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Ovarian failure caused by Gardasil? Not so fast…

Well, I’m home.

AFter spending a fun-filled three days in Nashville at CSICon communing with fellow skeptics and trying to awaken them to the problem of quackademic medicine, I made it back home. There were plenty of attendees who didn’t make it back on time because flights to the East Coast were being cancelled left and right, courtesy of Hurricane Sandy. For example, Steve Novella and the entire SGU crew were forced to rent a van and drive 950 miles to Boston after their flight was cancelled sometime Saturday night. Difficulties aside, if there’s one thing that almost always happens whenever I go out of town, regardless of whether it’s for my real job, my blogging avocation, or an actual vacation, it’s that something pops up right before I’m scheduled to leave that I want to blog about but don’t get to. Rarely do I make it back to such topics, but this time around I felt as though I wanted to get back to this one. The reason is that I noticed something going on that rose above the usual chatter coming from antivaccine cranks.

Antivaccinationists, of course, fear and loathe vaccines. However, they fear and loathe certain vaccines more than others, and the level of fear and loathing depends somewhat upon location. Here in the U.S., if there’s one vaccine that’s feared and loathed perhaps more than any other, it’s the vaccine against the human papilloma virus (HPV). That usually means Gardasil. I’ve speculated before why certain antivaccinationists seem to hate Gardasil more than any other vaccine, and I think I’ve come up with a plausible explanation. Basically, the hatred of Gardasil is the result of an unholy fusion of antivaccine beliefs with the fundamentalist religion so prevalent in the U.S. that makes the brain dead argument that protecting young women against infection by sexually transmitted organisms that can lead to cervical cancer will somehow inevitably lead to promiscuity, godlessness, and the Downfall Of The American Way of Life, because, you know, if women didn’t have sex before marriage and only had sex with one man for the sole purpose of reproduction they wouldn’t need Gardasil. I exaggerate, but only a little. No, wait. Actually, I don’t exaggerate. This is the basic belief behind the fundamentalists’ fear of Gardasil. Sometimes this belief leads to some of the absolute dumbest canards ever. (Just use the search box to search this blog for “Gardasil” if you don’t believe me.)

What I had noticed is that the arguments coming from the antivaccine fringe had been flying fast and furious right before CSICon, and I was curious why. For instance, the antivaccine crank blog Age of Autism ran a series of posts with titles like Spotlight on Gardasil, complete with three chapter excerpts from Mark Blaxill and Dan Olmsted’s epic paean to pseudoscience, Age of Autism, and Age of Autism Science Summary: Death after Quadrivalent Human Papillomavirus (HPV) Vaccination. Meanwhile, over at Gaia Health, The Refusers’ blog, and something called the Population Research Institute, antivaccinationists were going wild over a case report published in, appropriately enough, BMJ Case Reports that suggests (to antivaccinationists at least) that Gardasil caused premature ovarian failure leading to menopause a 16 year old girl.

I am not impressed.

Let’s start with the last one first, because it’s hard to believe that gruel this thin was published in the peer-reviewed literature. The case report is, beginning to end, the speculative chasing of the specter of Gardasil, trying desperately to blame it for this unfortunate girl’s ovarian failure leading to premature menopause at the extremely young age of 16. And the antivaccine movement is eating it up, too. For instance, the PRI states:

It is very rare for a healthy 16-year-old girl to go through menopause. It is also a personal tragedy of the first order, one that will only grow in magnitude as she marries and yearns to start a family.

While Dr. Little could not confirm that Gardasil caused the destruction of the girl’s reproductive system, she was able to rule out all other possible causes. The circumstantial evidence implicating Gardasil is strong.

And Gaia Health opines:

The girl has been thoroughly examined and tested. There is no known explanation other than the series of three Gardasil vaccinations she had.

That is the basic argument at the heart of this case report: Because investigations didn’t turn up any obvious cause for this unfortunate girl’s premature ovarian failure, it must have been the Gardasil that done it. Yes, the argument is just that vacuous and weak. Let’s go back to the report itself, and then let’s go to how antivaccinationists are spinning it. This case report was published by Deirdre Therese Little and Harvey Rodrick Grenville Ward from Australia. The case is basically described thusly:

A 16-year-old girl presented with a history of 5 months amenorrhoea, preceded by approximately 12 months oligomenorrhoea. Menarche had occurred at the age of 13 in 2007 with initially light periods which became heavier and developed a regular monthly pattern over the following 12 months.

Early in 2009 menses became irregular. In early 2010 they became scant and occurred infrequently, two or more months apart. Menstrual periods ceased in January 2011. Following the development of amenorrhoea, the patient experienced hot flushes. She identified that an alteration in the menstrual pattern had started following HPV vaccination.

