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Katie Couric on the HPV vaccine: Antivaccine or irresponsible journalist? You be the judge!

I’m not really happy to have to write this post, but a blogger’s got to do what a blogger’s got to do. The reason is that Katie Couric has done something requires—nay, demands—a heapin’ helpin’ of Orac’s characteristic Respectful Insolence. Why should I give the proverbial rodent’s posterior about who gets the Insolence today? The reason is that, when it comes to medicine, Katie Couric has done a fair amount of good. After the tragic death of her husband at a young age from colon cancer, she became an activist and spokesperson for colorectal cancer awareness, even famously undergoing her very own on-air colonoscopy in 2000. Then, in 2005, as part of Breast Cancer Awareness Month, she similarly underwent mammography on the air on the Today Show. She was even one of the co-founders of Stand Up To Cancer (SU2C). Indeed, I saw her accept the AACR Award for Distinguished Public Service earlier this year. In brief, Katie Couric was supposed to be one of the good guys, and usually she is.

There is, however a somewhat darker side. Couric tolerated the notorious antivaccine reporter Sharyl Attkisson for years, even after Attkisson demonstrated that she was an Andrew Wakefield fangirl and dropped stinky bombs of burning stupid on the blogosphere about vaccines in the form of abusing the Hannah Poling case and promoting Helen Ratajczak’s mind-numbingly scientifically ignorant “review” of the evidence regarding vaccines and autism, among numerous other examples. She even once pulled the classic crank tactic of the “pharma shill gambit” on Paul Offit and “vaccine defenders” in a despicable journalistic hit piece called How Independent Are Vaccine Defenders? When pro-vaccine groups complained, someone at CBS News, likely Attkisson, passed the complaint along to the antivaccine cranks at AoA.

So, despite her good works on the cancer front, I wasn’t entirely surprised to see alarmed warnings that Katie Couric was going to do a segment on the vaccine against the human papilloma virus (HPV) from people like Seth Mnookin. The segment appears to be an installment of something Couric calls The Big Conversation, and the story was entitled The HPV Vaccine Controversy, and it contained segments like Is the HPV Vaccine Safe? Because I have a day job and can’t watch vapid daytime TV, I DVRed the episode and watched it, just so that I could report on it for you. The things I do for my readers! Then it popped up online, so that you, too, can share my pain.

It was even worse than I thought it was going to be, and I knew it was going to be bad when it was advertised as having a mother who thought that Gardasil killed her daughter. And so it did. What I didn’t realize is that Couric also had one of the founders of the anti-HPV vaccine crank blog SaneVax on her show, Rosemary Mathis, and her daughter Lauren. If you want to get an idea of just how much quackery and pseudoscience is promoted by SaneVax, just search this blog for the term. I’ll just give you two examples. First, SaneVax latched onto a dubious finding of trace amounts of HPV DNA in Gardasil to launch a fear mongering campaign of such monumental ignorance about molecular biology and science itself that it was breathtaking in its scope. Then about a year ago, SaneVax published a guide to blaming the deaths of children on Gardasil. I kid you not. The title of the despicable article was A Parent’s Guide: What to do if your child dies after vaccination. More recently, SaneVax published an article entitled Gardasil HPV: What to Do If You or Your Daughter Suspect Premature Ovarian Failure, another bogus claim made about Gardasil by antivaccinationists.

One of the founders of this group was one of the mothers Couric interviewed as an equal to a real pediatrician. Yes, the entire segment was structured as a “he said, she said” tour de force of false “balance.” On the one hand, we have two anti-HPV mothers, one who thinks that the HPV vaccine killed her daughter and the other who thinks it injured her and as a result helped form a website that spreads the vilest, most idiotic pseudoscientific fear mongering about HPV imaginable. On the other side, there was a lone pediatrician trying to promote science-based medicine and a mother who had her daughter vaccinated and didn’t regret it. Somewhere in the middle, but not really given what she says, is Diane Harper, represented as having been integral to the development of Gardasil. In reality, Harper is on the anti-HPV side and, being represented as the definitive Gardasil authority, weighs heavily on the message, even though she doesn’t get the last say.

The segment starts with Couric asking, “Have you all heard about the controversy surrounding the HPV vaccine?” I’m half tempted to answer here, “No.” The reason is that, scientifically speaking, there is no “controversy.” The HPV vaccine, be it Gardasil or Cervarix, is effective and incredibly safe. The whole “controversy” is not a controversy at all, but rather a manufactroversy, and Couric does her part in promoting that manufactroversy through the tried and not-so-true technique of false balance.

