Analysis Politics

The HPV Wars: Perry Sells Out but Bachmann Spreads Misinformation

Martha Kempner

In the most recent debate, Michele Bachmann jumped all over Rick Perry's decision to mandate the HPV vaccine and reminded viewers that he had taken money from the manufacturer.  But instead of using this as an opportunity to look at her opponent's willingness to sell out, she trotted out old arguments and spread misinformation about this lifesaving medical advance. 

So as I reported yesterday, Governor Rick Perry seems willing to sell out women’s health and just about anything else for some campaign contributions.  My article suggested that his decision to break with his conservative, anti-choice, anti-sexuality education base and mandate that girls entering the sixth grade in Texas be vaccinated against human papillomavirus (HPV) had more to do with donations from and connections to the vaccine’s manufacturer than it did with a genuine interest in protecting women’s health.  And I gave numerous other examples of policies and programs (from prison health to radioactive waste), not to mention political appointments, where Perry seems to be for sale to the highest bidder. I thought there was a lot of fodder here for going after the governor on shady practices and a lack of conviction behind his beliefs.

In the most recent Republican debate, his opponents, most notably Michele Bachmann, did go after him for the HPV mandate suggesting that Perry was bought off by the drug company and was not really “erring on the side of life.”  But instead of using this as an issue that could shed light on his character and his business practices, they focused on the HPV vaccine itself and invoked old messages of fear and shame by stringing together words like little girls, inoculations, drug company profits, and sexual diseases. And if these insinuations of the vaccine as an evil, money-making, innocence-destroying scheme weren’t enough, Bachmann followed up the debate with interviews in which she said it was dangerous and caused mental retardation. 

Wow.  I think it’s time we take a step back from politics and remember what we are talking about: a vaccine that can prevent cancer.  That’s right cancer.  For the first time ever, there is a vaccine that can prevent our children from getting cancer, and instead of jumping up and down, singing hallelujah, and praising science, these politicians are trying to make it sound like a bad thing.   

None of this is new.  The abstinence-until-marriage zealots started making these arguments years before the vaccine was even on the market.  They said it would give kids license to have sex and lead to rampant promiscuity.  When public health experts suggested the vaccine be given to girls at age 11, these zealots began to argue that it would take away their innocence and force parents to explain sex at far too early an age.  And when none of that worked, they said it hadn’t been tested well enough, screamed about side effects, and warned parents that it was dangerous.   

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I know that fighting propaganda with information is rarely effective – Michele Bachmann, for one, doesn’t seem to care about truth.  But just in case some of those people who were considering voting for her do, I am going to take a stab at diffusing her arguments with facts. 

Before I do, I want to remind everyone about HPV.  Human papillomavirus is the most common sexually transmitted disease (STD) in the United States.  It is estimated that 20 million Americans have HPV and that 6 million become infected each year.  HPV is easily spread from infected skin to uninfected skin.  Transmission can be prevented by condoms, however, the infected skin can be in areas that are not covered by the condom, such as on a man’s scrotum.  In truth, most people who have HPV will have no symptoms or adverse health effects and may never even know they had it.  Some people, however, will get genital warts, which may go away on their own or may need to be removed by a health care provider.  Certain strains of the virus, if left untreated, can lead to cervical cancer.

Okay, that said let’s look at the arguments against the vaccine.

It will lead to promiscuity.  Let’s face it the same people say this about every advance in women’s reproductive health education and care.  We’ve heard these arguments about sex education for example: “if you teach them about sex it’s like giving them license to have it.” Research has shown that this isn’t true; sex education does not cause young people to have sex sooner, to have more sex, or to have more partners.  In fact, young people who have gone through comprehensive sexuality programs that teach about both abstinence and contraception are more likely to delay sex, have fewer partners, and use contraception when they do become sexually active.  Same thing with making condoms available to young people; research found that students in schools where condoms were available were not more likely to have sex but were more likely to use condoms.  Need I go on? 

Depriving young people of lifesaving information and healthcare services because of these warped (and consistently disproved) ideas about promiscuity is nothing short of unconscionable.  

