Here is a Facebook response to a conversation that I had one evening:
Sorry if I sound like an ideologue, but it is because I AM a science ideologue. This claim I will not deny. :) If this is a scientific discussion, science is what I will go with. The definition of an ideologue is someone who (and to make it clear I was not implying you are an ideologue) has a predetermined position, and tries to make the science fit their non-scientifically based beliefs. This is, in my experience, what anti-vax people do. Making claims that are either not true, or cherry-picked is their hallmark. They have decided that vaccination is wrong,for whatever reason, and try to use whatever data they can find that seems like it supports their position. They make claims that are testable and verifiable, and when that data shows they are incorrect, they change the topic and move on. The pattern is the same in every case that I have come across.
I will try to stick to the points raised in order. The fact that Gardasil and Cervarix prevent HPV should be seen as a positives in and of themselves. If you stop the spread of genital warts (and that is what HPV is) this will inevitably be a good thing. The fact that drug companies use the cervical cancer angle as their main selling point is a matter of marketing, but the fact remains, if we could stop/prevent large numbers of HPV infections (which at this point is almost ubiquitous, with something like 30-40% of sexually active adults in North America being exposed to it at some point) this is a positive end by itself. You mention the cost (millions of dollars) of the vaccine, but this will be nothing but a cost saving measure. An ounce of prevention is worth a pound of cure. Treating cancer of any kind is VERY expensive, even if the treatment regimes currently available for cervical cancer are relatively good ("the 11th most treatable"). Wouldn't it be cheaper to prevent as much of it as possible in the first place?
Of course continued screening is the recommended action plan, because, yes, cervical cancer can happen with or without HPV, but why would you not take measures to stop what we already know is THE major causitive factor? Also, it is worth mentioning that despite the fact that the prognosis is fairly good for cervical cancer in relation to all other cancers, cancer of any kind is still crazy deadly. Quoting from the Nation Cervical Cancer coalition: "Worldwide, in 2008, it was estimated that there were 473,000 cases of cervical cancer, and 253,500 deaths per year" That means that not only is this a fairly widespread condtiion, the 11th most treatable cancer kills more that half (53%) of the people diagnosed. Not great. Cancer sucks, and a vaccination that prevents cancer is nothing but a Godsend. Also, just a point of logic, saying that you should continue screening regardless of whether you got the vaccine or not is like saying that even if you didn't smoke, you may still get lung cancer, so get a check up from time to time. Seems reasonable to me.
Pertussis (quoting from a site that met the Google search for the exact thing I know exists and was looking for): "Serious adverse events to vaccines occur in approximately 1 out of every 1 million people (who have received the vaccine). A person is much more likely to have life-threatening complications from pertussis and other diseases than they are to have a severe reaction from the vaccine." This is saying a lot considering how effective the vaccine has been in making pertussis a rare condition that is usually seen only in the non-vaccinated world. It used to be rampant (before the vaccine that is). The CDC site says says the following: "(severe problems) are so rare it is hard to tell if they are caused by the vaccine"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap . This means that there are so few serious complications that statistical significance is hard to get because the observed problems happen often enough in the background that it becomes very difficult to say whether the vaccine even caused them! In other words, they are very, very rare. Again, the research has been done and published and reviewed, and health care providers and public health agencies (including Health Canada) have reached a consensus in this respect. That consensus is to vaccinate for pertussis.
Regarding the flu shot, it is actually remarkably effective. Surprisingly so even. According the the CDC (Centres For Disease Control) it is, like you mention, variably effectsoive. This is because evolution is a bitch, and hard to predict. On a good year, the vaccine "can be expected to reduce laboratory-confirmed influenza by approximately 70% to 90% in healthy adults <65 years of age." On a bad year, its "effectiveness against laboratory-confirmed influenza was 60% among persons without high-risk conditions, and 48% among those with high risk conditions, but it was 90% against laboratory-confirmed influenza hospitalization." These are huge numbers. The flu is a serious killer, and the reason that even bigger numbers (the flu kills swaths of old people every year across the world) don't die every year is because of the vaccine.
I admit that I have only received the seasonal flu vaccine a few times, and often miss it. My reason is also laziness. But I see this in only the most self-concerned way as I figure that I, personally, am unlikely to die of the flu. However, the problem, as with all vaccinations, is that you aren't just a potential victim of disease itself, you are also potentially a carrier. Although young people rarely die of the flu, they often pass it on to old people (grandma/grandpa) who do actually die of it. Just like a computer virus, the effects are exponential so that if you cut off a tree branch, it never gets the chance to branch out and infect more people. The cost savings multiply with every non-infection.
http://www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm
Anyway, I rant about this a lot, and if I sound like an ideologue it is because I hear the same things again and again. I try to avoid such accusations by trying to honestly report the science as I have heard it described since I am, obviously, a non-specialtist. I just listen to this stuff week in and week out, and I get concerned when anti-vax people try to get their information out, and it is factually flawed. I tend to prefer the consensus opinion of public health agencies over anyone else as they are in the trenches every day, and are the people required to be up on the most current science. They are usually pretty good at it, and even if they (in absolute terms) suck at it, they are basically our best option.
