Human Papilloma Virus and Cervical Cancer

After I say that Nobel Prize in Medicine is usually given for research of little or no proven value, one counterexample I’ve heard is the 2008 prize for the discovery that cervical cancer is caused by the human papilloma virus (HPV). This should allow us to reduce cervical cancer via vaccination.

There are several things wrong with this example:

1. The predicted improvement has not been observed. The average age at which a woman is diagnosed with cervical cancer is 48 years old. To assess the effect of HPV vaccination — usually given to young girls — on cervical cancer you need to wait thirty years. Thirty years haven’t passed. The history of medicine is full of examples where treatments that supposedly worked — such as tonsillectomies, given to millions — when tested turned out to not work. The history of medicine is also full of examples where supposedly wonderful treatments (e.g., frontal lobotomies) turned out to have side effects so bad the treatment was stopped.

2. Cervical cancer is not a big source of death. In the United States, it kills perhaps five thousand women per year. Heart disease kills hundreds of thousands of people per year; so do all forms of cancer taken together. And pap smears, which cost little, actually work. “Cervical cancer is 100% curable if detected early,” says one website.

3. Because pap smears work well, it isn’t clear there is room for improvement. To find out you’d want to compare two groups: (a) pap smears plus HPV vaccination and (b) pap smears alone.

4. It isn’t clear the vaccine will work, even if HPV infection does cause cancer. There are at least 100 varieties of HPV; the vaccine protects against two. Does vaccination against two varieties increase infection by other varieties (because different viruses compete for the same niche)? Hard to rule this out. Again, there are many examples in medicine where actually helping people turned out to be far harder than experts had predicted, even when the initial idea wasn’t nonsense. An example is the oncogene theory of cancer, which also has a Nobel Prize associated with it.

In summary, not a counterexample.

39 Responses to “Human Papilloma Virus and Cervical Cancer”

  1. RAD Says:

    Seth, some counter points:

    - You seem to be conflating the discovery that HPV causes cervical cancer with the efficacy of the HPV vaccine. I’m assuming these are separate things.

    - Cervical cancer may not be a big source of death but, like breast cancer, it seems to kill relatively young people. If you were to define some notion of “Cost to Society” then 5000 mid-age women might be significant.

    - Pap smears may be low price but that may not be the same as low cost. Pap smears are costly in terms of patient time and discomfort (both physical and psychological). If HPV vaccinations eventually reduce the frequency of required pap smears then this can benefit women without bending the price/cost curve.

    Seth, I’m not disagreeing with your assessment, I don’t know enough about the topic, but I’d re-focus the target of your skepticism before accepting it as fact.

  2. Jason Says:

    What a narrow and — dare I say it — misleading critique. Let’s take a look:

    0. I’m not sure you’re the ultimate arbiter of what has or will have “proven value,” but the 2008 prize, shared between the HPV-related discovery and the discovery of HIV seems by several measures to be yielding practical benefit, of which vaccination is only one. Also, the prize identifies what the committees views as important discoveries within the basic science of physiology and medicine. As with much basic science, the value often doesn’t emerge for a long time, or emerges from discoveries stemming from the original one.

    1. This is true, although not exactly relevant to evaluating the Nobel prize. This is one application, and it will take time to discover if the vaccine affects cancer rates (among other things) over time. However, the data is already showing strong affects in a) infection with cancer causing strains of HPV, and b) cervical abnormalities. Perhaps you’re right that some other cause will emerge to mean that cancer rates down the road persist despite these signposts that they won’t, but if you have a compelling theory as to why, you haven’t presented it here.

    2. As is the case with most disease, mortality is not the only important measure. The vaccine and other advances stemming from this discovery has the potential to reduce a lot of morbidity, both physical, and psychological (see below). But I’d also add that in the third world, cervical cancer is a leading cause of death among low-income women. The wealthy U.S. is not a typical example.

    3. Pap smears work pretty well in part because they have a medium-high false-positive rate, and false negatives matter relatively little because of the slow moving nature of the disease. Assuming of course that women get regular, expensive testing. For women who don’t, the usefulness of a single pap goes way down.

    But there’s good news on this front thanks to — yes, that’s right — the discovery that certain strains of HPV cause cervical cancer. New testing that detects the actual strains of infection increases the accuracy of detection, and should decrease the needed frequency of screening. So in addition to reduced morbidity from actual cancer, women should experience less physical discomfort from screening and from unnecessary interventions. It will also reduce psychological morbidity by reducing the number of false positives.

    These advances should also reduce the cost of screening while increasing the convenience, which means more women in poor countries should be able to get screened, saving more lives and preventing more suffering.

