Commentary Sexual Health

Vaccinating Children Is a Social Responsibility We Can Not Afford To Shirk

Martha Kempner

Last year research linking vaccines to autism was debunked as a complete fabrication.  Now a new study shows that the HPV vaccine does not cause promiscuity. There are no excuses left.  Parents have an obligation to society to vaccinate their children.  Not doing so is selfish.

This article is published as part of a series on cervical cancer in partnership with the National Latina Institute for Reproductive Health.

See all our coverage of Cervical Cancer Awareness Month 2012 here.

So, I am that mom on the playground, the one who—while happy to play with my kids— craves adult interaction and looks for opportunities to strike up conversations with other parents.  It’s actually pretty easy (presumably because other mothers find pushing a toddler on a swing as mind-numbingly dull as I often do). I comment on similarities between our kids, something mine is doing, or something hers just said and nine times out of ten we are deep in discussion about our lives and experiences with motherhood within five minutes.  We trade stories and advice about sleep training, breast feeding, potty training, discipline techniques, daycare, and pediatricians.

Of course, I always try to be careful not to be too opinionated during these conversations.  In my liberal New Jersey town, I can be almost certain that the random playground mom agrees with my politics but parenting issues are so much trickier.  I never know who is going to agree with my stance on sleep training (just turn the monitor off, the kid will stop crying eventually) and who will think I’m barbaric; who will agree with me that jarred food is really just as good as pureeing it yourself and who will think I’m lazy; or who will view the sleep fairy (the one who gave my daughter a present every morning that she slept in her own bed the year she was three) as a cute invention by a desperate mother and who will think I was just too wimpy to get bedtime right.  And, yes, before you say anything, the reason I fear the judgment of other parents is clearly because behind the smiling and nodding I’m judging them as well.   

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Still, in nearly all of these conversations—even if our parenting styles are radically different—we can find a common ground on which to bond and commiserate. There is one topic, however, that I just try to avoid—vaccines. A friend once described it as the third rail of parenthood.  Just don’t touch it.  

While vaccines were once widely regarded as the medical miracles they are, today there is a large contingent of parents who distrust them and choose not to get their children vaccinated at all or pick and choose which vaccines they’re going to get and when.  Opposition to vaccinations began when British researcher Andrew Wakefield published a study in the Lancet suggesting a link between vaccines and autism. Over the next decade or so, study after study failed to replicate this link but distrust of vaccines grew anyway and celebrities like Jenny McCarthy publicly blamed vaccines for their children’s autism.  Unfortunately, this trend does not seem to have stopped even after information was released last year which showed that Wakefield fabricated his data.      

It’s hard to predict where a parent is going to stand on this issue.  Smart people with whom I tend to agree on most issues of politics and parenting completely disregard the science, express a generalized distrust for medicine, and refuse to vaccinate their children.  I know that a large and growing proportion of parents in my progressive community are using the school system’s broad “religious exemption” to send their unvaccinated children to school.

If this subject were to come up as we watched our children come headfirst down a slide, I might just smile, nod, and walk away but it would be painful. Because what I really want to say is “wow, that’s not just stupid, it’s selfish.” 

There, I said it. Choosing not to vaccinate your child is selfish and the only reason you can afford to do it without the likelihood that your child will get a life-threatening illness is because I vaccinated my child. 

An op-ed in the New York Times last week said this in a slightly nicer way. The article was written by Steven L. Weinreb, a physician certified in oncology and hematology who is himself suffering from a form of leukemia. Weinreb recently underwent a stem-cell transplant and explains that until his new cells mature he has the immunity of a newborn and is very prone to diseases such as chicken pox, measles, and the flu.  These illnesses, which are usually not life threatening can be very dangerous to newborns and people with compromised immunity system and yet those are the people who cannot get vaccinated as the vaccines can be dangerous to them as well. Not to worry, he says: “My newborn buddies and I do have some protection, however: the rest of you.” 

