Gardasil – saves your cervix, does nothing to your ovaries

Vaccine myths are like the fart smell that somehow gets trapped in your air-conditioning in your car.  They both seem to keep going around and around, reappearing at random, and are both similarly fetid.

Doing the rounds of the social media sites this week is the old chestnut that Gardasil, the human papilloma virus vaccine, caused a teenage girl’s ovaries to implode, and that Merck, that rich powerful conglomerate of evil, conveniently forgot to investigate the effects of the vaccine on the female reproductive system.

Actually, this is old news.  I wrote a couple of blogs in in the past about Gardasil conspiracy theories, including one about the whole Gardasil-kills-ovaries thing (and another here).  In the last couple of years, nothing much has really changed, well, except that the benefit of the HPV vaccine has become much clearer, and the hysteria of the anti-vaxxers has become more pronounced as a result.

For example, the article that’s recently been making the rounds is a 2013 article by Jonathan Benson at Natural News.  This particular article was discussing a paper published in the highly esteemed British Medical Journal [1] (which you can read for yourself here). Benson’s opening paragraph shows how ignorant and/or biased anti-vaccine proponents can be.

“A newly-published study has revealed that Merck & Co., the corporate mastermind behind the infamous Gardasil vaccine for human papillomavirus (HPV), conveniently forgot to research the effects of this deadly vaccine on women’s reproductive systems. And at least one young woman, in this case from Australia, bore the brunt of this inexcusable failure after discovering that her own ovaries had been completely destroyed as a result of getting the vaccine.”

There are a couple of big errors here.  First, the article in the BMJ isn’t a study, merely a case report.  There’s a big difference, namely the fact that a case report is just that, a report of a single case.  It’s not a study that proves that one thing causes another, but merely raises the possibility that there might be something going on that other peers should be aware of or further investigate.  The lack of definitive proof didn’t stop Benson from making his other big error, leaping to a rather tenuous conclusion that this girl’s ovaries imploded because of Gardasil.

In actual fact, Premature Ovarian Insufficiency (or POI), was known about long before the Gardasil vaccine was invented.  In 1986, the known incidence was about 1 in 10,000 young women between the ages of 15 and 29 [2], and there’s no known cause in more than 90% of the cases.

So, if Gardasil was one cause of ovary implosion in young women, then it stands to reason that the rate of ovary implosion would be much higher after the introduction of Gardasil.  Is that the case?

As it turns out, the answer is no.  A big fat no.  According to the Therapeutic Goods Administration in Australia, the number of Gardasil doses that have been administered in Australia has been more than 9 million.  The number of reports of ovary implosion? Three.  Just three.

That works out to be a rate of 0.003 per 10,000.

That’s quite a lot less than the rate of ovary implosion before Gardasil was invented.  Maybe Gardasil protects your ovaries rather than destroys them.

So Gardasil isn’t rendering anyone’s daughters infertile.  The TGA has reviewed this issue a number of times and reached the same conclusion every time … there is NO link between Premature Ovarian Insufficiency and the HPV vaccine.

What the HPV vaccine is doing is reducing the incidence of genital warts and gynaecological cancers.  For example, in the years leading up to the introduction of the HPV vaccine, the number of women presenting with genital warts was about 1 in 10.  In the four years after the vaccine was introduced, the rate of genital warts had fallen between 70 to 90% depending on the age group.  The effect was especially obvious in the women under the age of 21, whose rate of genital warts dropped from over 1 in 10 to less than 1 in 100 after the introduction of the vaccine.

The rate of cervical cancer changes also fell, with a study by Gertig and colleagues in 2013 showing that a full three doses of the HPV vaccine decreased the risk of high-grade (that is, nasty pre-cancerous) pap smear changes by nearly 50% [3].

So you won’t hear this from the Natural News team or others of their ilk, but vaccination with the HPV vaccine decreases your risk of genital warts by over 90%, decreases your risk of nasty cervical cancer changes by about 50%, and increases your risk of ovarian implosion by about 0%.

