This week's column: HPV battle ahead

This week's Exile on Jones Street column is about the move by fundamentalists to keep NC from requiring HPV vaccinations. The vaccine is highly effective against the virus which causes most cervical cancers. Also, an update on Rep. Price's oversight plans for the DHS, plus 'Canes in the big man's house and a quick note about how the Bonds of 2008 are shaping up.

Here's the text:

North Carolina is considering adding several more vaccinations to the list of what the state will pay for to inoculate poor and indigent children. On the list is a vaccination against HPV—Human Papillomavirus—which causes most cervical cancer. That's OK, says the N.C. Family Policy Council, a fundamentalist group that has argued against universal HPV vaccinations.

But if the state wants to take HPV prevention any further, as in requiring girls to have the vaccination before entering school, the council says they'll fight it just as other groups have done elsewhere. South Carolina is already in the midst of a push to require the vaccination, and last week Rick Perry, the Republican governor of Texas, bypassed a fight in the legislature by issuing an executive order requiring the vaccinations.

After the U.S. Food and Drug Administration approved the vaccination last year, N.C. Family Policy Council President Bill Brooks said his group would follow the lead of Focus on the Family, which has argued that the vaccinations could promote sex before marriage and lead to greater risk of sexually transmitted diseases. Brooks issued a statement after the FDA ruling that said: "The development of a vaccine against cervical cancer is an important medical advancement and we support its availability. However, since HPV is unique among other routinely vaccinated diseases because it is contracted through sexual activity and not casual contact in a classroom like the flu or measles, we believe that parents, and not the state, should have the final say about whether to vaccinate their child."

HPV is almost exclusively the cause of cervical cancer, which is the second-leading cause of cancer deaths among women worldwide and kills roughly 4,000 women in the United States annually. Gardasil, the new vaccine, has proven to be 100 percent effective against the types of HPV that cause two-thirds of all cervical cancers. Another vaccine is under development.

Price to hold hearings

Even before the appointment of 4th District U.S. Rep. David Price as chair of the House Appropriations Committee that oversees the Department of Homeland Security budget, the Chapel Hill Democrat was high on the must-visit list for DHS Secretary Michael Chertoff. The two had an informal visit at Price's office in December.

Now, they'll meet in more formal circumstance as Price gears up hearings on policies, funding and priorities for each of the department's 22 agencies.

Price has said he believes the department has over-emphasized anti-terrorism programs and needs to shift priorities and funding to better deal with general disaster preparedness and support for first-responders.

Hat trick
Not sure why it was 6th District U.S. Rep. Howard Coble of Greensboro standing up there with the Carolina Hurricanes, President Bush and this state's two senators as the Stanley Cup winners made their official trip to the White House.

Maybe the Democrats from Raleigh were busy or maybe they didn't want to hear the president wax poetic about coach Mike Commodore's hair or tell the winners how he likes people with low expectations.

And Coble, who along with fellow N.C. GOP Rep. Walter Jones is opposing Bush's escalation plans, didn't get a real friendly welcome either.

"Fine looking lid, isn't it?" the president said, referring to Coble's championship Canes hat. "I thought you might be wearing that to cover up your bald head."

On top of that, as of Monday morning, the 11-term congressman's name was still spelled "Koble" on the White House Web site.

Bond watch
Still basking in the glow of North Carolina being one of only seven states with top marks from all three bond rating agencies, State Treasurer Richard Moore released his assessment of how much debt the state can afford to add each year over the next 10 years. Moore says strong revenue growth and low interest rates have allowed the amount to rise from last year's estimate of $214.4 million to $384 million for this year. That opens the door for a larger dollar figure on any bond referendums that would go to the voters in 2008.



Is anyone working on a full-blown expose on the NC Family Policy Council and its death wish for women who have sex?

Q: Why should I get my daughter vaccinated with GARDASIL now? Can't it wait?

A: Like other vaccines, GARDASIL works to help prevent illness. GARDASIL works when given before there is any contact with HPV Types 6, 11, 16, and 18. That’s why it’s important that you talk to your daughter's doctor or healthcare professional about getting her vaccinated with GARDASIL now—not later. You’ll be helping to protect her future from cervical cancer and genital warts even before she is old enough to worry about them.

