Safe and Effective HPV Prevention -- Science Versus Right Wing Ideology

[ This article was written on 16 July 2009 ]

Safe and Effective HPV Prevention – Science Versus Right Wing Ideology

The term “Human Papillomavirus” (HPV) actually refers to about 130 strains of related viruses, all of which can infect the mucous membranes and the epidermal tissues of human beings. The vast majority of HPV infections resolve by themselves without any form of treatment; it is estimated that about 70% of HPV infections resolve within one year of initial diagnosis, and that about 90% of HPV infections resolve within two years. Of the roughly 130 strains of HPV that have been identified and studied, it is estimated that between 30 and 40 strains are transmitted through sexual contact. In women, some strains of HPV can lead to the development of cervical cancers; in men, some strains of HPV can lead to the development of penile and anal cancers. In both men and women, some strains of HPV can lead to the development of unsightly genital warts.

It is important to note that those strains of HPV that can ultimately lead to the development of cervical cancers in woman, or penile and anal cancers in men, seldom lead to the development of genital warts in either sex. Conversely, those strains of HPV that can ultimately lead to the development of genital warts in either sex seldom lead to the development of cancers. Furthermore, many strains of HPV are harmless and completely benign; the majority of persons infected with one or more strains of HPV are unaware of their own infections.

HPV infection is believed to be the most common form of sexually transmitted disease in the US population. Data pertaining to the prevalence of HPV infection in the adult US population are highly variable and inconsistent – this is because some studies include all persons who have ever been infected with one or more strains of HPV in their prevalence estimates, whereas other studies report only those cases in which subjects are currently infected with a detectable strain of HPV in their prevalence estimates. To further compound the difficulties associated with properly determining the prevalence of HPV infection in the adult US population, different studies have included different strains of HPV and have omitted different strains of HPV to arrive at prevalence estimates. For the above reasons, HPV prevalence estimates vary from 14% to over 90%. Clearly, any discussion of the prevalence of HPV infection in the adult US population must be qualified by proper identification of the strains of HPV tested for, and the definition of “infection” utilized by the research protocols in question (past infections as well as current infections, or current infections only). What is universally acknowledged is that about 90% of sexually active adults will at some point contract one or more strains of HPV infection; almost all sexually active adults in the US will suffer from HPV infections at some point during their lifetimes.

It is also utterly beyond dispute that certain strains of HPV are considered to be “high risk”, in that persistent infection with one or more of these strains may progress to the development of precancerous lesions, and ultimately to the development of invasive cancer (cervical, penile, oral, or anal). Almost all cervical cancers are caused by HPV infection; this has been established definitively. While less data are available pertaining to HPV-related cancers in men, it appears that persistent infection with the same “high risk” HPV strains in men may progress to the development of penile or anal cancers. As with cervical cancer in women, HPV appears to be a causative factor in almost all cases of penile and anal cancers in men. Furthermore, HPV strain 16 – which causes cervical cancer in women – has also been shown to cause oropharyngeal cancer in both sexes; however, men are much more likely than women to develop such cancers, which frequently present at the base of the tongue and in the tonsils. It must again be stressed, for the purposes of absolute clarity, that the vast majority of cases of HPV infection are not high risk and will not lead to the development of cancer in either sex.

Against this backdrop, the American Cancer Society (ACS) estimates that more than 11,000 women were diagnosed as suffering from cervical cancer in the US in 2008, and that about 3,900 women died from this disease that year alone. The ACS predicted that about 1,600 cases of penile cancer and about 1,900 cases of anal cancer would be diagnosed in men in the US in the years 2006 and 2007 respectively. Between 12,000 and 15,000 cases of oropharyngeal cancer are diagnosed in the US annually, and about 3,000 people die from such cancers in the US every year; most of these oropharyngeal cancers develop in men. Worldwide, more than 300,000 women die from cervical cancer alone each year.

Although about 14 strains of HPV can lead to the development of cervical cancers in women (and penile and anal cancers in men), more than 70% of all cases of cervical cancer are caused by HPV strains 16 and 18, which are also associated with the development of penile and anal cancers in men. More than 90% of all cases of genital warts are caused by HPV strains 6 and 11. Using only the estimates released by the ACS, strains 16 and 18 alone could be responsible, in any given year in the US, for the development of more than 7,700 cases of cervical cancer in women, for the development of more than 1,100 cases of penile cancer in men, and for the development of more than 1,300 cases of anal cancer in men. These figures may be derived from crude estimates, but they are not unreasonable.