He goes on to explain that the purpose of vaccines is to protect “the herd.”  Weinreb states that “if 75 percent to 95 percent of the population around us is vaccinated for a particular disease, the rest are protected through what is called herd immunity.” Unfortunately, the new distrust of vaccines mean that the vaccine rates in the herd are dropping and the results are just what public health professionals feared. Weinrab points to measles as a good example of this dangerous trend.  Before the vaccine was introduced in 1963, 400 to 500 people in the United States died from the disease each year.  By vaccinating the majority of the population, cases of the disease have dwindled.  For each year between 2001 and 2008, the median number of cases (not deaths) in the United States was 56. In the first six months of 2011 alone, however, there were more than 150 reported cases—the most since 1996. And, the vast majority of those who were sickened had not been vaccinated or had uncertain vaccination histories.  

As parents when we make the decision whether or not to vaccinate our children we have to think not only of them but of their friends and classmates.  Weinreb says this: “We assist the infirm, pay our taxes and donate to charity, and getting vaccinated — for the flu, for adult whooping cough, for pneumonia—is just another important societal responsibility.” I couldn’t agree more.

I would, however, add the HPV vaccine to that list and suggest that part of our social responsibility is to vaccinate our children—both boys and girls—against this sexually transmitted infection that can lead to cervical cancer (which kills approximately 5,000 women a year in this country). While it may not be your child you save, widespread vaccination is the only way we can wipe out this very common disease.  

I realize that the HPV vaccine differs from the others in at least one key way; my child will not get HPV by sitting next to your child in class or riding the school bus with him.  HPV is a sexually-transmitted virus and as such individuals have to play a more active role in its transmission.  And, here is where a different kind of opposition arises.  The opposition to this vaccine is not rooted in the now debunked research connecting vaccines to autism (though it has undoubtedly benefited from a generalized mistrust of vaccinations). This opposition, which comes largely from the same far right voices that oppose sex education, condom availability, access to birth control, and abortion, suggests that since HPV can be prevented through behavior (don’t have sex),  vaccinating against it is unnecessary.  Moreover, they argue that vaccinating young women against HPV (like giving them a condom or letting them get emergency contraception without a prescription) will make them promiscuous.  Like so many arguments this one boils down to the patronizing desire to control women’s sexual behavior and the irrational idea that if you take away the consequences of sex girls will turn into sluts. 

Good news, it doesn’t happen.  A new study from the Centers for Disease Control and Prevention found that having received the HPV vaccine did not affect whether young women engaged in sexual activity. Researchers used data from the National Survey of Family Growth (NSFG) to look at the behavior of young women ages 15 to 24:

“A main goal of this NSFG analysis was to explore any association between sexual behaviors and receipt of HPV vaccine. Results do not indicate a difference in sexual experience by HPV vaccine status.” 

Specifically, young women who are vaccinated against HPV are no more likely to be sexually active or to have more partners than unvaccinated girls. The lead researcher on the study explained:

“This survey represents a snapshot in time, and we cannot rule out the possibility that the HPV vaccine leads to sexual risk taking.  But this should help calm concerns of parents and (health care) providers to some degree.”

In fact, there is more good news from the study as the research also found that young women who were vaccinated were more likely to use condoms than their unvaccinated peers.  “Sexually active young women who had received the vaccine were more likely to report always using a condom in the past 4 weeks than sexually active young women who had not received the vaccine.”  The researchers say that it’s possible that those young women who received the vaccine are more likely to be concerned about STIs and safer sex in the first place or that receiving the vaccine and perhaps the education that goes with it can lead to safer sex.  Either way they conclude that “data do not suggest that receipt of HPV vaccine causes dis-inhibition or perceived lessened risk and thus more sexually risky behavior.”

So we can scratch the fear that vaccines cause autism off the list (despite what Michele Bachmann said a few months ago), and we can scratch the fear that the HPV vaccine causes promiscuity off the list as well. 

