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HPV Vaccination: More to It Than Soundbites

  • Blog Post by: Bill Gleason
  • October 17, 2011 - 6:48 PM

 

Capsid Protein L1 of Human Papilloma Virus type 16 - using UCSF Chimera

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.

Lesson 1

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.

Lesson 2

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.”

To put things in perspective, the mortality for cervical cancer is approximately 4,000, for breast cancer 40,000, and for cigarette smoking 500,000.

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.

Lesson 3

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.

 

This piece was first published on the Chronicle of Higher Education Brainstorm blog.

 

 

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