    4. The vaccine doesn’t protect against non-cancer causing strains. It protects against the most common cancer-causing strains. You’re right that there isn’t long-term data yet, but I’m not sure I understand your point. We shouldn’t promote vaccination because it’s not 100% effective? No vaccine is 100% effective. We shouldn’t promote a vaccine shown to reduce infection rates of cancer-causing strains and reduce cervical abnormalities because… why exactly?

    So in summary, the discovery that HPV strains lead to cervical cancer has no predictable practical benefit except for: leading to improvements in screening that will reduce mortality, reduce morbidity, and save money; leading to a vaccine that reduces infection rates, reduces morbidity, and will likely — in 30 years or so — show reductions in cervical cancer mortality; and also vastly increasing scientific understanding of the mechanisms of a type of mutagenesis.

    I don’t know if you’re a Monty Python fan, but the example of the Romans and the aqueduct springs to mind.

  3. Jason Says:

    Oh, who could resist: https://www.youtube.com/watch?v=ExWfh6sGyso

  4. as Says:

    It’s important to know whether venereal warts causes cervical cancer whether the vaccine works or not because it illustrates the danger of promiscuity.

    Getting a Pap smear done is a terrible thing. You have to go to a doctor’s office, get naked, put on a paper gown, lie down on a bench and put your feet up in stirrups. Then the nurse sticks a long metal thing in your vagina in order to scrape your cervix. It would be a good idea to tell girls that cervical cancer is caused by a venereal disease and that they don’t have to get a pap smear done every year if they’re sure they haven’t been infected with the HPV virus.

    The recommended Pap smear intervals have changed. They used to say get it done every year, but then it was changed to every three years if your previous ones hadn’t shown any irregularities. It was probably performed too frequently for many women.

    If a doctor or nurse finds out that you don’t get regular check-ups at the gyno, they jump on you (out of concern I understand) to get a Pap smear done. They never tell you about the connection to venereal disease. I used to go to a dermatologist regularly and they would always ask me about my last Pap smears. I also know women (like my mother and her friends) who NEVER go to the gynecologist and same thing, they get yelled at on the rare occasion they do go to a regular doctor for something.

  5. as Says:

    HPV also causes oral cancer and anal cancer. People don’t usually get Pap smears in their throat or butthole.

    Seth: Let me ask you the same question. How do you know that HPV causes oral and anal cancer? All that’s been observed is a correlation, as far as I can tell. What about the possibility that early stages of the cancer make HPV infection more likely?

  6. as Says:

    Chastity is the issue at hand here, correct? If a woman gets cervical cancer, it means that (1) she was bad (2) the man was bad or (3) they were both bad.

    What if they lied about their chastity or faithfulness?

    “Roving Mates Called Factor In Cancer”

  7. Seth Roberts Says:

    Jason, do I say “we shouldn’t promote a vaccine because it’s not 100% effective?” No, I say that treatments should be tested before they are applied to large numbers of people. Since when is that controversial? Such tests will make clearer the relative size of costs and benefits.

    Surely you know that the assumption you make here — you assume that costs are small relative to benefits, since all you talk about are benefits — has been wrong dozens of times in medical history. Dozens of popular treatments (at least) were stopped or drastically scaled back after it became clear their costs outweighed their benefits. Mammograms are the latest example where it has become clear that the cost/benefit ratio is substantially worse than expected.

    Also, why are you sure that HPV infection (infection with certain strains) causes cervical cancer? What about the possibility that early stages in cancer progression make HPV infection with those strains more likely? Lack of certainty that HPV infection causes cervical cancer is another good reason to test the effect of vaccination.

  8. Joe Says:

    as Says:

    “HPV also causes oral cancer and anal cancer”

    That is one powerful little virus! It shouldn’t be long now before “global warming” will be blamed on HPV, too, merging two of the biggest scientific hoaxes of all time.

    Jason:

    “the 2008 prize, shared between the HPV-related discovery and the discovery of HIV seems by several measures to be yielding practical benefit, of which vaccination is only one.”

    What that particular prize actually identifies is the moment in time when many previous laws of science were turned on their heads. When correlation would now essentially mean the same thing as causation. When the scientific method would mostly be discarded. When historically proven and effective scientific techniques would now simply be ignored, like Koch’s Postulates. When viruses and retroviruses would now be deemed capable of doing things they absolutely are not capable of doing. When the “virus hunters” and BigPharma won the battle for control of the scientific paradigm.

    A sad day indeed.

