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Had Your Flu Shots Yet?


Kimmo
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I know as humans tend to view ourselves as apart and above nature, but with regard to actions in the face of infections we as a society are no different than school of fish, flock of birds, or herd of gazelle confronted by a predator

 

what are you rambling about? put the 1950's national geographic down and come back, joe. come back to 2012.

 

come back to the world of reflective humans, the ones capable of making informed decisions based on facts and actual events, joe, the ones capable of making vaccines in the face of deadly illnesses, joe, and then actually making them safer as our thinking evolves. yeah that's right joe, SAFER. did you know we've made our vaccines safer?

 

far out, man, don't gotta be like them birds and fish forever.

 

 

there will generally always be a sacrificial cost of individuals to save the whole.

 

is that right, joe? always? i admire your talents of prognostication.

 

It's a cruel world in that respect - but that's living - and our frontline responses to infectious disease will always come at an unavoidable cost of some lives being adversely affected to one degree or another.

 

ACCEPT THE STATUS QUO!

 

brilliant. let's do this with politics also. and in our personal lives. and we'll teach our children this lesson too: SOME THINGS ARE UNAVOIDABLE, SO PLEASE DON'T EVEN TRY. ACCEPT WHAT YOU ARE TOLD.

 

 

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I know as humans tend to view ourselves as apart and above nature, but with regard to actions in the face of infections we as a society are no different than school of fish, flock of birds, or herd of gazelle confronted by a predator

 

what are you rambling about? put the 1950's national geographic down and come back, joe. come back to 2012.

Dude, if you can't figure out the essential, unyielding truth in that statement and acknowledge it you are completely adrift in any discussion about infectious disease in general and vaccines in particular. Completely adrift and lost, babbling without the slightest grounding in reality.

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I know as humans tend to view ourselves as apart and above nature, but with regard to actions in the face of infections we as a society are no different than school of fish, flock of birds, or herd of gazelle confronted by a predator

 

what are you rambling about? put the 1950's national geographic down and come back, joe. come back to 2012.

Dude, if you can't figure out the essential, unyielding truth in that statement and acknowledge it you are completely adrift in any discussion about infectious disease in general and vaccines in particular. Completely adrift and lost, babbling without the slightest grounding in reality.

 

joe says:

 

"Actions in the face of infections".

 

we share about as much in common with the animals you listed above in this regard as we do with their anatomy.

 

maybe you have fins and wings and a really small brain, sure, but in the "face of infections", humanoids have a massive response repertoire, whilst the animals you listed? well, it's pretty much let "nature" run its course.

Edited by Kimmo
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sure, i got your point, but we disagree on the particulars that make up your metaphor (we disagree on vaccine risk assessments and how they are arrived at).

 

and, as stated before, i think the individual risk currently is near zero from the vaccinatable illnesses (that vaccines have no doubt helped eradicate), but it is the potential collective risk that undervaccination might lead to that causes me concern.

 

Okay. Sounds like the best we can do is wave across the chasm. If you read the IOM report - I'd be curious to know which particulars/specifics you don't accept/disagree with.

 

i doubt it's as deep a chasm as one might surmise. there's a lot of nuance to (most) things in this life; rarely are they black and white. but i'll wave a friendly wave regardless.

 

i'll take a look at your links....

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Definition of cervical cancer: Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). Cervical cancer is almost always caused by human papillomavirus (HPV) infection.

Estimated new cases and deaths from cervical (uterine cervix) cancer in the United States in 2012:

 

 

New cases: 12,170

Deaths: 4,220

 

From cancer.gov

 

So, which vaccine will save more lives? Bayesian statistics. Do the math, report back.

 

 

 

 

interesting stats on those most affected by cervical cancer and what increases risks, in the following link. really no surprises....

 

-hispanic/latino highest risk.

-african american second.

-smoking doubles the incidence rate.

-number of sexual partners; can't get it without unprotected (generally) sex.

 

i would guess that other factors weight the stats: general health, alcohol use, diet, etc.

 

so here we have an illness that affects 1 in approximately 1,500 women, and this is WITHOUT accommodating for the above factors.

 

yet the merck/cdc phalanx pushes this vaccine as a response to an "epidemic of preventable deaths".

 

(obviously, without unprotected sex, one's risk goes to +-0.)

 

 

link

 

and no, gspotter, your point isn't lost. the vaccines will save lives. it's just that there are other just as effective ways to do it, without paying pharma $400 every 4 years.

 

now if one doesn't want to take responsibility for one's health and health decisions, sure go for it. $400 every few years isn't a huge fee to allay one's concerns (no matter how small the risk might be).