I will try to stick to the points raised in order. The fact that Gardasil and Cervarix prevent HPV should be seen as a positives in and of themselves. If you stop the spread of genital warts (and that is what HPV is) this will inevitably be a good thing. The fact that drug companies use the cervical cancer angle as their main selling point is a matter of marketing, but the fact remains, if we could stop/prevent large numbers of HPV infections (which at this point is almost ubiquitous, with something like 30-40% of sexually active adults in North America being exposed to it at some point) this is a positive end by itself. You mention the cost (millions of dollars) of the vaccine, but this will be nothing but a cost saving measure. An ounce of prevention is worth a pound of cure. Treating cancer of any kind is VERY expensive, even if the treatment regimes currently available for cervical cancer are relatively good ("the 11th most treatable"). Wouldn't it be cheaper to prevent as much of it as possible in the first place?
Of course continued screening is the recommended action plan, because, yes, cervical cancer can happen with or without HPV, but why would you not take measures to stop what we already know is THE major causitive factor? Also, it is worth mentioning that despite the fact that the prognosis is fairly good for cervical cancer in relation to all other cancers, cancer of any kind is still crazy deadly. Quoting from the Nation Cervical Cancer coalition: "Worldwide, in 2008, it was estimated that there were 473,000 cases of cervical cancer, and 253,500 deaths per year" That means that not only is this a fairly widespread condtiion, the 11th most treatable cancer kills more that half (53%) of the people diagnosed. Not great. Cancer sucks, and a vaccination that prevents cancer is nothing but a Godsend. Also, just a point of logic, saying that you should continue screening regardless of whether you got the vaccine or not is like saying that even if you didn't smoke, you may still get lung cancer, so get a check up from time to time. Seems reasonable to me.
Pertussis (quoting from a site that met the Google search for the exact thing I know exists and was looking for): "Serious adverse events to vaccines occur in approximately 1 out of every 1 million people (who have received the vaccine). A person is much more likely to have life-threatening complications from pertussis and other diseases than they are to have a severe reaction from the vaccine." This is saying a lot considering how effective the vaccine has been in making pertussis a rare condition that is usually seen only in the non-vaccinated world. It used to be rampant (before the vaccine that is). The CDC site says says the following: "(severe problems) are so rare it is hard to tell if they are caused by the vaccine"http://www.cdc.gov/vaccine
Regarding the flu shot, it is actually remarkably effective. Surprisingly so even. According the the CDC (Centres For Disease Control) it is, like you mention, variably effectsoive. This is because evolution is a bitch, and hard to predict. On a good year, the vaccine "can be expected to reduce laboratory-confirmed influenza by approximately 70% to 90% in healthy adults <65 years of age." On a bad year, its "effectiveness against laboratory-confirmed influenza was 60% among persons without high-risk conditions, and 48% among those with high risk conditions, but it was 90% against laboratory-confirmed influenza hospitalization." These are huge numbers. The flu is a serious killer, and the reason that even bigger numbers (the flu kills swaths of old people every year across the world) don't die every year is because of the vaccine.
I admit that I have only received the seasonal flu vaccine a few times, and often miss it. My reason is also laziness. But I see this in only the most self-concerned way as I figure that I, personally, am unlikely to die of the flu. However, the problem, as with all vaccinations, is that you aren't just a potential victim of disease itself, you are also potentially a carrier. Although young people rarely die of the flu, they often pass it on to old people (grandma/grandpa) who do actually die of it. Just like a computer virus, the effects are exponential so that if you cut off a tree branch, it never gets the chance to branch out and infect more people. The cost savings multiply with every non-infection.
http://www.cdc.gov/flu/pro
Anyway, I rant about this a lot, and if I sound like an ideologue it is because I hear the same things again and again. I try to avoid such accusations by trying to honestly report the science as I have heard it described since I am, obviously, a non-specialtist. I just listen to this stuff week in and week out, and I get concerned when anti-vax people try to get their information out, and it is factually flawed. I tend to prefer the consensus opinion of public health agencies over anyone else as they are in the trenches every day, and are the people required to be up on the most current science. They are usually pretty good at it, and even if they (in absolute terms) suck at it, they are basically our best option.