On June 8, 2006, the US Food and Drug Administration (FDA) approved the release of Gardasil (marketed by Merck), which is a prophylactic HPV vaccine targeted at four specific strains of HPV. Because Gardasil is a prophylactic vaccine and not a therapeutic vaccine, it must be administered to young persons before they become infected with HPV. GlaxoSmithKline is also seeking FDA approval for the release of Cervarix in the US; Cervarix is another prophylactic HPV vaccine. Cervarix has already been approved for usage in Europe, the UK, and Australia; it is expected that it will receive FDA approval for marketing in the US by late 2009. Both Gardasil and Cervarix have been approved for usage in young women only as of the time of writing.

Gardasil has been demonstrated to be effective in conferring immunity to HPV strains 6, 11, 16, and 18. Cervarix has been demonstrated to be effective in conferring immunity to HPV strains 16 and 18 (with some cross-reactive protection against strains 31 and 45 too); however, Cervarix is formulated with an adjuvant that has been found to boost the immune system response for a longer period of time than has been shown for Gardasil. Cervarix generated more than twice as many antibodies for HPV strain 16, and more than six times as many antibodies for HPV strain 18, than Gardasil at seven months post-vaccination, in all women aged 18 through 45. Cervarix also induced more than 2.7 times more “memory” B cells than Gardasil at seven months post-vaccination for both HPV strains 16 and 18 in women with no detectable B-cell response prior to vaccination. Cervarix is used by the UK government as part of its national program for the vaccination of all teenage girls.

Because almost all sexually active adults – both married and unmarried – acquire one or more strains of HPV at some point during their lives, both common sense and a basic understanding of epidemiology suggest that these vaccines should be administered to young persons before they become sexually active. Gardasil is therefore recommended for usage by girls and young women between the ages of nine and 26 in the US, whereas the Cervarix proposal currently before the FDA recommends usage of this vaccine by girls and women from the age of 10 upwards – in both cases, subject to the caveat that vaccination will only be effective if administered to those subjects who have not yet acquired detectable HPV infections with any of the strains against which these vaccines are effective.

As of the time of writing, about 26 states in the US are embroiled in controversy over whether or not to make inoculation of young girls with Gardasil mandatory, in the same manner as that in which inoculations with other vaccines against common (but potentially lethal) communicable diseases are mandatory. Most of the states engaged in this debate are leaning in the direction of making these vaccinations mandatory.

In both the US and the UK, there exists a lunatic fringe, the members of which assert that some or all vaccines are inherently dangerous; that some of the most commonly-administered vaccines (e.g., the measles, mumps, and rubella (MMR) vaccine; the tetanus, diphtheria, pertussis (TDP) vaccine) have caused suspicious deaths and diseases (particularly autism); that doctors who administer vaccines are either in league with, or have become unwitting accomplices of, Big Pharma; and that vaccines should be withheld from children on the grounds that vaccination programs are part of a covert pact between “socialist” (or “capitalist”) governments and Big Pharma. Similarly, in both the US and the UK, there exists a lunatic fringe, the members of which assert that HIV does not cause AIDS; that HIV is an entirely harmless virus; that doctors who treat HIV infection as a serious illness are either in league with, or have become unwitting accomplices of, Big Pharma; that the very medications developed to treat HIV infection and to interrupt the replication of HIV (reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, etc.) actually cause AIDS; and that evil “socialist” (or “capitalist”) governments are in league with Big Pharma to create a self-perpetuating disease. A backlash from the anti-vaccine crowd is therefore entirely to be expected relative to the release of both Gardasil and Cervarix.

Excluding members of the standard anti-vaccine crowd, one would think that the release of a new vaccine capable of preventing thousands of deaths from several particularly deadly forms of cancer in both men and women in the US alone each year would be met with great enthusiasm, and would be hailed as a medical breakthrough. Not long ago, the notion that a virus could cause a deadly form of cancer would have been met with great skepticism, if not outright ridicule. Now, however, the pathogenesis of cervical cancers in women (and anal and penile cancers in men) is much better understood, and the role of several prominent strains of HPV in the development of these cancers is utterly beyond dispute. In most of the nations where Cervarix and / or Gardasil have been rolled out nationally, these vaccines have indeed been incorporated into government vaccination programs with little or no public resistance or dissent. However, a vociferous group of protestors, the members of which have almost nothing in common with the members of the standard anti-vaccine crowd, has emerged in the US; this group threatens to undermine or to prevent the distribution of Gardasil to schoolgirls in the US. This group is not opposed to the distribution of other vaccines, such as the MMR vaccines or the TDP vaccine – to the contrary, members of this group advocate continued distribution of these vaccines, but campaign specifically against the distribution of Gardasil (and will doubtless campaign specifically against the distribution of Cervarix when the FDA approves Cervarix too).

