posted
So does California, IIRC. Actually, I believe most states require HepB vaccine. Also DTP, varicella (chicken pox) and a slew of others -- exactly which ones are required and at what ages varies from state to state.
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Essentially, there's a weighing between the damage to society by not requiring vaccinations and the damage to society by requiring vaccines. Some people believe that requiring something is always more damaging (yet are generally willing to countenance at least minimal taxation for defense and basic law enforcement, so they apparently mean always more damaging than being invaded, murder, and theft; at that point it becomes a question of where to draw the line, not if there's a line to be drawn, though), but most people reject this view.
Some things probably aren't virulent enough to justify the harm of required vaccinations. Some probably are. I know you've already touched on this somewhat, but it really does become a question of where you draw the line; if you've already accepted that some things can reasonably be required vaccinations, then its necessary to evaluate the specific criteria that they meet, and determine if other diseases do or do not meet similar specific criteria.
This is a very good way of putting it.
I haven't personally decided which side of the line the cervical cancer vaccine is on. I guess that's what I'm trying to gleam from this discussion -- what is the criteria from determining whether a vaccine is justifiable and does the cervical cancer vaccine meet the criteria?
I don't know right now. I do know that I believe making some vaccines mandatory is justifiable.
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quote:Also, "we don't have universal health care, so we shouldn't vaccinate people" strikes me as a non sequitur.
I don't think it is. My house analogy makes it perfectly clear. Health care in the US is underdeveloped IMO, it needs to be more available, not more specifically mandatory.
There's no reason both things can't be done at once. You need a roof over your head even if your house isn't built yet.
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Farmgirl, I think that is actually an old report. The rotavirus vaccine (I assume it's the same one [actually, this is the new one -- see edit below]) was pulled for intussusception concerns extremely quickly -- it was pulled, reviewed, and the scuttlebutt*** is that it's being cleared and will be reintroduced soon. It looks like this was a false alarm.
***(I trained under one of the top vaccination experts in the country who was working on this, and he kept me updated while I was in residency in the US. He is the vaccine expert on the AAP Redbook (the pediatric infectious diseases "bible"). According to him, this is a case that shows how well the vaccine surveillance and vetting process works: they monitored aggressively for possible problems and pulled it early for thorough review (even if not a real problem).
---
Edited to add: Ah, I think I see what is happening. It's still reassuring.
There were concerns raised about the rotavirus vaccine released in 1998, and it was pulled quickly. The concerns proved unfounded. A new version was introduced in the US last year (not in Canada, though, as far as I know). Now the FDA has put out feelers to see if there are reasons for concerns this go around -- but they are not "warning" people about a new concern.
Actually, the rate of intussusception are lower than would be anticipated as a background rate. That is to say, over millions of times when the vaccine is being given, you would expect to see a certain number of cases of intussusception coincidentally with the vaccination -- not caused by it, but just associated temporally with it because the vaccine is being given to kids at ages when they will be getting intussusception anyway.
However, the surveillance system isn't picking up as many coincidental cases as they expected! So the FDA is going hunting, just to see if the surveillnace system is working.
From the article you linked:
quote:The rotavirus is thought of as the leading cause of early childhood diarrhea. The dangerous condition, called intussusception, is the same that led to the withdrawal of the first rotavirus vaccine, RotaShield by Wyeth, eight years ago. However, FDA says the 28 new cases of the disease are not high enough to exceed the so-called background rate.
The background rate is the incidence expected naturally. "It looks like this is the natural background rate that we are seeing," also said Dr. Michelle Goveia, medical director for pediatric medical affairs at the vaccine's manufacturer, Merck & Co. Inc. Dr. Goveia also said RotaTeq was tested in trials involving 70,000 infants, and that little difference in cases of intussusception were seen in those given the vaccine and those given placebos.
"We believe we designed the study rigorously and we didn't see a ... relationship," she said (six cases were seen in RotaTeq recipients vs. five in placebo recipients).
