So great has been the endurance, so incredible the achievement, that, as long as the sun keeps a set course in heaven, it would be foolish to despair of the human race.
Ernest L. Woodward
Michele Bachmann's Gardasil Moment
"I don't want my life to have no purpose whatsoever, and if I can help spread the word about cervical cancer and the HPV vaccine, then I haven't lived in vain. If I can help take this cancer away from one child, to keep one child from suffering like I am. If I could get them to understand, then I will have done my job as a human on this Earth." -- Heather Burcham, 31-year-old Houston schoolteacher, ABC News interview, before she died of cervical cancer in 2007. Rest in peace, sweet angel.I discussed multiple topics in my periodic Political Potpourri feature last Wednesday, the last one being a discussion of the predictable Gardasil controversy in a recent GOP Presidential debate. I remember Perry had caused a firestorm in Texas a few years backs in issuing an executive order wanting to mandate inoculation of tweenage girls with Gardasil. Note that I do not claim to be an expert on human papillomavirus and the relevant discussion is based on other cited sources.
On a personal level: as a bachelor, I've never had children and probably never will have the privilege; I've always envied men whom had daughters, including my little brothers. I will say this much, having reviewed the evidence in preparation for this commentary: if it was my decision, my hypothetical daughter would have these shots. Cervical cancer is the second most common killer of cancer in women worldwide (the major reason it is less in the US is because of the commonly administered preventive pap smears); I would not gamble my child's health and life on the prior virtue of her future partner. [Of course, I would prefer that she meet and fall in love with a nice Catholic boy, like her dad, and not a male slut.]
There are over 150 types (and 200 subtypes) of human papillomavirus. HPV types 16 and 18 are thought to be responsible about 70% of cervical cancers and up to half or more of sexually active people have been infected at some point by some types or strains of HPV (others are thought to be highly correlated with genital warts). Gardasil is a preventive drug designed to control for the infection of HPV types 16 and 18 and two others (related to genital warts). It is generally thought to be safe and effective (98%), particularly among young adults, although its long-term effectiveness has not been established. (A related drug, Cervarix, relevant to HPV types 16 and 18, is approved for use by tween and early teenage girls and is effective for at least 4 years.) Gardasil has been approved for both sexes over a wider age range and for a wider number of HPV types.
Vaccines are more effective with people not already infected with a specific STI (sexually transmitted infection) type. Most HPV infections go away within a year or so although some can remain dormant. Most women with high-risk infections do not develop cervical cancer (but about 10% result in dysplasia or cervical cancer). There are other known risk factors for cervical cancer, and Gardasil is not a substitute for general preventive care and responsible sexual behavior (including relevant religious/moral beliefs regarding sex outside of marriage, monogamous/selective relationships and the relevant, proper use of quality condoms, especially if you do not know the sexual health of one's partner, but note that condoms only reduce the likelihood of transmission). Almost all cases of cervical cancer reported detection of HPV DNA; roughly 11,000 women a year are diagnosed with cervical cancer, and 4000 women a year die from it. Texas high schools enroll over 4 million students.
Just under half of high school students (by gender, with a slightly higher percentage of males) report having had sexual intercourse at least once.There are a number of relevant issues involved, and I'm somewhat surprised, giving pervasive feminist ideology, we haven't heard much discussion about vaccinating tweenage boys (after all, how do girls get infected?)
There is no doubt that if your mother, sister, or daughter is diagnosed with cervical cancer, and you know that it never would have happened if she had been been vaccinated with Gardasil, that's a real tragedy; even one victim is a victim too many.
Over half the high school girls in Texas are not sexually active, and STI's are not contagious. I honestly think Rick Perry was genuinely motivated by the health concerns of young women, and he was not alone. By the time the drug had been released, at least 20 states had introduced legislation calling for mandatory vaccination. But to a large extent, Merck, the manufacturer of Gardasil, was behind that, motivated by the imminent release of Cervarix.
Only two states (Virginia and DC) have since passed school vaccination policies like Perry intended; Virginia doesn't enforce it and DC has an opt-out form for parents. At least 20 have passed some sort of pro-vaccine legislation, at least to provide education and/or provide funding for it, e.g., for Medicaid.There are cost issues, with many doctors complaining insufficient reimbursement (for roughly $360/patient cost for the 3-shot series), with many federal and medical groups recommending vaccination, but not necessarily calling for its mandate. There have been vaccine production issues, reports of side effects, and vaccine mandates typically roll out on a slower basis over a period of years, after there has been more of a shakeout period of any issues with new drugs emerging after their introduction in the market. Recall, Gardasil was approved in 2006 and Perry's executive order was issued within a year (8 months). Another complaint about the governor's action was a double standard: other vaccines (i.e., whooping cough and meningitis) approved earlier were still awaiting their own mandates.
I think Bachmann's performance in the debate, particularly in the way she attacked Rick Perry is one of the turning points in a Presidential candidacy like Howard Dean's infamous "scream"; Bachmann in particular cited some reported incident by a mother that Gardasil, caused mental retardation in her daughter. Fact Check notes of 35 million doses, there have been 19000 reports of adverse events, most non-serious ("pain, redness, and tingling at the injection site and fainting and headaches"). A report doesn't necessarily mean that Gardasil "caused" the event; it could merely be coincidental: you need a preponderance of data. There were 4 reports of ADEM, a neurological event potentially leading to decreased mental capabilities. IOM dismissed the alleged linkage on insufficient evidence. For example, ADEM can occur in a natural frequency apart from the use of Gardasil, so the question is whether ADEM incidents in a Gardasil group are significantly more than one would expect in a control (no Gardasil) environment. Fact Check speculates perhaps the woman whom spoke to Bachmann wasn't aware of the more precise scientific name for her daughter's condition.
