HPV Vaccine
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Here is a new vaccine for human papillomavirus or HPV.  Take a look at one place you find this virus. It's a monkey virus. Coincidentally the same monkeys that were used to make the polio vaccine.

Med Citation
Articles by Wood, C. E.
Articles by Cline, J. M.

Vet Pathol 41:108-115 (2004)
© 2004 American College of Veterinary Pathologists

Cervical and Vaginal Epithelial Neoplasms in Cynomolgus Monkeys C. E. Wood, H. Borgerink, T. C. Register, L. Scott and J. M. Cline Comparative Medicine Clinical Research Center, Wake Forest University Health Sciences, Winston-Salem, NC

Papillomavirus-associated cervical cancer is the second most common neoplasm in women but has rarely been reported in animals. This report describes cervical and vaginal intraepithelial neoplasms identified in routine histologic specimens obtained from 20 (5.2%) of 385 female cynomolgus macaques (Macaca fascicularis) being used in long-term studies. Lesion incidence was similar in both control and hormonally treated animals (4.7% and 5.5%, respectively). Neoplasms included benign vaginal papillomas, mild to severe intraepithelial dysplasias, and two invasive cervical carcinomas. Common morphologic features included koilocytosis, nuclear atypia, and expansion of the basal epithelium. Selective staining of lesions with at least one of three papillomavirus antibodies was observed in all cases (20 of 20). In contrast, immunostaining of lesions was negative for Epstein-Barr–related virus proteins (0 of 20). The unique similarities between the observed lesions and those seen in women suggest that macaques may provide a suitable animal model for study of papillomavirus oncogenesis.

Key words: Cervical intraepithelial neoplasia; immunohistochemistry; Macaca fascicularis; nonhuman primates; papillomavirus.

Request reprints from Dr. C. E. Wood, Comparative Medicine Clinical Research Center, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1040 (USA). E-mail: chwood@wfubmc.edu.

The cynomolgus monkey is best known as the first clinical test animal for the development of the polio vaccine. They are involved in WNPRC studies of infectious disease, reproduction and other areas.

http://www.primate.wisc.edu/wprc/pdfs/Macaque.pdf

Do we really need this vaccine? Merck wants to make it a law we take it?

Updated: 4:52 p.m. ET Jan 30, 2007

AUSTIN, Texas - Merck & Co. is helping bankroll efforts to pass state laws requiring girls as young as 11 or 12 to receive the drugmaker’s new vaccine against the sexually transmitted cervical-cancer virus.

Cathie Adams, president of the conservative watchdog group Texas Eagle Forum, said the relationship between Merck and Women in Government is too cozy.

“What it does is benefit the pharmaceutical companies, and I don’t want pharmaceutical companies taking precedence over the authorities of parents,” she said.

 

http://www.msnbc.msn.com/id/16891832/ for the full story....

http://www.corixa.com/default.asp?pid=infect_detail&id=23

Product Detail
MPL® adjuvant, our flagship adjuvant, is a derivative of the lipid A molecule found in gram-negative bacteria, and has been observed to be a potent immunostimulant. Licenses for MPL adjuvant have been granted to several affiliates of GSK and to Wyeth-Lederle Vaccines for development in over 20 disease targets. Vaccines that incorporate MPL adjuvant have completed or are now in late-stage clinical trials to protect against infection from:
herpes virus;
hepatitis B virus;
human papilloma virus;
malaria; and
respiratory syncytial virus. Technical Description
MPL adjuvant is a proprietary form of monophosphoryl lipid A, a derivative of bacterial endotoxin, one of the most potent immunostimulants known. Prepared from a heptoseless mutant of Salmonella minnesota, MPL is chemically similar to lipid A but lacks an acid-labile phosphoryl group and a base-labile acyl group. MPL retains the beneficial biological activities of lipid A but with a safety profile suitable for evaluation in pediatric applications.MPL may be a key component of vaccines using technologies such as recombinant and synthetic antigens. While vaccines incorporating these antigens are considered safer than previous attenuated or killed whole-cell vaccines, many of them are poorly immunogenic in the absence of a potent adjuvant. MPL has demonstrated utility with peptide, bacterial sub-unit and synthetic polysaccharide antigens. Vaccines for infectious diseases and allergy desensitization containing this microbially derived adjuvant have demonstrated that MPL is well tolerated in human clinical trials involving thousands of doses.Clinical Experience with MPL
In GSK's clinical trial involving nonresponders and comparing Engerix-B with the new vaccine containing our MPL adjuvant, investigators measured seroconversion rates (protective antibody levels) one month after each of three vaccine doses; at zero, one and six months. After the first dose, 78% of the group given the new vaccine seroconverted versus 59% of the Engerix-B. After two doses, 96% versus 76% seroconverted. After the third and final treatment, 98% of patients receiving the vaccine containing MPL adjuvant seroconverted compared to only 81% of patients given Engerix-B.In a multicenter study of healthy individuals, more than 98% of those vaccinated with Engerix-B containing MPL adjuvant achieved protective anti-hepatitis B antibody levels after just two doses, whereas three doses of the current Engerix-B product were required to obtain a similar level of protection.Mechanism of Action MPL activates cells of the monocyte/macrophage lineage and stimulates release of several cytokines, including IL-1, IL-12, TNFa and GM-CSF. Presumably through the action of these cytokines, lymphoid and antigen-presenting cells, including dendritic cells, are recruited to the local lymphoid organs where efficient immuno-enhancing cellular interactions can take place. These initial events mediated by MPL induce a strong TH1-type of cellular response characterized by increased production of IFN-g and IL-2. In turn, IFN-g promotes the production of complement fixing antibodies (i.e., IgG2a in the mouse), a hallmark of responses mediated by MPL.MPL enhances immune responses to a variety of viral and bacterial antigen types, including peptides, proteins, polysaccharides and tumor cell lysates. Antigens successfully tested in preclinical studies include hepatitis B surface antigen, tetanus toxoid, trivalent split influenza, and a recombinant protein derived from the saliva-binding region of an adhesion protein of Streptococcus mutans. MPL produced striking results in studies with capsular polysaccharide antigens from organisms such as Hemophilus influenza b, several strains of pneumococcal bacteria and the Vi antigen from Salmonella typhi.


Clinical Trials
MPL adjuvants have completed Phase III clinical trials with GlaxoSmithKline hepatitis vaccines. This document is intended to provide only an overview of Corixa's product candidates. For complete information, please refer to the company's Annual Report on Form 10-K, press releases and other public information.

Vaccine prevents cervical cancer
By Rita Rubin, USA TODAY
An experimental vaccine against cervical cancer has moved a step closer toward becoming the first cancer vaccine of any kind on the market. Scientists are reporting Friday that the vaccine was 100% effective in preventing cervical cancer and precancerous changes tied to two types of a common sexually transmitted virus. "It's a very impressive finding," Christopher Crum, director of women's and perinatology pathology at the Brigham and Women's Hospital in Boston, said Thursday.

  A WOMAN'S RISK

An estimated 10,370 women in the USA will be diagnosed with cervical cancer in 2005, and 3,710 are expected to die. A look at a woman's risk of developing the cancer, by age group:
Birth to 39: 1 in 636
40 to 59: 1 in 340
60 to 79: 1 in 368
Lifetime: 1 in 130
Source: American Cancer Society, Cancer Facts & Figures 2005
The report is the first from a large-scale trial of a cancer vaccine. In April, researchers published similarly encouraging results from a smaller study of the Merck vaccine.

Spokeswoman Janet Skidmore said Thursday that Merck plans to apply to the Food and Drug Administration by year's end for permission to sell the vaccine. "There is the potential it could be available late next year, assuming all goes well," she said.

The vaccine, called Gardasil, targets human papillomavirus (HPV) types 16 and 18, thought to cause 70% of cervical cancers, and HPV types 6 and 11, associated with 90% of genital warts cases. Up to 70% of sexually active women will become infected with HPV, which clears up on its own more than nine times out of 10. Lasting infection causes virtually all cervical cancers.

In April, the researchers suggested that the vaccine might be most effective in 10- to 13-year-olds, who are not likely to be infected with HPV.

Preteens and adolescents, sexually active or not, could receive the HPV vaccine along with the other shots they're required to get, said co-investigator Kevin Ault, an Emory University obstetrician/gynecologist who did his research when at the University of Iowa.

It would be just as important to vaccinate boys as girls, Ault said. He cited the rubella vaccine to illustrate his point. All babies are immunized against rubella to prevent them from spreading the disease to pregnant women, because it can cause birth defects.

Skidmore says Merck is testing the vaccine in girls and boys as young as 9. The FDA will decide whether it should be sold for use in preteens, she says. The latest findings from the company-funded study, being presented at the Infectious Diseases Society of America meeting in San Francisco, involved more than 12,000 females, ages 16 to 23. They were randomly assigned to receive either the three-shot vaccine or dummy shots.

The analysis began a month after they received their last shot and continued for an average of 16 months. None of the females who received the vaccine was found to have precancerous changes or cervical cancer, compared with 21 of those who received the dummy shots. GlaxoSmithKline also is testing a vaccine against cervical cancer but has not yet reported results.

So they've made a vaccine for a vaccine induced disease. Great.

There are already 82 VAERS reports about Gardasil


http://www.medalerts.org/vaersdb/findfield.php?PAGENO=1&PERPAGE=10&VAX=HPV4

 

Texas Governor Perry took Merck money before mandating cervical vaccine David Edwards and Mike Sheehan
Published: Thursday February 22, 2007
http://www.rawstory.com//news/2007/TX_Gov._Perry_took_Merck_money_0222.html

Texas Gov. Rick Perry (R) says that it's just a coincidence that he and eight other lawmakers received donations of $5,000 each from Merck lobbyists just a few days before mandating the drug giant's HPV cervical cancer vaccine for all females in Texas ages 12 and up.

"There's been a lot of pressure about the implications of vaccinating young girls against sexually-transmitted diseases," says CNN's Ali Velshi in the video below, "some people thinking that that encourages promiscuity at that age."