  9. as Says:

    Seth: Let me ask you the same question. How do you know that HPV causes oral and anal cancer? All that’s been observed is a correlation, as far as I can tell. What about the possibility that early stages of the cancer make HPV infection more likely?

    “The first was posited by a doctor in Florence in 1842. He noticed that prostitutes and married women died of cervical cancer, but nuns almost never did. Though he might have discerned that it was sexually transmitted, he was thrown off by another fact: Nuns often died of breast cancer. His conclusion was that nuns’ corsets were dangerously tight.”

    Link

    Oral and anal cancer: you get the cancer where you perform the sex act, right?

    Seth: More associations. I don’t see how that answers my question.

  10. as Says:

    Cervical cancer is also on the list of AIDS defining illnesses.

  11. Joe Says:

    as Says:

    “Cervical cancer is also on the list of AIDS defining illnesses.”

    But only with a positive test for HIV antibodies.

    Cervical cancer with no HIV = cervical cancer.

    Cervical cancer with HIV = AIDS.

    Does that make any sense to you?

  12. as Says:

    Joe Says:
    March 10th, 2014 at 3:18 pm

    Cervical cancer with no HIV = cervical cancer.

    Cervical cancer with HIV = AIDS.

    Does that make any sense to you?

    If you have HIV but not HPV, would you get cervical cancer? (I realize such a person is unlikely to exist).

    If you don’t have HPV, would you ever get cervical cancer?

    If a person with HIV develops Kaposi’s sarcoma or cervical cancer, what does that mean? Could they have developed Kaposi’s sarcoma without being infected with herpesvirus 8?

  13. Joe Says:

    as Says:

    “If you have HIV but not HPV, would you get cervical cancer? (I realize such a person is unlikely to exist).”

    No, because neither virus can cause cancer.

    “If you don’t have HPV, would you ever get cervical cancer?”

    You could, yes, but it would have nothing to do with HPV.

    “If a person with HIV develops Kaposi’s sarcoma or cervical cancer, what does that mean? Could they have developed Kaposi’s sarcoma without being infected with herpesvirus 8?”

    A person with KA almost certainly got it because of long-term “popper” abuse (amyl nitrate), plus a weakened immune system (probably caused by additional recreational drug abuse).
    http://www.duesberg.com/media/jlpoppers-3.html

    And no one really knows how women get cervical cancer, no matter what he or she might tell you. It’s a disease of older women, yet only a very tiny fraction of them actually die from it. If a woman has routine Pap smears, it’s almost impossible to die from it.

  14. as Says:

    Seth: More associations. I don’t see how that answers my question.

    Nuns don’t get cervical cancer, but they do get another female cancer and that is breast cancer. It’s not that they live some super healthful lifestyle where they don’t get cancer at all like hunter gatherers.

    Prostitutes get cervical cancer.

    The more a man cheats, the more likely it is that his wife will get cervical cancer.

    The cervix is in the female genital area.

    This makes it seem like cervical cancer is caused by a venereal disease.

    When people have sex in the mouth or in the butt, they get the cancer in that area instead.

    I don’t understand why you don’t find the HPV – cervical cancer link plausible.

    Seth: I do find it plausible. But I also find another explanation worth considering.

  15. Jason Says:

    Contra Seth’s argument, there’s very little controversy about the HPV-cancer link. (Nice summary here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769629/)

    I’m not enough of an expert to find holes in the molecular genetics research (and neither is Seth), but my rudimentary understanding is that the evidence goes well beyond mere association. Not to mention the emerging medical literature that demonstrates reduced cervical abnormalities in the vaccinated population, which pokes a pretty big hole in Seth’s alternative theory about cancer leading to infections rather than the other way round.

    Speaking of that alternative theory, let’s look at it in the context of the evidence. Seth is suggesting that cervical cancer develops in some undetectable form of the disease (which I’m not sure is even possible in how we define cancer), remains latent for years and years showing no physical symptoms except HPV infections, until finally it becomes detectable — and just by coincidence — tends to do so in women with higher viral load from HPV infection.

    Is that possible? I suppose. Is it plausible? Not very. Is it more plausible than the current prevailing theory? Certainly not.

    Seth: In general, cancer develops very slowly. One theory is that four different mutations are required for a cell to become cancerous. The first three mutations have no obvious effect. This is not terribly controversial, since most cancer increases as the fourth power of age. I haven’t been able to find how cervical cancer changes with age.

  16. Robin Says:

    Nobody seems to have mentioned that the HPV vaccination has led to a small number of otherwise healthy young women/girls having severe reactions and either dying or ending up in a pretty bad state.