That balance starts out with an interview with an interview with Emily Tarsell, whose daughter Christina died unexpectedly at the age of 21. Tarsell has been telling the world that she thinks Gardasil killed her daughter for quite some time now, telling the Institute of Medicine, having her story featured on website of the the antivaccine group National Vaccine Information Center (NVIC). Couric begins, as is appropriate, by expressing sympathy for Tarsell’s loss. It’s always horrible when a parent loses a child. Even recognizing that, this interview was pretty pointless, consisting mainly of going on and on about how awesome Christina was and how awful it was that she died. Emily Tarsell did not present a single shred of evidence that Gardasil had anything to do with her death, and when Couric asked her what her daughter’s symptoms were, she demurred, refusing to answer, “Because we have a case pending, I cannot go into detail what happened each time,” referring to each dose of Gardasil. All we learn is that Emily died suddenly 18 days after receiving her third dose of Gardasil, and that the autopsy failed to find a cause of death. You can see it all here:

Of course, what isn’t mentioned is that Emily Tarsell is on the board of directors of the antivaccine political group known as the Canary Party, which was behind the effort to have a Congressional hearing in front of the House Committee on Oversight and Government Reform, chaired by Darrell Issa. Fortunately, it failed. This time. Of course, up until now, Tarsell has not been shy at all about telling her daughter’s story in detail. For example:

Here we learn that Tarsell didn’t think about Gardasil as the cause of her daughter’s death until weeks later, when a family member mentioned reports of Gardasil and that Tarsell remembered that her daughter had complained of not feeling well after the shot. What was wrong? She said she was tired and felt dizzy when she stood up.

Then there’s this video:

Here, we learn that a few days after the third Gardasil vaccine, Emily felt dizzy and complained of fatigue. These are very vague symptoms, and could be due to many things. As tragic as it is and as much sympathy as we all feel for Tarsell, her story is a perfect example of the post hoc ergo propter hoc fallacy. Just because Christina Tarsell received Gardasil before she died unexpectedly does not mean Gardasil caused her death. It doesn’t even mean that it caused her vague symptoms of fatigue. In fact, given the literature out there, it almost certainly didn’t.

Next up was Diane Harper. After seeing Harper in action on Katie Couric’s show, I now take back the benefit of the doubt that I gave her, particularly after her crack later in the show that pediatricians are “trained to give vaccines, not trained to do Pap smears.” Besides being wrong, it’s a quote so full of burning stupid—yes, I’m calling Harper out on that—that I change my mind. Harper has become a crank, and she does now hate Gardasil. In essence, her argument was that, because only 10% of women with HPV infection develop chronic infection, why vaccinate? She also points out that approximately 10% of girls acquire HPV before their 11th birthday, which is when the first dose of Gardasil is recommended to begin.

Her biggest trope, however, is that HPV vaccines “only” last five years. There is simply no reason to believe that is true. The reality is that HPV vaccines haven’t been licensed long enough to know how long vaccine-induced immunity persists. Even so, although we might not yet know how long HPV vaccine immunity will last, but we do know that the duration of vaccine coverage (95%) protection remains at least five years. Indeed, a recent analysis of nearly 5,000 women on Nordic countries found that Gardasil “is effective up to 6 years following vaccination with a trend of continuing protection up to 8 years following vaccination,” and Matthew Herper points out that an analysis by also indicates that people still have immune responses 8 years after getting the shot.

The rest of the time, Harper seems to have a magical faith in the ability of Pap smears to catch cervical lesions early enough to allow interventions that prevent progression to full-blown cancer. While this is true in a perfect world (i.e., where women receive their Pap smears according to recommendations), in the real world, efficacy isn’t as great, but there’s also a philosophical issue here: Isn’t it better to prevent cervical neoplasia that can lead to cervical cancer rather than treating it when we find it, particularly when it can be done so safely? Let’s just put it this way. As Tara Smith writes:

Dr. Harper believes the HPV vaccine is over-hyped, and that Pap screening is “100% accurate” so no HPV vaccine is really needed. This, frankly, is hogwash. Even with emphasis on screening, here in the U.S. we have 12,000 cases and 4,000 deaths from cervical cancer alone each year. (And in Mnookin’s post and in Matthew Herper’s Forbes post, both note that head and neck cancers can also be caused by HPV as well–but have no good screening process).