He reports though that "this thing is coming undone by word, rumor and report of connection between Rick Perry's office and Merck."

The main lobbyist for Merck previously worked as Chief of Staff for Gov. Rick Perry. Several other states are considering making the vaccine mandatory, thanks in part to Merck's aggressive lobbying.

 

The great Gardasil vaccine cover-up


Cynthia A. Janak

Cynthia A. Janak
February 27, 2007


The World Health Organization (WHO) is promoting this drug that has serious side effects. Here are some of the reasons why.

Did you know that 80% of cases of cervical cancer occur in low-income countries? That means that only 20% happen in the more developed countries like the US. Worldwide there are 500,000 new cases each year and 250,000 deaths. What this means is that 50,000 deaths occur in the developed countries of the world.

http://www.who.int/reproductive-health/publications/hpvvaccines/text.pdf

The average age of a woman with cervical cancer is 48. The effectiveness or dangers of this vaccine will not be known for at least a decade. Let's put things into perspective. Cervical cancer results in just 3,700 deaths nationally every year compared to heart disease, which kills over 300,000 women annually.

http://www.wnd.com/news/article.asp?ARTICLE_ID=54219

So this means that cervical cancer deaths in the United States are 1.5%. I believe that our percentage is so low because we have women go to their doctors yearly and get checked for this awful disease and catch it early. If we are at such a low percentage then why is Merck pushing so hard for this vaccine? Why has the FDA put this vaccine on the fast track to approval when all the testing is not finished?

In my last article about Merck I told you about the law suits because of Vioxx. This drug was also put on the fast track and look at the damage and deaths that it has caused.

This is what the WHO had to say about corruption in the pharmaceutical market.

http://www.who.int/bulletin/volumes/84/2/news.pdf

Dr. Jerome Kassirer, a former editor of the New England Journal of Medicine (NEJM), contributed an article to the report documenting his own experiences with the long financial tentacles of the pharmaceutical industry.

In the United States, 90,000 pharmaceutical representatives ply doctors with gifts and junkets. The US $2 billion spent annually just on free meals and other hospitality events would dwarf many health budgets in African countries.

"Yet the doctors receiving all these gifts are unanimous in insisting it has no effect on their practice," said Kassirer, a professor at Tufts University School of Medicine in the United States.

Kassirer also points to a famous decision by the US Food and Drug Administration (FDA) to keep the drugs Vioxx and Bextra on the market after concerns were raised over cardiovascular risks. Most of the panelists on the FDA committee, it later emerged, had financial ties to the manufacturers. If these panelists had declared a conflict of interest and refrained from voting, the decisions would have gone the other way.

The web of payments can entrap whole governments, Kassirer said, for example by enlisting them to fight in support of the industry's corner against generic manufacturers.

In country after country, however, the evidence suggests that losses of public funds are significant. In the United States, both Medicaid and Medicare — government-run health insurance organizations — estimate that 4-10% of their budget is lost to overpayment.


Here is a little known fact about the Gardasil trials. Gardasil contains 225mcg of aluminum. In the clinical trials aluminum was placed in the placebo instead of a saline.

Merck made a major goof up in their Gardasil report (9682302), in that it did have one chart with a saline placebo group. All the other charts there are only columns for Gardasil and placebo. I am going to assume that they placed the saline group and the aluminum group together for the other charts. Do we have another Vioxx cover-up here, maybe?

 

Table 6
Vaccine-related injection-site and Systemic Adverse Experiences*


 


As you can see, Merck skewed the numbers by adding the Saline group with the Aluminum group. As you also notice by the differences in the three groups, Aluminum plays a major part in the side effects. It looks to me, the lay person, that Merck purposely skewed the numbers to reflect that the side-effects were minimal. My personal opinion is I don't think so!!!!!

Gardasil has 225 mcg of aluminum (as amorphous aluminum hydroxyphosphate sulfate adjuvant) I took this right from the Merck report that is 10 pages long that I now have in my Merck file.

Here is what Dr. Mercola has to say about aluminum hydroxide.

The aluminum hydroxide used in many vaccines has been linked to symptoms associated with Parkinson's, ALS and Alzheimer's.

Aluminum hydroxide, which stimulates immune response, has been used for 80 years in vaccines such as those for hepatitis A and B, and the Pentacel cocktail for diphtheria, pertussis, tetanus, polio and meningitis.

Scientists discovered the link after injecting mice with an anthrax vaccine developed for the first Gulf War. After 20 weeks, a fifth of the mice developed a skin allergy, and memory problems increased by 41 times compared to a placebo group. Also, inside the brains of mice, 35 percent of the cells that control movement were destroyed.

U.S. drugmakers are currently testing aluminum hydroxide as an additive in flu shots, even though a recent study of the efficacy of avian flu vaccine found that it only worked roughtly 50 percent of the time, and then only at a dose roughly 12 times what is typically given for a seasonal flu vaccine.

http://www.mercola.com/2006/apr/11/there_are_more_toxins_in_vaccines _than_mercury.htm


Now, I do not want you to think that aluminum and the toxicity is something that is new. It is not. They have known about aluminum in the scientific circles for years. I have some publications that are over 25 years old.

It is very disturbing to me to know that the pharmaceutical community knew about this toxin and still administered it to my children and grandchildren when they were vaccinated. My parents used to get a yearly flu shot and they both had Alzheimer's disease for years before they passed. How irresponsible can a company be to put this in the vaccines? This is worse than anything that the cigarette companies have done.

http://www.springerlink.com/content/gp1m552418336v04/

 


Histochemical localization of aluminum in the rabbit CNS

G. Y. Wen1 and H. M. Wisniewski1

(1) New York State Office of Mental Retardation and Developmental Disabilities, Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, 10314 Staten Island, NY, USA

Received: 7 May 1985 Accepted: 9 July 1985

"Summary: Aluminum was observed in the nucleolus, interchromatin granules, rough endoplasmic reticulum, free ribosomes, euchromatin, and the heterochromatin of the neuron. The association of aluminum with the first four r-RNA-containing cellular components and with the last two DNA-containing chromatins suggests the association of aluminum with the nucleic acids. The aluminum may interfere with the normal mechanism of the protein synthesis of r-RNA and of the transcription or gene modulation of DNA. Aluminum was also observed in the astrocytic process and in the nuclei of endothelial cells, pericytes, and the muscle cells of the blood vessels. The detection of aluminum in the pyrimidal cells of the cerebral cortex and hippocampus and in the spinal cord neurons, was observed 1 h after i. v. injection, indicating a rapid entry of aluminum from the injection site through the blood-brain barrier (BBB) to the neurons. Using Morin stain, pyramidal neurons of the cerebral cortex and hippocampus, motoneurons of spinal cord, ganglion cells, and bipolar cells of retina and Purkinje cells of cerebellum, exhibited yellow fluoroscence, with peak intensitiy at 560 nm. Tangles were observed in these six types of neurons. The granule cells of hippocampus and cerebellum and the photoreceptors of the retina exhibited green fluorescence with the peak intensity at 490–500 nm. Tangles were not observed in these three types of neurons."

The Evidence That Aluminum Causes AD Is Compelling25

Aluminum
was found to be toxic to the nervous system of animals over 100 years ago. Injecting aluminum into the brains of sheep was reported in 1965 to result in changes in the brain that showed a "striking resemblance" to AD in people. In 1973, brains of AD patients were found to contain more aluminum than people dying without this disease. About the same time, kidney patients on dialysis were found to suffer, sometimes fatal, brain damage (encephalopathy) from aluminum in their antacids (these antacids are used to bind phosphates in their intestines). More than 100 toxic actions of aluminum have been identified and many are damaging to the human brain.

 

  1. Savory J, Garruto RM. Aluminum, tau protein, and Alzheimer's disease: an important link? Nutrition. 1998 Mar;14(3):313-4.

     

http://www.nealhendrickson.com/mcdougall/2004nl/040600pualzheimer.htm

Just a few more little items that I feel you will find interesting about all of this.

This is taken from http://www.informyourself.com.au/Gardasil.html

According to the Merck product manufacturer insert, there was 1 case of juvenile arthritis, 2 cases of rheumatoid arthritis, 5 cases of arthritis, and 1 case of reactive arthritis in 11,813 Gardasil recipients plus 1 case of lupus and 2 cases of arthritis out of 9,701 participants primarily receiving an aluminum containing placebo. Clinical trial investigators dismissed most of the 102 Gardasil and placebo associated serious adverse events, including 17deaths that occurred in the clinical trials as unrelated.

The national Vaccine Information Center (NVIC), Sums the situation up correctly: "With cervical cancer causing about one percent of all cancer deaths in American women due to routine pap screening, it was inappropriate for the FDA to fast track Gardasil. It is way too early to direct all young girls to get three doses of a vaccine that has not been proven safe or effective in their age group."


And Micholas Regush wrote in Vaccine Madness back in 1992, states that "rare spontaneous or chemically induced chromosome abnormalities which are consistently observed in HPV DNA-negative and positive cervical cancers induce cervical cancer."

"[C]arcinogens may be primary inducers of abnormal cell proliferation rather than HPV [Human papillomavirus]." "Since proliferating cells [cancer cells dividing wildly] would be more susceptible to infection than resting cells, the viruses would just be indicators rather than causes of abnormal proliferation."2

I also have a four page document from The Institute on Money in State Politics. According to this document Merck spent $2,460,352 to state-level candidates and party committees. New Jersey, Florida, California and Pennsylvania received more than $1 million or 44%.

To date, Gov. Rick Perry as received $21,000 from the pharmaceutical giant's political action committee. Perry was second only to former California Gov. Gray David, who received $28,000.

According to this report the state of Texas received $158,143 in campaign contributions.

I have about 100 pages about Merck and Gardasil and it made interesting reading.

