What Have We Learned From Bachmann’s Recent Gardasil/HPV Eruption?
Being a scientist makes spontaneous blogging on some topics problematic. A couple of weeks ago, Michele Bachmann made the unsupported claim that HPV vaccination led to “mental retardation.”
At the time two bioethicists— professors Steve Miles at the University of Minnesota and Art Caplan at the University of Pennsylvania—called out Bachmann and challenged her to provide evidence in support of her claim. Miles was first and offered to contribute $1,000 to a charity of her choice. Caplan upped the ante by $10,000. The offer expired with no response from Bachmann. Some right-wing luminaries, including Rush Limbaugh and Ed Morrissey, also came down hard on Bachmann for this claim.
1. Bachmann is not fit to be president.
Since I am interested in biological structure, I wanted to look a little more into the science of the HPV vaccines. Fascinating. Proteins from a variety of human papilloma viruses are produced by genetic engineering. The menu includes viruses that lead to cervical cancer as well as genital warts and other baddies. Such vaccines are a scientific tour de force. I also learned that the adjuvant used to make the vaccine contains aluminum. An adjuvant makes a vaccine more effective for reasons that are not crystal clear. It is possible that this adjuvant is responsible for the pain of injection experienced by those vaccinated.
2. A lot of good and nontrivial science has gone into this vaccine. Producing it is expensive.
Which leads into the final lesson. Or at least into a discussion of what makes the HPV/Gardasil controversy not simply a soundbite matter.
I need to give all credit to Alison Bass for calling this fact to my attention in her excellent essay “Coverage of Rick Perry’s vaccine misadventure misses the point.”
The problem is that the public health benefits of providing HPV vaccines to relatively affluent children may not make a lot of financial sense. Merrill Goozner has explored this idea in his post: “The Gardasil Hustle.”
As Bass points out: “Merck itself estimated it would cost $1.4- to $1.6-billion to immunize young girls from the disease, which can be picked up fairly easily (and much more cheaply) with regular pap smears.”
The distribution of cervical cancer is loaded heavily against the poor. The highest incidences may be found in African-American women and in white women living in Appalachia (see Cancer Health Disparities).
The poor are either uninsured or cannot afford Pap smears.
It may make more sense to use the money spent on HPV vaccinations for Pap smears for poor women who cannot afford them.
There is a lot of money on the table here. The Web is a nightmare for a truth seeker. You can find people claiming that HPV is more cancer causing than cigarettes or that the HPV vaccine is contaminated with HPV DNA. And it is sometimes difficult to know what to make of some of these Web sites. They look plausible. Some are even written by medical doctors, and some doctors put links to them in their tweets. What is the average parent in search of information to do? I’ll post some thoughts on this in the future.
Endnote: Thanks to Alison Bass for her always thought-provoking work.
Picture Credit: Tracy Singleton
(This post originally appeared in the Chronicle of Higher Education on the day after the Ames straw poll.)
Dombey and Son
“As the last straw breaks the laden camel’s back”
Mr. Keillor frequents the Side Track Tap, but there is another place in town, the Birchwood Cafe. It is inhabited by a bunch of lefties, elderly hippies like me, vegans, people with nose-rings and purple hair. You know, that type. They buy food locally and hate Monsanto.
So this morning there was much discussion at the ‘Birch over Mrs. Bachmann’s disembowelment of Mr. Pawlenty, our beloved former governor. Some even felt sorry for TeaPaw but there was a great deal of Schadenfreude. It was the coffee special of the morning.
Yuh see, TeaPaw was the victim of really bad timing. He had cultivated his garden in Iowa for the last two years much to the annoyance of people who wanted him to show some leadership in fixing our budgetary problems in Minnesota. He left us about six billion dollars in the hole. Mrs. Bachmann pointed out some of his other shortcomings in the swordfight, er debate, prior to the so-called straw poll.
Another mistake that Pawlenty made – hindsight being 20/20 – was making such a fuss about Iowa. The Ames straw poll is basically a farce. It costs thirty bucks to vote. Talk about a poll tax. The Ron Paul web site generously offered a free ride from anywhere in Iowa as well as a free ticket. Of course someone had to pay for the ticket, didn’t they?
Intelligent folks—like Romney—didn’t participate. Except Romney was smart enough to show up for the debate and the nation-wide publicity. He didn’t do very well in the straw poll, but no one is asking him to step aside. And of course Rick Perry waited for the day of the straw poll to toss in his Stetson.
The timing thing with Bachmann was remarkable. Pawlenty and Bachmann have never been friends. She did a quick conversion to Iowaism. Everything I need to know I learned in Iowa. Probably kindergarten. That sort of stuff. Pawlenty was also in a bad spot because of his previous encounter with Romney where he wussed out. So when Bachmann put the pin in his balloon, he unwisely struck back. Bachmann is absolutely a master at making critics look bad.
So we’ve basically been spared of both Pawlenty and Bachmann in Minnesota politics for the foreseeable future. Wow, does that feel good.
