abnormal cervical cell changes in women are incredibly common, and can require expensive treatment and monitoring. I can’t speak directly to the cost of treating warts, but I suspect in more persistent cases the bill can run pretty high. I can say from experience that a series of abnormal pap smears and colposcopies (viewing the cervix with a microscope and taking samples of abnormal tissue) is ridiculously expensive. Just monitoring this disease for two years before my body cleared it cost me just shy of $3000.00,and this was without any of the laser or cryotherapy treatments a woman might need if her cellular abnormalities progress farther than mine did. So while many or most women who actually receive preventive screenings and early care do NOT progress to full-blown cervical cancer, there is substantial cost from the get-go. Obviously not everyone is able to pay for this, meaning they either don’t receive treatment (which can of course lead to the condition progressing until they HAVE to be treated–or someone other than the patient ends up “picking up the tab.” Considering we spend so much time debating the cost to the health care system of a variety of other conditions, I’d be very interested in some statistics about the cost of treating HPV. This might strengthen the case for vaccinating men as well . . .

  42. AgnesScottie
    Posted March 27, 2009 at 1:10 pm | Permalink

    Men are affected by HPV, just less often than women. It protects against two strains of HPV that cause warts, and anyone who has been in a scare tactic middle school health class knows that men can definitely get genital warts. HPV has also been linked to penile cancer, though the number of penile cancers is lower than the number of cervical cancers.

  43. MissKittyFantastico
    Posted March 27, 2009 at 2:13 pm | Permalink

    From what I’ve read, they HAVE done studies and determined there is no causal link. Some people are just determined to be suspicious of vaccines– look at the whole thing with autism. Its been scientifically discredited again and again but people won’t let it go, and now we’re wasting resources on that that could be used to look for the actual cause of autism.
    Some vaccines do have dangers, and what you do is weigh the risk of a side effect from the vaccine against the risk and severity of getting the disease. For example, the smallpox vaccine caused deaths in a certain percentage of the people who got it– but it was much much smaller than the number of people who would die if they actually got smallpox. While there was a decent chance of catching smallpox it was well worth it, but now its not and we don’t give that vaccine to kids anymore.
    Even if 32 people had died directly as a result of the Gardasil vaccine, out of the millions who’ve had the vaccine I bet it still comes out as far far safer than not getting the vaccine. Obviously if that were the case they would/should notify people, but that’s such a miniscule risk compared to the risk of the disease that I would still get the vaccine. As it is, it seems that the idea that those deaths were CAUSED by gardasil has been thoroughly debunked.
    The only risk I’ve ever read that relates to ALL vaccines is the idea that it might “set off” an auto-immune disorder. From what I can tell that hasn’t been proven but hasn’t been thoroughly disproven either. But again, even if it is true, the risk is much lower than the risk of dying of the disease you’re trying to avoid (also in this particular case I think they theorize that those people were most likely prone to that auto-immune disorder anyway, and it could have been set off by any attack on the immune system, like a cold– its hard to say since they don’t really know what causes those disorders yet).

  44. thegecko
    Posted March 27, 2009 at 6:25 pm | Permalink

    The whole vaccine-autism debate makes me nuts. That’s been thoroughly disproven and yet, some folks just won’t let it go. The people who are adamantly anti-vax seem to have forgotten what high rates of mortality used to exist due to the prevalence of pathogenic infection. A lot of children in the bad old days didn’t live to see adulthood, and those deaths are entirely preventable today. I’ve been seeing articles crop up here and there regarding outbreaks of measles and mumps in the U.S. because parents won’t vaccinate their kids.
    I can’t tell you how many people I know that insist getting the flu vaccine can make you sick. I missed my shot this year and have spent the last two weeks getting over an influenza infection. I’ll never skip it again.
    I’ve not had Gardasil myself, but I’m low-risk (married and monogamous) and my insurance doesn’t cover it. Honestly, if money weren’t a factor, I’d probably get it anyway. I’m a lot more afraid of cancer than I am of some dubious side effect.

  45. MissKittyFantastico
    Posted March 27, 2009 at 6:37 pm | Permalink

    Yeah, and the thing is that as long as the vast majority of kids get vaccinated, the diseases don’t spread as much so the kids that don’t get vaccinated will likely be ok. But once you start convincing lots of other people not to vaccinate their kids either, diseases start spreading and become a big problem very quickly.

  46. platon2043
    Posted March 28, 2009 at 2:21 pm | Permalink

    I think you’re off track. Merck wants to make as much money as possible, which means vaccinating every man, woman, and child in the United States. You are sorely mistaken if you think they are trying to give it only to women because they are engaged in some kind of dark devious plot to “experiment” on females. Merck is motivated by money primarily, and its in their best interest to go after everybody.
    So why did they start with women? Because its easy to do studies showing cause and effect with females. Females get cervical cancer, not males. Doing the initial studies on males doesnt make any sense because you can only measure indirect effects thru partner interactions.
    From a business perspective, its important to get maximum return on investment. This is best achieved by operating in stages. Stage I is get the females on board, stage II is getting the males on board. That way you have a steady revenue stream already established when you start the male trials. Why would a company spend extra billions doing both male and female trials simultaneously before you get FDA approval on one subset? That doesnt make financial sense.
    This isnt about some dark plot to “experiment” or marginalize females or take advantage of them. The goal is to make money.

  47. platon2043
    Posted March 28, 2009 at 2:27 pm | Permalink

    Syncopal events (fainting) are a known side effect of vaccines. But thats not because of an inherent cause, but because they are mostly psychologically induced. Its the same thing as drawing blood–people look at it and pass out for psychological reasons. Almost every single one of these cases occurs in adolescents > 12 years old. The older kids tend to perseverate more on the shots and that can cause fainting.
    Even still, its rare. The VAERS (vaccine event reporting system) statistics show that the MCV, HPV, and DTAP vaccines have a syncope rate of about 1 in 10,000. Thats the same as regular blood draws or other processes involving needles. These events all resolve within 10 minutes and there’s no long term complications. The people who have syncopal events with vaccines are hte same people who have syncopal events with blood draws, or draining absesses, or anything involving needles. Its nothign to be concerned about.

  48. platon2043
    Posted March 28, 2009 at 2:31 pm | Permalink

    Even so, how is that a real problem? Its better than just saying “oh well, we’ll see what happens”
    By giving the shots to boys starting age 9, we can prevent millions of women from getting cervical cancer. Yeah, its not perfect and doesnt CURE the disease, but so what? We cant cure smallpox either, yet the vaccination campaign has effectively ended what was once a worldwide scourge. The last case of smallpox in the entire world happened in Somalia in 1977.

  49. thegecko
    Posted March 28, 2009 at 3:05 pm | Permalink

    Yep, I’ve heard of that. The girl I was referring to was thought to have had a spell due to hypoglycemia/dehydration, but I wouldn’t be surprised if there was a psychological component to the incident as well. Some folks just can’t handle needles.

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