Merck stands to make billions on the United States citizen by having legislation passed forcing this toxic vaccine on our innocent youth. It is my opinion that they are using this as a way to pay for all the lawsuits that have been filed in the Vioxx cases. I personally do not want to pay for that out of my hard earned dollars. I would rather spend that money on more fruits and vegetables rich in anti-oxidants for my family. Foods that are rich in anti-oxidants help build a better immune system that helps ward off disease. I believe that all families would rather do that than spend $360 for a vaccine that might work for 4–5 years and then have to pay for boosters after that.

Oh, on the way to looking up other things, I found what the Brits are going to have to pay for this travesty. They are going to pay 450 pounds which in US dollars is $880. Can anyone say rip off, I sure can.

Merck is exploiting the gay community with this vaccine in the UK. They are going to play on the fears of gay men and have them get a vaccine that has not even finished its clinical trials for safety. Here are some excerpts from that article.

LONDON (Reuters) — Homosexual men in Britain are requesting treatment with Merck & Co Inc's new HPV vaccine Gardasil, with dozens immunized in recent weeks, a London clinic said on Friday.

"We started offering vaccination to gay men in January and recently we've been giving about 10 a week," said Dr Sean Cummings of the Freedomhealth clinic in London's Harley Street.

Since many sexually active people are already contaminated with HPV, patients are swabbed before vaccination to determine which, if any, sub-types of HPV they may be carrying.

"If you've got a full house (of HPV sub-types) then there is no point in immunizing," Cummings said.

However, some experts said the benefits of vaccinating men were not yet clear.

The Terrence Higgins Trust, Britain's leading HIV and AIDS charity, said the case for mass vaccination in men would depend on the outcome of further clinical trials.

Gardasil costs 450 pounds ($880) for a three-dose course at the Freedomhealth clinic, which has a reputation as a specialist in gay men's health.


http://www.reuters.com/article/health-SP/idUSL2323302420070223

At least in the UK they are going to wait for further clinical trials before they start any mass vaccination of gay men.

What is wrong with this country? Why are we mandating mass vaccinations of our young girls? Can anyone say it could be for the money? I guess we are getting off cheap with paying only $360.

BREAKING NEWS:
Neurological disorders affect 1 billion people: WHO

Tue Feb 27, 2007 1:22PM EST

GENEVA (Reuters) — Neurological disorders ranging from migraines to epilepsy and dementia affect up to one billion people worldwide and the toll will rise as populations' age, the World Health Organization (WHO) warned on Tuesday.

The number of people suffering from Alzheimer and other debilitating dementias, currently some 24.3 million people, is expected to double every 20 years, with prevalence levels rising in developing countries, it said.

In a report entitled "Neurological Disorders: Public Health Challenges," the United Nations agency urged that neurological care become part of basic health care so that underdetected disabilities are diagnosed and treated, especially in Africa.


At this point I want to repeat what Dr. Mecola had to say about aluminum. "The aluminum hydroxide used in many vaccines has been linked to symptoms associated with Parkinson's, ALS and Alzheimer's."

Maybe the WHO and the UN should ban the use of aluminum in the vaccines that people are getting through their health initiatives. What a concept to preventative medicine.

Gardasil is the biggest and the best scam since the rising gasoline prices.

We as citizens of the United States of America need to demand that Merck take Gardasil off the market and insist that our Government investigate the "illegal" practices of the pharmaceutical giants and our elected officials in taking campaign contributions as legal bribes to pass legislation. These sanctioned practices by our government officials needs to stop and so do they. These people are harming the United States citizens in more ways than one.

They ALL need to be removed from office before they can do any more damage to our democratic way of life. I say we remove the Hillarys and the Obamas and the Kennedys and the Shumans and all of them. They have consorted with the enemy within, opened our boarders to terrorists and illegals that suck our economy and health care system dry.

Wake up America! It is time for us become strong again with honest and trustworthy leadership that will not make up lies for a dollar.

Call your legislators today and demand the removal of Gardasil legislation forever. Don't let Merck or any drug company run our country and hurt our youth for money.

Call Merck today and tell them to stop using aluminum in any and all vaccines because it is dangerous to the health of the people.

What started this debate? Read my first article about Gardasil, "The King of Texas."
http://www.renewamerica.us/columns/janak/070206

TO FIND YOUR SENATORS AND CONGRESSMEN

Find your Senators=> www.Senate.gov/general/contact_information/senators_cfm.cfm
Find your Congressmen=> www.House.gov/writerep
Find your Congressmen & Senators=> www.MoralLaw.org/delegation.htm
Find your Newspapers=> www.TownHall.com/action/write_media.html/
Find Local Talk-Radio=> www.Radio-Locator.com


Lawrence A. Bossidy, Retired Chairman and Chief Executive Officer, Honeywell International Inc. Director, J.P. Morgan Chase & Co. and Berkshire Hills Bancorp, Inc. Merck Director since 1992.

AFA.Net/activism

Richard T. Clark, CEO and president, Merck & Co., Inc., 2005; president, Merck Manufacturing Division, 2003-2005; chairman, Medco Health Solutions, Inc., 2002-2003; chairman, president and CEO, Medco Health Solutions, Inc. (formerly Merck-Medco Managed Care, L.L.C.), 2000-2002; executive vice president and COO, Merck-Medco, 1997-2000; senior vice president, Quality Commercial Affairs, MMD, 1997. Joined Merck in 1972.

Merck & Co., Inc.
One Merck Drive
P.O. Box 100
Whitehouse Station, NJ 08889-0100 USA
Phone: 908-423-1000
Monday-Friday 8:30 AM — 5:30 PM ET

 

Cynthia Janak is a freelance journalist, mother of three, foster mother of one, grandmother of five, Pharmanex executive, Chamber of Commerce member. Her expertise is as an administrative professional. Her specialties are adoptee and genealogy research and research journalism. Hobbies: Writing prose, crocheting, Conservative Studies, and rehabbing houses. She is a freelance journalist for the Empire Journal. You can contact Cynthia Janak at cj1951@ameritech.net

© Copyright 2007 by Cynthia A. Janak
http://www.renewamerica.us/columns/janak/070227
 

The new king of Texas


Cynthia A. Janak

Cynthia A. Janak
February 6, 2007


On July 4th, 1776, we declared our independence from England. We wanted to be a nation that was governed by the people for the people.

It has been over 200 years since we had a king rule this country and it has been great. We have freedom and a government that is composed of legislative, executive and judicial branches. This form of government is "supposed" to protect us from any individual becoming so powerful that he rules by decree instead of going through the process that we hold dear.

But what is happening today? We have politicians that are circumventing the system that our forefathers so carefully put in place to prevent a monarchy in this country. How are they doing that? What our elected officials are doing is enacting executive orders and writing statements that change laws or bypass the legislative process. This is happening more and more in all the executive branches of our government in this country.

The most recent abuse of this power is the governor of Texas. Governor Perry, through an executive order, has mandated that female children receive a vaccine that could be harmful. He bypassed the opinion of the people and of the legislature which was in opposition to this mandate. They did not want to put into law forced vaccinations of Gardasil, a Merck & Co. product.

Before we get into this any further, let's look at who Governor Rick Perry really is. First and foremost he is a west Texas rancher who became governor because President Bush resigned the governorship to run for president. He has since this time in 2000 been re-elected to the governorship.

Let's go back to May of 1995. There was an incident that involved the abuse and death of a hog at the Tyler County Fair. I know it doesn't sound like much but this will help show you the mind set of this man.

This is what happened. A young man put a water hose down the throat of a hog that he entered in the fair to add more weight to the animal. This is a far cry from encouraging the animal to eat or drink. Needless to say, the hog died.

Then Governor Bush sent then Commissioner of Agriculture Rick Perry to investigate the abuse. Perry sent two staffers to do the investigation into the alleged abuse. These staffers came back to report that the incident was "accidental." Here is an excerpt from the letter to then Governor Bush. "The underlying issue which has created a whirlwind of attention is whether or not an animal has the same rights as a human being."

What has this to do with shoving a hose down an animal's throat? Nothing!!! To me this is the opposite of the removal of a feeding tube and staving a person to death. Perry, with his comment, basically, condoned this action by the youth. To me this shows that he has little regard for a living creature.

Guilt by association, on Sunday, June 25th, 2000 there was an article in the Easton, Maryland, The Sunday Star, titled "Bush scandals, bad policy." I would like to know why this article or something similar did not run in other newspapers. I was glad that I was sitting down when I read the article. It showed me that Bush caters to the big business and not so much to the people.

One example is Metabolife's Washington lobbyist gave $141,000 to Bush's gubernatorial campaigns and $100,000 for his presidential campaign. At the time, Metabolife's Ephedrine products were linked to 8 deaths but for some reason stricter limits on the drug were dropped.

In the same article it states that $1.5 million was given to Perry in contributions and loans to give him the edge over John Sharp. This money was provided by James Leininger. Leininger was a supporter of "tort deform" which made it impossible for anyone to sue big business. Can you say we have a big business connection here?

Don't worry. I am going to tie all of this together in the end.

Now we come to pharmaceutical giant Merck who put a product on the market call Vioxx. On August 22nd, 2005, CNNMoney reported that Merck lost its first lawsuit in regards to Vioxx. One of the arguments by Lanier the attorney for widow Carol Ernst was that Merck concealed information about the health risks associated with the drug to protect sales.

What did Merck say about this, they said that Vioxx did not cause Ernst's death. They asserted that arrhythmia had not been linked in the Vioxx studies.

Can you say that the drug came on the market too soon? I can.

This article also states that Merck has 4,200 product liability lawsuits that represent about 7,500 plaintiff groups had been filed. In May of 2005, Judge Eldon Fallon told reporters that lawsuits could reach 100,000.

A tiny bit about the company Merck. Merck (MRK) Reuters article dated January 30, 2007's headline is "Merck profit falls, hurt by charges, generic Zocor." A summary of the article is that generic drugs are hurting their profit. The other item that is hurting Merck are the "tens of thousands of lawsuits" that are filed because of Vioxx adverse side effects.

