Vaccine Doesn’t Cause Sex

Human Papilloma Virus, NIH

A new study indicates that the vaccine against the sexually transmitted human papillomavirus (HPV) does not causes girls to become more promiscuous.

The researchers looked at "markers" of sexual activity after vaccination including records on whether girls had sought birth control advice; tests for sexually transmitted diseases or pregnancy; or had become pregnant. Hardly any of the girls who got the shots at age 11 or 12 had done any of these things over the next three years and the study found no difference in these markers compared with unvaccinated girls.

The study followed almost 1,400 girls enrolled in a Kaiser Permanente health plan in Atlanta.

The study did not examine older girls. However, other research indicates the vaccine does not increase promiscuity among older girls, either, the San Francisco Chronicle reports.

HPV Wart, Image by George Chernilevsky

Controversy has surrounded the shot since its inception. Paranoid parents and religious zealots have been arguing that the shots would make little girls go out and start having sex. Their claims should have been seen as absurd and the brouhaha should have dissipated quietly and quickly. For one, there are far more compelling reasons to avoid having sex like unwanted pregnancies or simply not being socially, sexually or physically ready or interested in it. Indeed, the vaccine is recommended for boys and girls at age 11 or 12 because that is well before most of them start having sex.

It is also delusional, hypocritical and irresponsible to pretend that we can keep our children pristine and pure until they have married the parentally-approved spouse of our dreams. Some kids will experiment with sex before then and it is extremely difficult to stop this without doing things that can damage parents’ relationships with them. Parents who remain in denial of their children’s sexuality, or who try to suppress it, run the risk of having children who are ignorant about the risks or reckless and, consequently, get pregnant or an STD.

Here are some of the facts around HPV and the vaccine from the Scienceline blog and the Science Based Medicine blog:

• Human papillomavirus (HPV) can cause cervical, anal, penile, vulvar, vaginal, mouth and throat cancer and can affect both boys and girls. Thus the CDC is now recommending that boys and young men, as well as girls, be vaccinated against HPV.
• HPV is the only known cause of cervical cancer, which kills roughly 300,000 women annually, one of the highest causes of cancer death for women globally.
• HPV is the most common sexually transmitted infection in the world, infecting half of all sexually active men and women in their lifetimes. One estimate suggests that between 75 and 80% of all Americans will be infected at some point in their lives
• The majority of those infected never know it, which means they may unknowingly be transmitting it to their partners, but that it is persisting in their bodies where it could be contributing to the development of tumors
• The vaccines, Gardasil and Cervarix, are 70% effective at preventing cervical cancer and 90% effective at stopping genital warts
• Clinical trials show that the vaccine has no serious side effects. While there have been claims of vaccine-related deaths, none have been verified and no causal links between the vaccine and fatalities have been proven
• The vaccines are much more effective when administered to young teens than when given to older teens and adults
• It won’t make them mentally retarded, contrary to Michelle Bachman’s claims. In fact, there is no credible evidence that anyone has become retarded because of the vaccine.

Why Get the HPV Vaccine For Your Children?

This Pumpkin's Mommy Refused to Get It Vaccinated (image from Flickr, cjc4454)

The following is from the Scienceline blog and the Science Based Medicine blog:

• Human papillomavirus (HPV) can cause cervical, anal, penile, vulvar, vaginal, mouth and throat cancer and can affect both boys and girls. Thus the CDC is now recommending that boys and young men, as well as girls, be vaccinated against HPV.
• HPV is the only known cause of cervical cancer, which kills roughly 300,000 women annually, one of the highest causes of cancer death for women globally.
• HPV is the most common sexually transmitted infection in the world, infecting half of all sexually active men and women in their lifetimes. One estimate suggests that between 75 and 80% of all Americans will be infected at some point in their lives
• The majority of those infected never know it, which means they may unknowingly be transmitting it to their partners, but that it is persisting in their bodies where it could be contributing to the development of tumors
• The vaccines, Gardasil and Cervarix, are 70% effective at preventing cervical cancer and 90% effective at stopping genital warts
• Clinical trials show that the vaccine has no serious side effects. While there have been claims of vaccine-related deaths, none have been verified and no causal links between the vaccine and fatalities have been proven
• The vaccines are much more effective when administered to young teens than when given to older teens and adults
• It won’t make them sexually promiscuous (either they will be or they won’t be, depending in part on how their parents talk to them and support them). The only drugs that might promote promiscuity are those that lower their inhibitions, like alcohol
• It won’t make them mentally retarded, contrary to Michelle Bachman’s claims. In fact, there is no credible evidence that anyone has become retarded because of the vaccine.

The Pot Calling the Kettle Dumb—Bachmann, Paul Try to Out-Stupid Perry

As reported earlier this week on Modern School, right wing Christian fundamentalist Rick Perry, supported rampant teen sex in the state of Texas by mandating Guardsil (HPV) vaccinations for teen girls, in opposition to the rhetoric and philosophy of his ilk. Not surprisingly, it turns out that nearly $30,000 was donated to his gubernatorial campaign by drug giant Merck, manufacturer of Guardasil.