"It's a known serious, life-threatening adverse event that is being seen at an expected level postmarketing. But because it is so serious, we asked the company to change the label," FDA spokeswoman Karen Riley said. A warning was also posted on FDA's website.
Dr. Paul Offit, the vaccine's co-inventor, suspects the FDA wants basically to "shake the tree" for more reports about the vaccine's adverse effects.
"I am actually encouraged by those data: 28 cases, when you would have expected at least 500 cases, that is really reassuring," said Offit, of the Children's Hospital of Philadelphia. "I don't see how those numbers suggest something's awry. If anything, they suggest nothing's awry." [emphasis added]
posted
CT: I'm glad to see you post that. I heard something about this on NBC news a few days ago but they were spinning it for drama to make it sound like the FDA was concerned. I remembered thinking, "28 kids get sick out of millions and they're concerned?!?" I'm glad to see my instinct about the story was correct. I wish journalists would be more responsible in reporting stories, though, as most people don't think like me. Posts: 2392 | Registered: Sep 2005
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posted
Bizarre or sensationalistic spin on news stories seems par for the course, unfortunately. It doesn't make the very difficult job of making sense of complicated medical stuff any easier. *shakes fist
quote: Now the FDA has put out feelers to see if there are reasons for concerns this go around -- but they are not "warning" people about a new concern.
Yeah -- then the news agencies that ran that as a "new" thing (got it off Google News) yesterday and made it sound like the FDA was concerned (via their headlines) - those agencies should be called on the carpet.
posted
It makes me so mad that very smart, involved and concerned people who are trying to take active roles in their (and their families') own medical care have to fight an uphill battle against some of the mass media. It's just wrong to make that harder, you know?
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quote:It makes me so mad that very smart, involved and concerned people who are trying to take active roles in their (and their families') own medical care have to fight an uphill battle against some of the mass media.
It's one reason why I urge that everyone needs to be medically literate. They don't need to know everything a doctor or nurse does, but they need a good handle on the most common terminology, they need to know where to go to find out information (I personally recommend everyone own a good prescription drug guide - The Davis Drug Guide for nurses is my fav) and they need to know what questions to ask.
For example, my mother in law would frustrate me to no end when she'd call my husband and ask him what the drugs she was prescribed would do. She wouldn't ask the doctor, because she was too intimidated. But no one should take a prescription without knowing what it is, how to spell it, what the common side effects are, what potential interactions there are, and exactly how and when to take it and for how long. Too many people don't ask, don't take responsibility for their own health care. We have wonderfully talented, intelligent, and gifted medical personnel in this country but no one is more invested in your health than you are.
The mass media problem you mention here, CT, is part of it. People should be educated on how to wade through all that. No one should graduate high school without a rudimentary knowledge of how statistics work. They should be taught to look deeper, and not just accept what the 20 second soundbite says. I guess that really falls under some type of training in media citizenship. I don't know. Soapbox issue for me, I guess.
For instance, I had a woman yell at me because her husband was given the same chemo drug I was and he experienced the side effect of cold sensitivity. She was angry because the nurses, she said, had not warned her it could happen. Well, I had the audacity (according to her) to suggest, politely, that one thing she should make sure always to do is look up drugs and their side effects whenever she or her husband is given one. That's what I did, and I was forewarned about the side effects (plus the nurses did tell me, and I suspect told either her or her husband too but when one is parsing the information that they have cancer, sometimes the memory of those conversations isn't good due to the emotional shock.) She yelled at me and said no one should ever have to look things up, the nurses and doctors should be responsible. As I said before, I do believe most medical professionals are excellent at their jobs, but they still haven't the investment in my health that I do and I'm going to go look up that info for myself. *shrug* I suppose not everyone feels the way I do, though.
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Her claim is that the vaccine is expensive, will not be generally effective, and has side effects worth worrying about.