And:

Harper acts as if finding HPV via Pap smears is like rainbows and unicorns, but it too has a risk-benefit equation, and I’d so much rather have received a vaccination than to have gone through that. And, some women’s treatments for HPV infections and cervical abnormalities are even more extreme than mine was.

Indeed. An argument can be made that in developed countries Pap smears can produce results as good as the vaccine in terms of lowering death rates, but there are tradeoffs. Moreover, if HPV incidence is driven low enough by mass vaccination, Pap smears could be done less frequently or only targeted to high risk populations. If better HPV vaccines are developed to cover more types of HPV, this process could accelerate to the point where Pap smears are not even necessary any longer. Be that as it may, I’ve seen Harper make far more nuanced arguments, understanding that it’s not black and white. Her argument that Gardasil’s benefits are overhyped and that the cost-benefit ratio of the vaccine might not be worth making it part of the recommended vaccination schedule even had some resonance with me before. My thinking has evolved on the issue. Be that as it may, here, it’s very clear, despite her waffling, that Harper thinks Gardasil is a waste of time and that women should just get Pap smears.

Throughout the entire segment, what is most frustrating about Harper’s responses is that she sidesteps the answer to one question. She is asked on at least two occasions whether she thinks the benefits of HPV vaccines outweigh the risks. Both times, she answered another question, first dodging the question of whether she thought Tarsell’s blaming the HPV vaccine for her daughter’s death was plausible, and then near the end she waffles about if “you’re comfortable” with the risks and benefits of the HPV vaccine you should have it. She can’t, however, resist making the aforementioned crack about pediatricians being trained to give vaccines rather than Pap smears, adding that the best gift you could give your daughter would be a certificate for a pap smear at age 21.

As mentioned before, Couric also interviewed Rosemary and Lauren Mathis. Rosemary Mathis founded the antivaccine (specifically, anti-HPV vaccine) group SaneVax, and Lauren is her daughter. Her story is even less convincing than that of Emily Tarsell. It’s summarized in a news story from 2010, in which it is stated that Lauren was bedridden for 85 days.

Doctors diagnosed her with an enlarged liver and a nonfunctioning gallbladder.

“I was scared and for probably a year I slept beside her because I was afraid for her to go to sleep,” Mathis said.

After seeing other doctors and specialists across North Carolina for nearly a year, a doctor at Duke Medical Center confirmed that Lauren’s illness was directly related to a vaccine. Mathis said the only recent vaccine given to Lauren was Gardasil.

The story as shown on Katie Couric’s show is here:

In this, Lauren states that she felt sick after each vaccine and lost two years. Apparently Lauren developed some sort of chronic illness, leading her mother to take her from doctor to doctor, feeling as though she was being ignored. Finally, a doctor at Duke diagnosed her with “vaccine injury.” What type of vaccine injury, you ask? I can’t tell you because Rosemary Mathis doesn’t tell. She just says “vaccine injury.” She also doesn’t tell us how this doctor, whom she doesn’t name, came to the conclusion that Lauren had “vaccine injury.” This is a key component of Rosemary Mathis’ story, but I’ve as yet been unable to find anywhere where she revealed the identity of this doctor (or, as it is sometimes portrayed, “doctors”). In this post on the SaneVax website, Rosemary Mathis states:

She went from being an Academically Gifted student to one who struggled to complete her 8th grade year of school. She was placed on a modified school plan by her principal who fully backed her because she was an excellent student who had been in the North Carolina Academically Gifted Program since 2nd grade. Her life became an endless round of hospital and doctor visits with little resolution to the severe pain that she was experiencing. She was even sent for surgery on her gall bladder at Wake Forest Baptist Medical Center where a skilled surgeon recognized the symptoms were more than gall bladder dysfunction and thankfully did not operate. We have spent the past year researching this horrible vaccine and the side effects and treating her with vitamins and medicine. My daughter is currently being treated by Duke University’s Children’s Hospital and Wake Forest Baptist Medical Center’s Brenner’s Children’s Hospital and the bills are now in the tens of thousands of dollars. Thankfully, I am a manager for Lowe’s Home Improvement Warehouse in their Corporate Office and have a good insurance policy which has helped cover the costs associated with the effects of Gardasil.

Lauren’s dates of vaccinations were 2/4/08 (Lot #1448U); 4/16/08 (Lot #1757U); 8/18/08 ( Lot #0067X).