On first presentation to her local doctor she was prescribed the OC for amenorrhoea after exclusion of pregnancy. She elected not to take the contraceptive pill at that time and sought further opinion regarding her continuing amenorrhoea.

Investigations were quite thorough, including a complete battery of tests related to reproductive function, including prolactin levels, androgen profile, FSH and LH levels, and many others. They even did a karyotype to check and make sure that the girl had two X chromosomes. Well, I shouldn’t say “even.” It’s part of the routine investigation. Now here’s where the authors reveal their bias. They point out in the introduction that premature ovarian failure has an estimated incidence of 10/100,000 person-years between the ages of 15 and 29. Other sources suggest that the incidence of such ovarian dysfunction might be as high as 1 in 1,000 before the age of 40. The authors also cite sources that find that the cause of ovarian failure before the age of 40 “remains unknown in up to 90% of cases.” In other words, in the vast majority of cases premature ovarian failure is idiopathic. We don’t know what caused it. In the cases where a cause can be identified, potential causes are several and include autoimmune disorders (I bet you know where this is going), genetics, chemotherapy, hysterectomy (a rather obvious cause), thyroid dysfunction (no word in the case report whether thyroid studies were done; I’ll assume that they were), Turner syndrome, inadequate gonadotropin secretion or action, and viral infections.

Because Little and Ward can’t find any evidence that any of these causes were the root cause of this girl’s premature menopause, they gleefully leap to the conclusion that—you guessed it!—it must have been the Gardasil! I kid you not. And when did this girl receive her anti-HPV vaccine? According to the case report, she received doses in May and August of 2008. Now let’s go back to the case report. this girl started to have irregular menses in early 2009, more than five months after her last dose of Gardasil, and then she didn’t stop menstruating until a year later, in early 2010.

Yes, obviously, it must have been the Gardasil. (That’s sarcasm, in case you didn’t notice it.) In fact, the authors think it’s the Gardasil so much that not only did they report this girl’s premature ovarian failure as a possible adverse event to the Therapeutic Goods Administration of Australia, but they undertook a search for reports examining whether the HPV vaccine had any effects on rat ovaries, after having found a report that showed no effect due to Gardasil on rat testes. They even went so far as to submit a Freedom of Information request for such data, which, they darkly point out, hasn’t panned out yet.

Obviously, it must have been the Gardasil, and obviously the pharmaceutical companies are hiding something. (That’s more sarcasm, in case you didn’t realize it.) The authors even go so far as to write:

Had this young woman taken the OC as prescribed for correction of her oligomenorrhoea/amenorrhoea, her diagnosis of premature ovarian insufficiency may not have been determined for perhaps some years. The possibility of its link to an adverse pharmaceutical event might also have been lost.

Anecdotal evidence from an informal discussion with high-school students suggests that one in three girls of this age is taking an OC for reasons of cycle control, acne management or for contraception. Given the prevalence of OC usage in this age group, combined with the possibility of initial OC prescription for the management of oligomenorrhoea (presumably to reduce associated anxiety, re-establish a ‘normal’ cycle and to protect bone mass, etc), conditions affecting menstrual function in this age group will be undetected and undiagnosed. Menstrual abnormalities and particularly ovarian insufficiency at this time may therefore be under-reported as possible adverse events following vaccination or other medication.

You read it right. The authors are saying that, because the first symptom of premature ovarian failure is irregular menstrual cycles and because the treatment for irregular menstrual cycles is often oral contraceptives, menstrual abnormalities up to and including premature ovarian failure might actually be underreported, leading to the underreporting of ovarian insufficiency due to Gardasil. Yes, according to Little and Ward’s insinuation, we’d see this horrific epidemic of young girls robbed of their womanhood before they even had the chance to experience it and bring new life into the world if it weren’t for those darned birth control pills! Now, I realize that journals tend to have a laxer standard for the sorts of speculation allowed in case reports (their being case reports and all and hypothesis-generating rather than hypothesis testing), but this is ridiculous. It goes far beyond the pale. Even though the authors say multiple times that their observations do not prove that the quadrivalent HPV vaccine is toxic to ovaries, based on the way they wrote this case report it is breathtakingly obvious that this is exactly what they think and that the reviewers probably made them put those caveats into their case report.