Don’t let the repugnant hot air of the anti-vaxxers put you off.  Vaccination with the HPV vaccine is safe and effective, not harmful like the vaccine myths would have you believe.

References

[1]        Little DT, Ward HR. Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination. BMJ Case Rep 2012;2012.
[2]        Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol 1986 Apr;67(4):604-6.
[3]        Gertig DM, Brotherton JM, Budd AC, Drennan K, Chappell G, Saville AM. Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study. BMC medicine 2013;11:227.

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Dr Caroline Leaf and the 98 Percent Myth

Dr Caroline Leaf believes that nearly all our diseases come from our thoughts.

Dr Caroline Leaf believes that nearly all our diseases come from our thoughts.

In the hustle and bustle of daily life, most people wouldn’t stop to consider what makes people sick.  In my profession, I get a front row seat.

In the average week, I get to see a number of different things.  Mostly “coughs, colds and sore holes” as the saying goes, although there are some rarer things too.  And sometimes, people present with problems that aren’t for the faint of heart (or stomach – beware of nail guns is all I can say).

Normally, the statistics of who comes in with what doesn’t make it beyond the desk of the academic or health bureaucrat.  The numbers aren’t as important as the people they represent.

But to Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist, the numbers are all important.  To support her theory of toxic thoughts, Dr Leaf has stated that “75 to 98% of mental and physical (and behavioural) illness comes from one’s thought life” [1: p37-38].  She has repeated that statement on her website, on Facebook, and at seminars.

As someone with a front row seat to the illnesses people have, I found such a statement perplexing.  In the average week, I don’t see anywhere near that number.  In general practices around Australia, the number of presentations for psychological illnesses is only about eight percent [2].

But Australian general practice is a small portion of medicine compared to the world’s total health burden.  Perhaps the global picture might be different?  The World Health Organization, the global authority on global health, published statistics in November 2013 on the global DALY statistics [3] (a DALY is a Disability Adjusted Life Year).  According to the WHO, all Mental and Behavioural Disorders accounted for only 7.2% of the global disease burden.

You don’t need a statistics degree to know that seven percent is a long way from seventy-five percent (and even further from 98%).

Perhaps a large portion of the other ninety-three percent of disease that was classified as physical disease was really caused by toxic thoughts?  Is that possible?  In short: No.

When considered in the global and historical context, the vast majority of illness is related to preventable diseases that are so rare in the modern western world because of generations of high quality public health and medical care.

In a recent peer-reviewed publication, Mara et al state, “At any given time close to half of the urban populations of Africa, Asia, and Latin America have a disease associated with poor sanitation, hygiene, and water.” [4] Bartram and Cairncross write that “While rarely discussed alongside the ‘big three’ attention-seekers of the international public health community—HIV/AIDS, tuberculosis, and malaria—one disease alone kills more young children each year than all three combined. It is diarrhoea, and the key to its control is hygiene, sanitation, and water.” [5] Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years (DALYs)), and poor-quality drinking water is an important risk factor for diarrhoea.” [6]

Diarrhoeal disease in the developing world – the second most common contributor to disease in these countries, afflicting half of their population – has nothing to do with thought.  It’s related to the provision of toilets and clean running water.

We live in a society that prevents half of our illnesses because of internal plumbing.  Thoughts seem to significantly contribute to disease because most of our potential illness is prevented by our clean water and sewerage systems.  Remove those factors and thought would no longer appear to be so significant.

In the same manner, modern medicine has become so good at preventing diseases that thought may seem to be a major contributor, when in actual fact, most of the work in keeping us all alive has nothing to do with our own thought processes.  Like sanitation and clean water, the population wide practices of vaccination, and health screening such as pap smears, have also significantly reduced the impact of preventable disease.

Around the world, “Recent estimates of the global incidence of disease suggest that communicable diseases account for approximately 19% of global deaths” and that “2.5 million deaths of children annually (are) from vaccine-preventable diseases.” [7] Again, that’s a lot of deaths that are not related to thought life.