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posted
I agree that the commercials are misleading (or at least misleadingly incomplete) by not noting the association with sexual activity. I also think some of her claims are misleading.
A lot of this is already covered earlier in this thread.
quote:First of all, it’s not going to “wipe out” cervical cancer, no matter how many women are vaccinated. It offers protection against only four of the 100 strains of HPV – not to mention offering zero protection against non-HPV relaed cervical cancer.
2 of those 4 strains cause 70% of all cervical cancers, and the other 2 cause 90% of genital warts. And if there are non-HPV-related cervical cancers, they are so vanishingly rare as to be indetectible.
quote:So even if all women everywhere were immunized and the vaccine were 100% effective, women would still die of cervical cancer.
I don't understand the point. There is virtually nothing in medicine that is 100% effective, and yet we can still reduce the burden of morbidity and mortality by a tremendous amount for many diseases. This doesn't matter because it isn't 100%? That doesn't make sense.
quote:None of which I would have a problem with if I could see some enormous medical benefit. But I don’t.
quote:First of all, there are the side effects. According to Vicky Debold of the National Vaccination Information Center, "Young girls are experiencing severe headaches, dizziness, temporary loss of vision and some girls have lost consciousness during what appear to be seizures."
This is a notoriously biased site. Despite what they name may imply, it is a private (non-government-affiliated) website that gathers data geared toward discouraging vaccination, and they illegitimately repost data copyrighted*** by the CDC without including the necessary information the CDC requires you to read (for context to interpret the data) before you can freely access that information on the CDC site.
[This is important because the information above does not compare to how many young women report those symptoms who did not receive the vaccine, or who received a different sort of shot. Those reported side effects are not directly attributable to the material of the vaccine. This is misleadingly reported, and such error could be avoided by not reposting the (copyrighted***) information without the appropriate disclaimers.]
I agree that there are many problems with the vaccine and good questions to ask about it being mandated for young women. I'd like to see those questions raised in a way that isn't misleading and relies on the best primary sources with the most accurate information available.
------
Edited to add:
***This use of "copyright" is inaccurate. "Illegitimate" is accurate, though. Please see Dagonee's post below. (Thanks, Dagonee.)
posted
CT, thanks for your commentary on this. The anti-vaccine advocates have been jumping all over this lately, and I'm glad there's credible people responding.
One quick note about works "copyrighted by the CDC": nothing produced by the CDC can be copyrighted, because U.S. government works are not eligible for copyright.
That's not to say that I think it's right to remove the work from the necessary context. Unfortunately, though, there's no way to prevent it via copyright law, and the other laws that might apply - consumer protection, fraud, etc. - have much higher thresholds before they can be invoked.
Some things that were produced by private entities funded in part by CDC money can be copyrighted, and the CDC may publish those works on the web site with the permission of the copyright owners.
quote: I'd like to see those questions raised in a way that isn't misleading and relies on the best primary sources with the most accurate information available.
This is incredibly important. The people who overstate the dangers of vaccines make it much harder for anyone to adequately evaluate the situation. The danger goes in both directions: legitimate concerns can be diluted or dismissed by lumping them in with crackpot concerns, and people who would benefit from the vaccines can be discouraged from taking them.
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posted
Thanks for the clarification [and outright correction], Dagonee. I knew the documents were lifted from the CDC website, checked to make sure that wasn't authorized, and made sure the webmaster of the CDC knew. I assumed that the same "you don't have to establish copyright except by writing it, because that establishes it in and of itself" mantra extended to that organization.
Maybe that's why the NVIC seems to be able to get away with it without repercussions.
Anyway, thanks. I can't stand to be incorrect. I will slip a disclaimer in above with thanks to you.
Posts: 14017 | Registered: May 2000
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posted
Well this is no longer just a discussion point, for me and my family. Today I took my 14 year old to the doctor because she needed a tetanus booster in order to enter high school. The doctor said that Gardisil was available and did I want to give it to her.