Little and Ward even suggest an epidemiological study of young women vaccinated with quadrivalent HPV vaccine versus those not vaccinated against HPV with long term followup of ovarian function. This is a ridiculous suggestion. Unless Gardasil is pure poison to the ovaries, it would take thousands of women to detect differences between vaccinated and unvaccinated women even if the incidence of premature ovarian failure were as high as 1 in 1,000, and it would take many years of followup. That doesn’t even take into account how hard it would be to control for confounding variables. It would be one thing if Little and Ward had actually observed correlation between Gardasil vaccination and premature ovarian failure, but in reality they confused correlation with causation without even having the correlation. It is a common failing of antivaccinationists.

Meanwhile, over in the antivaccine underground, this report is being used to resurrect even wilder speculation about L-histidine somehow invoking autoimmune disease (which, by the way, this girl appears not to have had), all because girls not infrequently complain of joint pain and because weight gain has been reported in girls who have received Gardasil. The L-histidine gambit is one of the dumbest of many dumb antivaccine gambits, but, like the formaldehyde gambit, it keeps rearing its ugly head, just not as frequently. Then, of course, there’s the polysorbate 80, which has become another vaccine additive that antivaccinationists love to hate, so much so that they take reports that polysorbate 80 can cause infertility in rats and extrapolate them to humans, even huge doses were required to cause the effect in rats. In Gaia Health, polysorbate 80 allegedly combines with aluminum in a horrific fashion:

The most frightening trait of polysorbate 80 may be that it crosses the blood-brain barrier and can take other substances with it. It is used for that purpose. The drugs loperamide4 and doxorubicin5 are coated with polysorbate for just this purpose—to drag them into the brain.

So what else can polysorbate 80 drag into the brain? Gardasil utilizes aluminum as an adjuvant, even though it’s a dangerous neurotoxin. Injection of aluminum is associated with several neurological disorders, as is reported in Gaia Health and Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations6, rheumatoid arthritis, autoimmune thyroid disease, inflammatory bowel disease, multiple sclerosis, diabetes, and autism may all be associated with aluminum adjuvants in vaccines.

Can polysorbate open the blood-brain barrier to let aluminum in? No one really knows because no one has looked. There is, though, no legitimate reason to assume that it cannot.

No evidence whatsoever is presented to support this speculation. These guys are starting to sound like Mark and David Geier and their “theory” about how testosterone somehow binds mercury and keeps it from being chelated. Gaia Health’s speculation is what we in the biz like to call pulling it out of one’s nether regions. The result is just as stinky.

There’s almost no limit to the ridiculousness to which antivaccinationists will descend to attack Gardasil, and, unfortunately (or, depending on your point of view, fortunately) I just realized that I’ve gone on longer than I had planned (big surprise!) on the first article, leaving myself no room for a discussion of the claim of death by Gardasil publicized by AoA, the subject of which is the latest spew by Lucija Tomljenovic and Christopher A Shaw, whose previous spew you might remember.

Maybe tomorrow. It would allow me to follow up a case I discussed about three months ago, and—who knows?—maybe Christopher Shaw would notice and deign to comment again. On the other hand, his latest paper is pretty bad; I don’t know if I can deal with two papers this bad two days in a row.

Either way, the attack on Gardasil continues apace.

ADDENDUM: I intentionally concentrated on the biased and utterly speculative nature of this particular case report, which was so speculative and biased that the editors of BMJ Case Reports should hang their heads in shame for having published such twaddle. What I didn’t mention (although I thought about mentioning it) is that whenever you see a publication as bad as Little and Ward’s case report, it’s at least 95% likely that the authors have a serious axe to grind and that they are publishing because of ideology leading them to twist the case report or data to fit rather than having their conclusions flow naturally from the data. In this case, some of my commenters have pointed out that Dr. Little is on the board of advisors for an Australian Catholic anti-abortion group called Family Life International, whose official patron laments the growth of promiscuity and the “redefining” of marriage (big surprise, the group is against gay marriage as well). On the website is a diatribe against Gardasil, which, FLI gravely notes, is “often associated with promiscuity,” along with a link to a YouTube video of the antivaccine propaganda film The Greater Good. It also turns out that Ward is, as one of my commenters put it, cut from the same cloth, described as a “pro-life obstetrician/gynecologist.” He also apparently helps an antiabortion activist named Stephanie Gray give talks at local churches in Canada in which she shows graphic abortion videos to convince the audience that abortion is “wrong 100% of the time.”

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

112 replies on “Ovarian failure caused by Gardasil? Not so fast…”

Shaw’s out fishing – he needs to get more ‘evidence’ to publish more BS in third rate journals.

But regarding the polysorbate 80 and L-histidine – the newest buzz I’ve been reading from the AV camp is the ‘obvious synergism’ between the compounds.

