Circumcision Debate

http://thebulletin.us/articles/2009/10/25/top_stories/doc4ae4b76d07e16766677720.txt

I know many of you are pro-Gardasil but this article raises some serious problems with this particular vaccine. I'm not against vax in general (we all got flu shots and Bella got the H1N1 mist the first day it was available) but this particular one has always rubbed me wrong.

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As best as I understand the situation, the vaccine is in excess of 95% efficient for boys and girls in blocking the strains of HPV that it was designed to block. The reason they link that to reduced rates of cancer is because they believe that HPV infectin leads to cancer. I don't think they can directly test the efficiency against CC because it takes too long to develop and too few people develop it anyway.

For example, they say that in general 9 people per 100,000 contract CC per year (mostly older people). To do a study you need to see at least 50 events for it to have weight. So you'd need 3 or 400,000 people over about 3 or 4 years. So directly measuring such an event would be logistically difficult. The event of contracting HPV occurs far more often so they can measure that but they are using the supposition that less occurrence of HPV will mean less occurrence of CC.

Several years ago, I did some extensive research on HPV and found some conflicting information.

For instance, I found that 97% - 98% of those infected with HPV will develop a natural immunity to the virus within 3 years.  The problem is that during this time, they are highly contagious.  HPV is a very easy infection to pass and can be passed via "the toilet room handles."  The virus can live on such surfaces for quite a time.

The suspected infection rate is estimated at 70% at some time during life.  The most vulnerable time is during the late teens and 20's when people are most likely to have multiple sexual partners.  One person could infect many people.

One study of 13 -15 year old girls found that 54% had been infected at some point in their life.  The researchers concluded that they were infected as they passed through their mother's birth canal.

What does all this mean?  Simply by vaccinating girls and boys before they became sexually active, the infection rate could be halved in a single generation and halved again in the second generation and halved again in the third generation.  By the third generation, the vectors of transmission would be sufficiently broken that the virus would eventually disappear of it's own accord.

Now, we have to balance that against the significant adverse effects.  It has been 5 years since the vaccine was introduced and the article states that 44 girls have died or about 9 per year.  Before we can come to any conclusions, we have to know how many have been given the vaccine to calculate the risk factor.   Then, we have to weigh that against the number of women who develop cervical cancer to make a decision.

The National Campaign for HPV and cervical cancer states that there is no reason a woman should die of cervical cancer but I question that.  Surely, some do not get regular pap smears but it also appears that there are ones who are misdiagnosed and think they are safe.  One that comes to mind is comediane Gilda Radner, a star on "Saturday Night Live" who died of cervical cancer.  Surely she had the financial wherewithall to have regular pap smears to detect the cancer.  Did she just not regularly visit her gynecologist?

The cure for cervical cancer is usually a historectomy.  How many women die of the surgical procedure or infections such as hospital acquired MRSA infections?  This also must be known before a conclusion can be made.

From the article, it sounds like a simple decision but it clearly is not so simple.  All factors must be weighed before such a decision can be made.

Frank