Regardless of his motivations, the policy would certainly save lives. Guardasil protects against human papillomavirus, which can cause cervical cancer, a disease that currently has a fatality rate higher than 30% (see Discover Magazine Blogs “Bad Astronomy”).

Despite the benefits in terms of public health, Perry’s GOP presidential nemesis Michele Bachmann used the Guardasil flap as an opportunity to rip him a new orifice to stick his head into (and in the process, wedged her head more deeply into her own orifice). During the recent GOP debate she said that Gardasil "can have very dangerous side effects." She also said that a woman came up to her claiming that her daughter became mentally retarded because of a Guardasil vaccination.

Such high profile criticism of a vaccine will certainly provide strong inspiration to the anti-vax movement, which thrives on pseudoscience, superstition, and unsupported claims. The problem is that there is no evidence whatsoever that the vaccine can cause mental retardation, while other side effects and dangers are relatively minor (see Michele Bachmann needles Perry on vaccinations from Discover Magazine blogs).

Not only has there never been a single confirmed case of Guardasil-induced mental retardation, but a bioethicist has offered Bachmann $10,000 if she can provide some evidence for her claim.

What is most appalling and dangerous is that such a claim could be made by a presidential candidate and left unchallenged by the media. Bachmann’s source was an unnamed woman who may or may not exist, while there was no vetting or confirmation by any doctors or scientists. As far as anyone knows, the claim could have been fabricated by Bachmann or her handlers. However, even if the woman does exist and did make the claim, that does not make it true and Bachmann should not have publicized the claim until she had solid evidence from medical or scientific professionals. By doing so, she fanned the flames of anti-vaccination hysteria and the general anti-science tendency that has been growing in this country.

The anti-vaccination movement is based almost entirely on fear, while fear itself depends more on the perception of a threat than the actuality of a threat. It is like crying “fire” in a crowded theater: people will likely react first to the cry, and not stop and consider whether there is any truth to the claim.

When the government said Saddam Hussein was responsible for the 9/11 attacks or that he had weapons of mass destruction, this was sufficient to terrify the American public and convince them to support an unprovoked war and the curtailing of their rights and freedoms at home, despite the fact that neither claim was true and the evidence against both claims was readily available to those willing to look a little more deeply.

When Andrew Wakeman claimed he had evidence that vaccines caused autism, parents were quick to believe him and to deny vaccinations to their children, placing their own children and everyone else at increased risk for measles, pertussis, and other serious and preventable diseases. Yet when Wakeman was completely discredited, his paper retracted, and his license to practice medicine revoked for fraud and misconduct related to his anti-vaccination work, the damage had already been done. Despite the fact that it has been repeatedly demonstrated that vaccines do not cause autism and that there have been no documented and verified cases of vaccines causing autism, the seeds of fear had been so deeply planted that large numbers of people are still convinced that vaccines do in fact cause autism.

GOP contender Ron Paul has also jumped into the fracas. A political action committee supporting his candidacy produced a video calling Gardasil "a STD vaccine," a clever manipulation that implies that the drug allows wild, disease-free sexual activity. This, of course, is exactly the kind of anti-sex, anti-health and anti-teen spin that religious conservatives have been putting on the drug all along.

In actuality, Guardasil is a drug that protects against one deadly but preventable disease. It does not protect against any other STDS or against pregnancy, so it is not even close to a free-ticket to free love. Vaccinating teenagers against this disease does not promote or encourage unprotected or premarital sex any more than sex education programs or access to condoms do. There are still plenty of reasons for children to avoid or delay sexual activity and there are plenty of children will continue to have unprotected sexual encounters despite access to condoms, birth control and Guardasil.

What this debate is really about is America’s Puritanical attitudes toward sex and its hypocritical attitudes toward teenagers (plus some political grandstanding). In reality, teenage pregnancy and STD rates have been steadily declining for the past decade, while STD and unplanned pregnancy rates for their parents’ and grandparents’ generations have been climbing.

Rick Perry, Idiot or Greedy Idiot?

It’s easy to write off Rick Perry as a right wing lunatic and an idiot. After all, he denies climate change and evolution and believes social security is nothing more than a taxpayer financed Ponzi scheme that must be abolished. However much Perry believes the absurdities he spews publicly, it is not simply ideological jibberish. In fact, one might wonder if it is ideological at all.

Case in point: as governor of Texas, he mandated HPV vaccinations for teenage girls. It was a great move in terms of public health. However, it was the antithesis of what a typical right wing Christian fundamentalist would support. Many fundamentalists argue that HPV vaccinations promote premarital sex and teenage sexuality, that it is an invasion of privacy and usurps parental control, and that it is classic Big Government waste and repression.