Members of this group of protestors assert that the distribution of this vaccine to schoolgirls will “encourage promiscuity” in the nation’s youth, and will undermine so-called “abstinence only” sex education curricula. Under the Bush Administration, such misguided and short-sighted policies were encouraged by the federal government, both internationally and in its dealings with the states; “abstinence only” curricula typically taught that sex should only take place between men and women after marriage, and that all sexual activity occurring prior to or outside of marriage was “wrong” and “immoral”. Whereas more enlightened societies throughout the world incorporate comprehensive sex education curricula into their school systems – curricula that teach schoolchildren about the role that condoms can play in preventing the transmission of HIV from HIV-positive persons to HIV-negative persons, for example – “abstinence only” programs teach schoolchildren that only complete abstinence from sexual activity until marriage is effective in preventing the transmission of HIV and in preventing the transmission of sexually transmitted diseases. While ex-President George W. Bush’s $45 billion international AIDS prevention and treatment programs did bring AIDS drugs to almost three million people living in very poor countries such as Rwanda and Uganda, these programs required that health workers peddle this lie and promote complete abstinence from sex outside of marriage over condom use, setting back sexually transmitted disease prevention efforts, HIV transmission prevention efforts, and family planning efforts immeasurably. “Abstinence only” education policies are utterly ludicrous in the context of cultures in which a man’s virility is still deemed to be a hallmark of that man’s success in society.

I am fully aware of the fact that I will face accusations of “racism” for making the following observations – and that some of these accusations will almost certainly be launched by those who oppose the distribution of Cervarix and Gardasil for the above-mentioned reasons.

In the interests of full disclosure – I was born and raised in South Africa. I left that country for political reasons in 1986, when apartheid was in full force and when it appeared that South Africa would never become a true democracy. The tragedy that is slowly unfolding in that country today has largely been ignored by the Western media, for political reasons – it is profoundly humiliating, embarrassing, and difficult to admit that the South Africa once held up to the world as a shining model of racial tolerance, integration, and prosperity is rapidly disintegrating under the new government, and that the cheers and applause of 15 years ago (when the African National Congress (ANC) government was voted into power in 1994) have given way to a culture of unbelievable violence, as crime continues to rock the nation, and as endless acres of freshly filled graves commemorate the government’s abject failure to acknowledge the existence of, and to treat, HIV infection and AIDS.

The newly elected President – Jacob Zuma – has at least four wives, and at least 18 children attributable to him (the price of a wife in Zulu culture is still 11 cows, and polygamy is still considered to be entirely normal in South Africa). Zuma loves to dress up in traditional Zulu attire – leopardskin and a loincloth – and to sing his favourite song (“Bring Me My Machine Gun”) at ANC party rallies and public appearances. Zuma faced 783 counts of corruption, fraud, bribery, money-laundering, and racketeering – charges which were mysteriously dismissed in April 2009 after the head of the National Prosecuting Authority argued that the former leader of the “Scorpions” – a once-proud police anti-corruption unit that has since been disbanded – had abused the legal process. Judge Chris Nicholson, who ruled that the charges against Zuma were to be thrown out, stated that there had been political interference in the case – an allegation made by Zuma’s supporters, who insisted that Zuma was the victim of a political witch-hunt organized by his rival, then-President Thabo Mbeki.

In May 2006, Zuma was acquitted of raping the daughter of a deceased friend. Although he was acquitted of the rape charge (the courthouse was surrounded by hundreds of angry Zuma supporters as the judge considered his verdict), Zuma was widely condemned for remarks made during the trial. Zuma had been aware of the fact that his accuser was HIV-positive; Zuma stated during his trial that he had taken a shower after having had consensual sex with her, as a means of reducing the likelihood of contracting HIV infection.

When asked which of his four wives will be his First Lady, he explained that: “There is no First Lady. If there is an occasion, one day we will have the wife we are with, another day we will have another one”.

Zuma boasts, openly, about his virility and about his manhood, accusing his critics of hypocrisy: “Many of them have wives, girlfriends and children that they try to hide. I love all my wives and children and I'm proud of them, so I'm completely open about it”.

Although South Africa recently became one of six nations that permit gay marriage in both name and substance, Zuma has shown utter contempt for gay South Africans, and has commented (as President, and as the chief executive officer responsible for defending and enforcing the laws of the land) that the gay marriage law is a “national disgrace”. (South Africa’s constitution is the only written constitution in the world that specifically and unambiguously prohibits sexual orientation discrimination in both the public and the private sectors; however, a written constitution is only as strong as the will to defend it, and the majority of black South Africans make no secret of the contempt and disdain that they harbor for gay men and lesbians. How long this provision of the national constitution will continue to be enforced is therefore a matter of legitimate conjecture.)