One other thing about Merck, they pay Richard T. Clark, CEO and President $4,160,106 for the year of 2005, Judy C. Lewent, CFO, Exec. VP., $1,946,700 for the year of 2005. There are more officers that receive over a million a year but I did not feel the need to list all of them here. Now remember this does not include the gift stock options that they receive.

Now, I am going to take you down the path of the vaccine, Gardasil by Merck.

At the http://www.medalerts.org site, there is a link to "National Vaccine Information Center." This site provides the public with the resource to research different vaccines. I found that there were 82 reports of adverse reactions reported in regards to this vaccine.

There are several articles and papers to read about this drug that Texas, Governor Perry wants to inflict on the female youth of his state. My focus is going to be on the side effects that have been reported. All the reports I am going to reference the patient had no preexisting conditions.

Days since Vaccination — 0–1 hr. after vaccination — pt reported to feel dizzy, weak, vision went black for a few seconds, got pale with purple lips.

Days since Vaccination — 0 — Vasovagal syncope(drop in blood pressure) shortly after receiving hep A and Gardasil vaccine, fell, hit nose on a drawer, loss of consciousness, sent to ER in transport broke nose.

Days since Vaccination — 0 — ...complained of pains, numbness. Started walking down hall fainted and had tonic/clonic movement (grand mal seizures) for 15 sec.

Days since Vaccination — 0 — immediately after the injection...the patient experienced pain and stinging at the injection site that lasted about 2 minutes and radiated the arm. The patient also reported feeling faint following the injection and experienced swelling.

Days since Vaccination — 0 — At the time of the vaccination the patient experienced extreme pain at the injection site and fainted.

Days since Vaccination — 0 — Vaccine given after physical. Patient fainted, vasovagal (drop in blood pressure), hit head on carpeted cement floor. Loss of consciousness 1 min, had tonic (stiffening of the limbs) posturing of right hand only some shaking.

Days since Vaccination — 0 — Patient said right deltoid area, became red, swollen, quarter size hard knot, achy, painful to raise arm.

Days since Vaccination — 0 — Immediately after vaccine administration patient had syncopal episode with tonic posturing fell from table. Responded with gentle stimulation versus normal 5 minutes post regaining full consciousness.

Explanation of terms:

Vasovagal Syncope — Vasovagal syncope is not a serious or life threatening condition, but in effect an abnormal reflex. This results in a drop in blood pressure leading to decreased blood flow to the brain resulting in dizziness or fainting.

The symptoms in vasovagal syncope are slightly different for each person, but often include many of the following characteristics:

 

bulletMost episodes occur while standing, occasionally sitting and almost never lying down

 
bulletPatients often describe feeling very warm and sweaty before blacking out

 
bulletNausea and rarely vomiting can precede episodes

 
bulletObservers often describe the patients as pale ("white as a sheet")

 
bulletPatients are usually unresponsive ("out") for less than a minute

 
bulletPatients may have some twitching while unresponsive, but seldom shake violently, bite their tongue or lose control of bowel and bladder function. The latter are more suggestive of a primary seizure.

 
bulletAfter regaining consciousness, patients are usually immediately aware of their surroundings, who and where they are

 
bulletAfter an episode, patients often feel somewhat dizzy and report feeling tired for as much as 24 hours

 
bulletPatients that learn to recognize the warning signs can avert losing consciousness by sitting or lying down promptly.

 

http://www.londoncardiac.ca/pages/vvs.htm

tonic/clonic movement — Generalized tonic clonic seizures (grand mal seizures) are the most common and best known type of generalized seizure. They begin with stiffening of the limbs (the tonic phase), followed by jerking of the limbs and face (the clonic phase).

During the tonic phase, breathing may decrease or cease altogether, producing cyanosis (blueing) of the lips, nail beds, and face. Breathing typically returns during the clonic (jerking) phase, but it may be irregular. This clonic phase usually lasts less than a minute.

Some people experience only the tonic, or stiffening phase of the seizure; others exhibit only the clonic or jerking movements; still others may have a tonic-clonic-tonic pattern.

Incontinence may occur as a result of the seizure. The tongue or inside of the mouth may be bitten during the episode; breathing afterwards may be noisy and appear to be labored. Contrary to popular belief, nothing should be placed in the mouth during the seizure; turning the patient on one side will help prevent choking and keep the airway clear.

Following the seizure, the patient will be lethargic, possibly confused, and want to sleep. Headache sometimes occurs. Full recovery takes minutes to hours, depending on the individual.

http://www.epilepsyfoundation.org/answerplace/Medical/seizures/types/genConvulsive/seizuretonic.cfm


After this I went to find out about the drug Gardasil from one of my favorite sites, WebMD. (My suggestion to everyone reading this is to request your doctor to check in the PDR (Prescription Drug Reference) for the specifics and side effects of any drug that is going to be prescribed. Doctors are good healers but they cannot know everything about every drug or vaccine that is out there today.)

First the uses for Gardasil.

"This medication is a vaccine used to prevent cervical cancer, genital warts and abnormal tissue growth in the vagina/cervix that can lead to cancer in women. These conditions are commonly caused by certain types of human papillomavirus (HPV).

This medication does not protect against all types of HPV, only the types in the vaccine. (2 HPV 16 & HPV 18) It is used to prevent the diseases and will not treat active cervical cancer, genital warts or other diseases caused by the types of HPV in the vaccine.


Side Effects of Gardasil.

Redness, itching, swelling, bruising, and pain at the injection site may occur. Fever may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell you doctor immediately if any of these rare but very serious side effects occur, joint pain/swelling.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.


Precautions of Gardasil.

Before receiving this medication, tell your doctor or pharmacist if you are allergic to it: or to other vaccines; or if you have any other allergies.

Before receiving this vaccination, tell your doctor or pharmacist your medical history, especially of: immune system problems,. (e.g. HIV infection), bleeding disorders (e.g. hemophilia, thrombocytopenia), current fever/illness.


Interactions of Gardasil.

Before receiving this vaccination, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g. warfarin), cancer chemotherapy, coricosteroids (e.g. prednisone, dexamethasone), drugs that weaken the immune system (e.g. cyclosporine, tacrolimus).

Notes for Gardasil.

As with any vaccine, this vaccine may not fully protect everyone who receives it.

Getting this vaccine does not replace cervical cancer screening. Continue to have regular obstetrician/gynecologist checkups.


Now I want to make a comparison between what Merck and Medical News Today says about the vaccine.

Merck:

There were no discontinuations due to serious vaccine-related adverse events. Adverse events were higher among those who received GARDASIL compared with placebo recipients. The most common vaccine-related adverse event reported was local discomfort at the injection site.

Medical News Today:

The most common injection site and systemic adverse events were pain and headache, respectively.

This is interesting considering what the "National Vaccine Information Center" had to say about the side effects. Can anyone say cover-up for profit?

The ingredients of Gardasil.

Each 0.5-mL dose of the vaccine contains approximately 225 mcg of aluminum (as amorphous aluminum hydroxyphosphate sulfate adjuvant), 9.56 mg of sodium chloride, 0.78 mg of L-histidine, 50 mcg of polysorbate 80, 35 mcg of sodium borate, and water for injection. The product does not contain a preservative or antibiotics.

I want to bring your attention here to the aluminum that is used in this vaccine. From what I have read this type of aluminum is used to help with absorption of the vaccine. My question to you is where does the aluminum go after it has done its job? I am not a scientist and I would like the answer. This is what I found on this.

This was taken from an article about "Aluminum and the Prevention of Alzheimer's Disease by Dr. Joseph Mercola.

http://www.mercola.com/1998/archive/aluminum_and_alzheimer_prevention.htm

The cause of AD is unknown. However, environmental influences appear to be important. Aluminum is a widely recognized nerve toxin. It has been found in increased concentrations in all AD affected tissue. Recent scientific studies provide four independent lines of compelling evidence that implicate aluminum's role in the cause of AD.

The last bit of information about this wonderful vaccine is that the price tag is high. This is what Merck had to say about that.

Manufacturer Merck & Co. has set the price at $360 for a series of three injections, and it is often covered by insurance.

I am going to tie this all together for you. This governor Perry has no clue how harmful this vaccine could be to the female youth of his state. If he had done his research into the vaccine as I have done today we would not have an executive order mandating this abuse of young women.

Here is a company that has a history of lawsuits because of its drugs but yet this governor ignores this well known fact. For some reason he is looking the other way and is going to turn over your children and hard earned money to this Pharmaceutical Giant. Maybe it could be because the normal person would never expose their children to such a harmful vaccine knowingly.

Governor Perry should have listened to what the people and the legislature had to say about making this mandatory. But he did not. The King wanted his way and had little intention of listening to the legislature of his state.

What does that say to me, volumes! This act by this King of Texas is in violation of the rules that govern this wonderful country. From what I have seen today, in my opinion, it looks as if the contributions of the big business lobby are guiding his actions. It is my opinion that he wanted to keep the money rolling in for his re-election campaign.

How many of our young people are going to have to die from anaphylactic shock or be confined to a nursing home for brain damage because of lack of blood to the brain before this drug is taken off the market? How many more Terry Schiavo's do we have to have out there?

My reason for writing this article is to let the people of this wonderful country, the United States of America, know that the King has returned to rule this country and we were all sleeping when it happened.

You need to take action now because we no longer have any time left to save the United States of America. Look at who you have in your government. Check out what bills they have passed and what is in them. Look at what your governors are doing with their executive order privilege which is to be used only in cases of emergency. And lastly, and it pains me to say this but, look at the executive orders and the statements that our President has put in motion. It makes me weep and pains my heart.

We hired all of these individuals to protect our rights under the Constitution as United States Citizens. We pay these people their salaries to do the work that we hired them to do. It has come the time to fire all of them and start anew so we can bring back the greatness that this country once was again.

Don't let a King run this country by decree. Stop the trend now.