With her second Gardasil vaccination, Lauren also received Varicella 165U and Menactra U2559AA. Symptoms over this past year and a half have included: enlarged liver, gall bladder attacks, severe nausea, chest pain, severe abdominal pain, severe headaches, brain freezes, stomach ulcer, sensitivity to light.

This all sounds like some sort of hepatitis, perhaps autoimmune. Or perhaps she had primary sclerosing cholangitis. One wonders if the doctor at Duke saw autoimmune hepatitis or cholangitis and decided Lauren had had vaccine injury. Certainly my speculation is no more ridiculous than coming up with a diagnosis of “vaccine injury” just by looking through medical records. I’d love to know on what basis the doctor in question, if he even exists, diagnosed Lauren with “vaccine injury,” because I am unaware of a mechanism by which vaccine injury could cause gallbladder dysfunction.

The segment concludes with Dr. Mallika Marshall, a pediatrician at Massachusetts General Hospital and “Katie” medical contributor, who explains why she recommends the HPV vaccine for both boys and girls.

Overall, Dr. Marshall does as good a job as any science-based contributor could be expected to do under the circumstances, pointing out that just because these girls received vaccines before getting sick doesn’t mean it was the vaccines that made them sick and trying to inject some common sense and science into the discussion. Unfortunately, it’s too little, too late. The issue had already been irrevocably and intentionally framed by two women who think that their daughters were either killed or horribly injured by HPV vaccines, another woman who barely disguises her contempt for the HPV vaccine and her belief that pap smears are better, and a script dripping with false balance and obvious sympathy for the viewpoint that HPV vaccines are dangerous. It’s a horrible, horrible piece, and tacking Dr. Marshall on at the end, as valiantly as she strives to fight the waves of pseudoscience engulfing the show without being too “harsh.” The producers should be ashamed, but they are clearly shameless if their response to criticism is any indication:

We reached out to Couric’s producers; a person close to the program defended the segment by observing that the show “regularly discusses important topics in the hope that people can make their own decisions.”

May I then assume that Katie will soon be airing “both sides” of claims that 9/11 was an “inside job”; evolution is a “theory in crisis”; the moon landing was a hoax; and the Holocaust never happened? If not, why not? What she has done with Gardasil is the equivalent: Examining an issue that does not have two sides and then applying liberal helpings of false balance. Worse, by framing this as a “debate” or a “he said, she said” format, Couric’s producers have falsely elevated complete loons like SaneVax founder Rosemary Mathis to the seeming level of real experts like Dr. Marshall. There are controversies about the HPV vaccine. Whether it is safe or not is not one of them, and giving the floor to the most committed antivaccine activists to appeal to emotion rather than science is not how to discuss them. Couric’s producers and Couric herself were far more interested in “human interest” and controversy than actual medical and scientific accuracy.

Worse, Couric promotes a viewpoint that has no evidence to support the risks she attributes to HPV vaccination. Indeed, the evidence is very much against the existence of such risks attributable to Gardasil. For example, recent large cohort study of nearly 1,000,000 girls between the ages of 10 and 17, 296,000 of whom had received at least one dose of the HPV vaccine and 160,000 of whom received all three doses failed to find any link to health problems, either long or short term. Nada. Zip. Gardasil is incredibly safe. It’s also effective. Earlier this year, a study by the CDC showed that the prevalence of the cancer-causing strains of HPV has dropped by half among teenage girls in recent years, evidence of major success of the HPV vaccine. This is good news, given that the risks of HPV infection are very real. Every year about 12,000 women develop cervical cancer, and HPV is by far the most common cause. Couric’s mothers and Diane Harper are simply wrong, wrong, wrong.

It’s amazing how, in one fell swoop, Couric has called into question her dedication to science-based medicine after having done yeoman work promoting it with respect to colon cancer and other cancers. When asked in the title whether Couric is antivaccine or irresponsible journalist, I didn’t actually think that Couric is antivaccine. However, she is irresponsible. By giving voice to the crankiest of the antivaccine cranks with such an obvious biasing of the segment towards them, Couric has demonstrated irresponsibility on a massive scale. For shame. I don’t think she’s becoming the next Jenny McCarthy (a tempting title for this post that briefly crossed my mind, but way too obvious and easy), but she has dropped a massive turd of antivaccine pseudoscience on national TV. Maybe she’s trying to emulate Dr. Oz, except that even Dr. Oz probably wouldn’t have touched this.