GARDASIL is given as 3 injections over 6 months and can cause pain, swelling, itching, and redness at the injection site, fever, nausea, and dizziness. Only a doctor or healthcare professional can decide if GARDASIL is right for you or your daughter.

Maybe the theocrats don't mind their own daughters dying, but why do they want to stop others from saving the lives of their children? NC isn't talking about forcing anyone to have this vaccine that I can see. We're talking about paying for it as a part of our so-called public health system.

I rarely find myself siding with Big Pharma on anything, but this one seems like a no-brainer.

Clarifying a bit

Not to jump to their defense, but the FPC said it would be OK to approve it for payment by the safety net programs, but doesn't want it to be required along with the other health check ups and vaccinations--measles, polio and so on--students need to have before they're enrolled in school. The vaccine is approved for ages 9-26, so it would probably be required prior to the fourth or fifth grade.
The idea that it gives young women a false sense of security about STDs is a rather stunning argument given that this is a life-threatening disease.

This is why you're the journalist

and I'm the hot head. Thanks for the clarification.

It seems to me that the risk to women would be greatly reduced if their parents routinely got them vaccinated while they were living at home rather than waiting until sometime "in the future."

Maybe it should, at the very least, required before a marriage license could be granted to the abstinence-only crowd? That would make sense, except for the fact that the abstinence-only crowd engages in risky pre-marital sex just as often (or more in some sub-segments) as those who don't sign abstinence-only pledges.

Don't mind vaccinations, but...

Let us please make sure the disease against which we are vaccinating is worse than the vaccine.

I have two little girls. I do not want them to come up sterile or worse 10 years out because the greedheads at big Pharma and their whores in politics needed a fix now.

Sorry. This ain't smallpox. Or polio. Or even tetanus.

We are talking about exposing millions to side effects so that they MIGHT not get a cancer 30 years later, vaccinating against a virus causation which is at best unproven.

I think I will opt out for my children just now.


I'm sorry. I forgot we're in an age where science=politics and all research is questionable.

From the FDA announcement cited above:

"Today is an important day for public health and for women's health, and for our continued fight against serious life-threatening diseases like cervical cancer," said Alex Azar, Deputy Secretary, U.S. Department of Health and Human Services (HHS). "HHS is committed to advancing critical health measures such as the development of new and promising vaccines to protect and advance the health of all Americans."

HPV is the most common sexually-transmitted infection in the United States. The Centers for Disease Control and Prevention estimates that about 6.2 million Americans become infected with genital HPV each year and that over half of all sexually active men and women become infected at some time in their lives. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths attributed to it in the United States each year. Worldwide, cervical cancer is the second most common cancer in women; and is estimated to cause over 470,000 new cases and 233,000 deaths each year.

For most women, the body's own defense system will clear the virus and infected women do not develop related health problems. However, some HPV types can cause abnormal cells on the lining of the cervix that years later can turn into cancer. Other HPV types can cause genital warts. The vaccine is effective against HPV types 16 and 18, which cause approximately 70 percent of cervical cancers and against HPV types 6 and 11, which cause approximately 90 percent of genital warts.

"This vaccine is a significant advance in the protection of women's health in that it strikes at the infections that are the root cause of many cervical cancers," said Andrew C. von Eschenbach, MD, Acting Commissioner of Food and Drugs. "The development of this vaccine is a product of extraordinary work by scientists as well as by FDA's review teams to help facilitate the development of very novel vaccines to address unmet medical needs. This work has resulted in the approval of a number of new products recently, including Gardasil, which address significant public health needs."

Gardasil is a recombinant vaccine (contains no live virus) that is given as three injections over a six-month period. Immunization with Gardasil is expected to prevent most cases of cervical cancer due to HPV types included in the vaccine. However, females are not protected if they have been infected with that HPV type(s) prior to vaccination, indicating the importance of immunization before potential exposure to the virus. Also, Gardasil does not protect against less common HPV types not included in the vaccine, thus routine and regular pap screening remain critically important to detect precancerous changes in the cervix to allow treatment before cervical cancer develops.