It turns out that Perry’s seemingly hypocritical policy on HPV was shaped by his ties to Merck, which produces HPV vaccine. When confronted with this fact, Perry claimed he only received $5,000 from the pharmaceutical giant, according to Democracy Now. “If you think I can be bought for $5,000, I’m offended.”

It turns out that he actually received $30,000 from Merck and he can be bought—it just requires slightly more money. However, $30,000 is still pretty cheap, and a fantastic deal for Merck.

Perry’s connections with Merck are not limited to direct campaign donations. One of his aids was also a lobbyist for Merck. The drug company has also donated $380,000 to the Republican Governors Association since 2006, the same year that Perry began to play a prominent role in the organization.

HPV Uncut: Get Vaccinated and Wear a Coat

As you probably know by now if you read my blog with any consistency, I was a professional scientist first, before becoming a science teacher, and that I like to stay up to date on the latest scientific news and discoveries, not only for professional growth and development, but also for my own amusement and. And, like my students, I am particularly drawn to science that is creepy, disgusting, prurient and weird. So it should be no surprise that the following article by Michelle Clement (Scientific American online blogs) caught my attention: What's the deal with male circumcision and female cervical cancer?

Circumcision Tools at the Jewish Museum, NY (Image by istolethetv)

As one would hope, the article was written with a great deal of humor: “Recently, while I was getting drinks at a pub with about a dozen or so other biologists, I was involved in a very animated discussion about circumcision -- because that's what biologists argue about when they're drinking, apparently. ‘They do it to increase stamina. It desensitizes the penis,’ said a microbiologist. (There's some evidence to the contrary on the bit about stamina, actually.)”

This reminded me of the two things I miss most about being a scientist (in contrast to being a science teacher): having the time and energy to go pubs in the first place and having the time, energy, interest and knowledge to casually talk science with peers. The one or two times I have found myself in a pub with colleagues, the conversation was dominated by complaining about work, which is not surprising since our spouses and partners are sick of hearing about it, while the public in general thinks we have it way too easy. When we do discuss science at work, it is almost always in the context of how to best teach it and never just a casual discussion of the merits of a particular new study or discovery. Fortunately for me my wife is a scientist. So when she gets tired of hearing me complain about my job (and vice versa) we can geek out together and talk about circumcision, autism, anti-vaccine hysteria, coprophagia and other important topics.

Let us return to the merits of male circumcision. Clement, in a fit of drunken lucidity, decided it was best to not rely on the unsubstantiated claims of her male peers, and decided to research the subject more thoroughly. She reviewed a 2002 paper in the New England Journal of Medicine (NEJM) that found that circumcision correlated with a decreased risk of penile HPV infection. Similar results were found by a 2009 study in African men. HPV, of course, can cause cervical cancer. The curious thing is that there was no significant correlation between circumcision and cervical cancer except if the uncircumcised partners were also likely to engage in risky sexual behavior.

This research tells us several important things. First, parents should relax and not immediately go have junior’s dingus snipped just to protect his future sexual partners. Rather, it would be safer, cheaper and less cruel to simply encourage safer sexual activity and get him vaccinated against HPV. It also reminds us that correlation is not the same as causation. HPV can cause cervical cancer, whereas circumcision correlates with a decreased risk of HPV. However, increasing the risk of HPV is not the same as causing HPV. In other words, an uncircumcised man may have an increased risk of HPV, especially if he engages in risky sexual behavior, but that doesn’t mean he has or will have HPV.

That being said, Clement also found a more recent paper published this year in The Lancet which looked at African men and their partners. This research found that after controlling for lifestyle variables, monogamous women partnered with circumcised men had significantly lower rates of HPV infection. The authors of this study concluded that circumcision should not be ruled out as a method of reducing HPV infection. However, because they only looked at monogamous women, these results cannot be extrapolated to women with multiple sexual partners. Also, if the men were non-monogamous, they would have a higher risk of contracting HPV regardless of the status of their foreskins. Lastly, this study showed an increase risk in HPV transmission, not cervical cancer.

Even if circumcision does reduce the risk of contracting and spreading HPV, it is certainly not as effective as condoms and vaccines, and therefore should only be considered as a supplement to the promotion of safer sex practices (and not a solution on its own) and only in populations where vaccines and condoms are routinely rejected. Considering that there is now an effective HPV vaccine, (and that there are so many other STDs that can be reduced through safer sex practices) it seems absurd to even consider circumcision as a prophylactic.

Of course, all this talk about circumcision reminds me of the old one about the moyel who, after a long and productive career of circumcising young Jewish boys, had acquired quite a collection of old foreskins. So he took his collection to the village leather worker and asked if he could make him something nice.

"Sure," said the leather worker. "Come back in a week."

So a week later the moyel returns and the leather worker hands him a wallet. Needless to say, the moyel is crestfallen. "This is it, this tiny little wallet? After 40 years of toil and saving, and all I get is this little thing?"

"Ah, but if you rub it," said the leather worker, "it will become a suitcase."