Now we’re back to the facts: HPV is the most common STI, it can lead to cancer, and we now have a vaccine to prevent it. We have a vaccine that prevents cancer. And so I say, as parents, and as members of the herd, it is part of our societal responsibility to get our children vaccinated against HPV.

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.

Commentary Politics

Is Clinton a Progressive? Not If She Chooses Tim Kaine

Jodi Jacobson

The selection of Tim Kaine as vice president would be the first signal that Hillary Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

During the 2016 presidential campaign, former secretary of state and presumptive Democratic presidential nominee Hillary Rodham Clinton has frequently claimed to be a progressive, though she often adds the unnecessary and bewildering caveat that she’s a “progressive who likes to get things done.” I’ve never been sure what that is supposed to mean, except as a possible prelude to or excuse for giving up progressive values to seal some unknown deal in the future; as a way of excusing herself from fighting for major changes after she is elected; or as a way of saying progressives are only important to her campaign until after they leave the voting booth.

One of the first signals of whether Clinton actually believes in a progressive agenda will be her choice of running mate. Reports are that Sen. Tim Kaine, former Virginia governor, is the top choice. The selection of Kaine would be the first signal that Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

We’ve seen this happen before. In 2008, then-presidential candidate Barack Obama claimed to be a progressive. By virtue of having a vision for and promise of real change in government and society, and by espousing transparency and responsibility, he won by a landslide. In fact, Obama even called on his supporters, including the millions activated by the campaign’s Organizing for Action (OFA), to keep him accountable throughout his term. Immediately after the election, however, “progressives” were out and the right wing of the Democratic party was “in.”

Obama’s cabinet members in both foreign policy and the economy, for example, were drawn from the center and center-right of the party, leaving many progressives, as Mother Jones’ David Corn wrote in the Washington Post in 2009, “disappointed, irritated or fit to be tied.” Obama chose Rahm Emanuel as Chief of Staff, a man with a reputation from the days of Bill Clinton’s White House for a reluctance to move bold policies—lest they upset Wall Street or conservative Democrats—and a deep disdain for progressives. With Emanuel as gatekeeper of policies and Valerie Jarrett consumed with the “Obama Brand” (whatever that is), the White House suddenly saw “progressives” as the problem.

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It became clear that instead of “the change we were hoping for,” Obama had started on an impossible quest to “cooperate” and “compromise” on bad policies with the very party that set out to destroy him before he was even sworn in. Obama and Emanuel preempted efforts to push for a public option for health-care reform, despite very high public support at the time. Likewise, the White House failed to push for other progressive policies that would have been a slam dunk, such as the Employee Free Choice Act, a major goal of the labor movement that would have made it easier to enroll workers in unions. With a 60-vote Democratic Senate majority, this progressive legislation could easily have passed. Instead, the White House worked to support conservative Democrat then-Sen. Blanche Lincoln’s efforts to kill it, and even sent Vice President Joe Biden to Arkansas to campaign for her in her run for re-election. She lost anyway.

They also allowed conservatives to shelve plans for an aggressive stimulus package in favor of a much weaker one, for the sole sake of “bipartisanship,” a move that many economists have since criticized for not doing enough.  As I wrote years ago, these decisions were not only deeply disappointing on a fundamental level to those of us who’d put heart and soul into the Obama campaign, but also, I personally believe, one of the main reasons Obama later lost the midterms and had a hard time governing.  He was not elected to implement GOP lite, and there was no “there, there” for the change that was promised. Many people deeply devoted to making this country better for working people became fed up.

Standing up for progressive principles is not so hard, if you actually believe in them. Sen. Elizabeth Warren (D- MA) is a progressive who actually puts her principles into action, like the creation against all odds in 2011 of the Consumer Finance Protection Bureau, perhaps the single most important progressive achievement of the past 20 years. Among other things, the CFPB  shields consumers from the excesses of mortgage lenders, student loan servicers, and credit card companies that have caused so much economic chaos in the past decade. So unless you are more interested in protecting the status quo than addressing the root causes of the many problems we now face, a progressive politician would want a strong progressive running mate.