 

Cynthia Janak is a freelance journalist, mother of three, foster mother of one, grandmother of five, Pharmanex executive, Chamber of Commerce member. Her expertise is as an administrative professional. Her specialties are adoptee and genealogy research and research journalism. Hobbies: Writing prose, crocheting, Conservative Studies, and rehabbing houses. She is a freelance journalist for the Empire Journal. You can contact Cynthia Janak at cj1951@ameritech.net

© Copyright 2007 by Cynthia A. Janak
http://www.renewamerica.us/columns/janak/070206
 

 Ten reasons why HPV vaccine is 'murky' issue
 Sunday, February 4, 2007

 The word "cancer" triggers emotions ranging from fear to empathy to panic. But we cannot let our emotions cause us to spend money or create mandates without careful research. We need to evaluate claims of drugmakers, lobbyists and lawmakers when they seek money for cancer prevention efforts.

Here are 10 reasons why we are skeptical about efforts to mandate for school girls the HPV vaccine against the sexually transmitted cervical-cancer virus.

10. Merck and Co. (the manufacturer of the vaccine) has funneled money through Women in Government, an advocacy group made up of female state
 legislators around the country.

 9. Sen. Connie Lawson, the General Assembly's No. 1 advocate for the vaccine, is a member of Women in Government.

 8. A top official from Merck's vaccine division sits on Women in Government's business council.

 7. Women in Government President Susan Crosby, a former Indiana state legislator, said the vaccine could "eliminate a cancer." Yet Gardasil, is NOT a cancer vaccine. It is a vaccine for a virus; specifically for four of the more than 100 types of HPV, two of which cause 70 percent of cervical cancer in women, and two that cause 90 percent of genital warts.

 6. Merck could generate billions in sales if Gardasil - at $360 for the three-shot regimen - were made mandatory across the country. Depending on how many girls are Medicaid-eligible in each state, much of that money could come from Medicaid dollars - even if the vaccine is recommended, not mandated.

 5. The top 10 leading killers of women in the U.S. are heart disease, stroke, lung cancer (more than 70,000 deaths of women per year), respiratory diseases, Alzheimer's, breast cancer, diabetes, accidents, flu/pneumonia and colon cancer. About 3,700 U.S. women die of cervical cancer each year; that is about 1/8th of the number of women who die from colon cancer, the No. 10 killer of U.S. women.

 4. Because the vaccine was only studied for 3 1/2 years, the long-term effectiveness and safety of this vaccine has yet to be determined. It took years for thalidomide and Vioxx (also a Merck product) to demonstrate their most negative side effects.

 3. Pap smears have dramatically reduced cervical cancer deaths in the U.S. But Gardasil does not protect against all cancers of the cervix. If the number of Pap smears go down because of women's false sense of security, the number of cervical cancer deaths could go UP!

 2. Scarce health care dollars should be spent in the most effective way possible. We believe an investment of billions could be better spent in efforts to battle the top 10 killers of women. (See No. 6 and No. 5.)

1. With an issue as "murky" as this, our little girls should not be guinea pigs.

 OUR VIEW is written on a rotating basis by Grace Housholder, Dave Kurtz, Matt Getts and Michael Marturello. Publisher Terry Housholder is also a member of the editorial board. We welcome readers' comments.

 

Experimenting On Teen Girls
March 7, 2007 by Phyllis Schlafly
It all looked so easy. Just hire lobbyists who have access to the right public officials, make strategic campaign contributions, and finance a front for women to carry your message. This wasn't a typical advertising campaign to sell the new vaccine for HPV (human papillomavirus), called Gardasil, by repetitive commercials on the television network evening newscasts. The real money to be made from this drug depends on government mandating and funding it for all girls.

Marketing costs of inducing state governments to require all teenage girls to be given this vaccine would be just pennies compared to the billions of dollars that would flow to Merck. The profits could even be enough to bail out Merck from its potential billion-dollar liabilities on Vioxx (which is why some say that HPV stands for Help Pay for Vioxx).

So Merck hired Texas Governor Rick Perry's former chief-of-staff to carry the ball. On the slowest news day of the year in Texas, the Friday before the Super Bowl, Governor Perry issued an Executive Order requiring young girls to receive Merck's HPV vaccine in order to enter the sixth grade.

The Associated Press reported, based on documents, that Perry's current chief-of-staff Deidre Delisi discussed Merck's HPV vaccine with aides on Oct. 16. On the very same day, Merck's political action committee donated $5,000 to Perry's reelection campaign plus an additional total of $5,000 to eight Texas lawmakers.

Meanwhile, Merck financed a new "Women in Government" organization, composed of women state legislators, to push for the vaccine. Does it evade regulations against lobbying if women legislators are merely "educating" each other?

Recently released staff emails reveal that Governor Perry's aides were themselves shocked by his mandate. Commenting on the first draft of his Executive Order, one aide said, "that first line sounds almost like a Merck commercial."

Perhaps Perry's rush to put a mandate in place was to preempt the Texas legislature from holding hearings that would expose how senseless this mandatory vaccination of 11-year-old girls would be. Hearings would reveal that this vaccine has not been shown to prevent a single case of cancer.

"I believe that their timing was a little bit premature so soon after [the vaccine's] release, before we have a picture of whether there are going to be any untoward side effects," says Dr. Anne Francis. She chairs the usually pro-vaccination American Academy of Pediatrics committee.

Merck's HPV vaccine was approved by the FDA only eight months ago, based on minimal testing (including few tests with young girls), and it has largely unknown risks and benefits. Even in the best case scenario, it would protect against only some strains of HPV, leaving girls vulnerable to many other sexually transmitted diseases.

The Association of American Physicians and Surgeons, the Texas Medical Association, and the American Academy of Pediatrics do not support this vaccine mandate. State legislatures in Michigan, Indiana and Maryland have declined to make this vaccine mandatory.

Governor Perry is so far unapologetic. He wrapped himself in a new version of Hillary Clinton's "for the children" excuse, arguing that his mandate is "for young ladies who are dying of cancer."

But the average age of diagnosis of cervical cancer is 48. Not even Merck claims that inoculating an 11-year-old girl will protect her against sexually transmitted diseases five, ten, twenty and thirty years later.

"I got hammered in church this morning on the Merck thing, and it was just Saturday," Perry's Chief Clerk Greg Davidson emailed the day after the Executive Order was issued. "Do we have any talking points or stats or anything that can help me fight through Sunday. This is brutal."

No list of talking points can justify forcing this vaccine on schoolchildren for a disease that is not contagious in the classroom environment. Follow the money.

The HPV vaccine requires three shots priced at $360, not counting the costs of separate doctor visits and administrative expenses. Sexual abstinence costs zero dollars and, unlike the vaccine, is 100 percent protective against sexually transmitted diseases.

The U.S. government spends billions of dollars to promote teenage abstinence from illegal drugs, and forces the tobacco companies to spend billions to promote teenage abstinence from smoking. Why not put a fraction of the government's proposed vaccine costs into promoting teenage abstinence from sex?

Instead, the Perry mandate would force the vaccine on good girls who don't engage in premarital sex and don't need the vaccine. At the same time, girls who receive the vaccine will be given a false sense of security that will be even more costly to them than the high-priced vaccine is to the public.

The backlash against the mandate caused Merck to announce that it is suspending its lobbying campaign to make this vaccine compulsory, and the Texas Legislature is trying to cancel Perry's Executive Order. Stay tuned; Merck's lobbying campaign has to shift gears, but it isn't going away because too much money is involved.
 

Texas governor backs down on HPV vaccine bill
Won't veto legislation to block required cancer shots for sixth-grade girls
 

Thank God for men like Dennis Bonnen

I'm posting a quote from him from this article...

http://www.msnbc.msn.com/id/18575675

Republican Rep. Dennis Bonnen bristled at the governor’s criticism of his bill.

“We should not and are now not going to offer the 165,000 11-year-olds in Texas up to be the study group for Merck to find out what the implications of this vaccine would be for these girls,” he said.

And Gov. Rick Perry said on Tuesday  he won’t veto a bill that would block state officials from following his order that all sixth-grade girls be vaccinated against a virus that causes cervical cancer.

A win for the little girls of Texas.....

Judicial Watch Uncovers Three Deaths Relating to HPV Vaccine
Event Reports Obtained from FDA Detail 1,637 Adverse Reactions to Gardasil

 

Read this on Judicial Watch's Web Site:
http://judicialwatch.org/6299.shtml

(Washington, DC) -- Judicial Watch, the public interest group that investigates and prosecutes government corruption, today released documents obtained from the U.S. Food and Drug Administration (FDA) under the provisions of the Freedom of Information Act, detailing 1,637 reports of adverse reactions to the vaccination for human papillomavirus (HPV), Gardasil.  Three deaths were related to the vaccine.  One physician’s assistant reported that a female patient “died of a blood clot three hours after getting the Gardasil vaccine.”  Two other reports, on girls 12 and 19, reported deaths relating to heart problems and/or blood clotting.

As of May 11, 2007, the 1,637 adverse vaccination reactions reported to the FDA via the Vaccine Adverse Event Reporting System (VAERS) included 371 serious reactions.  Of the 42 women who received the vaccine while pregnant, 18 experienced side effects ranging from spontaneous abortion to fetal abnormities.

Side effects published by Merck & Co. warn the public about potential pain, fever, nausea, dizziness and itching after receiving the vaccine.  Indeed, 77% of the adverse reactions reported are typical side effects to vaccinations.  But other more serious side effects reported include paralysis, Bells Palsy, Guillain-Barre Syndrome, and seizures.

“The FDA adverse event reports on the HPV vaccine read like a catalog of horrors,” stated Judicial Watch President Tom Fitton.  “Any state or local government now beset by Merck’s lobbying campaigns to mandate this HPV vaccine for young girls ought to take a look at these adverse health reports.  It looks as if an unproven vaccine with dangerous side effects is being pushed as a miracle drug.”

Judicial Watch filed its request on May 9, 2007, and received the adverse event reports from the FDA on May 15, 2007.  Judicial Watch has posted the adverse event reports below.