Since 1932, vaccinations in Australia have reduced the death rate from vaccine-preventable diseases by 99% [8].  Epidemiological evidence shows that when vaccine rates increase, sickness from communicable diseases decrease [9: Fig 2, p52 & Fig 8, p67].

Population based screening has also lead to a reduction in disease and death, especially in the case of population screening by pap smears for cervical cancer.  Canadian public health has some of the best historical figures on pap smear screening and cervical cancer. In Canada, as the population rate of pap smear screening increased, the death rate of women from cervical cancer decreased.  Overall, pap smear screening decreased the death rate from cervical cancer by 83%, from a peak of 13.5/100,000 in 1952 to only 2.2/100,000 in 2006, despite an increase in the population and at-risk behaviours for HPV infection (the major risk factor for cervical cancer) [10].

And around the world, the other major cause of preventable death is death in childbirth.  The risk of a woman dying in childbirth is a staggering one in six for countries like Afghanistan [11] which is the same as your odds playing Russian Roulette.  That’s compared to a maternal death rate of one in 30,000 in countries like Sweden.  The marked disparity is not related to the thought life of Afghani women in labour.  Countries that have a low maternal death rate all have professional midwifery care at birth.  Further improvements occur because of better access to hospital care, use of antibiotics, better surgical techniques, and universal access to the health system [11].  Again, unless one’s thought life directly changes the odds of a midwife appearing to help you deliver your baby, toxic thoughts are irrelevant as a cause of illness and death.

Unfortunately for Dr Leaf, her statement that “75 to 98 percent of mental, physical and behavioural illnesses come from toxic thoughts” is a myth, a gross exaggeration of the association of stress and illness.

In the global and historical context of human health, the majority of illness is caused by infectious disease, driven by a lack of infrastructure, public health programs and nursing and medical care.  To us in the wealthy, resource-rich western world, it may seem that our thought life has a significant effect on our health.  That’s only because we have midwives, hospitals, public health programs and internal plumbing, which stop the majority of death and disease before they have a chance to start.

Don’t worry about toxic thoughts.  Just be grateful for midwives and toilets.

References

1.         Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:

2.         FMRC. Public BEACH data. 2010  [cited 16JUL13]; Available from: <http://sydney.edu.au/medicine/fmrc/beach/data-reports/public%3E.

3.         World Health Organization, GLOBAL HEALTH ESTIMATES SUMMARY TABLES: DALYs by cause, age and sex, GHE_DALY_Global_2000_2011.xls, Editor 2013, World Health Organization,: Geneva, Switzerland.

4.         Mara, D., et al., Sanitation and health. PLoS Med, 2010. 7(11): e1000363 doi: 10.1371/journal.pmed.1000363

5.         Bartram, J. and Cairncross, S., Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med, 2010. 7(11): e1000367 doi: 10.1371/journal.pmed.1000367

6.         Hunter, P.R., et al., Water supply and health. PLoS Med, 2010. 7(11): e1000361 doi: 10.1371/journal.pmed.1000361

7.         De Cock, K.M., et al., The new global health. Emerg Infect Dis, 2013. 19(8): 1192-7 doi: 10.3201/eid1908.130121

8.         Burgess, M., Immunisation: A public health success. NSW Public Health Bulletin, 2003. 14(1-2): 1-5

9.         Immunise Australia, Myths and Realities. Responding to arguments against vaccination, A guide for providers. 5th ed. 2013, Commonwealth of Australia, Department of Health and Ageing, Canberra:

10.       Dickinson, J.A., et al., Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC Public Health, 2012. 12: 992 doi: 10.1186/1471-2458-12-992

11.       Ronsmans, C., et al., Maternal mortality: who, when, where, and why. Lancet, 2006. 368(9542): 1189-200 doi: 10.1016/S0140-6736(06)69380-X

Gardasil and the Deadly Scam

Making the rounds of Facebook is an article published on The Daily Sheeple (“Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam,” 2014) about Gardasil, the Human Pappilloma Virus vaccine.