Despite there being no evidence of such an occurrence, of course. IIRC the whole polysorbate 80 passing the BBB is being hung on a nanoparticle study where they used polysorbate 80 coated (I don’t recall if it was steric or electrostatic) particles to deliver drugs to the brain.

The obvious AV jump to conclusion – it had to be the coating that allowed the particles to pass the barrier. They ignore the size of the particle itself – anything less than 300 nm can pass a cell membrane, particles under 75 nm can pass the nuclear envelope. One of the reasons I shake my head at folks who give their kids nanosilver, yet scream about ‘heavy metals’ in vaccines.

You would think that if exposure to HPV antigens reduced fertility, someone would have noticed it by now.

The authors are saying that […] menstrual abnormalities up to and including premature ovarian failure might actually be underreported.

More specifically, their Occam’s-razor-defying auxiliary hypothesis is that routine Gardasil would be causing an EPIDEMIC of teenage menopause, but when the incidence of this complication is reduced to 2/3 (subtracting the 1/3 of teenage girls taking OC), the EPIDEMIC disappears below the threshold of visibility.

From the Family Life International site, to which Dr Little is an advisor:

Keynote address by the FLI’s patron, given to FLI advisors:

“2. Defending Marriage and Family

Marriage and the family have been wounded by the growth in promiscuity…”

http://www.fli.org.au/?page_id=1499

No. Dr Little has no axe to grind at all.

“Even though the authors say multiple times that their observations do not prove that the quadrivalent HPV vaccine is toxic to ovaries, based on the way they wrote this case report it is breathtakingly obvious that this is exactly what they think…”

This is the kind of thing that drives me bonkers, when people act like giving caveats about how they’re not doing what they’re doing proves they’re not doing it…even though they are. Like when you ask someone to support a claim they made that can’t be proven, and they’ll say “Hey, I’m not saying I’m 100% sure of this” before insisting that they can’t be wrong, while still refusing to support their claim at all. They might even go so far as to say they’re only “99% sure” of their claim, as if that’s a meaningful difference which means they don’t need to provide any proof at all. But of course, *any* claim requires proof, even if you’re only 10% sure it’s true…whatever that means. As if you can quantify the certainty you have on something that you believe to be true, and only 100% certainty requires evidence.

But people do that all the time, in order to justify lazy thinking. They know they can’t be making the logical leaps they’re making, yet…they just can’t help themselves, because they soooooo want their belief to be true, while also wanting to claim the mantle of “Science,” not because it’s deserved, but because they know it’s respected. But the whole reason science is respected is because it backs up its claims with proof, and doesn’t make leaps of faith. And if you think something’s true before you have evidence supporting it, you’re doing it backwards.

I was wondering what angle Deirde Little had. The paper fairly leaps from correlation to causality.

It may also have some relevance that she is convenor of bioethics for the Catholic Womens League of New South Wales.

The paper fairly leaps from correlation to causality.

Not even hindered by the absence of correlation.

[ off-topic – but does that ever stop anyone here? 🙂 ]

Darwy,

“Red fruits with cream”? (Google translate thinks that’s Danish, which obviously I don’t know…) What’s the story behind that?!

What’s the story behind that?!
I think it’s a way of finding out who can’t pronounce Danish (i.e. just about everyone).

In that case, I could just ask those of my relatives who are native Danish speakers… 😉

More seriously, I’m looking forward to Orac’s take on the latest from Lucija Tomljenovic and Christopher Shaw.

Anyone being able to explain why one would like to get a diuretic into the brain – with or without polysorbate 80?

One of my grad-school buddies was a Danish student, and he taught me how to say “Røde grøde med fløde”. Pronounced correctly in Danish, it sounds approximately like someone gargling.

The paper fairly leaps from correlation to causality.

Not even hindered by the absence of correlation.

Oh no, there is a correlation. It’s just hidden because of the use of oral contraceptives. So the absence of correlation is actually evidence that OCs mask the effect.

BTW, anti-vaxxers howl all the time about conflict of interests. However, COIs go well beyond Jake Crosby’s 7 degrees. Where is the disclaimer that “At least one of the authors is an active participant in an organization that promotes the belief that Gardisal causes promiscuity and needs to be stopped:”

“Menstrual abnormalities and particularly ovarian insufficiency at this time may therefore be under-reported”

And I may be Michelle Pfeiffer. If you can get past the part about not being thin, blonde and beautiful.

As soon as I read the connection between one of the researchers and an organization with the word “Family” in the title, I started smelling a rat.