ADDENDUM: The ever-helpful antivaccine cranks at Age of Autism have provided an “unofficial” transcript of the show.

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]

204 replies on “Katie Couric on the HPV vaccine: Antivaccine or irresponsible journalist? You be the judge!”

Dr,
“The Gardasil vaccination is a unique vaccination because it is composed of proteins and does not have a chemical structure”
What does this mean?

You’ve got to wonder why Dr. Diane Harper who is an “international expert on HPV and HPV prevention” has not read the reports from outside the United States about the data about lasting protection of HPV vaccine….since the vaccine was first licensed.

I listed intently to what Dr. Harper said; “Gardasil doesn’t last long enough to prevent future cancers” and when she fed Katie Couric that line, “It lasts only 5 years?” I am appalled.

As sad as the death of a young woman is, from an “undetermined” cause, according to her mother…or from cardiac arrest as listed on the medical examiner’s report, according to the earlier video…it does not, IMO, mean that Gardasil vaccine caused her death.

The other testimonials provided by Lauren Mathis and her mother do not offer any proof that the numerous symptoms she experienced are associated with Gardasil vaccine.

Katie ought to stick with lightweight topics and not be used as a tool by the likes of the NVIC and SaneVax.

Orac:

Emily Tarsell did not present a single shred of evidence that Gardasil had anything to do with her death, and when Couric asked her what her daughter’s symptoms were, she demurred, refusing to answer, “Because we have a case pending, I cannot go into detail what happened each time,” referring to each dose of Gardasil. All we learn is that Emily died suddenly 18 days after receiving her third dose of Gardasil, and that the autopsy failed to find a cause of death.

Yes, but the document found in the US Court website provides a big hint. I found EMILY TARSELL, As the Executrix of the Estate of CHRISTINA TARSELL
…. FINDING OF FACTS
.

As someone who has a kid with a genetic heart condition that is most often diagnosed after “sudden cardiac death” (fortunately his was found on an echocardiogram after a murmur was heard), I tend to notice certain things. Like this bit in the document:

On November 20, 2007, Christina saw a doctor for chronic sinus congestion. The doctor detected an irregular pulse rate. Exhibit 4 at 136. An EKG was abnormal, indicating premature atrial contractions and that Christina ’s heart was beating in pairs. Id. at 142.

Approximately one month later, the EKG was repeated. It appears unchanged from the previous one. Id . at 135 and 141. In February 2008, Christina had a transthoracic echocardiogram. It produced normal results. Exhibit 4 at 139.

Then there are notes that Christina complained about being dizzy and faint. My son’s cardiologist always asks him if he gets dizzy or faint, or feels like his heart flutters.

I can only go by our experience and say with perfect 20/20 hindsight that Ms. Tarsell should have taken her daughter to a cardiologist after learning about the faintness and dizziness.

Also, even though the echo showed no physical abnormality, that does not mean both EKGs can be ignored. There can be electrical abnormalities in the heart that cannot be seen by an echo. Sure, my kid’s echo and cardiac MRI showed a very definite physical abnormality, but the condition causes cells to be disorganized for electrical pulses. That is why he has an EKG taken more often than an echo (okay, it is cheaper, but important).

I know it is confirmation bias, but my son was diagnosed with the echocardiogram after an abnormal murmur was found the same week some just a year or so younger dropped dead from the same genetic heart condition. Since then I have taken notice of those particularly morbid news stories, and have been astounded at the variety of heart conditions that can cause “sudden death.” Many of them, including my kid’s condition, while the child is asleep.

(oh, and I don’t want to be a pedant… but the paragraph that starts off with “Dr. Harper believes the HPV vaccine is over-hyped, ” looks like it is formatted like a blockquote, but does not seem to be quote)

Wow Chris. You found an interesting piece of information. IANAL…but, IMO, that claim that Emily Tarsell has made before the Vaccine Court appears to be quite weak.

I also convinced, that Mrs. Tarsell should have brought her child to a cardiologist, in light of the atrial arrythmia episodes and in light of the ongoing symptoms of weakness to the threshold of syncope.

What does this mean?

It means that somebody needed an editor. (It does seem to be dated 2004.) Gardasil contains multiple VLPs, so I guess you could say it doesn’t have a unique chemical structure, but that’s fairly silly, given that it says “quadrivalent” right on the label. “Protein” doesn’t get one too far because… hellooo? Tetanus toxoid?