    As a father of two young girls, I’m super-focused on knowing a hell of a lot more about so-called vaccinations before they go anywhere near my kids.

    Scaremongering? Well, it seems that measles is pretty low in the mortaility stakes amongst those who get it and are not either immune-compromised and/or malnourished.

    Why then are most national “health services” so relentless in their characterisation of measles as a terrible disease, seemingly up there with tetanus and cholera, that needs endless resources and attention to stampt it out?

  17. Jason Says:

    Robin: Nobody has mentioned it because the publicized cases don’t hold up to scrutiny. That doesn’t mean the vaccine is 100% of course. Nothing is.

    As for your point about measles, you’re falling victim to a classic misdirection technique: focusing on mortality to the exclusion of all other harm from disease.

  18. Joe Says:

    as Says

    “Nuns don’t get cervical cancer, but they do get another female cancer and that is breast cancer. It’s not that they live some super healthful lifestyle where they don’t get cancer at all like hunter gatherers.”

    Nuns lead healthy lives. They don’t smoke. They don’t abuse drugs. They generally eat healthy foods, and not too much of it. They gets lots of sleep. They don’t have promiscuous sex. And they’re generally happy, stable people (except for Sister Mary Catherine, my 2nd grade teacher, who whacked me with a ruler almost every single day). That’s why nuns practically never get cervical cancer.

    Unfortunately, they also have a much higher incidence of breast cancer than married women, because early pregnancy is protective against cancer.

    And hunter-gatherers did get cancer,although it was very rare.

    “Prostitutes get cervical cancer.”

    Because they are promiscuous, abuse recreational drugs, eat poorly, get little sleep, take antibiotics prophylactically, have severely compromised immune systems, etc.

    “When people have sex in the mouth or in the butt, they get the cancer in that area instead.”

    The vast majority of people (perhaps as high as 99.99%) who have sex in the mouth or the butt never get cancer in those areas.

    “I don’t understand why you don’t find the HPV – cervical cancer link plausible.”

    Unless you believe that correlation is the same thing as causation, there’s no reason to believe it. There is no scientific proof that HPV causes cervical cancer. There is only correlation.

  19. Joe Says:

    Jason:

    “Contra Seth’s argument, there’s very little controversy about the HPV-cancer link”

    That’s a little like claiming there’s a “97% consensus” on global warming. :)

    http://wattsupwiththat.com/2013/11/20/the-97-consensus-myth-busted-by-a-real-survey/

    There is all kinds of controversy about the cause of cervical cancer, HPV, etc., but you have to be willing to look for them.

    Note: It’s just as hunch, but I think you’d probably say the same thing about, say, statin drugs, too, right? :(

  20. Joe Says:

    Robin:

    “Nobody seems to have mentioned that the HPV vaccination has led to a small number of otherwise healthy young women/girls having severe reactions and either dying or ending up in a pretty bad state.

    As a father of two young girls, I’m super-focused on knowing a hell of a lot more about so-called vaccinations before they go anywhere near my kids.”

    Good for you! Educate your girls, do your best to raise them to avoid recreational drugs, unhealthy lifestyles, etc., urge them to get regular Pap smears, and they’ll have a greater chance of being struck down by lightening than by cervical cancer.

  21. as Says:

    Joe Says:

    urge them to get regular Pap smears

    I would never urge any girl to do that. A hand in the vagina is a terrible thing.

  22. Robin Says:

    Jason wrote:

    “Robin: Nobody has mentioned it because the publicized cases don’t hold up to scrutiny. That doesn’t mean the vaccine is 100% of course. Nothing is.

    As for your point about measles, you’re falling victim to a classic misdirection technique: focusing on mortality to the exclusion of all other harm from disease.”

    The publicised cases DO hold up to scrutiny. Not all of us here are in the US and outside the US, for example in Denmark and New Zealand, there are cases of healthy young women reacting severely to Gardasil. To be clear: it is uncommon, but measles mortality is miniacule also.

    Now, measles and other harm. What, exactly, are you talking about? Gambling, alcohol and tabacco are fully legal, contribute to GDP, raise significant amounts of tax, and result in massive, widespread harm to society that studies show is acute and enduring (alcoholics are a disaster for their immediate and extended families, and the relationships of the same people with others).

    A life in perspective is about appropriate responses to risks.

    What risk are you referring to that measles causes that is so devestating, that is worth the concern, cost, adverse reasctions, and risk of vaccine use where there is no long-term knowledge about it?

    As for “misdirection technique”s, I think you are referring to the Straw Man fallacy, and if so I utterly reject this. The measles issues is directly relevant to this discission. However, YOU are referring generally to general health benefits of measles vaccinations.