In the face of the above, no explanation should be necessary as to why “abstinence only” education programs should never be imposed on South Africa, and why any proposed HIV or HPV prevention program premised on calls for young people to remain chaste until marriage would constitute utter lunacy.

President Obama has already reversed the global “gag rule” that made it illegal for those advocates of family planning that received federal funding from even mentioning abortion in the context of birth control. This reversal was met with howls of outrage from the hard right, which had been able to impose this restriction on such advocates for the past eight years. President Obama has already issued an Executive Order rescinding ex-President George W. Bush’s ban of embryonic stem cell research. He will almost certainly reverse “abstinence only” education policies, to the extent that they have not already been reversed.

The hard right is now calling on its members to oppose making Gardasil available to teenage girls, and to oppose state programs that would make such inoculations mandatory for all young girls about to enter the public school system. What is particularly sickening about the manner in which HPV vaccines have been attacked are the blatant distortions and lies of omission made by and on behalf of those who oppose the administration of these vaccines.

The Christian Heritage Party (CHP) in Canada is a right-wing federal political party that, like the “Christian Reconstructionist” movement in the US, advocates that the nation be governed strictly according to biblical teachings. Christian Reconstructionists are significantly more extreme than are members of the CHP – inspired by the late Rousas John Rushdoony, Christian Reconstructionists have called for adulterers to be stoned to death; for gay persons to be stoned to death; for rebellious children to be stoned to death; and for a return to Mosaic law (Old Testament law) in all aspects of government, at all levels of government. The CHP issued a press release pertaining to Gardasil, making a number of outrageous and misleading claims, many of which have been repeated by social conservatives and by other right-wing organizations.

Typical claims made by such groups and individuals include the following:

“Gardasil “only” protects against four of the 30 to 40 different strains of HPV that are transmitted via sexual contact, whereas Cervarix “only” protects against two of these strains.”

This incredibly misleading assertion, whilst technically correct, completely ignores reality. The HPV strains 16 and 18 cause more than 70% of all cases of cervical cancer in women (as well as causing penile, anal, and oropharyngeal cancers in men). Similarly, the HPV strains 6 and 11 cause more than 90% of genital warts. Gardasil specifically confers immunological protection against HPV strains 6, 11, 16, and 18 – in other words, Gardasil specifically confers immunological protection against the very strains of HPV that are known to be involved in the pathogenesis of more than 70% of cervical cancers and in more than 90% of genital warts. To argue that Gardasil “only” protects against four strains of HPV is to argue that Gardasil “only” protects against the vast majority of deadly cancers and unsightly genital warts that are caused by HPV in human beings.

Aside from this, readers should bear in mind the fact that no vaccines are absolutely, 100% effective. Vaccines do not guarantee complete immunity to a disease. Sometimes, the host’s immune system fails to mount an adequate defensive posture, or does not respond to the vaccine at all. To date, no successful vaccine has been developed to confer human immunity to HIV; this does not, however, mean that no such vaccine will ever be developed, or that the eventual development of such a vaccine is impossible.

Gardasil has also been demonstrated to confer partial efficacy against other stains of HPV; specifically, Gardasil has about 38% efficacy against 10 other HPV strains responsible for more than 20% of cervical cancers in women. Both Merck and GlaxoSmithKline (and government regulatory authorities) insist that HPV vaccines should not replace standard Pap smears, which are recommended for all sexually active women on a regular basis.

“HPV is only spread by sexual promiscuity – giving HPV vaccine to young women therefore rewards promiscuity…”

As has been discussed above, about 90% of sexually active Americans contract HPV infection at some point in their lives, in most cases without ever knowing that they have become infected. This argument also fails to take into consideration the fact that women who are virgins at marriage may marry men who are infected with one or more strains of HPV (and vice versa). This argument also fails to address the reality that many women are raped each year in the US. The above argument is therefore a direct slap across the face of almost every American woman – implicit in this argument is the assertion that all American women are sluts, deserving of infection with HPV (and hence deserving of other sexually transmitted infections, and deserving of HIV infection too). Those who make the above argument owe a massive apology to all sexually active women, not just in the US but across the globe. The same apology is owed to all sexually active men, not just in the US but across the globe; this argument cuts both ways, and those who oppose the maintenance of a sexual double standard should recognize that this argument is an insult to almost all members of both sexes.