[A] doctor at Duke diagnosed her with “vaccine injury.” What type of vaccine injury, you ask? I can’t tell you because Rosemary Mathis doesn’t tell. She just says “vaccine injury.” She also doesn’t tell us how this doctor, whom she doesn’t name, came to the conclusion that Lauren had “vaccine injury.” This is a key component of Rosemary Mathis’ story, but I’ve as yet been unable to find anywhere where she revealed the identity of this doctor…

That’s suspicious, but par for the course for an antivaccinationist.

Dr. Harper believes the HPV vaccine is over-hyped, and that Pap screening is “100% accurate” so no HPV vaccine is really needed.

I really hate when antivaxers brought up the pap smear.
It’s putting on the same level a detection system (“screening”? Hello?) and a preventative system (vaccination).
One truer argument would be that vaccination will not replace pap screening, as the vaccine is not covering all strains of HPV, and is not 100% perfect (coming to this, pap screening is not 100% either). Beside, HPV is not the sole cause of cervical carcinoma.

But still. Saying “screening is enough” is like a farmer saying “I don’t need fences, I have a camera in my henhouse so I will know if a fox sneaked in.”

Jeff: That document is very strange. It looks sort of like a high school science project gone terribly wrong. There are figures showing generic structures for amino acids, making a big deal about the word zwitterion, which just means that when you have groups that like to ionize at neutral pH, you should draw the structure in the ionized form to make that point. It has almost nothing to do with the structure of a particular protein or a part of a protein, because the ionized groups are no longer ionized when present in a protein, but tied up in covalent peptide bonds. (exceptions can be the amino acids at either end). In other words, most of the material at the top is just rehash from the protein chapter of some elementary textbook.

The part about something having no chemical structure is also strange, because every molecule has some sort of chemical structure. The point that might have been attempted is that there are more than one substance present, and each is apparently part of the structure of the real virus. The difference is that only part of each protein is put into the vaccine, and that the protein parts are made artificially rather than purified from infectious virus. That’s what the wordiness about recombinant DNA is about — it’s just the tool to make a non-infectious substitute for a part of the virus so the human can generate an antibody response.

As for the TV host Couric, I suspect that she is over her head, has been over her head, and is (a) trying to do the right thing about colon cancer and breast cancer and (b) doing the show that the producer and writers handed her. I suspect that if you were to ask her about the molecular biology of colons or vaccines, she would be able to parrot back a few words and phrases, but would not do a very good job of discussing serious science. I am the first to admit that I am only vaguely aware of her existence, but have heard the name and have probably seen her on Letterman or some such. Being a television presenter is not as easy as it looks, and being able to sound knowledgeable (or even sane) on camera, without saying “Uh” and “Um” four times a sentence is uncommon.

I can’t understand the love-fest antivaxers have with pap smears.
For starters, they are not 100% sensitive for picking up abnormalities (ergo they must be useless; since according to antivax folklore anything not 100% safe and effective is useless).
Abnormalities mean women are subjected to further invasive procedures which are unpleasant and potentially damaging to future health and fertility (see Tara Smith again for details).
A large percentage [around 30%] of women who develop cervical cancer have actually had a recent pap smear (so they are not that great at averting the consequences they are meant to prevent)
Despite widely available screening, 12,000 women still get cancer each year (so many vulnerable women don’t even get screened in the first place for whatever reason).

If antivaxers applied the same twisted logic to pap smears as they did to vaccines, they would be saying they are one of the worst medical inventions on the planet. But the reason they love smears is because… loving them means they can be antivaccine, and as our dear and glorious leader often says, it’s always about the vaccines, isn’t it?

I wonder if you have any speculation as to what turned Dr. Harper into a ‘crank’?

Re: pap smear vs. gardasil, when I last looked at gardasil 5 years ago, and I am certainly not a doctor or have any expertise whatsoever, it did strike me as a reasonable argument that it would be better to place gardasil dollars into making pap smears more available to women because at that time, 5 years ago, it was said the most effective treatment against cervical cancer and many other ailments was an annual pap smear. And gardasil wouldn’t eliminate that requirement, so that making pap smears more readily available was a better choice in a regime of limited dollars.

Please note: that’s not saying gardasil was dangerous or anything, it was just a cost benefit analysis of gardasil which at the time was claimed to be the most expensive vaccine protecting against hpv viruses versus pap smears promoting overall women’s health.