Edited by Kimmo
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maybe you have fins and wings and a really small brain, sure, but in the "face of infections", humanoids have a massive response repertoire, whilst the animals you listed?

For humans as a species, and as clustered large populations, the totality of our response to infectious disease is absolutely no different than the massed evasions of a school of Mackrel being attacked by Amberjack or of a flock of pigeons evading a Peregrine. No different in any way - someone is inevitably coming up with the short straw.

 

We do get lucky on occasion as we have with Smallpox, but for the most part, and at least for the moment, we confront many diseases like Flu and Malaria with fast mutation rates which, despite our best efforts, will always 'take' a percentage of us. All our best efforts can mitigate that 'take' to a degree, but again, all our mitigations are no more than a collective evasive response to predation.

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joe, i think you were pretty unequivocal regarding your support for the hpv vaccine, and jayb, vaccines in general:

 

 

Dr. Harper helped design and carry out the Phase II and Phase III safety and effectiveness studies to get Gardasil approved, and authored many of the published, scholarly papers about it. She has been a paid speaker and consultant to Merck. It's highly unusual for a researcher to publicly criticize a medicine or vaccine she helped get approved.

 

 

 

excerpts from an interview with her:

 

Yes, (merck's) marketing campaign was designed to incite the greatest fear possible in parents, so that there would be uptake of the vaccine. If parents and girls were told the benefits and harms of Pap screening and HPV vaccines as described above, an informed and valued decision would have been able to be made. Many may have chosen to continue with a lifetime of Pap screening and forgo the vaccines, with the unknowns of duration of efficacy and safety unable to be answered for many more years."

 

Dr. Scott Ratner and his wife, who's also a physician, expressed similar concerns as Dr. Harper in an interview with CBS News last year. One of their teenage daughters became severely ill after her first dose of Gardasil. Dr. Ratner says she'd have been better off getting cervical cancer than the vaccination. "My daughter went from a varsity lacrosse player at Choate to a chronically ill, steroid-dependent patient with autoimmune myofasciitis. I've had to ask myself why I let my eldest of three daughters get an unproven vaccine against a few strains of a nonlethal virus that can be dealt with in more effective ways."

 

Merck also says it's looking into cases of ALS, commonly known as Lou Gehrig's Disease, reported after vaccination. ALS is a progressive neurodegenerative disease that attacks motor neurons in the brain and spinal cord. Merck and the CDC say there is currently no evidence that Gardasil caused ALS in the cases reported. Merck is also monitoring the number of deaths reported after Gardasil: at least 32. Merck and CDC says it's unclear whether the deaths were related to the vaccine, and that just because patients died after the shots doesn't mean the shots were necessarily to blame.

 

"Parents and women must know that deaths occurred. Not all deaths that have been reported were represented in Dr. Slade's work, one-third of the death reports were unavailable to the CDC, leaving the parents of the deceased teenagers in despair that the CDC is ignoring the very rare but real occurrences that need not have happened if parents were given information stating that there are real, but small risks of death surrounding the administration of Gardasil."

 

 

link

 

and

 

link

 

would you say, joe, that the deaths mentioned were simply an unavoidable part of our response to an infectious disease?

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Dr. Harper's main complaints are around business practices, public health matters around the interplay of HPV vaccines and Pap Smears, and with how long the vaccine will have efficacy. Issues around cancer prevention are epidemiological and public health issues.

 

All her concerns taken into account, along with understanding the HPV rates in the US (HPV prevalence was 24.5% among females aged 14 to 19 years, 44.8% among women aged 20 to 24 years, 27.4% among women aged 25 to 29 years), and we had and have absolutely no qualms whatsoever about having had our daughter vaccinated. Add to that if she only gets a decade of efficacy that still gets her through to age 26 in our case.

 

With regard to the myofasciitis circumstance of Dr. Ratner's daughter, as tragic as they may be, even if there were ten cases reported that would make an incidence rate of 0.00000043 for the number of Gardasil vaccinations. The incidence of U.S. female auto fatalities is 0.000053 - should we keep our daughters off the road as well?

 

Similarly, even if there were any association shown between Gardasil and ALS and there were ten cases instead of two that would again be an incidence rate of 0.00000043. The female incidence of MS is 0.00006 to put that risk in perspective.

 

With regard to the speculation of Gardasil deaths:

 

The study's main findings include the following:

 

More than 23 million doses were administered nationally since the HPV vaccine was licensed in June 2006. There were a total of 12,424 reports to VAERS of adverse events following HPV vaccination through December 2008.

 

Since the HPV vaccine was approved, the vast majority (94%) of adverse events reported to VAERS after receiving this vaccine have not been serious. An adverse event is considered serious if it is life threatening, or results in death, permanent disability, abnormal conditions at birth, hospitalization or prolonged hospitalization.