“HPV is a disease spread by behaviour, so even if Gardasil eliminates the four kinds of HPV against which it may provide immunity, the other 26 kinds will become epidemic if behaviour is not changed…”

I realize that it is difficult for the reader to believe that any sane person can make this argument with a straight face – but this is precisely the argument made by some “social conservatives”. There is absolutely nothing to suggest that the vaccination of all young girls with Gardasil will lead to a massive surge in premarital sexual activity, or that the vaccination of all young girls (or boys) with Gardasil will in any way change the sexual behaviour of women (or men) who receive the inoculations. Furthermore, the four strains targeted by Gardasil are targeted because they are the strains that cause most of the diseases associated with HPV infection – the other strains of HPV are mostly benign. Nevertheless, in the precincts of the hard right today, this argument masquerades as logic...

The lies told by members of the hard right become increasingly bizarre with each addition. Consider the following:

“No one knows what side-effects this vaccine will have on these girls in future years: might it render them sterile?”

Isn’t it possible that a massive meteor could strike the planet and wipe out all forms of life within the ensuing six months? Isn’t it possible that the Empire State Building could collapse before the end of the year due to factors that were not taken into consideration when it was designed and built, or that are not yet recognized but will one day be understood? Both Gardasil and Cervarix have undergone extensive testing by government regulatory agencies, not just in the US but in numerous other Western nations that have their own drug screening and licensing procedures and authorities (e.g. governmental agencies in Canada, the UK, Australia, New Zealand, Japan, etc.). The FDA in the US licensed Gardasil after this product underwent all phases of testing required before any new drug or vaccine may be released onto the US market. In March 2007, GlaxoSmithKline submitted a Biologics License Application (BLA) for Cervarix, including data from clinical trials involving almost 30,000 women; this application included data from the largest Phase III cervical cancer vaccine efficacy trial ever conducted to date Merck submitted a BLA for Gardasil in late 2005, based on safety and efficacy data from a Phase III trial named FUTURE II, involving more than 12,000 women; Gardasil was deemed so effective that in February 2006, the independent Data and Safety Monitoring Board (DSMB) (an agency of the National Institutes of Health) recommended that the trial be terminated on ethical grounds so as to enable women in the placebo arm of the (double-blinded) trial to receive Gardasil.

Both Gardasil and Cervarix were tested and approved by Health Canada (the Canadian equivalent of the US FDA), by the Medicines and Healthcare Products Regulatory Authority (MHRA) (the UK equivalent of the US FDA), and by similar national regulatory agencies throughout Europe. When attempting to restrict the development and marketing of any product on health and safety considerations after that product has already undergone all forms of testing and evaluation required by law, the burden falls on the person or entity challenging the new product on such grounds to show just cause as to why the product in question should not be marketed, or why it should be withdrawn, not on the corporation that markets the product in question.

This argument is particularly cunning and devious, because it conflates the concerns that many women harbour regarding their fertility with the fear and ignorance engendered by those who make this argument and who stir up these fears in the first place. A vaccine typically contains a small amount of an agent that resembles a disease-causing microorganism. The introduction of this agent into the host stimulates the immune system of the host to recognize the agent as foreign, to destroy the agent, and to “remember” the agent (the last process is mediated by memory B cells). Should the real microorganism enter the body at a later time, the immune system is already “primed” to remember that agent and to destroy it (antibodies already exist). Gardasil does not contain live virus or dead virus; it contains only virus-like particles which cannot reproduce in the human body. Similarly, Cervarix contains the L1 protein of the viral capsid (the protein shell of a virus, which contains the nucleus and viral enzymes); it does not contain viral DNA.

As of February 2009, more than 40 million doses of Gardasil have been distributed worldwide, with no evidence of serious adverse effects. In fact, the number of reports of serious adverse effects of Gardasil is less than half the average percentage of serious reports related to the release of new vaccines.

“No one knows how long the effect of a vaccination will last. The HPV epidemic could rebound, worse than ever.”

And this is why further studies will be conducted in coming decades, to answer this question and to determine whether booster shots will be required for either (or both) vaccines. Currently, Gardasil has been demonstrated to be effective for at least four years. Cervarix has been demonstrated to be effective for at least 6.4 years. Neither Merck nor GlaxoSmithKline intend HPV vaccines to replace cervical Pap smears, and this point has been driven home by the relevant governmental licensing authorities in all jurisdictions where these vaccines have been approved.

"Giving young children a vaccine for a disease that is only spread by sexual promiscuity sends a bad message: ‘We expect you to be promiscuous, but your government will protect you against the consequences of irresponsible behaviour.’”

Firstly, this argument rests on a grossly flawed premise. As discussed above, HPV infections are not spread “only…by sexual promiscuity”, and this disgusting insult to thousands of US men and women who become infected each year, despite having been both chaste and faithful to partners who lack one or both of these attributes, should not be permitted to pass uncorrected and unrebuked.