This post is not about being a shill for Merck; I'll let Merck speak for itself. But millions of girls have been vaccinated worldwide since release of the drug, and anyone who has any basic working knowledge of statistics knows better than to place credence in outlier observations. She's even gotten rare pushback from the likes of Rush Limbaugh and Michelle Malkin.
Look, if Michele Bachmann wants to attack successful American businesses, there's already an incumbent President whom has been doing that for years. If Michele Bachmann wants to attack the FDA's approval process, that's a different issue. But not engaging in due diligence of the alleged incident before raising it during a debate was desperate and unworthy of a legitimate Presidential candidate. In fact, Bachmann has now fallen below Ron Paul for fourth place among active candidates (7% across polls).
There are three legitimate concerns I see regarding Rick Perry on this issue, the third not discussed by other conservative commentators, and I'm going to phrase the first two somewhat differently than Rush or Michelle:
- Gov. Rick Perry did not properly disclose his former chief of staff Mike Toomey's involvement with Merck as a lobbyist and/or the timing and amounts of modest Merck campaign contributions. In reviewing the evidence, I am convinced this is not an instance of crony capitalism, but a matter of conscience. See below.
- The concerns I have, as a libertarian/conservative, in Gov. Rick Perry's approach to the issue are: he has replaced Big Federal Government with Big State Government, and he has tilted the balance of power from the state legislature to the governor's mansion, both of those which I perceive as counter to the shared principles I have with the Tea Party involving individual rights and balance of power. The measure should have gone through the legislature first and should have explicitly addressed the issue of religious exemptions/parental consent.
- I think Gov. Perry's failure to veto the legislature's repeal in essence was a flip-flop in principle of the highest order; he basically threw Ms. Burcham and his own wife, Anita, a former nurse with two nursing degrees and a preventive cancer advocate, under the bus.
My order always has been and always will be about protecting women’s health.... Instead of vaccinating close to 95 percent of our young women, and virtually eliminating the spread of the most common [STI] in America [and] the second most deadly cancer among women, [the legislators] put rider language in the budget that prevents the state from funding vaccines for low-income women if it is mandated by the commission; they have relegated the lives of our young women to social Darwinism, where only those who can afford it or those who know about the virtues of it will get access to the HPV vaccine.I encourage the Texas legislature to mandate, with religious and parental consent exceptions, HPV vaccination of tweens, to require insurance coverage of an approved vaccine for relevant dependents, and to provide funding under Medicaid or means-tested subsidies for vaccinating eligible girls/young women.
Musical Interlude: My Favorite Groups
Fleetwood Mac, "Landslide". It's always interesting to see how other people relate to songs; this hauntingly beautiful song has been covered by a number of artists, including a notoriously anti-Bush female country act.
I haven't been commenting on most of the songs I've been embedding, As a writer (and an amateur songwriter), I admire others whom practice the craft and excel. As should be clear from my writing style, I believe in clarity and organization; I work with my prose like a sculptor his slab. Some of the topics I write about are very complex, and trying to make the material more accessible is extraordinarily difficult. I find myself constantly tweaking my posts before publishing them--not for my own benefit: I know the points I'm trying to get across. I provide a number of links for the convenience of my readers.
In the context of songs, the writer usually has to introduce a certain amount of ambiguity into the song so other people can relate to it. If Stevie writes a song directly about her breakup with Lindsey Buckingham or Cary Simon vents about Warren Beatty's self-image, it has only limited appeal: everybody has dealt with bad relationships, and we're not necessarily interested in other people's problems.
However, in terms of generality or abstraction in a song, I do think there's a line. As a listener, I'm making a decision as to whether I should vest myself into a song, and if I think the artist is being too indulgent, I won't bother. (Similarly, I have never been a fan of abstract art.)
I have a sense of humor about what Stevie Nicks would think about my interpretations of her songs (e.g., my stab a couple of days back on "Gold Dust Woman") in the unlikely event she would ever read them.
I believe the underlying themes involve the circle of life, self-image and not being able to see the forest/wood because of the trees. My take is that in the context of a relationship she had, she had reached the summit of life: the world was her oyster; she was confident and knew whom she was, and she was with the perfect man for her. She had built a world like her parents and ancestors had done for themselves. In her mind, she had achieved that idyllic image of her potential, what her parents and grandparents had always been confident of and seen in her.
But then, all of a sudden her world unexpectedly collapsed about her; she no longer feels in charge of her destiny and lacks confidence to move on. How could she ever fall in love again? She had lost the innocence of her childhood forever, the delirious beliefs of youth that one will never die, true love exists, and the world can be a better place. She longs for the wisdom and loving encouragement and reassurance of her parents and grandparents, whom had experienced their own failures in life and could put a failure in the perspective of one's whole life, that life does go on, that love like a phoenix can and will emerge from the ruins of a broken heart and relationship.
It was not just her self-image which crumbled in the world of their relationship, but that of a flawed Prince Charming. In the final verses, she subtly changes from her part in a relationship to her current/future partner's, i..e, from "I took my love and took it down" to "Take my love and take it down". This means that she has moved on from her broken relationship and is willing to trust again, opening her heart to a new man, one whom she realizes in reality can never be the Prince Charming of her childhood fairy tale. But she warns her new partner not to have unrealistic expectations about her, because she's only human and has her own flaws.
Okay, Stevie, you can stop laughing now...