I said I'd done the research, we talked about it with my daughter and the doctor and decided to go ahead and do it. So my daughter has now had the shot.
I will sit back and anxiously await her turning into a wanton hussy who sleeps with every boy she meets.
Seriously, though - I don't have a moral problem with this whatsoever. My question is will this potentially help protect my daughter, and is that protection worth the potential side effects that may arise? If I do a risk benefit analysis and it comes out in favor of the shot, I'm going to say Okay. We also got a meningitis vaccine which was not required for high school but I know some colleges require them now, and again, I weighed potential side effects against the potential benefits and decided to do it.
By the way, my daughter said it hurts. The leg she got the Gardisil in is much, much sorer than the leg which received the other two shots. So, she's not looking forward to getting the next two doses.
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posted
My 13 year old, OTOH, has not had the new shot yet. She had to get several other shots (two, I think) and a TB test at her checkup, so I told her she could decide if she wanted the new shot this year or next year. Since she's not scheduled for anything but the TB nest next year, she opted to wait. (Big shock.)
I guess she can be a "control" for Belle's daughter. Posts: 32919 | Registered: Mar 2003
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And what exactly do you think you're going to do with those?
Place a lock of each girl's hair in a tube and...um...do science-y things! With lots of color changing liquids and foaming!
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quote:Gardisil is in the leg? Oh, crap. I was going to get it from the school clinic...was hoping to go tomorrow morning. Nevermind.
It's an IM shot. My daughter chose to get it in her leg instead of her arm because she has color guard practice tomorrow and didn't want to have her arms too sore. I'm sure you could request it in the arm or hip, whichever you prefer if you don't want it in your leg.
And, if it matters, my daughter said just before bed that it had stopped hurting and she couldn't feel it anymore.
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posted
pH, also consider taking Tylenol or Advil a couple of hours in advance, if you have no contraindications. It can help more than you'd think.
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Around eight hours. She did take some Tylenol when we got home. I had told her to take it in advance, but she forgot.
CT is right (well, duh, of course she's right on a medical topic) about it helping more than it might seem to. I always took an OTC painkiller before I went in for my chemo treatments and I do think it helped with the numerous sticks and jabs I endured there.
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posted
Huh. That's useful. I'll keep that in mind. I'm glad your daughter's not hurting anymore. If Gardasil hurt worse than a tetanus shot for an extended period of time, I think I might be disinclined to get it.
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posted
My wife took my step daughter for a physical for sports last week. The doctor talked my wife into it by assuring her it was covered by the insurance, and that it would prevent cancer. No instruction or warning of the side effects. No discussion about the implications. Just "You should have this done."
And of course, now the insurance won't cover it, we now owe $300 and have to get her two more $300 shots if we want the thing to work, and my wife is worried to death the kid is going to be paralyzed.
quote:Originally posted by stihl1: My wife took my step daughter for a physical for sports last week. The doctor talked my wife into it by assuring her it was covered by the insurance, and that it would prevent cancer. No instruction or warning of the side effects. No discussion about the implications. Just "You should have this done."
And of course, now the insurance won't cover it, we now owe $300 and have to get her two more $300 shots if we want the thing to work, and my wife is worried to death the kid is going to be paralyzed.
I love doctors.
I know the way the school clinic does it, the doctor just writes you a prescription for the shot, and you pick it up from the drugstore and bring it to the clinic nurse, who gives you the injection. It only costs (hah, "only") $110 a shot. Is there a way you can do something similar?
quote:Originally posted by stihl1: And of course, now the insurance won't cover it, we now owe $300 and have to get her two more $300 shots if we want the thing to work, and my wife is worried to death the kid is going to be paralyzed.
I love doctors.
Have you spoken to the doctor's office again? [That's not right.]
Why does your wife think she'll be paralyzed? *interested
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quote:If Gardasil hurt worse than a tetanus shot for an extended period of time, I think I might be disinclined to get it.