So now it is on to Perry vs. Romney. Can’t wait. The ‘Birchers think that Perry will do to Bachmann what she did to Pawlenty. Wouldn’t doubt it.
Could I have another cuppa that Schadenfreude, please? (The ‘Birch has wifi.)
PS: I see that Paul Krugman is unhappy that he is losing his whipping boy. He had previously described our beloved governor as an “embarrassing ignoramus.” Krugman had this to say earlier today: “What made Pawlenty fun was that he was supposed to be the smart, capable candidate, someone who actually knew stuff; and yet every time he opened his mouth on policy issues, he revealed that he didn’t know a blessed thing.”
Wikimedia: Adam and Eve
Lucas Cranach The Elder (1528)
(Originally posted on Brainstorm at The Chronicle of Higher Education.)
Those ethically challenged folks at the University of Minnesota are at it again… A couple of years ago we had a dean who served on the Pepsi board even though it seemed a little incongruous for a med school dean to be involved with a company that made products that rotted children’s teeth. But of course we were assured by the Vice President of the Academic Health Center that this conflict had been declared manageable. Then we had the spectacle of a different dean pointing out that after all what was happening with respect to conflict of interest policies was not illegal: “We’re not violating a legal statute.”
And then there have been a number of bimbo eruptions at the Carlson school. An older one involved a faculty member who said of a potential speaker “It’s one thing if you’re bringing in a criminal to speak. But if someone’s under investigation, that’s fair game.” To what should be no one’s surprise given such an environment a student group has recently demonstrated what seems to be, at least, unethical behavior. A Missouri start-up is accusing students in a University of Minnesota class of copying its idea for a business.
So now what? The University of Minnesota has just announced a sizable donation from an outfit called Adam and Eve, purveyors of among other things, porn and hard-core DVDs. The press release announcing this happy marriage contains a link to the Adam and Eve site where wares may be inspected (probably NSFW and must be 18 to log on).
When asked about hardcore porn – something that’s believed to distort a person’s view of sexuality, Eli Coleman, director of the university program on human sexuality replied:
“If this was a company that was into child pornography or something like that, that was illegal, I don’t think we could morally accept something from people who are involved in illegal activities. But this is a company that’s responsible and is law-abiding…”
It is a sad day at a university when the ethical standard is: “If it is not illegal, we can do it.”
Image Credit: Wikimedia Commons
Choirboy Defense: Could these lads do anything wrong?
I realize that many Medtronics employees are heart sick over this situation. I extend my sympathies to them. I once had the honor of visiting with Earl Bakken in my lab on a snowy morning when we were the only ones who made it into work. I took the bus, and he crossed the street from the Radisson. Medtronic is a wonderful company and this situation is disgraceful. My bet is that the people responsible for this will soon be gone. Live long and prosper, Medtronic. Our state depends on innovative companies like yours.
Earlier published in the Chonicle of HIgher Education. and used with permission.
Something remarkable has happened. A whole issue—June—of a prominent journal, The Spine Journal, is devoted to destroying industry-funded research supporting the use of a bio-therapeutic agent for spinal fusion, so-called recombinant human bone morphogenetic protein form 2 (rhBMP-2) in the Medtronic product, Infuse.
This remarkable issue features an editorial that is available for download as a pdf: “A challenge to integrity in spine publications: years of living dangerously with the promotion of bone growth factors.” It initially cites seven research publications for scrutiny. Altogether these studies report zero, nada, side effects in 780 protocol patients. The authors dryly add another citation (from Hemingway’s The Sun Also Rises) to the list: “Yes, isn’t it pretty to think so.”
Since then the side-effects of rhBMP-2 have become widely known. These include conditions related to unregulated bone growth as well as other disorders including sterility in males and cancer.
And what did these criticized studies have in common: Megabucks for the investigators from, primarily, Medtronic. Some of the authors of these studies have financial involvements with Medtronic that run in the tens of millions of dollars.
Sadly, this story is nothing really new to those who have been following the medical-industrial complex for years. At our own place one of the docs got in trouble for testifying in favor of Infuse® research before Congress without letting his audience know that he was a consultant for Medtronic. Senator Grassley was annoyed. I’d also point out that Dr. Carl Elliott (against type if one of my Brainstorm colleagues is correct in her aspersions against the cowardly tenured) has been valiantly crusading against using clinical trials for marketing exercises and other unethical practices in clinical trials. Various administrative attempts to discredit him have been unsuccessful, but he is being criticized even to this day by a flack for the Academic Health Center at the University of Minnesota.
The writers of this piece were really on their game. They point out that one of the openings often used by these shills is the choirboy defense: “We are an honest profession; our integrity is unimpeachable; our ethical standards are not in doubt; potential conflicts of interest are only ‘potential’…” I’ve heard these same arguments used by three medical-school deans so far.
The editorial ends with the primum non nocere statement of the Hippocratic Oath. First do no harm. It admits that harm has been done. At first I was a little disappointed in this argument, but on reflection it really is that simple. I’ve heard a medical school dean justify behavior based on the fact that something was not illegal.