This was at a time when the Feds were being called on to subsidize gardasil vaccinations — perhaps a better use of that money would be a fleet of mobile pap smear labs.

We have many like Couric, to host Circus.

Now, Senators, how shall we distribute bread?

True “balance” would see Couric interview around 1390 people whose daughters/spouses died from HPV-induced cancer for every mother who claims vaccine killed her daughter, and around 40,000 women who had no side effects from vaccine for every one that died following vaccine.

That will be one mighty long Today episode. I doubt Orac has a DVR that could cope.

Maybe … They’re all in the pockets of Big Cytology who don’t want to see their revenue stream (screening paps) disappear when the burden of disease is lowered to a point that the recommended pap schedule either spaces out to 10 years or is limited to only those women who have high risk HPV detected on non-invasive testing. It’s a conspiracy!! This injustice must be made public! How many women have died within months of their last Pap smear?!? Won’t someone think of the children?????

Sarcasm btw.

I too was trying to give Dr. Harper the benefit of the doubt, but that may be the farthest she’s gone with benefit/risk/cost that I’ve ever seen. I’ve had pap smears, I hate pap smears, and I’m notoriously bad about going to the gyno, so I’ve gotten quite a few less than I should. I am young enough to have gotten the Gardasil series (oh, nothing happened, although I’d say my arm hurt on par with the HBV series). Getting the vaccine doesn’t mean I should stop getting paps, and I know that, I just really hate them. I’m the anecdotal poster child for why the HPV vax is important: lazy, semi-non-compliant older millennial.

This is so upsetting. What if this were a vaccine for colon cancer? I feel terrible playing to that level, but if it were, would Katie have done this? Where were the suffers of cervical/H&N cancers? How about some obituaries of those killed by HPV-related cancers?

The only good thing is there has been a lot of uproar. And Katie doing this is worse than Jenny’s shrill harpy voice. Not many people respect Jenny…a lot of people close to Jenny don’t respect Jenny’s opinion and have said so. But Katie is looked at as a semi-expert, or at least responsible.

@Dr. Trousers, #17– I think they are in the pocket of “Big Pappy” (anyone remember Pappy from “The Placebo Journal”?).

The final sentence of the time.com article I. Rony Meter cites in #5 says it all: “The damage a former Playboy Bunny has been able to do is bad enough. But Couric’s misdeeds are all the worse given that she’s taken much more seriously than Jenny McCarthy.”

Sorry but I’m too cynical to give Couric credit for any of her cancer awareness work. It’s all about ratings and PR which is the only logical consistency regarding her actions. This is precisely why I think it’s a bad idea to rely upon celebrities/talking heads to convey the “right” ideas. Even when they do, it’s almost always by accident.

@Jeff #1 & 2,,
I suggest you treat any scientific information from someone who thinks that Saccharomyces cerevisiae are bacteria with deep suspicion.

“Maybe … They’re all in the pockets of Big Cytology who don’t want to see their revenue stream (screening paps) disappear when the burden of disease is lowered to a point that the recommended pap schedule either spaces out to 10 years or is limited to only those women who have high risk HPV detected on non-invasive testing. It’s a conspiracy!! ”

As a ranking member of Big Cytology, I think I speak for the great majority of pathologists who’d be happy to see a marked decline in the number of screening Paps. Despite the introduction of HPV testing, new screening guidelines and vaccines, I haven’t seen much of a drop in the workload.

@Jay:

it did strike me as a reasonable argument that it would be better to place gardasil dollars into making pap smears more available to women because at that time, 5 years ago, it was said the most effective treatment against cervical cancer and many other ailments was an annual pap smear.

That was 5 years ago. We have 5 years of evidence for HPV vaccines and the evidence is overwhelmingly in favour of vaccinating.
Here’s an analogy: house fires. Think of pap smears as smoke detectors and gardasil as fire prevention measures. The former alerts you when a fire breaks out, the latter lowers the risk that a fire will break out.

Sorry, I have to say this, even if it doesn’t add to the discussion: what a powerful post. Thank you for speaking up.

@Jeff #1 & 2,,
I suggest you treat any scientific information from someone who thinks that Saccharomyces cerevisiae are bacteria with deep suspicion.

Maybe he got his information from the guy who said pertussis was a virus?

Right, so the show gives Tarsell a microphone and time without mentioning her affiliation with the Canary Party, Mathis is allowed to talk about anonymous doctors without being followed up with questioning and Dr Marshall is given
the promethean task of attempting to educate the audience after all of the preceding fol-de-rol. I hope she is well paid.