If what Sheeple are saying is correct, then Gardasil is a deadly scam!  We’ve all been conned into believing that Gardasil and other HPV vaccines were safe, and useful in protecting our children from cervical cancer, when really it doesn’t do anything but make money for Merck, that multi-billion dollar global tyrant, while our children wither and die.

True to the form of paranoid extremists everywhere, Sheeple uses hysterical accusations and mistruths in a breathless promotion of fear and ignorance.  The only deadly scam going on here is Sheeple’s.

Lets break down the article by Sheeple a little, then lets look at the facts from the peer-reviewed literature, not misquotes from misquotes.

Sheeple quotes an article on a similarly extreme blog, which took the quotes from another extremist blog.  It alleges that Dr Harper believed that Gardasil was pointless, and harmful, even more harmful than cervical cancer which it was designed to prevent.  The article alleges that there were 15,037 adverse reactions and 44 deaths.  They quote Harper to CBS stating that, “‘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,’ Harper tells CBS NEWS.  ‘The rate of serious adverse events on par with the death rate of cervical cancer.’”

The truth is that the rates of serious adverse reactions to the HPV vaccine are incredibly small.

The CDC Morbidity and Mortality Weekly report from the 26th July 2013 states that, “From June 2006 through March 2013, approximately 56 million doses of HPV4 were distributed in the United States … During June 2006–March 2013, the Vaccine Adverse Event Reporting System (VAERS) received a total of 21,194 adverse event reports occurring in females after receipt of HPV4” (Centers for Disease Control and Prevention, 2013).  That’s an adverse events rate of 0.04%.

The vast majority of vaccination side effects are a red, sore arm and fainting, which are not exclusive side effects to HPV vaccinations, but to all vaccinations in adolescents (Centers for Disease Control and Prevention, 2013; Harper & Vierthaler, 2011).  In large trials, the rate of vaccine side effects was comparable to the rate of side effects from the placebo (Centers for Disease Control and Prevention, 2013; Gee et al., 2011; Lu, Kumar, Castellsague, & Giuliano, 2011; Rambout, Hopkins, Hutton, & Fergusson, 2007).  So the vaccine is not the problem, it’s the histrionic teenagers.

In terms of deaths from the HPV vaccine, there aren’t any.  Rambout et al. (2007) wrote, “The meta-analysis demonstrated that, overall, the incidence of serious adverse events and death was balanced between the vaccine and control groups … Most deaths were reported as accidental, and none of the deaths was considered attributable to the vaccine.”  National Centre For Immunisation Research and Surveillance (2013) states that, “HPV vaccines are approved for use in over 100 countries, with more than 100 million doses distributed worldwide … No deaths reported in safety surveillance systems data in Australia or overseas, have been determined to be causally related to either of the HPV vaccines.”

Compare that to the current Australian road toll, which currently stands at 5.2/100,000 (Road Deaths Australia, December 2013).  It’s safer to have a HPV vaccination than it is to drive a car.

The Sheeple article also fails to correctly report the benefits of the HPV vaccine, which has already shown a dramatic drop in the rate of HPV infection (Lu et al., 2011) and the incidence of genital warts (Ali et al., 2013).

Given all of this, did Dr Harper really suggest that the HPV vaccine was useless and harmful?  I doubt she said anything of the sort, since in 2011 in a formal paper in a peer-reviewed journal, she said, “Should vaccination be an option that women choose for their cervical cancer protection, Cervarix is an excellent choice for both screened and unscreened populations due to its long-lasting protection, its broad protection for at least five oncogenic HPV types, the potential to use only one-dose for the same level of protection, and its safety.” (Harper & Vierthaler, 2011)

