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.

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.

Mengele in America

My students often ask me why they need to take science. My answer is pretty simple: scientific thought is the most effective method for understanding natural phenomena and making accurate predictions about it. When used correctly, the scientific method can also be useful in understanding some social phenomena. However, the scientific method is sometimes misused and abused, even by scientists themselves.

There are “innocent” examples of this, such as poorly designed experiment with too many uncontrolled variables, or when there are inadvertent biases.

However, there have also been numerous examples of deliberate or malicious attempts to subvert the scientific process for private gain. The tobacco companies, for example, have hired their own scientists to do research that “proved” cigarettes or second hand smoke were safe or, when this was no longer a tenable position to argue, to provide evidence that sowed doubt about the dangers. Oil companies have done likewise to sow doubt about climate change. (See Merchants of Doubt, numerous articles by Robert Procter, The Republican War on Science, among other sources).

Then there are the cases where scientists have done dangerous, terrible and unethical things to specific classes of human beings because they were deemed “undesirable” or “subhuman,” or because they thought they could get away with it. The most infamous examples are the experiments conducted by Josef Mengele on concentration camp prisoners. However, an American researcher, Dr. John Cutler, was doing heinous experiments on Guatemalans in 1946, at the same time that the Nuremberg trials were going on and Mengele’s work was being exposed to the world. The following details of these experiments are from a Democracy Now on 8/31/2011.

Cutler and his colleagues, with the complicity of the Guatemalan and U.S. governments, intentionally infected over 1,300 Guatemalan sex workers, prisoners, soldiers, orphans and mental patients with sexually transmitted diseases (STDs)—without their permission—in order to study the effects of penicillin. In some cases, when victims failed to contract an STD through unprotected sex, they were inoculated with STD bacteria through wounds made on the penis or face, or injected into the urethra, rectum or spine. Many of the victims were never provided any treatment. Others were provided inadequate or incomplete treatment and, as a result, infected their family members.

But Those Were Different Times, Not

It has been argued that those were different times, with laxer ethical values and a weaker understanding of the ramifications of such experiments. However, Cutler knew full well that what he was doing was unethical, dangerous and cruel, which is why he went to Guatemala to do it. According a New York Times report, Cutler’s reports made it up the chain of command to the U.S. Surgeon General, Thomas Parran Jr. In a letter to Cutler, one of his colleagues said, "The surgeon general says, 'Well, we couldn't do this in the United States,’" which is not only an acknowledgment of what was going on, but an admission that it was ethically wrong.

Cutler had already attempted similar research on prisoners in Indiana. While he supposedly acquired informed consent from the inmates, he deliberately misled them about the nature and dangers of the research in order to increase the number of participants. The fact that he went to prisoners in the first place was an attempt to circumvent safety and ethical norms, as prisoners were believed to be more willing to consent to dangerous research because they had less education or believed that compliance would help them get released earlier.

Tuskegee syphilis research victims

Tuskegee blood draw, 1953

 Tuskegee syphilis experiments

Not surprisingly, Cutler went on to be a major player in the Tuskegee experiments (1932-1972) in which more than 600 African American men were deliberately denied treatment for syphilis in order to study its progression. The men were never even told they had syphilis and were denied treatment, even after the advent of penicillin. Over 100 of the participants died of the disease or complications from syphilis, while many of their wives and children contracted the disease from them. Cutler was never apologetic for his role in the research and continued to insist that the work was valuable and appropriate.

Irresponsible Teen Moms or Middle Age Moms?

Adults never grow tired of attacking and blaming youth. According to Mike Males’ recent book, Teenage Sex and Pregnancy (2010) Peter the Hermit complained back in 1247 that “young people of today are forward, immodest and unwomanly in speech, behavior and dress.” Today we have liberals and conservatives alike (though for sometimes different reasons) attacking youth, especially teen girls. In Reviving Ophelia (1998), psychologist Mary Pipher panicked over an epidemic of eating disorders, phobias and depression. Rosalind Wiseman’s Queen Bees and Wannabes (2002) claimed that girls were confused, insecure, obnoxious, cruel and catty.

One of the most popular screeds against teen girls is that they are irresponsible, impulsive and take dangerous risks, resulting in high rates of pregnancy, abortions and sexually transmitted diseases (STDs). This also happens to be patently false, not just historically, but also compared with adult women. Pregnancy rates, rape, STDs, drug use and crime have all been plummeting for teens over the past decade, while they have been soaring for middle aged women. For example, the birth rate declined by 57% between 1995 and 2007 for girls under the age of 15 and 29% for 15-19 year-old girls. Even young women in their early 20s are having fewer babies. However, women over 40 have seen a 70% increase in births, while those in the 35-39 range saw a 50% increase. (Source: CDC WONDER—2009; cited in Males, 2010)

Another example is rape victimization. Between 1973 and 2007 there was a 37% drop in rapes of females between the ages of 12 and 24, and a 68% decline in other sexual assaults (from the Bureau of Justice Statistics; cited in Males, 2010). Likewise, HIV infection for 13-19 year-olds dropped 28% between 1993 and 2007, and 49% for 20-24 year-olds. However, for 40-44 year olds it increased 19% and for 45-49 year-olds, it went up 67%.This runs counter to the claim that teens are having more dangerous or pathological sex. Many, no doubt, are being more careful and learning how to fend off the unwanted attention of family members and neighbors.

In a seeming paradox today’s youth reports having more sex, and at a younger age, than their parents’ and grandparents’ generations. In 1970, only 5% of 15 year-old girls reported having had sex at least once and only 29% of all girls age 15-19 reported having had sex at least once. Today, the numbers are 25% for 15 year-olds and 50% for 15-19 year-olds (See Males, 2010, p99). If these self-reporting numbers are true, girls are indeed more promiscuous, but also far more responsible, too. They are having safer sex and they are having fewer pregnancies and STDS, despite having more sex.

It is interesting to consider that while teen birth rates have declined, contrary to the claims of the protectors of youth, overall infant and maternal health have not improved accordingly. Males notes that from 1995 to 2006, the number of low birth weight babies being born to U.S. women jumped by 23%, while the total percentage of all babies that are born with low birth weights increased from 7.3% to 8.3%. However, this increase is due primarily to the increasing age of mothers. The teens have done much of what the pundits and culture warriors have demanded: they are having fewer babies, doing less drugs, and committing fewer crimes. Women who delay child bearing until they are in their late 30s or early 40s, in contrast, are seeing increasing rates of autism, low birth weights, and negative health outcomes for themselves and their babies.

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."