    What are you talking about?

  23. Robin Says:

    as wrote”

    “Joe Says: urge them to get regular Pap smears

    I would never urge any girl to do that. A hand in the vagina is a terrible thing.”

    I can’t honestly work out whether you are serious (scary; what is a pap smear compared with terminal cancer? I have a prostate DRE every year. Not my idea of fun, but better than being unlucky and ignorant) or just joking!

  24. Robin Says:

    miniacule → miniscule

  25. Joe Says:

    as Says:

    “I would never urge any girl to do that.”

    That’s supposed to be a joke, right?

    Or do you just prefer that they die?

  26. as Says:

    I’m serious. It’s important to tell girls that cervical cancer, oral cancer, and anal cancer are the outcome of venereal diseases. Ectopic pregnancies too.

    I would never recommend a hand in the vagina every year or every three years or whatever the new standard will be.

  27. Joe Says:

    as Says:

    “I’m serious. It’s important to tell girls that cervical cancer, oral cancer, and anal cancer are the outcome of venereal diseases.”

    Even when there is no scientific proof that they are? And not even bother to tell them what can happen to them if they end up destroying their immune systems, by abusing recreational drugs, alcohol, smoking, taking antibiotics prophylactically, not getting enough sleep, good nutrition, etc? Just tell them to “get this little vaccination, honey, and you can have all the sex you want, with as many men as you want, in as many ways as you want”?

    You do realize that even the HPV = cervical cancer supporters recommend that women get routine Pap smears, right?

    That’s right. Gardasil or no Gardasil, they recommend routine Pap smears.

    Why do you suppose that is?

    “I would never recommend a hand in the vagina every year”

    But getting a useless vaccination every few years, for perhaps the rest of their lives, a vaccination that may have already killed over 100 girls and harmed ~ 20,000 others, that’s okay, eh?

    Wellallrightyhen!

  28. Seth Roberts Says:

    “The publicized cases don’t hold up to scrutiny.”

    You mean, unless you can prove that New Product X has caused harm, the public should not learn about cases where it may have caused harm? Yet the benefits of New Product X should be widely publicized, even though the benefits too are not proven?

    And they call this “evidence-based medicine”. A better name would be “good-news medicine”.

  29. Jason Says:

    Robin: What I mean by misdirection in this case is this: focusing on measles mortality as the sole measure by which we evaluate whether or not the measles vaccine is ‘worth it’ is a strategy to draw people’s attention away from the entirety of the measles disease burden on the infected, their families, and society.

    Robin and Seth: When I say the cases don’t hold up to scrutiny, I mean the evidence linking these reports doesn’t rise above the level of coincidence. Not even to the level of association that Seth insists is inadequate to connect a pathogen to disease. (Talk about a double standard…)

    As to Seth’s other point, no, of course I wouldn’t agree with such a broad statement about proof, and I don’t think many people would. Anecdotes in and of themselves represent a pretty low level of evidence, but they are evidence. But an anecdotal case of a young woman who died within 72 hours of receiving a vaccine is not in and of itself evidence of harm from the vaccine and more than an anecdotal case of a young woman dying within 72 hours of having a bagel is proof of harm from the bagel.

    Back to Joe… it really depends on how you define controversy, doesn’t it? Do I consider a few people whose arguments rely on willfully ignoring or misrepresenting evidence to be adequate to call something controversial? No, I guess I don’t. At least as you’ve represented them, your arguments refuting the HPV-cancer link a) ignore much of the evidence base, perhaps intentionally; b) rely on theories that were flawed even when produced 100 years ago, long before the science behind much of the current evidence was even developed; and c) don’t actually offer much of an argument beyond that you just don’t believe the existing evidence. To me, that’s not a controversy. Or at least, it’s not a scientific controversy. But people try to call the science in the question to back up political arguments that they know aren’t defensible purely on political grounds.

    On the statins question, you might be surprised. Purely in terms of evidence, there doesn’t seem to be much controversy that for primary prevention, statins aren’t very useful, and certainly aren’t justified based on the number needed to treat to prevent a cardiac event. There’s controversy about whether or not to change current clinical recommendations, but again, that’s not really a scientific controversy. It’s a political one. (Side note for anyone reading who found this because of statins: the evidence in favor of statins is much stronger among persons who have already had a heart attack.)

    I don’t object to a healthy skepticism about science. That science often turns out to be wrong is a feature, not a bug. What I do object to is the attempt to delegitimize scientific findings merely because they are inconvenient or unpalatable to a political or cultural viewpoint.