I don't want to pick on you, but this is a really odd statement to me. Even if it did hurt for an "extended" period of time (and what are we talking about, a day?) I don't see how that could possibly dissuade someone from getting something that might protect them from cancer.
Trust me, I've had cancer. If I could have taken a shot to prevent it and it made me sore for a month I'd still have done it.
Posts: 14428 | Registered: Aug 2001
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WAY better than a tetanus shot. Although my hip is a little sore. They made me stay in the clinic for a while afterwards to make sure I didn't have an allergic reaction, I guess?
But yeah. Not that bad at ALL. And I'm a complete wuss with shots.
I know it's been nearly a year since this thread; but I wanted to point out that this is why I wanted to take a "wait and see" approach when they first started pushing for it:
posted
The article says that there's no direct link, though. Additionally, we don't know how any of the women died.
Belle, I notice I didn't respond to your comment. Of course it would be worth getting if I thought it were going to make a difference in my cancer risk. However, at this time I'm not particularly at risk for HPV, and it seems worthwhile to wait a bit and see if they at least come out with something less painful, more effective, cheaper, etc.
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quote:Originally posted by Shigosei: The article says that there's no direct link, though. Additionally, we don't know how any of the women died.
Yup. The link is about as substantial as noting that there are secondhand (or even third-hand) reports of some men having had heart attacks within a few days of eating hunter-killed deer.
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Edited to add: In the FOX-News story linked, the occurrence of 28 miscarriages after the women were given the vaccination is noted. This number is meaningless unless it is directly compared to the number of miscarriages coincidentally related to this event that you would **expect** to have seen anyway (with no shot, nothing out of the ordinary) -- which might well be just that number, given the large number of women who've had the vaccination.
I shouldn't say "meaningless," actually. It does establish that the vaccination isn't 100% effective against preventing miscarriages.
(And, similarly, the Gardasil vaccination isn't 100% effective at preventing death, either. But neither is drinking water, eating the deer shot by your brother on his latest hunting trip, or doing Pilates. People have died within days of doing all of these. Sometimes at exactly the same time! But unless you compare that number to how many people you would have expected to die then (or in that timeframe) regardless, it's impossible to tell whether that number is worrying, reassuring, or apparently irrelevant.
I am not trying to be facetious -- epidemiology and statistics are easily misleading, and it helps (I think) to reframe the presentation in terms of equivalent and non-politically charged items. Sometimes the logic of it can become more clear that way.)
posted
As my husband has said before, NASCAR kills people, because whenever he's worked the race at Talladega, at least two or three people have died.
Then again, given that over 100,000 people spend the weekened at Talladega, wouldn't it be odd if no one in a crowd that large died over that period of time? (especially when you throw in heat and alcohol)
So, statistics like the ones in that article do not concern me. My daughter suffered no ill effects from the vaccine and while I don't believe that she will now never get cervical cancer, I do feel relieved that she has some measure of protection she didn't before.
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posted
Figures often beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: "There are three kinds of lies: lies, damned lies and statistics." - Autobiography of Mark Twain
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posted
I'll add that the source Fox news quotes is the Daily Mail - a paper known for whipping people up into a frenzy of fear (usually about immigration) without any facts to back it up.
"Daily Mail Readers" is a common term of contempt used when people are spouting unfounded rubbish.
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posted
I wasn't saying these girls died, for a fact, from the vaccine. Obviously they may NEVER know exact cause. If I was the parent of one of the girls, however, I would wonder if there were a connection.
But that certainly doesn't mean I think the vaccine is bad.
Penicillin has been used for years to save lots and lots of lives. However, for people who are allergic to it, it can be fatal. I'm just saying there is no one silver bullet that works for everyone universally.
That is the only reason I took the "wait and see" approach -- see how common and adverse the very worse reactions can be, then decide.
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So the FDA is going hunting, just to see if the surveillnace system is working.![[Mad]](mad.gif)
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Possibly as some sort of binocular devise.
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