(A recent study, published in the New England Journal of Medicine, also questioned the general effectiveness of Gardasil.)
 

SEX VIRUS VACCINE LINKED TO THREE DEATHS

Sunday June 24,2007

Lucy Johnston

THREE deaths have been linked to the controversial sex virus jab health officials want to give to all 12-year-old girls.

Doctors suspect the jab, which protects against a sexually transmitted human papilloma virus that causes cervical cancer, may also be linked to 1,700 “adverse reactions”.

Reports from the US, where the Gardasil vaccine has been used for nearly a year in some states, reveal that three
victims died soon after receiving the injection. They were aged 12, 19 and 20.

They seem to have suffered blood clots or heart attacks. Hundreds of others suffered what could be adverse side effects, including paralysis, seizures and miscarriages.

The news comes just days after the Department of Health announced the drug would be added to the childhood immunisation programme from autumn 2008.

The findings have alarmed UK health experts. Jackie Fletcher from the vaccine damage support group Jabs, said: “Trials of this jab have mostly been on adults, so we don’t have any idea of the long-term effect on children.”
Dr Peter Mansfield, a former GP who runs the Good HealthKeeping clinic in Lincolnshire, said: “It’s absolutely wrong that girls of 12 should be given this jab.”

Dr John Oakley, a west Midlands GP said the trials for Gardasil had been so limited that the children taking it  would be like “guinea pigs”.

The manufacturers, Sanofi Pasteur MSD, had not planned to release the data, but it was obtained under freedom of information laws by lobbyists Judicial Watch. The findings read like “a catalogue of horrors”, said its  president, Tom Fitton.

Other serious possible side effects  include paralysis, seizures and neurological conditions such as Bell’s palsy and Guillain-Barré Syndrome, which leaves patients paralysed for months and can kill.

Gardasil has stirred up a huge controversy. There is excitement because it is the first vaccine to be approved to fight cancer – but moral campaigners say it will encourage teenagers to have sex early.

Others have argued that boys, who also carry the virus, should be vaccinated as well.

A spokesman for the Medicines and Healthcare products Regulatory Agency (MHRA), meanwhile, said no “proven, serious new risks have been identified” by the findings, but said the effects would be monitored when Gardasil is used in the UK.

Nicholas Kitchin, medical director of Sanofi Pasteur MSD, said the fact that symptoms were reported after a vaccination did not necessarily mean they were caused by the vaccine.

http://www.express.co.uk/printer/view/11110

Gardasil administered in conjunction with the meningococcal vaccine, Menactra, increases risk.

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)
Promoting Openness, Full Disclosure, and Accountability
http://www.ahrp.org and http://ahrp.blogspot.com

FYI
Judicial Watch and the National Vaccine Information Center (NVIC) have separately issued updates involving serious adverse event reports about Merck's HPV (Gardasil) vaccine.

Most serious are a statistically significant risk linking Gardasil when co-administered with other vaccines, in particular, meningococcal vaccine (Menactral).

NVIC reports: "as of May 31, there have been 2,227 Gardasil adverse events filed with VAERS, including 13 suspected or confirmed cases of GBS  (two more GBS reports were made in June for a total of 15) and 239 cases of  syncope (fainting with temporary loss of consciousness), many of which  resulted in head injuries and fractures. Seven deaths have been reported after  receipt of Gardasil."

A total of 1,930 reported Gardasil adverse events involved administration of Gardasil alone, and 135 adverse events involved co-administration of Gardasil with Menactra.

ABC News reports that Earlier this year, the CDC did say there wasn't enough evidence to prove Gardasil could be used safely with other vaccines. http://abclocal.go.com/wls/story?section=health&id=5572168

What justification do officials of the Center for Disease Control and Prevention offer for their encouragement to physicians to co- administer Menactra and other vaccines with Gardasil when severe adverse event reports should raise alarms about safety ?

CDC officials' record of massive waste and inappropriate perks---as documented in a report by Sen. Tom Coburn, a practicing physician and ranking member of the Senate Subcommittee on Federal Financial Management Gov't Information and International Security--give one little trust in CDC policies.