Interesting. It’s a vaccine to prevent a sexually-transmitted disease that can lead to cancer of the reproductive organs. That’s irrelevant to the action of the vaccine, of course, since it works like most vaccines, and is administered like most vaccines (in the arm, not the unmentionables). There is no reason to think Gardasil would be any more likely to cause ovarian failure than FluMist would be, and yet . . . to some, this seems persuasive, because Gardasil is for prevention of cervical cancer, therefore its related to the reproductive tract in people’s minds.

So how *interesting* that this is the cause that is blamed! Even though there is no plausible explanation for how it was done. The world isn’t like a Sherlock Holmes story, where once you eliminate all the possibilities, whatever is left, however improbable, must be the truth. Mostly because it’s not usually possible to actually eliminate all the possiblities. If it’s not A, B, C, D, or E, that doesn’t automatically mean it’s K. There’s a great deal of alphabet that hasn’t yet been checked, and that’s completely ignoring previously undiscovered causes.

This case study came into my e-mail inbox via a Google alert. I myself have premature ovarian failure — of the idiopathic variety (I’ve participated in the clinical studies at the National Institutes of Health, where they rule out the known causes) — and I run an on-line support group for women with POF/POI (premature ovarian insufficience, what’s coming to be the preferred term at the NIH). I didn’t even hit “forward” on this rubbish. The woo runs strong in the group as it is and I spend a lot of time trying to combat it (especially sordid is the woo that prevents proper treatment of this disorder in terms of preservation of bone mass, cardiovascular health, quality of life, and longevity; sadder is the woo that promises pregnancy to those most desperate for it). Eventually, someone’s going to find this article and forward it; I’m glad to have a refutation.

PS: I came of age pre-Gardasil. But I have two young daughters (via adoption) and they will most certainly be receiving the Gardasil vaccine, unless something better comes along before they’re slated to receive it.

Pharmacist-in-Exile,

Anyone being able to explain why one would like to get a diuretic into the brain – with or without polysorbate 80?

If you mean the loperamide and doxorubicin, I wondered that too. You might want to get loperamide into the brain as it’s an opiate used to treat diarrhea that only lacks CNS effects because it doesn’t cross the BBB. Doxorubicin blocks DNA replication and is used as a chemotherapy agent, so I suppose it could be used to treat brain cancers if you could get it across the BBB.

While Dr. Little could not confirm that Gardasil caused the destruction of the girl’s reproductive system, she was able to rule out all other possible causes.

I bet she didn’t rule out broccoli.

@Krebiozen – or rain, or hail, or sunny days, or cell phone usage or the time of the day, or the time of the month, or genetic history, etc, etc, etc…..jeezzzzz

“While Dr. Little could not confirm that Gardasil caused the destruction of the girl’s reproductive system, she was able to rule out all other possible causes. The circumstantial evidence implicating Gardasil is strong.”

Wow…..here’s my testimonial then.

Two weeks ago I came down with a nasty cold. Having had the HPV injections myself back in 2009 and 2010. Since I haven’t had any other medical work since then, the circumstantial evidence implementing Gardasil is strong.

So the Gardasil caused my cold?

I bet she didn’t rule out broccoli.

Ouch.

Because it hits so hard.

I hope broccoli doesn’t cause problems for boys or my 2 yo is in trouble.

Orac wrote:

“….Investigations were quite thorough, including a complete battery of tests related to reproductive function, including prolactin levels, androgen profile, FSH and LH levels, and many others. They even did a karyotype to check and make sure that the girl had two X chromosomes. Well, I shouldn’t say “even.” It’s part of the routine investigation…..”

Yeah, but did the authors look for any of the many gene mutations reported to be responsible for 25 % of “idiopathic premature ovarian failure”…or are those genetic studies not permitted by the authors’ religious beliefs?

http://jme.endocrinology-journals.org/content/45/6/405.full.pdf

Thanks, “reasonablehank”

I’ve speculated before why certain antivaccinationists hate Gardasil more than any other vaccine, and I think I’ve come up with a plausible explanation. Basically, the hatred of Gardasil is an unholy fusion of antivaccine beliefs with the fundamentalist religion so prevalent in the U.S….

While this is undoubtedly true, I think the alliance is more tactical from the perspective of the broad antivaccine perspective. In term of strategy, Gardasil threatens their core demographic, both current and going forward. The notion of a vaccine that is directly appealing to young women, I suspect, strikes terror into their marketing hearts.

@Calli

Oh, great. Now we’re going to start seeing anti-vaccine claims that FluMist causes premature menopause. Probably due to the MSG, no doubt.

I can see it now. An anti-vaccine activist sees your comment, realizes the great gaping hole in their argument and, rather than coming to the sane conclusion that there is no connection, thinks, “Holy crap! How many other girls are going through menopause because of the untested [sic] vaccine schedule?”