Nevertheless, the more “mainstream” of the right-wing organizations have expressed precisely this sentiment. "Giving the HPV vaccine to young women could be potentially harmful", Bridget Maher of the Family Research Council (FRC) told the British magazine “New Scientist”, "because they may see it as a license to engage in premarital sex". This is the same mentality that was on display when right-wing, virulently homophobic politicians such as the late US Senator Jesse Helms did everything possible to prevent television and other public service announcements stressing the efficacy of condom usage in preventing the transmission of HIV from airing; according to this mentality, it is better for gay men to die of AIDS than to enjoy having sex using condoms.

How many persons reading this article seriously believe that teenagers contemplate the possibility of possible diseases several decades down the road when making decisions pertaining to sexual behaviour in the present? It is difficult enough to get teenagers to use condoms in order to prevent unwanted pregnancies a mere nine months down the road – does any reader seriously believe that teenage girls will hesitate before becoming sexually active on the grounds that they may develop cervical cancers 20 or 30 years after the event? And what of those teenagers – boys and girls alike – who remain chaste until marriage, but who marry partners who are already infected with active (but silent) HPV infections? Should these teens and young persons be sacrificed so as to maintain a grim façade of sexual purity? What “message” should we send to teenagers? Should we send the “message” that these teens should be allowed to die of preventable cancers so as to maintain the sexual purity of a “Christian” nation?

Victor Hugo – the 19th century French romantic poet, novelist, and dramatist – is credited with having made the following observation: “Strong and bitter words indicate a weak cause”. Bearing this quote in mind, consider the following words, written on 4 August 2008 by Henry Makow (a right-wing Canadian conspiracy theorist who has written more than his fair share of the usual tripe about the Rothschilds, the Illuminati, the Zionist conspiracy, the London-based international banking cartel, etc.):

“The [Canadian] government has allocated $300 million to vaccinate thousands of girls as young as age nine against a sexually transmitted disease, human papillomavirus (HPV), which occasionally [sic] causes cervical cancer. The vaccine (Gardasil) only works on girls with no sexual experience. So instead of teaching these children that it is self-destructive and dangerous to be promiscuous, the government is inoculating them as though they were going to become prostitutes [sic]. Instead of selling these girls on the street, the politicians are taking their cut up front, from big pharma, profiting from promiscuity, in the name of protecting the "public health." This is the shape of socialism in the New World Order: enriching corporations by degrading and drugging [sic] the population. In an interview with CBC-TV, a representative of Merck-Frosst, the maker of the vaccine, admitted that lobbying is how business is done in Canada. The 15 minute TV-Report … says that this is the only case of government-mandated mass vaccination in the world. The last time Canada took such drastic action was during a polio outbreak in the 1950's. But there is no epidemic of cervical cancer now. In fact it doesn't even rank in the top 10 cancers affecting Canadian women. Whereas 400 women die of cervical cancer annually, over 5,000 die of breast cancer.”

[This text, and the remainder of Makow’s article pertaining to HPV vaccines, can be read at http://www.henrymakow.com/canada_pimps_its_girls_to_big.html...]

It is difficult to know where to begin.

HPV does not “occasionally” cause cervical cancer, unless the reader defines “occasionally” in terms of the deaths of more than 300,000 women worldwide every year. Almost all of these cervical cancers are attributable to persistent HPV infections.

Makow then asserts that the government inoculates young girls “as though they were going to become prostitutes”. No – the government inoculates these girls as though a substantial number of them are going to have sex later in their lives; it is reasonable to assume that this number approaches 100% of them.

Makow’s next comment – about politicians taking their cut up front from big pharma in the name of protecting the “public health” – is indecipherable. How does the sale of Gardasil bear on the income of Canadian politicians? Are they bribed according to the number of doses administered? If so, why have we not heard anything from the office of the Crown Attorney in Canada, or from the offices of the US Attorneys in the US? Are they perhaps also all taking bribes to look the other way?

Makow then refers to the New World Order “degrading” and “drugging” the population. When did the administration of a vaccine qualify as “drugging” the population? Does administration of the MMR vaccine also constitute “drugging” the population? If not, why not? If not, what is it about Gardasil that differs from the MMR vaccine and that permits Makow to refer to Gardasil inoculations as “drugging” the population without making the same, inflammatory remark about the administration of the MMR vaccine?

And how is it “degrading” to receive a vaccination? Again, is the mandatory inoculation of children with the MMR vaccine “degrading”? Is the mandatory inoculation of children with the TDP vaccine “degrading”? The same questions apply here as apply to the issue of “drugging” the population.