  30. Jason Says:

    Also, Seth, I’m not able to find a name of your four mutations theory, so I can’t read much about it. But even if that were the case, it doesn’t increase the plausibility of your alternative theory in the context of the observed data. If anything, it makes the virus-cancer link seem more plausible, since it would provide an additional explanation of how an infection today could set off a chain of cellular change that results in cancer many years later.

    Seth: Surely you know that cancer increases as the fourth power of age. Look into how that is explained.

  31. Retired now Says:

    I think what irritates me about the whole vaccination debate is that medicine says it is now evidence based, but what it considers to be evidence depends on the political correctness of the belief. As a now grandparent I would like to see the RCTs which prove efficacy and safety of any vaccine given. But that data is not actually available. Just asking for it raises the hackles of any medical person who can’t provide it. They say “trust me” and frankly I no longer do. Association is not causation and while medicine demands proper RCTs for any alternative medical treatment they are more than prepared to accept association when it comes to vaccines.

    What made me really cautious about the HPV vaccination outcomes is that the doctors in sexual health clinics were claiming reduction in cancer within two years of the vaccine’s introduction and various groups of docs have made that claim at least annually since then. Anecdotal evidence isn’t acceptable in the place of RCTs. I want to know that the RCTs have been done over a decade or more for both cancer outcomes and in relation to safety. Noone has been able to give them to me. And I want to compare the numbers who report severe side effects with those who report cervical cancers. Only then can I make an informed choice.

  32. Robin Says:

    Jason wrote:

    “Robin: What I mean by misdirection in this case is this: focusing on measles mortality as the sole measure by which we evaluate whether or not the measles vaccine is ‘worth it’ is a strategy to draw people’s attention away from the entirety of the measles disease burden on the infected, their families, and society.”

    Sorry, but puclic health authorities have set the agenda here with their focus on brain inflamation and dealth as “possible outcomes” when they are justifying their resource spend on vaccinating against mealsles. They cite absolute numbers of people infected, and numbers of people taken to hospital. They do not mention the percentage of those infected who are fully vaccinated (a varying yet significant percentage, and in my book a false sense of “security” is of particular concern) and that of those who visit hospital, as it would be very, very rare for these people to not be checked and sent on their way straight away.

    I should concede that we are probably coming at this from different angles. Although chicken pox can be vaccinated against (at a cost, with scaremongering, and failure rate) we chose not to do this and instead our kids have all had chicken pox. Was it a hassle? Yes. Was it unpleasant and inconvenient? Yes. However, we have some confidence that their resulting immunity is robust, and the negative factors are really not that bad.

    Chicken pox is referred to as a horrendous, scarring, terrible disease in media by those who are selling or promoting the vaccine. I find this unacceptable, but you might feel this is quite OK to mislead and scare people.

    Concerning anecdotal evidence, of course it is difficult to establish causality. However, when a healthy 12 year-old girl feels immediately unwell immediately after a Gardasil injection, and goes downhill from there and dies, this indicates to me that as a parent I want to know significantly more about this. Nurses complain about Gardasil that most often the girl faints, breaks out in hives, etc. immediately following. This isn’t some random thing I read on the internet. I actually have had these conversations. Recently. I recognise your right to be concerned about the veracity of my claims, though.

    My general position is that I really don’t think we know enough about the immune system, nor do we have enough data to make high-quality guesses.

    Add this to obviously unhealthy amounts of power held by pharma companies and their consultants, the economics of big health, etc., and the overall picture isn’t a good one.

    I think Seth’s post above does a better job of summarising the situation – apologies for the long-winded response.

  33. Robin Says:

    Briefly, on measles, in NZ, people born before 1969 are considered to be completely immune to measles.

    Why?

    Because the measles vaccine was introcuced somewhere around then.

    That is, the first one, that was supposed to provide life-long immunity.

    Except it didn’t.

    So another one was introduced. A booster.

    Whooping cough is also an issue. Again in NZ, the situation was that mothers passed antibodies to their infants through breast milk, but this only occurred if the mother had had WC. A problem has arisen whereby mothers who were vaccinated against WC didn’t pass the antibodies to their infants, putting their infants at significant risk. The Ministry of Health in NZ has recently realised this and started a programme of pregnant mother vaccination in an effort to address this introduced problem.

    Many actors in this context take the approach that by the time adverse issue are detected and the impact determined, that they will be long gone, unavailable to take responsibility, or at the most, legally beyond reach.

  34. Seth Roberts Says:

    But an anecdotal case of a young woman who died within 72 hours of receiving a vaccine is not in and of itself evidence of harm from the vaccine any more than an anecdotal case of a young woman dying within 72 hours of having a bagel is proof of harm from the bagel.