One final word about every woman’s favourite health check, the pap smear.  Australia does have a low death rate from cervical cancer, compared to the rest of the world, even before the introduction of the HPV vaccine.  The national co-ordinated approach to cervical screening with pap smears is the reason why.  “Vaccination is not an ‘alternative’ to Pap tests; together these two approaches provide optimal protection. The National Cervical Screening Program recommends routine screening with Pap tests every 2 years for all women between the ages of 18 (or 2 years after first sexual intercourse) and 69 years.” (National Centre For Immunisation Research and Surveillance, 2013)

Is there a giant deadly scam behind the Gardasil vaccine?  Only from those who oppose it.  The same people wouldn’t think twice about letting their teenagers in a car, which is far more dangerous.  When it’s their turn, I’ll have no hesitation in having my children vaccinated for HPV.  If you disagree, that’s ultimately your choice.  But examine all the facts first.  Don’t let your children’s health rest on a baseless Internet meme.

References

Ali, H., Donovan, B., Wand, H., Read, T. R., Regan, D. G., Grulich, A. E., . . . Guy, R. J. (2013). Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ, 346, f2032. doi: 10.1136/bmj.f2032

Centers for Disease Control and Prevention. (2013). Human papillomavirus vaccination coverage among adolescent girls, 2007-2012, and postlicensure vaccine safety monitoring, 2006-2013 – United States. MMWR Morb Mortal Wkly Rep, 62(29), 591-595.

Gee, J., Naleway, A., Shui, I., Baggs, J., Yin, R., Li, R., . . . Weintraub, E. S. (2011). Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink. Vaccine, 29(46), 8279-8284. doi: 10.1016/j.vaccine.2011.08.106

Harper, D. M., & Vierthaler, S. L. (2011). Next Generation Cancer Protection: The Bivalent HPV Vaccine for Females. ISRN Obstet Gynecol, 2011, 457204. doi: 10.5402/2011/457204

Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam. (2014). The Daily Sheeple.  Retrieved Jan 17, 2014, from http://www.thedailysheeple.com/lead-developer-of-hpv-vaccines-comes-clean-warns-parents-young-girls-its-all-a-giant-deadly-scam_012014 – sthash.lDJcsFRt.dpuf

Lu, B., Kumar, A., Castellsague, X., & Giuliano, A. R. (2011). Efficacy and safety of prophylactic vaccines against cervical HPV infection and diseases among women: a systematic review & meta-analysis. BMC Infect Dis, 11, 13. doi: 10.1186/1471-2334-11-13

National Centre For Immunisation Research and Surveillance. (2013). Human papillomavirus (HPV) vaccines for Australians | NCIRS Fact sheet: March 2013.   Retrieved Jan 17, 2014, from http://www.ncirs.edu.au/immunisation/fact-sheets/hpv-human-papillomavirus-fact-sheet.pdf

Rambout, L., Hopkins, L., Hutton, B., & Fergusson, D. (2007). Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials. CMAJ, 177(5), 469-479. doi: 10.1503/cmaj.070948

Road Deaths Australia, December 2013. (2014).  Canberra, Australia: Commonwealth of Australia. Retrieved from http://www.bitre.gov.au/publications/ongoing/rda/files/RDA_Dec13.pdf.

Needles of Death

Acupuncture caused womans heart to implode.

A woman in the prime of her adult life had that life ripped away by acupuncture, a known deadly complementary therapy.  Worse, though, is that acupuncture therapists don’t warn of these potentially fatal outcomes or actively hide them.

Ernst(1) documents two cases of healthy women who have had their lives torn away from them as murderous acupuncture needles were inserted into their vital chest organs causing them to instantly fail.  Each woman would have died in agony as their heart and lungs were unable to get blood to their body’s vital organs.

One woman, a forty-four year old lady, had an acupuncture needle pushed into her heart, causing severe pain and breathlessness.  When she alerted the acupuncturist to her peril, his “cure” was to insert another needle, causing a full-blown cardiac arrest.