So the manufacturers of Gardasil in Canada “admitted” that lobbying is how business is done in Canada. What is of particular note about that? Lobbying is also how business is done in the US. Large companies in the US engage in lobbying too. Entities called Political Action Committees are formed to throw their financial weight behind specific candidates for public office. This system may not be ideal, and this system is certainly prone to abuses, but what is so remarkable about the fact that corporations in Canada and in the US engage in lobbying?

Makow then states that the Canadian program of inoculating schoolgirls with HPV vaccine is “the only case of government-mandated mass vaccination in the world”. Immediately thereafter, he states that similar “drastic” action was taken during the polio outbreak of the 1950s. He has contradicted himself in these two sentences. Which of these two mutually exclusive statements is accurate?

Finally, assuming that Makow is correct in mentioning that cervical cancer “only” kills 400 Canadian women every year, whereas breast cancer kills more than 5,000 Canadian women every year – if it is true that one type of cancer kills more people than another type of cancer, should the government refrain from administering a safe and effective vaccine against the latter type of cancer merely because it kills fewer people than the former type of cancer?

Makow’s column continues. It is filled with crude generalizations and stereotypes about the roles that women should play as wives and mothers in a Christian society. It also attempts to link Gardasil to instances of Guillian-Barre syndrome, facial paralysis, and “tingling, numbness, and loss of sensation”, pointing out that there were 385 reports of adverse reactions to Gardasil during the last six months of 2006. Here, Makow takes a page from the standard anti-vaccine crowd’s playbook, trying to link Gardasil to a host of disorders in the same way that the anti-vaccine crowd has tried to link the MMR vaccine to autism (in claims that have been investigated and thoroughly litigated, and found to be utterly devoid of merit).

There is another, more sinister reason behind the desire of so many fundamentalist Christians to restrict the availability and distribution of Gardasil and Cervarix to young women. Because the transmission of HPV cannot be prevented by using condoms (although condoms can reduce the likelihood of such transmission), HPV has been used as the hard right’s sexual trump card. If condoms cannot prevent the transmission of HPV, then the message stressing the importance of using condoms to prevent the transmission of HIV and sexually transmitted diseases is weakened (why bother to protect yourself from HIV, chlamydia, syphilis, gonorrhoea, etc. if you are still going to get HPV anyway?). Therefore, any vaccine against HPV infection is a threat to those members of the hard right who view HPV as a gift from nature (or from God) in their more general war on both sex and love.

It is utterly disgusting that so-called “Christian” fundamentalists are willing to trade the lives of young girls and women away to maintain their chokehold over all forms of sexual expression. In recent years, the fundamentalists have lost a great deal of their power. The US Supreme Court struck down all laws prohibiting consenting adults from having gay sex in private settings in the landmark case of Lawrence v. Texas, 539 U.S. 558 (2003), thereby throwing out the sodomy statutes of some 14 states in which it was still illegal for gay adults to have sexual relations (the Lawrence Court reversed an earlier decision (Bowers v. Hardwick, 478 U.S. 186 (1986)) in which the Court had upheld such statutes from constitutional attack just 17 years previously). With the November 2008 election of President Barack Obama and the election of a solid Democratic majority in both the US House of Representatives and the US Senate (which now has a filibuster-proof 60 vote Democratic majority), restrictions on the use of embryonic stem cell lines have been reversed, the anti-abortion global “gag” rule has been rescinded, and abstinence-only sex education programs have been targeted for reversal. Fear of HPV infection was the only card that the anti-sex crowd still possessed, and this card has been snatched from them by the release of cost-effective, successful HPV prevention vaccines.

The hard right can feel itself lose more and more power with every passing month. Six states have legalized gay marriage in both name and substance since Lawrence was handed down (Massachusetts, Connecticut, Iowa, Vermont, Maine, and New Hampshire). An additional five states grant to gay couples who seek them all of the rights, privileges, and benefits of marriage (at the state level) without the name (these relationships are referred to as domestic partnerships in California, Nevada, Oregon, and Washington, whereas they are referred to as civil unions in New Jersey). Four more states grant to gay couples who seek them a limited subset of the rights, privileges, and benefits (at the state level) of marriage (Colorado, Hawaii, Maryland, and Wisconsin). Both New York and the District of Columbia recognize gay marriages solemnized in jurisdictions where such marriages may be entered into legally.

Up until very recently, those who opposed gay marriage were able to comfort themselves by pointing out that gay marriage had only become legal in three states as the result of state supreme court rulings; then the state legislatures of Vermont, Maine, and New Hampshire voted in favour of gay marriage without any form of judicial prompting whatsoever, stripping the hard right of even this small shred of comfort.