 

The most common events reported were: Syncope (or fainting)–common after need injections, especially in pre-teens and teens.

 

Local reactions at the site of immunization (pain and redness)

 

- Dizziness

- Nausea

- Headache

 

Of the 12,424 reports of adverse events, 772 (6% of all reports) described serious adverse events, including 32 reports of deaths.

 

The 32 death reports were reviewed and there was no common pattern to the deaths that would suggest they were caused by the vaccine. In cases where there was an autopsy, death certificate, or medical records, the cause of death could be explained by factors other than the vaccine. Some causes of death determined to date include diabetes, viral illness, illicit drug use, and heart failure.

 

There were two reports of unusual neurological illness (per autopsy, probable variants of Amytrophic Lateral Sclerosis (ALS) often referred to as “Lou Gehrig's Disease”) that resulted in the death of two young females. There is no current evidence suggesting that the HPV vaccine caused these illnesses, but researchers from several highly regarded academic centers are studying the cases.

 

There was increased reporting of syncope and pulmonary emboli (blood clots of the lungs) compared with what has been found for other vaccines given to females of the same age. Of the people who had blood clots 90% had a known risk factor for blood clots, such as taking oral contraceptives (birth control pills). VAERS reports cannot prove the vaccine caused the adverse event in women with these risk factors. However, this finding needs further investigation.

 

Again, all things in the balance we are entirely comfortable in our decision and would make the same call today.

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Dr. Harper's main complaints are around business practices, public health matters around the interplay of HPV vaccines and Pap Smears, and with how long the vaccine will have efficacy. Issues around cancer prevention are epidemiological and public health issues.

 

joe, it doesn't sound like you read the articles.

 

"The number of women who die from cervical cancer in the US every year is small but real. It is small because of the success of the Pap screening program."

 

"The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC's Dr. Barbara Slade) were 3.4/100,000 doses distributed. The rate of serious adverse events on par with the death rate of cervical cancer. Gardasil has been associated with at least as many serious adverse events as there are deaths from cervical cancer developing each year.

 

"Pap smears have never killed anyone. Pap smears are an effective screening tool to prevent cervical cancer. Pap smears alone prevent more cervical cancers than can the vaccines alone.

Gardasil is associated with serious adverse events, including death. If Gardasil is given to 11 year olds, and the vaccine does not last at least fifteen years, then there is no benefit - and only risk - for the young girl. Vaccinating will not reduce the population incidence of cervical cancer if the woman continues to get Pap screening throughout her life.

 

"The informed consent/full disclosure as I described initially must be disclosed to parents and young women. The questions should be raised, 'How do you want to prevent cervical cancer? Pap screening? Vaccination? Both?"

 

the cumulative incidence of HPV infections for women in the U.S. through the age of 50 years old is 80%. That statement is true. That statement infers that nearly every one is infected with HPV at least one point in their life.

 

What is left out is that 95% of all HPV infections are cleared spontaneously by the body's immune system. The remaining 5% progress to cancer precursors. Cancer precursors, specifically CIN 3, progresses to invasive cancer in the following proportions: 20% of women with CIN 3 progress to invasive cervical cancer in five years; 40% progress to cervical cancer in thirty years. There is ample time to detect and treat the early precancers and early stage cancers for 100% cure.

 

here's an interesting excerpt, about vaccines in general:

 

Are the protocols of the CDC and VAERS (Vaccine Adverse Event Reporting System) properly processing reports of adverse reactions and deaths due to the vaccine? What do you see as the weak link in the VAERS system of collecting data?

 

"VAERS is biased in both directions, not allowing any veritable conclusions to be drawn about vaccine safety. If an association with an adverse event is detected statistically, there is not enough information collected in VAERS to determine causation, which is a multi-step process. Likewise, if no association with an adverse event is detected statistically, there is not enough information to reassure the public that no serious adverse events occur.

 

(HPV prevalence was 24.5% among females aged 14 to 19 years, 44.8% among women aged 20 to 24 years, 27.4% among women aged 25 to 29 years)

 

the above hpv stats indicate TOTAL hpv incidence (among those tested!!), NOT the strains that gardasil offers (very good) protection for: those strains are less than 5%, closer to 2% i believe.

 

 

and we had and have absolutely no qualms whatsoever about having had our daughter vaccinated.

 

that's fine, but make sure you are sharing correct information about the vaccine, and you simply are NOT doing that right now (whether it's because you simply misunderstand, or are willfully "disagreeing" with me (this gets my vote), i don't know).

 

Add to that if she only gets a decade of efficacy that still gets her through to age 26 in our case.