    You fear vaccines and bagels equally? Everyone I know fears vaccines more.

    If someone dies within 72 hours of a vaccination any sane person would increase how much they fear vaccines unless there is a more plausible cause of death. Any person with a good understanding of the logic of science would increase how much they fear vaccines unless it was proved that the cause of death was something else. I suspect that in the anecdotes you refer to there was not a more plausible cause of death, much less a proven alternative cause.

  35. Jason Says:

    Anyone with a good understanding of the logic of science? Really?

    Anyone with a good understanding of the logic of science would have a lot of questions before feeling confident connecting two events related only by proximity in time.

    Further, people with a good understanding of the logic of science don’t demand lower standards of proof for the things they believe versus the things they don’t believe.

    Seth: Science is about degrees of belief, not proof or “standards of proof”. Nothing is ever proved or disproved. Evidence pushes belief in Idea X (such as “vaccines cause harm”) up or down. If someone died within 72 hours of getting vaccinated that should increase belief in “vaccines cause harm” unless you are sure the person died for another reason.

    Where does your understanding of science come from? You have been poorly taught.

  36. Joe Says:

    Jason:
    “Back to Joe… it really depends on how you define controversy, doesn’t it?”

    Absolutely. Definitions matter. The best example of that is found in the “climate change” field. The climate alarmists began to use the term after it became apparent that the globe hadn’t warmed for over 17 years. Another “inconvenient truth”?

    “Do I consider a few people whose arguments rely on willfully ignoring or misrepresenting evidence to be adequate to call something controversial? No, I guess I don’t.”

    Jason, I think you need to expand your list of reading material. It’s not a few people, it’s from experts around the world. And if I thought they were misrepresenting the evidence, I wouldn’t put any credence into their claims or their research.

    “At least as you’ve represented them, your arguments refuting the HPV-cancer link a) ignore much of the evidence base, perhaps intentionally;”

    What evidence base? You have only a correlation upon which to hang your hat. A correlation shared by the vast majority of the population (HPV infection). Of which only a tiny fraction ever get cervical cancer and die. And which can essentially be totally avoided by getting regular Pap smears. And you somehow think it makes sense to “vaccinate” virtually everyone on the planet, with a “vaccination” that’s never been proven to protect against anything, and which may have already killed over 100 girls and harmed ~ 20,000 others. I think that’s criminally stupid.

    “b) rely on theories that were flawed even when produced 100 years ago, long before the science behind much of the current evidence was even developed;”

    What theory would that be, exactly? And what “science” is there behind the current evidence? That somehow correlation now means causation? When did that become science?

    “and c) don’t actually offer much of an argument beyond that you just don’t believe the existing evidence.”

    Oh, I believe the existing evidence. Unfortunately, the “evidence” consists of correlation, not causation. And anyone who’s ever taken even Bio 101 knows that correlation isn’t the same as causation. Your side wants to convict firemen for starting all those fires simply because firemen can be found at the scenes of most fires. My side demands more than that before we blame the firemen. Like real scientific (forensic) evidence.

    “To me, that’s not a controversy. Or at least, it’s not a scientific controversy. But people try to call the science in the question to back up political arguments that they know aren’t defensible purely on political grounds.

    As far as I’m concerned (I can’t speak for others here), this particular controversy isn’t about political arguments. It isn’t even about the subject of vaccinations in general. It’s about the scientific method. It’s about the wisdom of exposing millions of young women (and others) to the potential hazards (including death) of a vaccine that’s never been scientifically proven to prevent any disease, including the disease the vaccine is purported to protect them against. A disease that has historically affected only older women, and which takes the lives of only a tiny fraction of them, and even that tiny fraction can be protected by getting regular Pap smears. What ever happened to: “First, do no harm”?

    “On the statins question, you might be surprised.”

    Nothing surprises me anymore about the subject of statins.

    “Purely in terms of evidence, there doesn’t seem to be much controversy that for primary prevention, statins aren’t very useful, and certainly aren’t justified based on the number needed to treat to prevent a cardiac event. ”

    Yet one cannot visit a doctor anymore without being strongly urged to take a statin pill. Why? And just recently, the protocol has even been expanded to increase the target base by at least 40%. Why?

    “There’s controversy about whether or not to change current clinical recommendations, but again, that’s not really a scientific controversy.