"This is the first vaccine licensed specifically to prevent cervical cancer. Its rapid approval underscores FDA's commitment to help make safe and effective vaccines available as quickly as possible. Not only have vaccines dramatically reduced the toll of diseases in infants and children, like polio and measles, but they are playing an increasing role protecting and improving the lives of adolescents and adults," said Jesse Goodman, MD, MPH, Director of FDA's Center for Biologics Evaluation and Research.

Thanks for trolling.

He's not a troll just because he disagrees with you

and while I will agree that a causal relationship has been proven to exist, the side effects of the vaccine have not been determined. I opted out of new vaccines for RA as so many friends jumped on for a quick pain fix. Sorry, I'd rather live with pain, than die from the cure.

I too will wait to see what develops with the vaccines. My children are not sexually active and this will be added to our discussions about birth control, STDs, love, etc as they become sexually active. This is a decision they will be a part of.

Vote Democratic! The ass you save may be your own.

if so, sorry

the name threw me.

There is a new vaccine in the pipeline.

Not trolling

Let's see... FDA says so.

Were they right about, oh...


swine flu?

agent orange side effects?

gulf war syndrome?

Oh, yeah, I can see where believing them, especially with the greedheads in charge of it now makes perfect sense.

All I am saying, with girls 11 and 7, is I will wait. We will discuss it at length.

And stop calling me a troll. I am an elf.

then sorry

I've actually had elfin friends.

They make good cookies

and I hear they do a mean job on shoe repairs.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

They Are -

Especially if you wave dollars under their nose.

Let's not pick on the FDA

I mean, this administration's political appointees have got to go, but the FDA does a pretty good job. Consider:

  1. The FDA is actually engaged in a balancing act. If they require that everything be 100% safe before it goes out the door, then the utility of a drug that is 99.9% safe is wasted. Of course, if they went 100% for speed, then people would be dropping left and right. The ideal solution -- and this sounds screwed up, but I think it's true -- is for the FDA to strike a balance between speeding new drugs to market and making sure they're safe. To put it negatively, FDA officials are in the business of making sure that some people are waiting for medicines they direly need to get out of testing and other people are dying from bad interactions; that's where your maximum utility is. It's not a job I'd want.
  2. We actually need more, not less, FDA. I'm thinking of diet pills and herbal supplements. Have you seen some of the crazy shit people will say their pills can do?

That's just my humble plea for good clean conversation without too much needless trashing of the FDA.

Yes, but that said, we need an FDA

and, for that matter, an entire Federal Government, which is free from influence peddling and junk science which leads to disaster in policy.

Yes. more FDA.

No, not more of the same FDA.


Not true

We are talking about exposing millions to side effects so that they MIGHT not get a cancer 30 years later, vaccinating against a virus causation which is at best unproven.

To the extent that anything in medical science is ever "proven," the HPV/cancer link is proven. Gardasil is 80-95+% effective against the four viruses that cause (yes, cause) virtually all cases of cervical cancer.

I'm not in favor of the state mandating it for school attendance, but parents need to think twice (and twice again) what they would say to their daughters on that terrible day when (statistically speaking) some of them are diagnosed with cervical cancer.

That is a conversation that I am not prepared to have, so my daughters (ages 13 and 10) will start the 3-shot sequence at their next doctor's appt.

Mine are 13 and 11

As long as they are aware of the risks and we discuss them as frequently as we discuss the ills of alcohol, drugs and smoking, I feel my children will be equipped to actively make this decision with us when the time comes. There is another "terrible day" we might also have to face - one where we tearfully apologize for ruining their lives or their chances for happiness because we rushed to give them a vaccine that had not been tested thoroughly. The FDA approves a lot of drugs and I'm most wary of those that are fast-tracked. Gardasil was evaluated and approved in only six months.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

What I didn't say....

(sorry, this is an emotional discussion for parents of daughters...or at least it is for me)

What I didn't say is that I believe this vaccine should be available to everyone. It is very expensive as vaccines go and is likely to stay that way while it is optional. This vaccine should be available to everyone regardless of their ability to pay.

