HPV: To Vaccinate or Not Vaccinate

Wednesday, February 28, 2007
HPV: To Vaccinate or Not Vaccinate, that is the question....
With this new blog, I hope it opens eyes and sheds new light on this wanna-be conservative city of not even 250,000. This town has to be the the most naive place in the world. Not vaccinating for high risk HPV may not seem like a big deal now, but how will you feel if you don’t allow or encourage your daughter to be vaccinated and 20 years from now, you are at her bedside holding her hand, as she is dying a horrific death caused by cervical cancer? I am not sure I would be able to live with myself, knowing I may have had the opportunity to prevent this.
I am not a proponent of sidestepping legislation, but I do feel as a mother and Women’s Health Nurse Practitioner, that it should be made available to all those who request it. As far as side effects, there was a total of 102 subjects out of 21,464 total subjects (9 to 26 year old females, and 9 to 15 year old males) who received both Gardasil and placebo reported a serious adverse experience on day 1-15 following any vaccination visit during clinical trials. Most serious adverse experiences for Gardasil compared to placebo and regardless of causality were: headache (0.03% Gardasil vs. 0.02% Placebo). gastroenteritis (0.03% Gardasil vs. 0,01% Placebo), appendicitis (0.02% Gardasil vs. 0.01% Placebo), pelvic inflammatory disease (0.02% vs. 0.01% Placebo). The most common mild adverse experience was injection-site discomfort. I, as a medical professional, feel the benefits outweigh the risks. In the United States, approximately 9700 women are diagnosed with cervical cancer each year (and that is even after the diligent works by medical professionals to diagnose and treat precancerous lesions of the cervix). Approximately 3700 women in the U.S. die each year from cervical cancer. The overall cervical cancer death rate among African-American women is six times that among white women. Cervical cancer occurs most often in Hispanic women (double the incidence of non-Hispanic women). The total cervical cancer incidence and deaths may not seem exceptionally high in comparison to other cancers. It might seem more important if you or someone you love is diagnosed with cervical cancer. One other note, the Gunnell study, 2006, determined a 27-fold risk of cervical cancer in woman who smoke cigarettes and are infected with HPV type 16. Indeed, the utilization of funds to prevent this relatively low number of cancer patients (in the United States) may be put to better use to conquer and or treat other more prevalent cancers such as breast, lung, melanoma, or colon. But if this vaccine could possible prevent my daughter from cervical cancer, I would opt “for it” not “opt out”. What is important to understand is, not all high risk subtypes are covered by the vaccine,16 and 18 account for approximately 70% of all cervical cancers, therefore, it must be stressed that annual Pap smears will need to be continued, regardless of vaccination. Also, the vaccine is estimated to save 3 billion dollars per year by preventing the need for further diagnostic testing and/or treatment of precancerous lesions. As for males, the jury is still out. There are several studies that are being conducted to determine if males will benefit from the vaccine. HPV has been implicated in penile and anal cancer. In a city that has one of the highest rates of Chlamydia, and teen pregnancy, one would think that we would be willing to embrace the effort to reduce the incidence of cervical cancer, Chlamydia and teen pregnancy. Regardless of what one thinks, Lubbock’s adolescents and teens are having sex. Statistics as well as professional discussions with our community of adolescents and teens establish the fact that they are having consensual sex. Our city leaders and citizens should not be so naive.

I think we have bigger problems in the United States than to be up in arms over a viral vaccine.
Since September 11th, the freedoms that are at the core of our democratic society are, for many, no longer a guarantee. Hundreds of innocent Arab and Muslim individuals were rounded up and held for months with no idea why. Prisoners were shipped to Guantanamo Bay, where they have not been afforded the protections widely thought to be applicable under the Geneva Convention. New laws on domestic terrorism and relaxed restrictions on government surveillance of activists threaten long-established traditions of political expression. And perhaps most chilling, these detentions - like many actions by the Bush Administration - have been shrouded in a deep secrecy that is inimical to democratic accountability. I think most Americans gave their blessing to go into Afghanistan after Osama bin Laden (although now I refer to him as Osama bin Forgotten), but last time I checked, Iraq did not attack the U.S. How come almost all of the 9/11 hijackers were from Saudi Arabia? I have yet to see this administration to even question the Saudis. Nope, wouldn’t happen, the Bushes and Cheney’s are good friends with them. Thousands of our troops have been killed and hundreds of contractors. Thousands upon thousands have been injured and/or maimed. The terrorists are sure getting their money’s worth now, all they have to do is set back and wait, and Americans will eventually come by, making it a carnival shooting gallery. I believe the current statistics are 16 are injured for every single killed. This bogus surge, will just give the insurgents a bigger target. This is indeed a quagmire. But what else could we have expected, we invaded their country, overthrew their government (regardless how bad it was) and now occupy their land. As much as I dislike W., if another country invaded the U.S., overthrew our President (W ”Shrub”) overthrew the government, demolished cities and killed almost as many citizens as live in Lubbock, and displaced millions, believe me, I would be right out there fighting and defending our country ( just as the insurgents are). But look at the Iraqis viewpoint. What would you do? They are simply defending their country from the U.S., the aggressors. And now, this administration is playing bully with Iran. The U.S. is now funneling money to the Sunnis, so now we are financially supporting as well as previously training those that are killing us. What happen to diplomacy? I believe it was Eleanor Roosevelt, who wrote to Harry S. Truman in 1948,
“I can not believe that war is the best solution. No one won the last war and no one will win the next war.”

Inscribed on the pedestal of the Statute of Liberty is a phrase coined by Benjamin
Franklin: “They that can give up essential liberty to obtain a little temporary safety
deserve neither liberty nor safety.” Yet not since World War II have Americans
been more willing to sacrifice their individual constitutional freedoms in return for
a promise of greater national security.

And last, Edward Abbey once said “A patriot must be ready to defend his country against his government.” It is time we demand accountability by all three branches of our government. After all, don’t they work for US?