Marry Me Mindy,

I hope broccoli doesn’t cause problems for boys or my 2 yo is in trouble.

According to Wikipedia It is full of 3,3′-diindolylmethane which is a potent modulator of the innate immune response system, so who knows what terrible autoimmune diseases it might be causing? They could be masked by the effects of other vegetables people are eating. Where are the long term trials of broccoli in combination with other vegetables? Where are the studies of broccoli eaters and non-broccoli eaters? The safety studies that do exist have probably been meddled with by Big Farmer.

Sorry, Orac, I couldn’t resist this . . .

Turner syndrome, viral infections, inadequate gonadotropin secretion or action, and viral infections.

“You said viral infections twice.”

“I like viral infections.”

But, back on topic. . . I honestly can’t understand how people can be this mindless about some things. How’d then even get a casual connection out of that series of events?

Mike, it’s about them being wrong, or their heroes/idols being wrong. They have so much time and money invested in these cranks that to turn back now would be to admit their own massive failings and in their mind it’s easier and better to just attack the other side, no matter how illogical their position and logical the other side’s position may be. ex: mercury causing autism is proven false so they jump to the next metal, aluminum. If aluminum is proven to not cause autism then move to formaldehyde, if it’s not formaldehyde, then it must be something else. Whatever they can do to cling to the underlying vaccine=bad belief.

@kruuth

Don’t forget the tactic of waiting for enough time to pass that ideas have largely faded from public consciousness, then circle back to already discredited ideas, like mercury.

With regards to FluMist, etc.: I don’t get why it’s non sequitur to ask why there might be a prediliction for any side effects from Gardasil to be linked to the reproductive system; I’m thinking (as a lay person) that vaccine = weakened form of virus; since full strength virus is linked to disease in some part of the body, mightn’t there be a tendency for side effects to be there too? Is there any tendency for known vaccines to have the side effects linked to systems targeted by the full strength vaccine?

(Questions meant fully out of curiosity – I’m ‘pro-vaccine and my two daughters and son have all gotten their HPV vaccines).

I’m thinking (as a lay person) that vaccine = weakened form of virus

Gardasil isn’t an attenuated vaccine.

You’ve got it backwards–they didn’t go from observations to conclusions but from a preferred conclusion to the hunt for damning observations. Rather than get the causal connection out of the series of events, the connection was ready and waiting in place a priori.

Thanks – does the idea hold any water for other vaccines?

Yes Steve. Live viral vaccines tend to have a higher rate of side effects. For example, OPV can revert to wild-type polio virus in ~1/million doses and cause paralytic polio in the recipient. MMR and varicella vaccines can cause encephalitis in again ~1/milion doses.

But pulling these so called adverse effects out of thin air when there is no biological plausibility is just rot.

Calli Arcale:
There is no reason to think Gardasil would be any more likely to cause ovarian failure than FluMist would be, and yet

I was thinking the same thing last night. The authors point the appendage of blame at the adjuvants in Gardasil… which of course are the same adjuvants found in other vaccines. In this case, however, they are expected to know that they are components in a vaguely reproduction-related vaccine, causing them to single out the ovaries to wreak their destructive potential.
Or else the authors are guilty of magical thinking…

she was able to rule out all other possible causes.
Clearly it is not possible to rule out all other possible causes, because people have been developing idiopathic early menopause long before Gardasil and no-one knows the causes.

Interestingly, much of the opposition to Gardasil may be fuelled by conservative beliefs ( see MMM’s and others’ comments) about girls’/ women’s sexuality – as in ” let’s all pretend that this isn’t really happening”..
thus, they get all upset in addition to their anti-vax fears

AND the idea of the vaccine for boys makes them even more disturbed because it reminds them that there are many ways to get infected – including from OTHER males ( probably less of an issue for same-sex female)..
I think that that factor plays into the mix as well.

More seriously, I’m looking forward to Orac’s take on the latest from Lucija Tomljenovic and Christopher Shaw.

As noted on another thread, their Case 1 is presumably Ms. Jasmine Renata, the autopsy report matching in every respect. Case 2 is presumably Annabelle Morin of Quebec, who died in 2008; her parents are seeking evidence to sue Merck, which is how Shaw and Tomljenovic are examining her preserved brain samples.

Yeah, I thought I smelled a pro-natalist bias in there. I know for a fact I was certain at age 16 that I didn’t want kids, and I know ~20% of women are similar, so losing your fertility early is hardly the tragedy of epic proportions that language makes it out to be. (More subtle anti-adoption bias in there, too; never mind that the 16 year old in question could hypothetically adopt children even if she wanted them, but somehow or other, these pur laine forced-birthers rarely if ever bring that up, because secretly they hate adoption too.)