Is ethical behavior too much to ask of the medical profession?
ps. Since the first draft, the matter has gone viral. Paul Thacker—who until recently rode shotgun for Grassley—writes “War Breaks Out Over Medtronic’s Infuse®” and The New York Times chips in with: “Spine Experts Repudiate Medtronic Studies.” The Chronicle now has: “Researchers Paid by Medical Company Missed Flaws in Its Spinal Implant, Study Finds.”
But I have promises to keep
And miles to go before I sleep...
"Affordability for students here and at the University's four coordinate campuses remains a primary concern for the Bruininks administration. In 2009, the president announced the rebranding and expansion of the University's need-based aid strategy to include guaranteed aid for all Minnesota students from low- and middle-income families." (source)
Here's the start of an investigation into the shell game that is the so-called Promise Scholarships at the University of Minnesota. These have been held up as an answer to the dilemma posed by a high tuition model at the U. Supposedly students with great financial needs would be sheltered from the devastating costs of college and the resulting staggering debt loads.
The promise is an illusion.
To begin this discussion results may be found below for a cost comparison between two public universities, the University of Minnesota and the University of North Carolina. These results were obtained by entering data in forms provided by both universities on the web to estimate the actual cost of attendance, as well as debt load. If you'd like to try it yourself, go here and sign in as "guest."
Then fill out the forms for these colleges making sure that the so called AGI is zero, so that the student/parents are absolutely unable to contribute to the cost of education. You should get the following numbers. I intend to discuss them in a little more detail shortly, but the results are striking and indicate that Promise Scholarships need re-thinking. The net cost at the U of M is $11,268 and the student/parent is expected to borrow $8,600 per year for a staggering four year debt of $34,400.
Contrast this to the situation at the University of North Carolina where a student with the same financial resources would see a net cost of $2,700 with loans of ZERO to the student/parent.
Some quibbles may be made over this analysis but it is obvious that something smells bad in Morrill Hall and it is not the President's fish.
To illustrate the challenge of getting Morrill Hall to face reality, see a portion of the short video of President Bruininks being interviewed by Esme Murphy this morning on 'CCO. Truly a Five Pinocchio performance.
1. Very few universities have not seen a marked increase in applications: More than 28,000 students applied to be part of UW-Madison's freshman class in the fall, a record number and the biggest increase in at least 20 years
2. The Promise Scholarship pot of gold - $350 million - at 5% will yield $70 per student based on an enrollment of 25,000 undergrads.
3. President Bruininks has the chutzpah to claim: "The quality of education is better now today than it has been in any of the 42 years that I have been at the University of Minnesota."
There is plenty of evidence to counter the President's claim, for example:
There will be more on this in due course. We have a lot of work to do at the University of Minnesota so that we can be an institution of which the state can be proud. I hope the next administration does a much better job and re-establishes our land grant priorities.
However it is important to face up to our problems and not try to sweep them under the rug. This strategy has been a dismal failure.
Added Later: Response from Chris Coughlan-Smith:
Hi, Professor Gleason. I can assure there is no effort to suppress discussion on this community. We have a policy in place on the approval of discussions, filtering commercial and promotional items to the correct area and deleting only profane and offensive material.
An error appears to have been made over the weekend and our policy has been reiterated with all who moderate the discussions.
I've personally approved Mr. McNabb's comments in the past and will continue to do so. I wish one of you would have asked someone in this office for a clarification. Thank you.
Chris, group founder and owner
Image Credit: Wikimedia Commons
Recently I learned of yet another attempt to stifle criticism at the University of Minnesota. It is sad, indeed, that the administration and the alumni association are engaging in the tactics of censorship and intimidation.
I sincerely hope that the next president will not tolerate this kind of activity at our university.
From my friend and fellow alum, Michael McNabb:
The University of Minnesota Alumni Association has a LinkedIn web site for posts submitted by alumni. I have sent several single sentence posts with links to essays in The Periodic Table, such as:
See the attached My Activity section of the UMAA site.
On April 30 the UMAA site blocked the submission of a single sentence post [Administration seeks to stifle criticism of research] with links to these posts:
When I scrolled down to the end of the My Activity section I saw the following question:
Are you sure that you want to permanently remove, block and delete all contributions from this member?
Then I checked the main section of the UMAA site and saw that my previous posts had been deleted.
The mission statement of the Alumni Association states that it is "dedicated to connecting alumni, students and friends in lifelong support of the University of Minnesota and each other."
It appears that the Alumni Association considers the current administration and the University to be one and the same for it excludes any perspective that challenges a course of action undertaken by the administration. (It is far easier to exclude than to allow alumni to hear different perspectives and to engage in an exchange of ideas.)
A "guiding principle" of the Alumni Association is that it "represents the independent voice of the alumni." See the UMAA site above. By excluding different perspectives of alumni the Alumni Association acts as the representative of the administration to silence the independent voices of those alumni.