Contact: Vera Hassner Sharav
212-595-8974
veracare@ahrp.org <mailto:veracare@ahrp.org>
~~~~~~~
 

Now they want to experiment on babies...

http://www.theage.com.au/news/National/Cervical-vaccine-trial-on-babies-report/2007/08/27/1188066978713.html#

Cervical vaccine trial on babies: report
Email Print Normal font Large font August 27, 2007 - 8:09AM

A doctor who played a key role in trials of a cervical cancer vaccine is proposing testing it on babies.

Suzanne Garland, the director of microbiology and infectious diseases at the Royal Women's Hospital in Melbourne, is flying to the US to meet with drug companies and will discuss trialling the vaccine on babies up to a few months old, Fairfax newspapers report.

Professor Garland said there were benefits to immunising babies instead of schoolgirls, but one of the questions that would need to be answered was how long the vaccine would last, and whether a booster shot would be necessary years later.

The vaccine has been tested in children only over the age of 10.

© 2007 AAP
 

--8 more deaths connected to HPV vaccine
Adverse reactions from Gardasil number in thousands
Posted: October 6, 2007
1:00 a.m. Eastern

© 2007 WorldNetDaily.com Another eight deaths in just the past few months are being connected to Gardasil, Merck & Co.'s vaccine that targets the sexually transmitted human papillomavirus and is being considered by many states as mandatory for all schoolgirls, according to documents released by Judicial Watch. There also have been another 1,824 adverse reactions to the drug, bringing the "known total" of such problems to 3,461, according to the public interest group that investigates and prosecutes government corruption. "In light of this information, it is disturbing that state and local governments might mandate in any way this vaccine for young girls," said Tom Fitton, the group's president. "These adverse reactions reports suggest the vaccine not only causes serious side effects, but might even be fatal." WND previously has reported how Merck was lobbying state lawmakers to require the vaccination, but gave that up after its activities were unveiled. WND also reported when a key researcher into human papillomavirus, which is targeted by Gardasil, reported it needed more testing, and how even the Centers for Disease Control suggested the vaccine should not be mandatory. The dispute primarily has been over proposed state and other governmental requirements that schoolgirls be vaccinated against an infection transmitted only by sexual contact. The target of the vaccine is cervical cancer, since studies show that those who have HPV have a higher chance of later developing cervical cancer. However, opponents note that such cancers develop most often in older women, while the plan is to require girls as young as 11 or 12 years old to be inoculated. They cite the lack of evidence that the vaccine would have an impact later in life. Judicial Watch said it obtained documents from the U.S. Food and Drug Administration under the Freedom of Information Act detailing the new 1,824 cases. Those cases include as many as eight deaths related to the vaccine, on top of the three deaths reported earlier among 1,637 earlier reports of adverse effects. Among the new information Judicial Watch found: "Information has been received … concerning a 17 year old female who in June 2007 … was vaccinated with a first dose of Gardasil … During the evening of the same day, the patient was found unconscious (lifeless) by the mother. Resuscitation was performed by the emergency physician but was unsuccessful. The patient subsequently died."

"Information has been received … concerning a 12 year old female with a history of aortic and mitral valve insufficiency … who on 01-MAR-2007 was vaccinated IM into the left arm with a first does of Gardasil … On 01-MAR-2007 the patient presented to the ED with ventricular tachycardia and died." "Initial and follow-up information has been received from a physician concerning an 'otherwise healthy' 13 year old female who was vaccinated with her first and second doses of Gardasil. Subsequently, the patient experienced … paralysis from the chest down, lesions of the optic nerve…At the time of the report, the patient had not recovered."

The flood of adverse reactions during 2007 reported to the FDA through the Vaccine Adverse Event Reporting System, included 347 serious reactions. "Of the 77 women who received the vaccine while pregnant, 33 experienced side effects ranging from spontaneous abortion to fetal abnormities. Other serious side effects continue to be reported including, paralysis, Bells Palsy, Guillain-Barre Syndrome, and seizures," Judicial Watch said. And these numbers may not even include all the cases, Judicial Watch said. It filed a lawsuit this week against the FDA for failing to fully respond to its requests for information involving the vaccine. Specifically Judicial Watch wanted access to correspondence between Merck and the FDA regarding the vaccine, communications between the FDA and GlaxoSmithKline, which is working on a similar vaccine, called Cervarix, and reports by consumers, health professionals and others regarding problems with the HPV vaccine. When the organization's investigation into the HPV vaccine issue arose, and the first reports starting coming in, Fitton described it as "a catalog of horrors." One earlier report, No. 275438-1, describes the reaction as coronary artery thrombosis, sudden cardiac death. "Given Gardasil vaccine dose #1 3/12/07. Collapsed and died on 3/26/07… Echocardiogram revealed very enlarged right ventricle, small left ventricle as well as large blood clots within both the right atrium & right ventricle." Another report noted that the woman was vaccinated and "died of a blood clot 8 hours after getting the Gardasil vaccine." Officials with the Abstinence Clearinghouse noted in a position paper that groups including the Texas Medical Association, the American Academy of Pediatrics, the Association of American Physicians and Surgeons, and the American Academy of Environmental Medicine have come out publicly against mandatory vaccination. "The reasoning of these medical associations is clear. They are not opposed to medical progress, and certainly support all efforts to combat life-threatening diseases. The problem, as these organizations see it, lies in the fact that the drug only went through three and a half years of testing, leaving the medical community somewhat in the dark as to what serious adverse effects might result in the long term," the group said. "Along with the potential of serious adverse effects is the question of efficacy. There is evidence that after approximately four years, the vaccine's potency significantly declines. The long-term value of the vaccine has yet to be determined; if it wears off within six years, will girls and women need to repeat the battery of injections they originally received?" the organization wondered. Michigan was the first state to introduce a plan to require the vaccine to be given to young girls, but the proposal failed. Ohio also considered a failed plan in 2006. Then in 2007, after Merck's aggressive lobbying campaign and contributions to Women in Government, lawmakers in at least 39 states and the District of Columbia worked on sponsoring such plans.
 

Human Papilloma Virus Immunization in Adolescent and Young Adults: A Cohort Study to Illustrate What Events Might be Mistaken for Adverse Reactions
Claire-Anne Siegrist, MD;* Edwin M. Lewis, MPH;† Juhani Eskola, MD;‡ Stephen J. W. Evans, MSc;§ Steven B. Black, MD||

Pediatr Infect Dis J.  2008;26(11):979-984.  ©2008 Lippincott Williams & Wilkins

Posted

Abstract and Introduction

Abstract

Background: The large-scale implementation of human papilloma virus (HPV) immunization will be followed by cases of autoimmune diseases occurring in temporal association with immunizations. To anticipate events that might be mistakenly assumed to be caused by immunization, their prevalence was monitored before vaccine introduction.
Method: Cohort study carried out within a database of female adolescents (n = 214,896) and young adults (n = 221,472) followed in the pre-HPV vaccine era (2005), computing rates of emergency consultations, hospitalizations and outpatient consultations, and estimation of risks of coincident associations.
Results: Immune-mediated conditions were a frequent cause (10.3%) of emergency room consultation by adolescent girls. Nonallergic immune-mediated conditions affected 86 per 100,000, diabetes ranking first. In 2005, 53 per 100,000 adolescents and 389 per 100,000 women were hospitalized for diseases of presumed autoimmune origin, thyroiditis being the most frequent diagnosis. If HPV immunization had been used with 80% coverage, 3 per 100,000 adolescents would have required emergency care for asthma/allergy within 24 hours and 2 per 100,000 for diabetes within 1 week of an injection. The risks of hospitalization in temporal association with immunization are 4 times higher for thyroiditis than for multiple sclerosis or Guillain-Barré's syndrome, and more than 20 times higher in young women than in adolescents.
Conclusion: The distinction between HPV vaccine-caused adverse reactions and events only observed by chance in temporal association is difficult. The prior use of population-based data allows for identification of issues of potential concern, for monitoring the impact of large-scale interventions and for addressing rapidly vaccine-safety issues that may compromise vaccine programs.

Introduction

Concerns about supposed adverse effects of vaccines seem to occur regularly. Usually the evidence for the adverse effect leading to the scare derives from some case reports rather than from trials or carefully conducted comparative studies. Spontaneous reports of suspected adverse drug reactions, including those to vaccines, remain an important source of new information for monitoring the safety of medicines. However, suspicion about an event does not demonstrate causality. Many suspected adverse drug reactions are simply coincident in time with administration of the drug or vaccine.

During the next few years, there will be vaccines introduced to groups of people who have not traditionally been vaccinated. Pandemic flu vaccine may be given to age groups who have not been, in large scale, recipients of vaccines. The human papilloma virus (HPV) disease burden and the outstanding efficacy profile of the novel HPV vaccines are such that these vaccines are currently being implemented[1] or considered for implementation in many industrialized countries. Surveys predict that vaccine acceptance will be high, despite significant misunderstanding about HPV infection, cervical cancer screening, and the sequelae of HPV infection.[2-5] The interest of parents, young women, and health care providers in HPV vaccines will doubtless be strongly supported by large-scale promotional events led by 2 competing major pharmaceutical companies. This should result in rapid vaccine uptake by adolescents targeted by national immunization programs. In addition, catch-up immunizations will be implemented in some countries for young women, as prior exposure to HPV does not prevent vaccine-induced efficacy against other HPV genotypes.[6] Altogether, this is expected to lead to a rapid uptake of HPV vaccines by adolescent girls and young women in industrialized countries able to afford them.

The rapid large-scale implementation of a vaccine in the young adult population of industrialized countries is not without precedent. In the early 1990s, the recommendation to immunize adolescents with hepatitis B vaccines (HBV) was supported by such vigorous promotional efforts in France that it rapidly led to the immunization of 20 million individuals, mostly adolescents and young adults.[7] A few years later, reports of temporal association between HBV immunization and the onset of multiple sclerosis (MS)[8] were sufficient to fuel major vaccine-safety controversies associating HBV immunization to MS and other autoimmune diseases.[9] Public confidence was lost and national HBV vaccination efforts interrupted. A decade later, the existence of an increased risk of MS after HBV immunization in adults has still not been demonstrated.[10] However, as the best epidemiology studies may never exclude the existence of a risk, the debate continues, especially in France,[11] where HBV vaccine coverage remains below 25%.[12] This vaccine-safety issue spread internationally, including in developing countries, despite worldwide efforts for explanation and reassurance.[13] More recently, the large-scale implementation of a quadrivalent conjugate vaccine against meningococcal disease (Menactra) in adolescents led to 5 cases of Guillain-Barré's syndrome within 6 weeks of immunization. Although this did not exceed the expected baseline incidence, it was sufficient for the U.S. authorities to launch an alert.[14] A year later, an update indicated that because of the ongoing risk for meningococcal disease and the limitations of the data indicating a small risk for Guillain-Barre syndrome after a vaccination with quadrivalent conjugate vaccine against meningococcal disease, current Centers for Disease Control and Prevention recommendations remained unchanged. [15]

The novel HPV vaccines (Gardasil and Cervarix) share similarities with HBV vaccines. Both HPV and HBV vaccines are recommended as a 3-dose schedule given in at least 6 months, and include aluminum salts (Gardasil) or a new potent adjuvant (Cervarix) for which large-scale surveillance data is not yet available. Gardasil is produced by yeast, as was one of the HBV vaccines used in France in the 1990s. Both vaccines protect against sexually transmitted viral infections that may result in cancer (ie, will be implemented on a large scale not only in adolescents but also in the young adult population). Although the safety profile of the 2 HPV vaccines appears to be as excellent[16,17] as that of HBV vaccines,[13] they have formally been tested on less than 50,000 women. Thus, their safety databases are limited and rare (<1 per 10,000), severe adverse events may not yet have been identified. Consequently, reports of immune-mediated diseases issued from the postmarketing surveillance could be considered as possible adverse events, at least initially. These signals will be difficult to address given the limited availability of the incidence of most immune-mediated diseases in the adolescent and young adult population.

We are concerned that the large-scale implementation of HPV vaccines in industrialized countries could reactivate the vaccine-safety debates linking vaccination to autoimmune diseases. This could possibly represent a major issue for the sustainability of HPV immunization programs in industrialized countries, and consequently for their implementation in developing countries where they are most needed.[18] To anticipate the crisis and identify the potential danger signals, we have computed the utilization of health resources by the entire female adolescent and young adult population registered within the Northern California Kaiser Permanente (NCKP) Medical Care Program health maintenance organization (HMO) during 2005 The number of emergency consultations, hospitalizations, and outpatient consultations were used to identify the most frequent immune-mediated conditions, ie, those most likely to be temporally associated with a putative HPV vaccine administration.

Methods

Databases

NCKP maintains administrative databases to capture all inpatient and outpatient (including emergency department) utilization within the HMO. The utilization databases contain the date of admission or visit, International Classification of Diseases (ICD)-9 coded diagnoses, and a unique identification number.

Data Retrieval