By choosing Tim Kaine as her vice president, Clinton will signal that she values progressives in name and vote only.

As Zach Carter wrote in the Huffington Post, Kaine is “setting himself up as a figure willing to do battle with the progressive wing of the party.” Kaine is in favor of the Trans-Pacific Partnership (TPP), a trade agreement largely negotiated in secret and by corporate lobbyists. Both Sen. Bernie Sanders, whose voters Clinton needs to win over, and Sen. Elizabeth Warren oppose the TPP because, in Warren’s words, it “would tilt the playing field even more in favor of … big multinational corporations and against working families.”

The progressive agenda includes strong emphasis on effective systems of governance and oversight of banks and financial institutions—the actors responsible, as a result of deregulation, for the major financial crises of the past 16 years, costing the United States trillions of dollars and gutting the financial security of many middle-class and low-income people.

As Warren has stated:

Washington turned a blind eye as risks were packaged and re-packaged, magnified, and then sold to unsuspecting pension funds, municipal governments, and many others who believed the markets were honest. Not long after the cops were blindfolded and the big banks were turned loose, the worst crash since the 1930s hit the American economy—a crash that the Dallas Fed estimates has cost a collective $14 trillion. The moral of this story is simple: Without basic government regulation, financial markets don’t work. That’s worth repeating: Without some basic rules and accountability, financial markets don’t work. People get ripped off, risk-taking explodes, and the markets blow up. That’s just an empirical fact—clearly observable in 1929 and again in 2008. The point is worth repeating because, for too long, the opponents of financial reform have cast this debate as an argument between the pro-regulation camp and the pro-market camp, generally putting Democrats in the first camp and Republicans in the second. But that so-called choice gets it wrong. Rules are not the enemy of markets. Rules are a necessary ingredient for healthy markets, for markets that create competition and innovation. And rolling back the rules or firing the cops can be profoundly anti-market.

If Hillary Clinton were actually a progressive, this would be key to her agenda. If so, Tim Kaine would be a curious choice as VP, and a middle finger of sorts to those who support financial regulations. In the past several weeks, Kaine has been publicly advocating for greater deregulation of banks. As Carter reported yesterday, “Kaine signed two letters on Monday urging federal regulators to go easy on banks―one to help big banks dodge risk management rules, and another to help small banks avoid consumer protection standards.”

Kaine is also trying to portray himself as “anti-choice lite.” For example, he recently signed onto the Women’s Health Protection Act. But as we’ve reported, as governor of Virginia, Kaine supported restrictions on abortion, such as Virginia’s parental consent law and a so-called informed consent law, which, he claimed in 2008, gave “women information about a whole series of things, the health consequences, et cetera, and information about adoption.” In truth, the information such laws mandate giving out is often “irrelevant or misleading,” according to the the Guttmacher Institute. In other words, like many others who let ideology rather than public health guide their policy decisions, Kaine put in place policies that are not supported by the evidence and that make it more difficult for women to gain access to abortion, steps he has not denounced. This is unacceptable. The very last thing we need is another person in the White House who further stigmatizes abortion, though it must be said Clinton herself seems chronically unable to speak about abortion without euphemism.

While there are many other reasons a Kaine pick would signal a less-than-secure and values-driven Clinton presidency, the fact also stands that he is a white male insider at a time when the rising electorate is decidedly not white and quite clearly looking for strong leadership and meaningful change. Kaine is not the change we seek.

The conventional wisdom these days is that platforms are merely for show and vice presidential picks don’t much matter. I call foul; that’s an absolutely cynical lens through which to view policies. What you say and with whom you affiliate yourself do indeed matter. And if Clinton chooses Kaine, we know from the outset that progressives have a fight on their hands, not only to avoid the election of an unapologetic fascist, but to ensure that the only person claiming the progressive mantle actually means what she says.