Given that I don’t want kids, and my periods are still nightmarish, sign me up for premature menopause (not even that premature at my age)… *sigh*

I noticed that the full article lists the following conflicting interests:

None.

Seems like being on the board of an organization that has opposed Gardasil must have slipped her mind.

Ahem, having had experience with teenagers (my own and kids I counseled while a public health nurse/clinician), I pose this question to other commenters here.

Q-How do you know when a teenager is lying to you?

A-When their mouths are moving.

“There is no reason to think Gardasil would be any more likely to cause ovarian failure than FluMist would be, and yet ”

Indeed.

It’s not like the vaccine itself specifically has anything to do with the female reproductive system. It’s a vaccine that protects against a virus that can cause cervical cancer (as well as other cancers) and is commonly transmitted sexually, but it’s not like it is injected into the reproductive tract or targets or accumulates in the ovaries. As far as the ovaries are concerned, Gardasil itself is just another vaccine.

To associate Gardasil specifically and uniquely with ovarian failure would seem to require a fundamental misunderstanding of what the vaccine is, what it does, and how it works.

From such ignorance of near zero understanding of vaccines, one might assume that since Gardasil is used to prevent infection of a virus that can cause cancer in the female reproductive tract could cause problems in the reproductive tract.

Possible cause = hypothyroidism? I was hypothyroid as a teenager, myself. Obviously, there are so many other possible causes that it is very suspect that the anti-choice people come to this conclusion.

Gardasil is a very dangerous drug that should be banned. it is unnecessary for anyone to get it. It has caused a number of deaths and complications.

Gardasil causes such symtoms as seizures, strokes, dizziness, fatigue, weakness, headaches, stomach pains, muscle pain and weakness, joint pain, auto-immune problems, chest pains, hair loss, appetite loss, personality changes, insomnia, hand/leg tremors, arm/leg weakness, shortness of breath, heart problems, paralysis, itching, rashes, swelling, aching muscles, menstrual cycle changes, fainting, swollen lymph nodes, and DEATH!

Quite a nice little useless vaccine given out to little fornicators these days.

Bksea, I noticed that there are a couple of feedback options on the abstract. It looks like their conflict of interests should be brought to their attention (I don’t have an account).

Sounds like a bunch of fetid dingo kidneys to me.

Copy of full paper here:
http://www.fli.org.au/wp-content/uploads/Dr-Little-Report.pdf

PS: They did check thyroid function – it was normal.

PPS: Here is a review of the genetic causes of premature ovarian failure. Many of these exist as part of a distinct phenotype/syndrome, but some are otherwise not obvious and would occur in apparently “healthy” women.
http://humupd.oxfordjournals.org/content/8/5/483.full.pdf

Did the authors of this case report exclude any of them as a cause?
No.
All they did was rule out Turner’s syndrome and Fragile X.

I had a post here, but the moderator couldn’t handle it so the shithead deleted it. A common commie occurrence that happens often these days. Put his type in the white house and we will live in a state of censorship like China.

Someone is trying to raise money

Someone also appears to be trying to groom a new gritty hipster look. (Actually, I think it works.)

“To be seated with Drs. Carmel and Andrew Wakefield for dinner, please purchase a $750 ticket.”

*splorf*

I mean, it is better than Arranga’s sad effort trying to pass off the notion that “patrons” were sending in $64,000 or whatever the multiplier was by way of a Paypal shopping cart. I wonder if Ed is actually on the outs with this development.

@ Narad:

You know, I saw his new coiffure in another photo recently. He doesn’t look bad. For a master fraud.

Looks like a guy who has greying hair – and wants to look younger- so he touches up most of it BUT leaves a tiny bit so it doesn’t look like a TOTAL, obvious dye job.

Clues to dye jobs/ cover-ups for the uninitiated: it looks too even- not a variety of shades, darker and lighter, like real hair- except for the touch of grey. I also think it’s too dark for his skin tone.

-btw- there’s nothing wrong with dying your hair- for men or women- HOWEVER in his case, it’s another way of making himself attractive as he plays matinee idol to his ever admiring- mostly female- fans.
Con-men also wear nice suits.

When I saw that photo, I immediately flashed back to the Wahl Stubble Device. Time will tell. As for hair coloring, I am firmly in the henna camp, although I have so far only really needed it recreationally. The one thing I won’t accept is going yellowish rather than a proper white or gray.

There’s a FB page, too, FWIW

It’s always worth a fresh link to Patrick “Tim” Bolen.

Ex-doctor Andy has an odd definition for “integrity.” Perhaps it is closer to “delusional.”

