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More on the HPV vaccine for men

I was one of those feminists who spent a lot of 2007 planning community forums about the importance of having options, first and foremost, when it comes to sexual health. But it didn't sit well with me that HPV vaccination efforts only involved young women.

Last month marked an important breakthrough in sexual health: an FDA panel recommended Gardasil, the HPV vaccine, for males ages 9 through 26. Although men and women have equal chances of getting genital warts -- a symptom of HPV -- they don't have equal access to testing or vaccinations, which are not widely available for men. Being the equality advocate that I am, when I learned that the vaccines would now be recommended for both sexes, I started to do an Irish dance -- yes, like the ones in the River Dance commercials that air at 5 a.m. -- but halted mid-step.

It's not my intent to do an about-face on this issue, but now that the vaccine is almost here I am totally conflicted. On one hand, men should take their sexual health more seriously because of how health outcomes can affect them and their partners. The introduction of this vaccine gives men an incentive to invest in their sexual health. But there are drawbacks when considering the decision-making of Merck, the maker of Gardasil, and the circumstances surrounding how money has been spent to advocate for the vaccine.

My beef with Gardasil is really a beef with the unethical practices of Merck, the pharmaceutical giant that currently has a monopoly over the HPV vaccine in the U.S. A report published in Business Week reminded me of Merck's decision in 2006 and 2007 to lobby lawmakers to make the vaccine mandatory in some states. To boot, the article notes that we still aren't in the know about long-term effects of Gardasil.

Other ethical questions arise when we consider how health care providers have been influenced by Merck's monetary muscle. A report in the Journal of the American Medical Association revealed that Merck doled out grants to professional medical organizations, which allegedly pushed medical professionals to advocate for Gardasil. This report also noted that Merck's strategy put an increasing focus on all women and not populations that were most at risk to contract HPV.

Perhaps most intriguing is the need for critical questions that evaluate vaccination against preventative testing -- something that men still lack in the case of HPV. This was best captured by Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at Dartmouth, who was featured in a Los Angeles Times article last August. "If we vaccinate every single 12-year-old, it should reduce by half the number of cervical cancers in the next 35 years... (but) with Pap screening, we've reduced it by nearly 75 percent," she said.

Knowing that, this is my formal plea to Merck to invest in HPV testing for men if they haven't already started to do so.

But to Merck's credit, Gardasil can't be all bad if it is one formality away from being widely available for men. According to CNN, clinical trials revealed a 90 percent reduction in the infection of genital warts and cancerous lesions. Further, in an interview with Robert Ernst, medical director of unviersity health services at the University of Michigan, he confirmed, "The vaccine in men would help to prevent the spread of HPV to susceptible women, and therefore indirectly help to reduce the likelihood of cervical cancer in women." He also noted that Gardasil would vaccinate against penile cancers and gay men will have an opportunity to prevent strands of HPV that could possibly cause anal cancers.

For both men and women, getting the vaccine can be a gateway to checking up on other aspects of your sexual health and asking your provider sexual health questions. The vaccine is also important in and of itself -- it will make it really hard for you to contract genital warts, an infection that condoms won't protect you from. Not getting warts isn't just good for your health but also your genital self-esteem.

I can see the Merck commercials now: "With penis size anxiety and maintaining an erection, you'll have one less thing to worry about: warts!"

Reposted from the Michigan Daily

Posted by Rose Afriyie - October 02, 2009, at 10:56AM | in Activism , Health

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7 Comments

Barack Obama may be doing what he can, but I would not be in such a hurry to trust the public health officials in the United States. A few things about Gardasil: it is marketed to prevent cancer, but it has not, as far as I know, been confirmed that Gardasil itself is not carcinogenic. In addition to some really scary cases involving people receiving the vaccine and then erupting in warts -- all over their bodies, covering the palms of their hands -- at least eighteen people have died after receiving the vaccine.

Here's a source that seems to have done its homework, although the article is about a year old --

http://www.judicialwatch.org/documents/2008/JWReportFDAhpvVaccineRecords.pdf

[0+] Author Profile Page kaliyuga replied to aletheia_shortwave :

Just to reply to aletheia_shortwave, but I think some of your criticism are not correct. It's true that in the US the price of Gardasil may outweigh its benefit in cancer prevention (especially as regular screening gives as great or greater advantage). In that Merck's actions may be questionable. Then again in our current health care system are women going to be getting these cancer screenings if they don't have health insurance?

As for the safety of the vaccine there has been a lot of safety trials and ongoing monitoring. Side effects tend to be soreness at the injection site. The cancer risk from the shot is pretty much none since there is no virus DNA in the vaccine. These viruses cause cancer by inserting their DNA into the genome disrupting the cell's system for controlling the cell cycle and making it divide like crazy. As for the reported deaths, these are just correlations. A big case of this popped up in England and was reported in the BBC of a girl dying hours after another HPV vaccine (Cervarix). An autopsy showed that the teenager had died because of a massive tumor on her lungs and heart. Thousands of people die every day (even young teenagers) and when millions of doses of a vaccine are administered the probability of someone dying right after (even minutes after) getting an HPV vaccine is pretty much 100%. Statistically the amount of deaths in people receiving Gardasil and those that don't is about the same.

Also I don't think Judicial Watch is the best source. One they are not a medical organization, but a legal one. Also, though they seem to have been involved in some worthy things recently (suing to get Cheney's energy task force records, etc.) they are also a conservative organization that were involved with all sorts of shenanigans against the Clinton administration. You would also think that they might have some bias due to social conservatives' weird sex hangups and HPV being an STD.

As for my bias, I am not a doctor, I don't work for biotech or for Merck specifically. Though I guess you could say I don't have any special knowledge either. But, I think there are these misconceptions out there and they can be harmful and unfortunately the effort to counter these doesn't really materialize. Anyway looking back this reply has gotten pretty humongous so if you get this far, gold star for you!

[0+] Author Profile Page AuntieMay said:

Frankly, Gardasil scares because of the unknown side affects. I'm very suspicious that Merck rushed it through clinical trials and then started a huge marketing campaign partially based on fear and guilt.

It is encouraging that a vaccine for men is being discussed. Sexual health should be addressed for both genders. Which reminds me, where is the infamous male birth control pill?

If there is anything that checks my feminist belief of having agency in when, where, with whom and how often I engage in casual sex, it's HPV.

The fact that it is such a common STD and the fact that condoms don't protect against it even with proper, consistent usage, scares me off of the promiscuous fun I'd like to have.

Add to that the fact that there is NO cure for HPV and NO HPV test for men and therefore, being responsible and getting tested with a male partner before engaging in sexual contact is still no guarantee that a guy who gets a clean bill of sexual health won't give his partner HPV. I just feel like I should never have sex again, at least until there's a preventative test for men.

[0+] Author Profile Page Sex Toy James said:

HPV is scary. I'm looking forward to them getting Gardasil officially approved for men. If they had sooner I would already have gotten it.


[0+] Author Profile Page TD said:

I really don't understand the level of fear associated with HPV. Before this vaccine it was not a very large consideration. Most of the adult populace has had it with no side effects whatsoever. A vaccine is nice, but it doesn't seem to drastically change anything.

I've known people who have confused HPV with HSV, but that does not seem to be the issue.

[0+] Author Profile Page emb-random said:

In 2006 Merck was awarded Brand of the Year by Pharmaceutical Executive magazine for creationg a "market out of thin air" (Herskovits 2007, 60). Merck's aggressive advertising campaign essentially created a market (of fear) in order to sell their product.

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