Wednesday, March 18, 2015

one parent's concern about mandating an STI vaccine

I'll be honest, the vaccine debate makes me nervous.

My husband and I, we have our stance on vaccinations. We've discussed them for hours and hours and hours and hours. We've sifted through article after article, read tons of vaccine inserts, Googled all.the.things, and read peer reviewed studies on Friday nights (because I'm that kind of nerd). We've talked about them with multiple health care professionals, all with different opinions and backgrounds. We've prayed about our decisions, sought Godly wisdom and searched scripture.

But I'm not here to discuss our conclusions. The debate has become too hateful and heated to jump into that side of the pool.

I am, however, going to dip my toe into one area that I feel strongly needs to be nipped in the butt.

Like now.

There is a bill that has been recently introduced into the Nevada legislature. It would mandate the HPV vaccine for any and all children who attend a public school, charter school or private school (or daycare. Technically the CDC schedule doesn't recommend the HPV vaccine until age 9 and so theoretically this wouldn't apply to daycare. I don't understand, though, why this vaccine is even mentioned in Section 3 of the bill which applies only to child care. But maybe that's just the cynic in me thinking there could be more to that? Either way, it's weird and something I felt needed to be noted).

If you've watched TV in Nevada in the past few weeks you may or may not have seen a recent commercial for a new catchy campaign called "HPV Free Nevada."

Channel 8 ran an irresponsible story on it (more on why I call it that momentarily), which is how I first came to know about HPV Free NV. I was immediately concerned that the news story didn't include any rebuttal from parents or doctors. Not a single concern was presented from the other side of the coin. But obviously concern exists, considering that nationally, HPV vaccination rates in 2013 were only 37.6%. In Nevada the number is closer to 27%. Could that be a reason why we are considering mandated vaccination? Merck has to earn the money they invested in this back some how. (Sorry, the cynic in me slipped out again. I'll do my best to keep her quiet).

But the name of this new campaign is itself misleading. Even if we vaccinate every single person in Nevada with Gardasil or Cervarix, it would be impossible for the state to be "HPV free."

Which leads me to the first reason why this parent has concerns, actually is alarmed, about mandating a vaccine for HPV:

Gardasil only protects against 4 of the 150+ strains of HPV and Cervavix only protects against two. Now it's true that those 4 strains are the ones that most commonly lead to cases of cervical cancer (70% of the time), but that still leaves 30% of strains not included in these vaccines. And even when they release Gardasil 9, which is on it's way, it will still leave out 10% of the strains that can cause cervical cancers.

To claim that, "once they're (kids) vaccinated, they won't ever have to worry about HPV" as Channel 8 prints in their story, without rebuttal, is dangerous. It will lead to parents vaccinating under a false sense of security. It will lead to sexually active kids living under a false sense of security. A security that one can never be guaranteed. It must also be noted that the man interviewed in this story was referring not to the new vaccine (Gardasil 9), but to the one currently distributed, which covers only 4 types of HPV.

Mandating these vaccines will not lead to an "HPV free" Nevada, or any state for that matter.

But my concerns run far deeper.

 photo gardasil post_zpsomwtmzti.jpg

These are fairly new vaccines and the long term repercussions and effects are unknown. Gardasil was licensed in 2006. That is less than 10 years ago. To be honest, at this point in time, there are so many other vaccines not required for school in Nevada that I think much better arguments could be made for. But considering that the HPV vaccine is for a sexually transmitted disease, is it surprising to consider that parents are concerned about the long-term effects it could potentially have on their daughters', and now sons', reproduction?

Again I refer to the Channel 8 report where they quote the executive director of Immunize Nevada who said, "I think parents need to know that vaccinating your kids is safe. It's effective, it's studied, it's researched." As with the previous statement, no rebuttal. No counter information. No mention of the tens of thousands of VAERS (Vaccine Adverse Event Reporting System) reports made to include 12,305 ER visits and 220 deaths. Keep in mind that those numbers are with only 37% of the population being vaccinated. Imagine what will happen when it becomes mandated and [close to] 100% of the population is vaccinated. The numbers will go up, no question. 