@ Chris:

Unfortunately, all the woo-meisters I survey speak similarly.
Welcome to “through the looking glass” world!

steve

With regards to FluMist, etc.: I don’t get why it’s non sequitur to ask why there might be a prediliction for any side effects from Gardasil to be linked to the reproductive system; I’m thinking (as a lay person) that vaccine = weakened form of virus; since full strength virus is linked to disease in some part of the body, mightn’t there be a tendency for side effects to be there too? Is there any tendency for known vaccines to have the side effects linked to systems targeted by the full strength vaccine?

To laypeople like ourselves, it seems to make sense, and that was sort of what I was getting at. It seems to make sense; cervical cancer + vaccine + ovaries. Thing is, the vaccine isn’t actually targeted at the reproductive tract — and believe it or not, neither is HPV. It’s got a reputation for causing cervical cancer, but it causes a lot of other cancers too. And warts. So to fight it, targeting the cervix would make no sense. The vaccination is systemic; it is injected into the arm, just like the flu vaccine or TdaP, and it creates a systemic immunity to select strains of the virus. Local side effects are fairly common — swelling and pain around the injection site, mainly. Systemic side effects are rare, and similar to those for other vaccines. Which really should be no surprise, because apart from the protein strand that its teaching the immune system to recognize, it’s just like a lot of other vaccines. Side effects are going to be either localized to the injection site in the arm, or systemic, and will be similar to those associated with other vaccines. Ovarian failure has never, to my knowledge, been associated with any vaccine. And it’s a little suspicious to me that of all the vaccines it gets associated with, it’s this one. It’s far too convenient and reeks of confirmation bias.

Dims is going overboard with the misogyny. Really if you want to troll you should be a little more subtle with the display of psychosis.

Oh, man, this Bolen “legal analysis” is a riot. He’s utterly doomed on point 1, because the material was not paywalled. Point 2 is largely an aimless bridge between the failed point 1 and the Snidely Whiplash “trap” revealed in point 3. Point 3 itself is incoherent as far as Bolen’s contribution is concerned (no Timmy, the anti-SLAPP hasn’t been reached in the first place).

What I curious about is whether anybody recognizes the text that he’s quoting after his own babbling in point 3. I haven’t gone over all of the Arranga-presented stuff, but it would seem that either (1) this has already been considered and is aimless to repeat in this context or (2) somebody has popped his cork early.

@ dingo 199:

The first link you provided to the full BMJ article “failed”. Also see my link above to genetic causes of idiopathic premature ovarian failure, (full article not behind a pay wall).

http://jme.endocrinology-journals.org/content/45/5/257.full.pdf

Abstract

Premature ovarian failure (POF) is an ovarian defect characterized by the premature depletion of ovarian follicles before the age of 40 years, representing one major cause of female infertility. POF relevance is continuously growing because women tend to conceive ever more frequently in their thirties and forties. POF can present very early with a pubertal defect. More frequently, it is the end stage of an occult process (primary ovarian insufficiency, POI) affecting ∼1–2% of under-40 women. POI is a heterogeneous disease caused by a variety of mechanisms. Though the underlying cause remains unexplained in the majority of cases, various data indicate that POI has a strong genetic component. These data include the existence of several causal genetic defects in humans, experimental and natural models, as well as the frequent familiarity. The variable expressivity of POI defect in women of the same family may indicate that, in addition to some monogenic forms, POI may frequently be considered as a multifactorial defect resulting from the contribution of several predisposing alleles. The X chromosome-linked defects play a major role among the presently known causal defects. Here, we review the principal X-linked and autosomal genes involved in syndromic and nonsyndromic forms of POI with the wish that this list will soon become upgraded because of the discovery of novel contributing mechanisms. A better understanding of POI pathogenesis will indeed allow the construction of tests able to predict the age of menopause in women at higher risk of POI.

Fetid, putrid, dingo kidneys, indeed. Why would you only do a karotype to R/O Turner and Fragile X Syndromes, when genetic phenotypes have been identified?

^ “What I am.” And I had no idea that Orac wore a dress to the 7th-grade prom. In fact, it’s the first I’ve heard of 7th-grade proms in the first place.

@ Narad: I went through the Discovery Deposition that was heavily redacted by Ed Arranga…three-quarters of the numbered pages were “missing”. I think Timmy read the same heavily redacted Discovery Deposition.

speaking about discovery deposition, someone have a link to the full version? is it on Brian Deer’s website?

Alain

Alain…You should try to make time to read all of Deer’s articles…not just the Lancet-Wakefield “stuff”. He’s quite a journalist.

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