Is there a vaccination against stupidity?

If you have a life, you probably missed the Republican presidential candidate debate Monday night.

Which means you missed the flap over Texas’ brief mandate of vaccination against the human papillomavirus, instituted by executive order of Gov.  Rick Perry. The mandate was brief because Texas’ legislature blocked the mandate.

National Review’s Jonah Goldberg summarizes:

I think the charge of crony capitalism against Perry is valid generally and looks on target in this case in particular. The issue isn’t just that he got $5,000 from Merck. It’s that his former chief of staff was a lobbyist for Merck. I think Perry’s partial apology is heartfelt. He did it the wrong way and has said so.  …

Meanwhile, I think Michele Bachmann’s attacks on Perry are irresponsible and borderline demagogic. References to the “government needle” being “pushed into innocent girls,” sound paranoid and exploitative to me. And fueling anti-vaccine fears to score political points against Perry is beneath her. I think Fox or some other news outlet should investigate Bachmann’s claim last night on Greta Van Susteren’s show. Bachmann said that a member of the audience came up to her and told her with tears in her eyes that Gardasil caused “mental retardation” in her daughter.  I’m not doubting that someone told Bachmann that, but it’s a pretty serious — and unusual — claim. Regardless, the suggestion that Rick Perry is in any way responsible for it is ludicrous.

About Gardasil, the HPV vaccine, Henry I. Miller, M.D., of the Hoover Institution, points out:

Bachmann alluded to Perry’s executive order mandating the exposure of young girls to a “dangerous” vaccine and tried to distinguish Gardasil from other required pediatric vaccines that prevent infectious diseases. Note to Bachmann: The vaccine, Merck’s Gardasil, prevents infection with the most common strains of human papilloma virus. Once established, these viruses can ultimately cause genital warts as well as cervical, anal, vulvar, and vaginal cancers. Thus, by preventing the infection, the vaccine prevents all those sequelae.

In the extensive clinical studies (on more than 20,000 girls and women) that were performed prior to the FDA’s licensing of the vaccine, the vaccine was 100 per cent effective, a virtually unprecedented result. How safe is the vaccine? No serious side effects were detected; the most common side effect is soreness, redness and swelling in the arm at the site of the injection.

In summary, Gardasil has one of the most favorable risk-benefit ratios of any pharmaceutical. …

I am discouraged by politicians who not only don’t know much about science, technology, or medicine (which is perhaps understandable) but also don’t know what they don’t know (which is unacceptable).

Ed Morrissey passes on some more medical science:

“Mental retardation” typically takes place in a pre- or neo-natal event. Autism becomes apparent in the first couple of years of life — and primarily affects boys. Gardasil vaccinations take place among girls between 9-12 years of age. Even assuming that this anecdote is arguably true, it wouldn’t be either “mental retardation” or autism, but brain damage.

The FDA has received no reports of brain damage as a result of HPV vaccines Gardasil and Cervarix.  Among the reports that correlate seriously adverse reactions to either, the FDA lists blood clots, Guillain-Barre Syndrome, and 68 deaths during the entire run of the drugs.  The FDA found no causal connection to any of these serious adverse events and found plenty of contributing factors to all — and all of the events are exceedingly rare.

The “mental retardation” argument is a rehash of the thoroughly discredited notion that vaccines containing thimerasol caused a rapid increase in diagnosed autism cases.  That started with a badly-botched report in Lancet that allowed one researcher to manipulate a ridiculously small sample of twelve cases in order to reach far-sweeping conclusions about thimerasol.  That preservative hasn’t been included in vaccines for years, at least not in the US, and the rate of autism diagnoses remain unchanged.

Someone on Twitter pointed out that there is a long list of vaccines that are required for children before they enter school. And vaccines work less because you get one than because most of the population gets one. (Note that no one gets polio or smallpox anymore.) Moreover, teaching abstinence is important, but children have a habit of not following their parents’ advice. Can you guarantee that your child will fall in love with someone as abstinent as your child?

The better debate point, particularly for those who are skeptical of Perry’s conservatism, is Perry’s attempt to mandate the vaccine. Perry pointed out that the mandate had an opt-out provision, but the mandate was apparently to require health insurers to cover the vaccine; an opt-in provision reportedly would have meant that insurers need not cover the vaccine, saddling parents with the $300 cost. But again, the opt-out option did exist, and ignorance of the regulation is not much of an excuse.

To the extent voters are even paying attention, though, this kerfuffle may make nonaligned voters assume that the GOP is anti-science and anti-medicine. Independent voters are more likely to be impressed by medical experts’ positions on the HPV vaccine, as listed by the Los Angeles Times, than presidential candidates’ positions on the HPV vaccine:

Several health and medical organizations have released position statements or recommendations for the HPV vaccine. The American Academy of Pediatrics’ 2011 policy statement on childhood and adolescent immunization schedules recommends both the quadrivalent vaccine (otherwise known as Gardasil, which acts on four types of HPV) and the bivalent vaccine (also known as Cervarix, which protects against two HPV types) to guard against cervical cancer and genital warts. The AAP adds that the quadrivalent vaccine may be given to boys age 9 to 18 to help prevent genital warts.

Both Gardasil and Cervarix are also recommended for girls by the CDC in its 2011 interim Vaccine Information Statement. It stresses that the vaccine is important because “it can prevent most cases of cervical cancer in females” if given before exposure to the virus.

The American Cancer Society recommends the HPV vaccine for girls 11 to 12 years old, adding that girls as young as age 9 can get the vaccination as well. It holds off on suggesting women age 19 to 26 get the vaccine, citing a lack of evidence on its effectiveness in that group.

The Wall Street Journal is much more clear-eyed about the kerfuffle:

Opponents of mandatory vaccination include social conservatives who believe the vaccine will increase promiscuity, though we suspect watching MTV is a greater spur to teen sex. Opposition to state involvement in treatment decisions has more force: HPV is not casually communicable like polio or measles. Yet the executive order included a clause that allowed families to opt out for “reasons of conscience” or “to protect the right of parents to be the final authority on their children’s health care.” At a certain point, the distinction between “opt in” and “opt out” becomes academic when the violation of liberty is filling out minor paperwork.

The larger opportunity here is to eradicate a potentially terminal disease that has huge economic, social and other costs. Such progress is especially welcome when other government trends—the FDA’s cancer drug approvals, the eventual treatment restrictions inherent in national health care—are running in the opposite direction. …

Mrs. Bachmann’s vaccine demagoguery is another matter. After the debate the Minnesotan has been making the talk show rounds implying that HPV vaccines cause “mental retardation” on the basis of no evidence. This is the kind of know-nothingism that undermines public support for vaccination altogether and leads to such public health milestones as California reporting in 2010 the highest number of whooping cough cases in 55 years.

The GOP critique of government in the age of Obama would be more credible if the party’s candidates did not equate trying to save lives with tyranny.

It’s one thing for the voters of one Congressional district to send Bachmann to Congress. (After all, Milwaukee voters have been sending Gwen Moore to Congress and Lena Taylor to the state Senate.) It’s quite another for someone who apparently believes what she’s told without skepticism or even attempting to fact-check (vaccines cause mental retardation?) to get your vote for president. Bachmann wasn’t going to get the GOP nomination anyway, but one issue has demonstrated she doesn’t deserve it.

And, of course, there is this irrefutable point from Twitter:

I see Gardasil is still being debated. I’m sure the millions of unemployed are really worried about that.

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