It will rob young girls of their innocence.  When the promiscuity argument failed to turn parents against the vaccine, zealots turned to this one spurred on by the young age at which the vaccine is recommended.  The Centers for Disease Control and Prevention (CDC) recommends that the vaccine be given at 11 or 12, not because they expect young women to be exposed to HPV at these ages but because they need to ensure that the vaccine (all three shots in the series) be given before any possible exposure otherwise it won’t work.  I understand that parents can be uncomfortable when it comes to their kids and sex but we have to fight that discomfort for the sake of their health.  The average age of first intercourse in this country is about 16 but obviously some young people have sex earlier than that and it’s really important that all of them get the vaccine before they become sexually active. 

Part of this innocence argument has been directed at the conversation parents will be “forced” to have with their kids about sex when they get the shot.  Opponents have said that the 11- and 12-year-olds are too young to talk about sex and STDs.  The sex educator in me would argue that they are not at all too young to hear this information and that the vaccine would be a good “teachable” moment to talk about the risks of sexual behavior and the various ways (abstinence, vaccines, condoms, etc.) to prevent such consequences.  But if parents aren’t comfortable doing that – that’s okay.  Children don’t require detailed explanations of the shots they’re getting – I didn’t tell my daughter what Rubella was when she got her MMR, for example – they can just be told that it’s all part of keeping them healthy.

It’s dangerous.  This is the worst one because it is the most likely to be believed by parents of all ideologies. There is an unfortunate skepticism of vaccines in this country started by research connecting them to autism which was recently found to be completely fabricated.  And yet, it is still believed.  So when Michele Bachmann goes on national television and says that some woman told her that the HPV vaccine caused her daughter’s mental retardation, some people probably believe her despite the fact that it even sounds ridiculous (the HPV vaccine is given at 11, long after developmental delays would have begun and been noticed).  

Research has shown that the HPV vaccine is very safe.  The most common reaction is a sore arm.  In response to Bachmann’s remarks the American Academy of Pediatrics released a statement yesterday saying in part:  “There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.”

Even some members of her own party have said that Bachmann took this one too far by repeating the claims about mental retardation. Rush Limbaugh suggested that she “might have jumped the shark,” and Erik Erikson of the RedState wrote “Michele Bachmann is overplaying her hand on this issue and it is probably going to go away.”

I suppose there is some good news in all of this. The nation is talking about HPV.  All of the morning news shows did a segment on the exchange between Bachmann and Perry over the vaccine, it’s been reported on by CNN, MSNBC, and Fox, and it’s all over the blogosphere. Many of these news outlets have done a good job putting the politics aside and getting out the facts about HPV, other STDs, and the vaccine.   

Still, I find the whole incident depressing.  I can’t decide which is worse; a president that sells out women’s health for money or one that spreads misinformation for political gain. 

Worse than both of those might just be the fact that in the midst of two wars, record unemployment, increasing poverty, and a globally bad economy, the people who want to run this country think that scaring parents about teens and sex is the best use of their time (and ours).  

Roundups Law and Policy

Gavel Drop: Republicans Can’t Help But Play Politics With the Judiciary

Jessica Mason Pieklo & Imani Gandy

Republicans have a good grip on the courts and are fighting hard to keep it that way.

Welcome to Gavel Drop, our roundup of legal news, headlines, and head-shaking moments in the courts.

Linda Greenhouse has another don’t-miss column in the New York Times on how the GOP outsourced the judicial nomination process to the National Rifle Association.

Meanwhile, Dahlia Lithwick has this smart piece on how we know the U.S. Supreme Court is the biggest election issue this year: The Republicans refuse to talk about it.

The American Academy of Pediatrics is urging doctors to fill in the blanks left by “abstinence-centric” sex education and talk to their young patients about issues including sexual consent and gender identity.

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Good news from Alaska, where the state’s supreme court struck down its parental notification law.

Bad news from Virginia, though, where the supreme court struck down Democratic Gov. Terry McAuliffe’s executive order restoring voting rights to more than 200,000 felons.

Wisconsin Gov. Scott Walker (R) will leave behind one of the most politicized state supreme courts in modern history.

Turns out all those health gadgets and apps leave their users vulnerable to inadvertently disclosing private health data.

Julie Rovner breaks down the strategies anti-choice advocates are considering after their Supreme Court loss in Whole Woman’s Health v. Hellerstedt.   

Finally, Becca Andrews at Mother Jones writes that Texas intends to keep passing abortion restrictions based on junk science, despite its loss in Whole Woman’s Health.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.