Rates of emergency department, inpatient, and outpatient utilization were collected for females 9-18 years of age, likely to be targeted by adolescent immunization programs, and 19-30 years of age, who will be considered for catch-up immunization. To compute rates of utilization, the denominator was estimated by membership at the midpoint of the evaluation year, on June 30, 2005 (9-18 years of age, n = 214,896, adolescent group; 19-30 years of age, n = 221,472, adult group). The frequencies were computed with the first instance of each diagnosis code for each individual.

Selection of Target Diseases

For this report, we selected ICD-9 codes for immune-mediated diseases, considering that the biologic plausibility of a vaccine-induced trigger would markedly enhance the notification of temporal associations and thus the likelihood of signal generation.

Risks of Temporal Association Between Events and a Hypothetical HPV Immunization

The risk of coincident temporal association between medical conditions and a hypothetical HPV immunization was estimated under various assumptions. The distribution of medical events during the year was assumed as random, without any influence of season or month. We assumed a 0-1-6 months vaccine schedule, as officially recommended, and defined several time windows (from 1 day to 6 weeks after each putative vaccine dose) during which a previous HPV immunization would likely be considered as a triggering or precipitating event. The proportion of subjects with expected temporal associations between a medical event and trigger administered at 0-1-6 months intervals was calculated by dividing the yearly rate of event by the number of corresponding at-risks periods, taking into consideration overlapping periods. It was corrected for vaccine coverage likely to be reached in the adolescent (80%) and the young adult (40%) population.

Statistical Analyses

Rates of specific immune-mediated disease conditions were used to calculate the aggregate rates of immune-mediated events requiring medical attention in the adolescent or young adult population, respectively.

Results

Rates of Emergency Consultations for Immune-Mediated Conditions in Female Adolescents and Young Women

The demand for an emergency room (ER) consultation reflects either a recent onset or a recent exacerbation of a preexisting disease condition, 2 situations that inevitably lead to a search for putative precipitating events. Among 12,443 ER consultations required by 214,896 adolescent girls (aged 9-18) followed during 2005 in the NCKP Medical Care Program HMO, 35% resulted from infections and 30% from psychologic or psychiatric conditions (not shown). Immune-mediated conditions were the third most frequent cause (1277, 10.3%) of ER consultation by adolescent girls ( Table 1 ). Asthma conditions ranked first among atopic/allergic conditions, cumulating to a rate of 325 per 100,000 ER consultations. This included 183 per 100,000 ER consultations for acute IgE-mediated allergic reactions, including a few cases (3.7 per 100,000) of anaphylactic shock. Nonallergic immune-mediated conditions were frequent (86 per 100,000, Table 1 ). The first cause of ER consultation for nonallergic immune disease was juvenile- or adult-onset diabetes (51.3 per 100,000). In 2005, only 4 girls followed in the NCKP HMO required ER medical care for systemic lupus erythematosus (SLE) and none for MS. Emergency consultations for immune-mediated diseases were also frequent (837 per 100,000) in young women likely to be targeted by HPV catch-up immunization strategies ( Table 1 ). Asthma or other IgE-mediated allergic reactions also ranked first (366 and 302 per 100,000, respectively). Among diseases presumably of an autoimmune nature, diabetes, Bell palsy, and SLE had the highest rate of ER consultation ( Table 1 ).

Rates of Hospitalizations for Autoimmune Diseases in Female Adolescent and Young Adults.

The need for hospitalization also reflects either a recent disease onset or a recent exacerbation of a disease condition sufficiently severe to require inpatient medical care. In 2005, the hospitalization rate of adolescent girls for diseases of presumed autoimmune origin reached 53 per 100,000 ( Table 2 ). Thyroiditis, an autoimmune process in adolescents and young adults, was the most frequently encoded diagnosis. In contrast, episodes of MS or optic neuritis were relatively rare (3.7 per 100,000). The same ranking was obtained by the computation of outpatient consultations required by adolescent girls throughout 2005 ( Table 2 ), confirming the relative disease burden of these immune-mediated conditions. Of note, thyroiditis generated a 10-fold higher utilization of medical resources than any other condition in this category.

During the same period, the rate of hospitalization of young women for autoimmune conditions reached 389 per 100,000 ( Table 2 ). Thyroid disorders also ranked as the first cause of hospitalization for autoimmune-mediated diseases. SLE ranked next, whereas MS-like conditions required hospitalization rates of 12 per 100,000. Again, the computation of outpatient consultations provided a similar ranking ( Table 2 ), confirming the relative importance of the burden of these conditions on medical resources and their occurrence at a markedly higher rate in young women than in adolescents.

Temporal Associations Between Specific Disease Conditions and a Hypothetical HPV Immunization Regimen

All the above-mentioned events occurred in the pre-HPV immunization era. Consequently, none may be considered as an HPV vaccine-induced adverse event. The likelihood of an external factor being considered as a potential triggering/precipitating factor essentially results from temporal associations.[19,20] We thus estimated the likelihood of temporal association that would occur in pure coincidences, in the absence of any causal relationship, with the putative administration of 3 doses of a saline placebo administered at 0, 1, and 6 months intervals. Rates of ER consultation or hospitalization were computed by specific time windows to estimate the likelihood that an event would occur within a given interval after an injection. For psychologic reasons, the likelihood for an association to be considered as causally related is inversely proportional to the time elapsed between exposure to the putative factor and the onset/exacerbation of the disease. Based on biologic plausibility, we considered time windows of 1 day, 1 week, and 6 weeks after any injection putatively administered according to a 0-1-6 months schedule to all adolescents and young women ( Table 3 ).

Correcting the rates obtained in Table 3 for likelihood of exposure to an injection trigger predicts that if 80% of NCKP adolescent girls had been injected with a saline placebo in 2005, 3 per 100,000 would have required ER medical care for asthma or allergy within 24 hours of an injection. Two per 100,000 adolescent girls seen in the ER department for diabetes would have been within 1 week of an injection, and hospitalizations for autoimmune diseases would have occurred within 6 weeks of an injection in 10 per 100,000 adolescents. Of even greater concern, if a catch-up program reaching only 40% of young adult women had been implemented, 28 per 100,000 patients requiring hospitalization for the recent onset or exacerbation of thyroiditis would have been within 6 weeks of an injection. That such figures would not trigger vaccine-safety signals thus appears as most unlikely.

Discussion

Anticipating future vaccine-safety concerns at the time of the enthusiastic implementation of novel vaccines effective against cancer may seem odd. However, history has taught us that the life and death of immunization programs can occur rapidly. As a recent example, the Food and Drug Administration approved in 1998 a new recombinant Lyme vaccine that reduced new infections in vaccinated adults by nearly 80%. Just 3 years later, the manufacturer voluntarily withdrew its product from the market amid media coverage, fears of vaccine adverse events, and declining sales.[21] To date, there is no evidence that this Lyme vaccine would have caused the adverse events that led to its withdrawal. We are concerned that history may repeat itself with any large-scale vaccine introduction in an adult population, HPV vaccines being the closest to this important step.

Immunizations activate the immune system, which may be considered as sufficient to blame vaccines, should the onset or the exacerbation of immune-mediated diseases occur in temporal association with an immunization,[22] despite some evidence to the contrary.[23] The prevalence of autoimmune diseases in the young adult female population is not low. As an example, it is estimated that SLE occurs in 1 of 2000 Americans and in as many as 1 of 250 young African American women (NIAID, Understanding autoimmune diseases, http://www.wrongdiagnosis.com/artic/understanding_autoimmune_disease_niaid.htm), whereas MS affects 1 in 700 persons in the United States and 1 in 1200 in Europe.[24] Unfortunately, baseline disease incidences are not established for most diseases, and country, ethnic, and age-group specific incidences are largely lacking. Consequently, it will be difficult to monitor globally the impact or to demonstrate the lack of impact-of a large-scale immunization program on the incidence of autoimmune conditions. This was unfortunately illustrated by the allegation of a causal relationship between hepatitis B immunization and MS, which a decade of negative or inconclusive studies[25,26] has not yet settled. As autoimmune conditions have already been included in the adverse events section of the Gardasil Summary of Product Characteristics, one can predict that conditions occurring in temporal associations will be reported as potentially associated with HPV immunization.

Temporal association is required for vaccine-safety signals/concerns to be raised. However, additional factors are at play. This is best illustrated here by the fact that diseases that have most frequently been reported in temporal association with immunization, such as MS, SLE, or Guillain-Barré's syndrome are not the most frequent autoimmune conditions in adolescents or young women. This is likely to reflect the influence of additional factors including the severity of the disease and the absence of an alternative cause to the disease conditions. The data presented here suggest that reporting is also largely influenced by a notification bias resulting from the perception by the medical community that certain conditions (such as Guillain-Barré's syndrome for example) are much more likely than others (such as diabetes or thyroiditis) do to be triggered by exposure to infection or immunization. This implies that many new temporal association signals could be generated by effective pharmacovigilance systems.

Certain national health authorities are aware of the fact that the upcoming implementation of large-scale adolescent and adult HPV immunization programs will inevitably lead to the observation of disease conditions occurring in close temporal association with injections (Swiss Federal Office of Public Health, www.cfv.ch). They expect at least some of these cases to be notified to their pharmacovigilance systems, and fear that their interpretation will be made difficult by the lack of data on age-specific baseline incidence of disease, limiting the capacity of performing observed versus expected cases analyses. Consequently, clusters of cases or reports, possibly resulting from biased perceptions and notification processes, are likely to result into danger signals requiring the initiation of complex epidemiologic studies. One may unfortunately predict that certain issues may remain without conclusive answers for many years and exert a profound influence on the sustainability of HPV immunization programs.

The simple approach described in this report offers many advantages compared with the collection of individual reports resulting from temporal associations. First, the computation of medical resource utilization provides population-based data, which is particularly powerful for the assessment of infrequent events, as it may be extended to large parts of the population. Second, it may readily be repeated at regular intervals-providing a rapid tool for the monitoring of any disease condition, by the comparison of pre- and postintervention rates. Third, it is not limited by working hypotheses or triggered by a few individual case reports. As an example, we would not have predicted immune-mediated thyroiditis to be as frequent in adolescents and young women as was observed. Should this concern arise because of adverse event notification, rapid answers could be provided by comparing the rate of ER consultation and hospitalizations before and after the implementation of HPV immunization. This approach is not limited to immune-mediated diseases. We observed that gynaecologic conditions resulting into abnormal uterine bleeding or pain are frequent in adolescent and much more so in young women (not shown). Should a first episode of abnormal uterine bleeding in adolescents or fertility issues in HPV-immunized young women be attributed at some point to the recent administration of a uterine-targeting vaccine, population-based data could provide rapid answers. Lastly, such population-based approaches allow an estimation of the likelihood of disease conditions in various age groups. For example, the much higher risks of coincidental associations with autoimmune diseases that is expected in the young women compared with the adolescent population is worth considering at time of implementation of catch-up strategies in young women.

Predicting the future is difficult, and this study has limitations. The autoimmune conditions that may generate concerns may not be in our list. They could, however, be readily included into similar analyses, now or in the future. The data are from one single year, which does not allow for fluctuations or temporal variations of medical disorders. The utilization of medical resources is notoriously influenced by a number of factors, and may not reflect true disease prevalence. Diseases resulting into more than 1 hospitalization/consultation could have affected the data-which may be corrected by using unique patient identification numbers. The use of identification number would also allow discriminating between new onset of diseases and relapses, defined by the occurrence of a given ICD code before the suspected triggering event. A related potential limitation of our study is that the reason for a patient to seek medical care may not necessarily imply a relapse or exacerbation of an underlying condition. Consequently, rates of outpatient consultations, in particular, are likely to be less reliable than demand for emergency care or hospitalization. Rates of medical resource utilization will also differ from one population to another. Thus, it is important that the rates indicated here be not taken as figures against which to compare a given safety signal. Indeed, the objective of this study is not to provide universally valid baseline incidence rates of diseases in adolescent or young women at a national or international level. Its objective is to issue an alert for similar analyses to be run in as many populations and country settings as possible, before and after the implementation of large-scale interventions.

The apparently unavoidable future vaccine-safety issues, allegations, and debates warrant taking specific actions for HPV immunization programs to be sustained for many years. This includes a better evaluation of adolescent health, and the estimation of population-based incidence/prevalence rates in the pre-HPV vaccine era, to allow a rapid distinction between real vaccine-induced adverse events and alleged concerns. It also includes educational efforts to increase understanding that coincidence is not causality, and thus improve handling of putative vaccine-associated adverse events by the medical community, including by gynecologists who have been less involved with immunization issues than have pediatricians or general practitioners.


 

Table 1. NCKP Emergency Room Utilization by Female Adolescent and Young Women