    Here’s the scientific controversy: Statins were sold to the public as an easy and safe way to lower one’s cholesterol, right? Everyone knew that high cholesterol was a risk factor (i.e., correlation) for heart attacks, right? But wait, numerous studies have now shown us that just as many people with “low” cholesterol levels have heart attacks as those with “high” levels. And that there is essentially ZERO difference in overall mortality. Especially if one understands the difference between relative risk and absolute risk. So they better come up with an explanation for that, right, and quickly? So now they try to claim that for those with previous heart attacks, there is a barely measurable benefit. While they still try to push statins on all the rest of us! Why? Heck, once a person has reached the age of 65, those with higher cholesterol levels live longer than those with lower levels. That is, cholesterol appears to have a PROTECTIVE effect. So why in the heck would anyone want to artificially lower one’s cholesterol? I just don’t get it, and would you, if you could find a way to be honest with yourself.

    There may be something about statins that protect a small fraction of us against heart attacks, but it isn’t by lowering our cholesterol. That’s a scientific fact. It may have a slight anti-inflammatory effect, and more and more scientists are now attributing CHD to inflammation, so statins have been pushed on the public (as a whole) for exactly no good scientific reason. All thanks to an incorrect CORRELATION.

    Entire books have now been written about all the serious side effects of taking statin drugs (including death). Books such as “The Statin Damage Crisis,” by Duane Graveline, M.D., “The Heart Revolution,” by Killmer McNally, M.D., “The Great Cholesterol Myth, by Stephen Sinatra, M.D., and Jonny Bowden, Ph.D., “The Great Cholesterol Con,” by Malcolm Kendrick, M.D., “The Cholesterol Conspiracy,” David R. Hastings Lloyd, “You Will Not Die From A Heart Attack,” by David S. Grimes, M.D., “Ignore The Awkward,” by Uffe Ravnskov, M.D., Ph.D., “The Cholesterol Delusion,” by Ernest N. Curtis, “Low Cholesterol Leads To Early Death,” by David Evans and Tom Naughton, “The Truth About Statins,” by Barbara H. Roberts, M.D., and many more.

    I guarantee to you, Jason, if you read all those books, they will have to put a gun to your head to get you to swallow a statin pill.

    […]
    “I don’t object to a healthy skepticism about science.

    I have no skepticism about science. I have a lot of skepticism about the people who claim to practice it. And far too many of them are dangerous to our lives. That’s a scientific fact.

    “That science often turns out to be wrong is a feature, not a bug. What I do object to is the attempt to delegitimize scientific findings merely because they are inconvenient or unpalatable to a political or cultural viewpoint.

    I see no one here who fits that description. I do see a lot of people who QUESTION those so-called scientific findings, which is what scientists are supposed to do, right? In fact, it’s part of their job description!

    And I object to the people who try to ridicule or belittle them for doing their jobs. For caring about their children. For questioning the “experts.” For doing their own due diligence. And I think they should be roundly praised and congratulated.

  37. Joe Says:

    Jason:

    “Further, people with a good understanding of the logic of science don’t demand lower standards of proof for the things they believe versus the things they don’t believe.”

    Yet you’re apparently totally satisfied with having correlation essentially mean the same thing as causation, forgoing the scientific method altogether.

    Sigh.

  38. Joe Says:

    Jason:

    “Anyone with a good understanding of the logic of science would have a lot of questions before feeling confident connecting two events related only by proximity in time.”

    But they are not only related by proximity of time. Getting a shot, and then being hit by a car, might fit your description.

    But getting a vaccination, and then almost immediately (or soon after) suffer symptoms (e.g., seizures, strokes, dizziness, fatigue, weakness, headaches, stomach pains, vomiting, muscle pain and weakness, joint pain, chest pains, hair loss, appetite loss, personality changes, insomnia, hand/leg tremors, arm/leg weakness, shortness of breath, heart problems, paralysis, itching, rashes, swelling, aching muscles, pelvic pain, nerve pain, menstrual cycle changes, fainting, swollen lymph nodes, night sweats, nausea, temporary vision/hearing loss, death, etc.) that could LOGICALLY be connected to having foreign proteins and chemicals injected into your body, would not.

    No, it’s not proof. Anymore than any other correlation can be considered proof, but it sure jumps out as something that demands more investigation before going too much further.

    “First, do no harm.”

  39. Joe Says:

    The next “Big Thing”: PCSK9 inhibitors

    http://www.ncbi.nlm.nih.gov/pubmed/23652470

    They surely must already know by now that statins don’t work by lowering cholesterol (and don’t prolong life), yet here they are again, looking for yet another way to make money…er…lower cholesterol levels.

    It couldn’t be that most of the statin patents are running out…could it?

    God help us all.