Another woman, twenty-six years old, died after an acupuncture needle was inserted into one of her lungs causing the lung to collapse.  She eventually died from a tension pneumothorax, in which the punctured lung leaks air into the chest cavity with every breath, compressing the other chest organs like a Boa Constrictor.  A tension pneumothorax is one of the most terrifying ways to die.

Acupuncture is a multi-billion dollar industry.  Despite its potentially fatal consequences, it goes on, unabated and unregulated.  People need to be warned before more lives are lost to the needles of death.”

Do you feel scared of acupuncture after reading this?  Should you believe it?

These sort of beat up articles occur all the time.  A case report which links a vaccine or drug to an adverse outcome is exaggerated with highly emotional language and posted on conspiracy-driven anti-vaccination blog or site.  Then it gets sent around on Facebook or Twitter like an intellectual virus, taken as evidence of the evils of corporate western medicine by people who take the information on face value.

The latest that came across my Facebook page was of a claim that a 16 year old girls ovaries shrivelled after being exposed to the Gardasil vaccine for the Human Papilloma Virus/cervical cancer.(4)

The problem that these anti-vaccine activists have is that case studies, while interesting, have no evidentiary weight behind them.  Trying to make a case study out to be definitive proof for anything is like putting a grain of salt into a swimming pool and suggesting that you have salt-water.  How many cases of premature ovarian failure have been reported as a direct result of the Gardasil vaccine? I don’t know the exact answer to that, but I’d be surprised if I couldn’t count them on one hand.  Compare that to the hundreds of thousands of women vaccinated with the Gardasil vaccine.

One of the respondents to the anti-Gardasil blog(4) said, “This vaccine has never prevented a single case of oral, cervical, or anal cancer …”  Actually, it has likely prevented thousands.(2)  Case studies can’t see the bigger picture.

And for every case study against western medicine, there are just as many against complementary medicines and practices.  (There would be more, except that the dearth of regulation of the alternative and complementary therapy industry means that most of the adverse outcomes of alternative treatments go unreported).

Braun et al(3) report the case of a twenty-nine year old woman discovered to have an entirely treatable early form of cervical cancer on a pap smear, who died in agony from widespread metastatic cancer of the cervix, despite thirteen years of various complementary medicines (a homeopathic therapy consisting of a vitamin C-containing regimen and subcutaneous administration of mistletoe lectins, “regional hyperthermia”, Horvi-Reintoxin enzyme therapy, and pyrogenic lysates of bacteria combined application of Carnivora-Mistletoe-Ukrain).  This woman’s cancer was caused by HPV-18, which would have been prevented by Gardasil (if it was available to her.)

The point of the story is this: All treatments have side effects or complications.  If you look hard enough, you will find case reports of direct or associated illness from just about any traditional or complementary therapy.  But case studies are not good evidence.  They do not see the bigger picture.  They can not be generalised.

In trained hands, and for the right uses, acupuncture can be a very powerful therapeutic tool.  Acupuncture still does more good than harm.

In trained hands, and for the right uses, Gardasil and vaccines in general are very powerful preventative tools.  Vaccines still do more good than harm.

Neither are “needles of death”.

References

1. Ernst E. Acupuncture – a treatment to die for? Journal of the Royal Society of Medicine. 2010 Oct;103(10):384-5. PubMed PMID: 20929887.

2. Jin XW, Lipold L, Sikon A, Rome E. Human papillomavirus vaccine: safe, effective, underused. Cleveland Clinic journal of medicine. 2013 Jan;80(1):49-60. PubMed PMID: 23288945.

3. Braun S, Reimer D, Strobl I, Wieland U, Wiesbauer P, Muller-Holzner E, et al. Fatal invasive cervical cancer secondary to untreated cervical dysplasia: a case report. Journal of medical case reports. 2011;5:316. PubMed PMID: 21767367. Pubmed Central PMCID: 3156764.

4. http://www.thelibertybeacon.com/2013/07/22/gardasil-destroys-girls-ovaries-research-on-ovaries-never-considered-10497/