Recently, Maggie Gallagher – a well-known columnist for the hard right who has consistently and vehemently opposed gay marriage – took the Chair of an organization calling itself the National Organization for Marriage (NOM). This organization wasted more than $1.5 million on an anti-gay marriage video named “The Gathering Storm”, which – instead of galvanizing opponents of gay marriage – became a national laughing stock, spinning off countless parodies and an endless parade of spoofs on YouTube. The NOM had expected this video to be taken seriously; its members were appalled when, instead, it became the target of scorn, ridicule, and peals of mocking laughter. Frank Rich, writing for the “New York Times” (“The Bigots’ Last Hurrah”, 19 April 2009) pointed out that this advertisement represents the best and only significant effort of those who continue to oppose gay marriage; while Gallagher and her cronies try to attack gay couples with this inane joke, the mainstream media have pretty much ignored the most recent developments in Vermont, Maine, and New Hampshire, barely mentioning them in network newscasts. Rich pointed out that, far from being a national organization, the NOM is merely “…a fund-raising and propaganda-spewing Web site fronted by the right-wing Princeton University professor Robert George and the columnist Maggie Gallagher”.

Faced with a social and moral climate in which their members are literally being laughed at, it is little wonder that members of the hard right are now fighting, tooth and nail, to prevent anti-HPV vaccines from being distributed.

Katha Pollitt, writing for “The Nation” (12 May 2005) chillingly sums up opposition to HPV vaccination programs with the following observation: “Just as it's better for gays to get AIDS than use condoms, it's better for a woman to get cancer than have sex before marriage. It's honor killing on the installment plan”.

Research will be conducted in the near future to determine whether Gardasil and / or Cervarix are capable of preventing boys and men from becoming infected with HPV. This research will necessarily be packaged as neutral with respect to sexual orientation, to prevent the firestorm of homophobic abuse and criticism that would doubtless follow any announcement of research to determine whether these vaccines can prevent gay men (in particular) from developing anal cancers and the above-mentioned oropharyngeal cancers.

What is utterly nauseating is the manner in which those who oppose the release and distribution of Gardasil and Cervarix in the US assert that their objections are grounded in concerns for the health and welfare of those girls and women who choose to receive these vaccines. The true motives of those members of the religious right who oppose the release and distribution of HPV vaccines have absolutely nothing to do with the lives and health of the women to whom these vaccines are administered. Their true motives have nothing to do with safety issues. Their true motives have nothing to do with money. Their true motives have nothing to do with the strains of the virus against which these vaccines confer protection. Their true motives have absolutely nothing to do with the nature of the diseases that these vaccines prevent.

Teenagers do not make decisions pertaining to sexual conduct based on what could happen to them 30 or 40 years down the road – and the hard right knows this. Their true objections are based on the same crabbed, narrow-minded, moralistic mentality that led to President Reagan not even mentioning AIDS in a public speech for more than five years after his inauguration. By cleverly conflating the issue of personal morality with the disastrous “war on drugs” (asserting that politicians assist as corporations engage in “drugging” the population), the hard right obscures its true agenda. This agenda is anti-sex and, in the last analysis, anti-love.

The true motives of those members of the hard right who oppose mandatory HPV vaccination programs; who oppose making Plan B available over the counter (as it is in the UK and in numerous other jurisdictions); who oppose condom distribution efforts to high-risk groups (including gay men); who oppose the passage and enforcement of laws that compel pharmacists to fill prescriptions for emergency contraception; and who oppose laws that compel hospitals to tell women who have been raped about emergency contraception, is very simple – their true motive is to maintain the link between sex and reproduction, to keep women firmly in their place.

The fact that HPV impacts boys as well as girls is not even mentioned by the hard right – to acknowledge that about 10% of the male population is predominantly gay, and that boys could benefit from this vaccine in the same way that girls could benefit from this vaccine is to acknowledge that some boys are definitely gay – not something that those people who believe that homosexuality is a chosen behaviour wish to contemplate.

In short, these people wish to ensure that the “consequences” of “choosing” to be gay are slow and painful deaths. Now that HIV is no longer killing adult men and women in the USA to the extent than was the case a mere 15 years ago – now that HIV infection is no longer an automatic death sentence – these men and women take positive pleasure in contemplating the reality that an easily preventable viral infection may kill thousands of gay men every year. Note that their complaints to date have not even mentioned boys – in large measure because the governments (both state and federal) have been shockingly remiss in not investigating the possible benefits of inoculating boys with Gardasil or Cervarix.

The truth must be exposed – for the sake of the lives of tens of thousands of men and women who may otherwise be doomed to suffer and die, needlessly and painfully.