 

PLEASE read the articles, and understand that the efficacy period is 4-6 years! i believe dr. harper states 5, specifically. don't have the false impression that your daughter is protected for longer. also keep in mind the vaccine does not protect against all types of cancer-causing hpv's, so women still need pap smears (which are more effective than the vaccine in preventing cervical cancer!).

 

 

Again, all things in the balance we are entirely comfortable in our decision and would make the same call today.

 

i'm glad you were comfortable. it's a challenge being a parent and navigating a path through a world rife with decisions regarding every aspect of one's child's life and safety!

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Just chiming in to note that the cancer risk from HPV isn't limited to women:

 

Lancet Oncol. 2010 Aug;11(8):781-9. Epub 2010 May 5.

HPV-associated head and neck cancer: a virus-related cancer epidemic.

Marur S, D'Souza G, Westra WH, Forastiere AA.

Source

 

Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA. smarur1@jhmi.edu

Abstract

 

A rise in incidence of oropharyngeal squamous cell cancer--specifically of the lingual and palatine tonsils--in white men younger than age 50 years who have no history of alcohol or tobacco use has been recorded over the past decade. This malignant disease is associated with human papillomavirus (HPV) 16 infection. The biology of HPV-positive oropharyngeal cancer is distinct with P53 degradation, retinoblastoma RB pathway inactivation, and P16 upregulation...blah blah blah"

 

IIRC the HPV virus encodes a protein (E6) that binds to a protein that normally regulates cell-division (p53) and basically tricks the cell into tagging p53 for destruction via the pathway that the cell normally uses to selectively destroy/downregulate proteins. Nasty.

 

I think people have been working on drugs that will inhibit or reverse the binding of HPV E6 to p53 for a while but AFAIK the therapeutic repertoire is currently limited to surgery/chemo.

 

Imperfect protection is better than no protection and unless you are confident that you can predict the character of all of your son's future partners and the precise range of his sexual behaviors the balance of risks is decisively in favor of vaccinating.

 

 

 

 

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Imperfect protection is better than no protection and unless you are confident that you can predict the character of all of your son's future partners and the precise range of his sexual behaviors the balance of risks is decisively in favor of vaccinating.

 

what about one's daughter (the original topic)?

 

(i haven't looked at incidence in males, so won't comment.)

Edited by Kimmo
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Just chiming in to note that the cancer risk from HPV isn't limited to women:

 

Lancet Oncol. 2010 Aug;11(8):781-9. Epub 2010 May 5.

HPV-associated head and neck cancer: a virus-related cancer epidemic.

Marur S, D'Souza G, Westra WH, Forastiere AA.

Source

 

Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA. smarur1@jhmi.edu

Abstract

 

A rise in incidence of oropharyngeal squamous cell cancer--specifically of the lingual and palatine tonsils--in white men younger than age 50 years who have no history of alcohol or tobacco use has been recorded over the past decade. This malignant disease is associated with human papillomavirus (HPV) 16 infection. The biology of HPV-positive oropharyngeal cancer is distinct with P53 degradation, retinoblastoma RB pathway inactivation, and P16 upregulation...blah blah blah"

 

IIRC the HPV virus encodes a protein (E6) that binds to a protein that normally regulates cell-division (p53) and basically tricks the cell into tagging p53 for destruction via the pathway that the cell normally uses to selectively destroy/downregulate proteins. Nasty.

 

I think people have been working on drugs that will inhibit or reverse the binding of HPV E6 to p53 for a while but AFAIK the therapeutic repertoire is currently limited to surgery/chemo.

 

Imperfect protection is better than no protection and unless you are confident that you can predict the character of all of your son's future partners and the precise range of his sexual behaviors the balance of risks is decisively in favor of vaccinating.

 

 

 

a prominent homeboy on this here website can speak to the truth of this!

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Imperfect protection is better than no protection and unless you are confident that you can predict the character of all of your son's future partners and the precise range of his sexual behaviors the balance of risks is decisively in favor of vaccinating.

 

what about one's daughter (the original topic)?

 

(i haven't looked at incidence in males, so won't comment.)

 

AFAIK the principal mode of transmission is via oral sex - but don't know if there are significant differences in the transmission rate based on which particular behavior one is engaging in - but I don't think there is any group other than the celibate, the partnered-for-life-and-HPV-negative, or the too-late-already-got-HPVE16 populations that can rationally conclude that the cost and risks associated with getting vaccinated aren't vastly exceeded by the benefits on an individual level.

 

FWIW I think that most of the data that does the cost-benefit analysis in terms of population level cost-benefit aggregates finds that the population-level cost of vaccinating males exceeds the population-level benefits, but IIRC you don't seem to think in terms of broad-aggregates.

 

 

 

 

 

 

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