In fact, Japan withdrew their recommendation for the vaccine in 2013 after thousands of reports of adverse side effects.

Safe? I wouldn't call that safe. And even though there are plenty of children who have not had adverse reactions to the vaccine, I still wouldn't call it safe. We cannot make blanket, one-size-fits-all statements like that when they aren't entirely true. Which again, is why I think it's irresponsible to publish a report that doesn't include all the numbers and address the concerns. 

But back to the concern over long-term side effects. Heidi Parker, executive director of Immunize Nevada, claims this vaccine has been studied and researched (see quote above). It has. Obviously. But has it been studied thoroughly enough? Is 48 months long enough to determine that it is absolutely, without a doubt, no-reason-to-worry, safe? That's basically what she's telling parents. But many parents don't think so. Can we just stop and talk about that for a moment before this legislation is pushed through?

According to the National Vaccine Information Center, "Merck’s Gardasil vaccine was studied for less than two years in about 1,200 children under age 16 before it became the first licensed HPV vaccine in the U.S." Did you catch that? Only 1200 children under 16 were studied and those children were studied for less than 2 years. That's out of 18,000 individuals. And here we are, talking about requiring 9, 10, 11, and 12 year olds to be vaccinated with this? The majority of those tested in these studies were over the age of 16.

So again I ask, how can we say it's absolutely, no-reason-to-worry, safe, especially for individuals under 16? There were so few of them tested!

Now that we've addressed the concern over who was tested during the study, I think it's also worth noting that since the study was a mere 48 months long, Merck doesn't know definitively how long the vaccine is effective for. No longitudinal studies have been performed. Some suggest 4 years, others suggest 6. For the sake of this argument, let's go with a median guess of 5 years.

So let's flesh that out:

I vaccinate my daughter at age 9 because it's recommended that she be fully protected before sexual activity begins (all this because the government assumes that my daughter will be sexually active at a young age. Isn't that nice of them to protect her because they think I can't or won't or will just be oblivious? That's basically what they are saying by attempting to mandate this vaccine). This is because once sex begins, if she catches any of the 4 HPV strains contained in the vaccine, the vaccine will no longer protect her from the cervical cancer that stems from that strain (this may be obvious, but I figured it should be noted). Now, if the vaccine is only affective for 5(ish) years, I better be darn sure I'm taking her back in right at age 14 to be vaccinated again. And then 19. And then 24. And then 29. And so on and so forth.

But wait, what if I forget and it lapses a few months. Because let's be honest, I'm pretty sure 99.9% of people don't get boosters when they're supposed to. Especially adults. She could catch it in between!

Or wait, what if it wears off at 4.5 years because, who can really know! Now she's really exposed.

All that to say, some parents are a little hesitant about jumping all in on this notion that a shot can be everyone's savior when it comes to protecting against a disease that is linked only to certain behaviors. My desire is not to get into a debate about sex education, but if we're going to be completely honest, the only way we can guarantee that someone will not contract HPV is if he and she remain abstinent until marriage (oh boy do I sound old fashioned!). Relying on a shot to do that will only lead to disappointment and confusion.

Which brings me to my final point (at least for now). How is it logical to require immunization against a sexually transmitted disease in order for my child to attend school? I'll answer: it's not. I understand the argument for vaccinating against communicable diseases, airborn diseases, viruses and bacteria that my children can easily spread or contract through the air, touching a doorknob or sharing a straw. I cannot understand the argument in this instance. My child isn't going to school to have sex (although I guess if we head down that rabbit hole, in just a few years, sadly HPV may very well be an easily caught disease at school. But that's an entirely different conversation for another time). My kid is, however, breathing air, sharing lunch, hugging friends and interacting closely with other children. So defend vaccines against communicable diseases, but not for STIs.

Frankly, it is none of the teacher's, school's, school district's or the state's business whether or not my child has or has not been immunized for an STD.

That is none of their business and it should remain none of their business.