I also would like to see the vaccine developed for older age groups and men. Merck continues to study the effectiveness on men. My big question is why didn't they fast-track the vaccine for men as well? While men can't get cervical cancer, they do spread HPV. Nipping it at the source isn't a bad thing, right?

Vote Democratic! The ass you save may be your own.

Our daughter is 16.

And is at no risk of having sex anytime soon, for all we can tell. She'll be getting the vaccine before her next birthday.

I get that this is emotional . . . we've been having the discussion in our house for more than a year and it hasn't been easy.

I don't have a daughter,

If I did, I would discuss this with her doctor. I know that I was sexually active way before my parents ever thought I was. I also know of three acquaintances in high school (actually one was in junior high school) who was raped.) Not all sexual contact is the young woman's choice. If the doctor I trusted advised me that the vaccine was safe, I'd have my daughter vaccinated. If it were effective and prevented HPV in boys, I'd have my son vaccinated.

"Be the change you wish to see in the world." - Gandhi


It was tested in males, but not as extensively, and since guys don't get cervical cancer, it wasn't approved for them. But with herd immunity, vaccines not being 100% effective, and HPV being passed through boys, they should get the shot too.

I heard somewhere about gay men getting rectal cancer caused by HPV, and that the strains of HPV that cause cervical cancer can also cause penile cancer, which is a lot rarer.

If I weren't over the age limit, I'd go get it myself.

Wikipedia sez:

"A 2005 study in San Francisco found that 95 percent of HIV-infected gay men also had anal HPV infection, of which 50 percent of had precancerous HPV-caused lesions."


Of course...

to the fundies who think that offering the HPV vaccine == encouraging premarital sex, gay men "deserve" whatever they get, so it's not any help that it affects men. If penis cancer happened at the rate of cervical cancer, well, I bet they'd be all over mandatory vaccination.

Is it effective in boys?

and has it been approved?

"Be the change you wish to see in the world." - Gandhi

I'm new at the whole daughter thing

But when mine starts having sex, I imagine that I won't be among the first to know. We'll see about that, but what I know from watching it happen again and again is that parents – smart, rational parents who have achieved a measure of success in their own lives that suggests they generally have no problem living in the real world – can develop blind spots about their own children that make them (the parents) in to total fools. Now I understand that not all parents have that problem, but I'm pretty sure that those who do don't realize it.

That's point number one, and it isn't aimed at anyone in particular, though I fear that I've just pissed SD off. Two: as a "killed virus" (actually "no virus") vaccine, the fear for the future would be that the protein involved might cause some unexpected harm. It's hard for me to understanding balancing that vague and uncertain risk (which really comes with any injection) against the risk of HPV and cervical cancer and coming down on the side of not giving the shot. It seems to me sort of like those people who don't wear seatbelts because they're afraid of not being able to get out of the car after an accident, or because of seatbelt-caused injuries – these risks are very real, but weighed against the risks of not wearing one... we all buckle up.

Third, Pharma Pharma Pharma! Look, disliking a business or industries corporate practices is a really good reason to choose a place to shop, or to call your broker, or even to write letters. But no way is it a reason not to get a vaccine. If we found out tomorrow that Starbucks coffee, and only Starbucks coffee, prevented Alzheimer's, I would be ordering a non-fat no-whip four-pump triple venti white chocolate mocha within the hour.

Nope...not pissed off

also not blind. My girls and I talk...a lot...about everything. I'm not fooling myself into believing that I will be the first to know, but being female and um...actually being able to remember back that far I would say my girls are pretty far behind where I was at their age. The 11 yr old has had the first talk. The 13 yr old has been through sex ed at school so has had the full-blown discussion to make sure what was taught at school was appropriate and adequate. We've covered the "better embarrassed than diseased/pregnant or both" discussion.

Remember - by the time your little one is faced with taking these shots any harmful side effects will be known. Makes it a lot easier for you to render judgment now.

I feel we have the luxury of at least a few more years, but I'm smart enough to know that this decision can be rescinded if need be.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.