The host presumably is concerned about cancer prevention and early detection – so how would enabling fearmongering advocates who discourage usage of a safe vaccine that prevents several forms of cancer be part of her agenda?

Here’s a suggestion for a future guest ( BREAKING NEWS)

Mike Adams reveals( to clear up rumours) that he’s been poisoned by low “accumulative” levels of toxic “elements”( metals) despite living a “pristine lifestyle” with “clean organics” and super-foods.
Fortunately, he is excreting these poisons through his hair which already has contributed to a “brain awakening” and weight loss.

Correct. He who has been telling people how to eat and selling products which he consumes himself now tells us he’s been poisoned. Why does this story sound vaguely familiar to me?
Oh right.

I’ve been trying to think of a way to phrase this-

about ‘false balance’
perhaps there might be a way to impress upon audiences that usually the anti-vaxxers/ woo-meisters represent their own personal experience and the opinion of a single person or a small group- in emotional fashion,
whereas the scientist who presents data is usually speaking about consensus opinion ( of many people- experts) who review observations of thousands of subjects over decades ( research) with emotions conveniently extracted.

Emotions might stack the deck towards recall of the material presented in that manner- we can inform audiences of that. Also the individual testimonies of anti-vaxxers are not independent of each other and “pure” but mutually influenced by highly partisan material ( websites, books).

-btw- I hope you approve of my segue above – I like it better than ” OT but….” if I do say so myself.

Well, they are fussing and fuming at AoA, making all sorts of accusations about people who post safety studies of Gardasil vaccine and the scientific papers showing dramatic drops in HPV infections.

I’ve been wondering why Diane Harper has taken this stance, since she is an “international expert on HPV and HPV prevention”. How embarrassing it must be for her, that (“non-expert”) science bloggers have come up with studies showing she is not just wrong, she is spectacularly wrong, about the efficacy of Gardasil and Pap smears.

Harper comes off as a fool who will suffer the consequences of the well-deserved ridicule heaped on her by the science community.

Why are all there all these regulations for fire-retardent materials? We have smoke detectors to alert us of fires, and firemen to put them out. Why bother trying to prevent them in the first place?

Because there was someone who died in a car crash while driving his van home with a fire-retardant sofa in the back.
These things are dangerous! No-one should run the risk of having to get them.

The Gardasil vaccine wouldn’t have a chemical structure if it was made by taking some HPV, diluting it in water, diluting that solution in more water, and continuing the process until there was not any HPV left. Isn’t that how they make it?

“Mike Adams reveals( to clear up rumours) that he’s been poisoned by low “accumulative” levels of toxic “elements”( metals) despite living a “pristine lifestyle” with “clean organics” and super-foods.
Fortunately, he is excreting these poisons”

He’s been excreting poisons all over the Internet for a long time. Fortunately, sites like RI are good at detoxifying them.

@ Dangerous Bacon:

But now he claims that he’s p!ssing them out not just writing.

Well, these cranks are succeeding; people like Jay in this comments thread think that Pap smears are “treatments.”

Gardasil is an extremely dangerous vaccine, which has already been rejected in the court of public opinion. It includes only two cancer-causing serotypes, 16 and 18, when there are at least twelve other oncongenic strains not included in the vaccine. In clinical trials, vaccinated women got more precancerous lesions than women in the control group, just not types 16 or 18. There are many other types waiting to fill the gaps left by taking out the four serotypes in the vaccine. As Dr. Harper stated, 10-15% of girls have preexposure to HPV through vertical transmission from the mother or through horizontal, nonsexual skin contact. These girls have a greatly INCREASED risk of developing cancerous lesions, yet no effort is made to screen them out before vaccination, as it would be very expensive, and it’s so easy just to deny that whatever damage may occur was caused by the vaccine. HPV is not enough to cause cancer on its own: most sexually active people contract the virus, and over 99% of those clear it from their bodies with no treatment. In a small number it progresses to cancer when exacerbated by factors like smoking, vitamin deficiencies, or unprotected sex with several partners. Taking folic acid can cure cervical lesions when they occur. As Dr. Harper stated, rather than take all the risks of this vaccine, one can instead follow the new protocol of regular Pap tests combined with HPV DNA testing, and, if found early, these lesions have a 100% cure rate. Katie’s web site now has hundreds of comments by families whose children were severely damaged or killed by the vaccine, with hundreds more both by anti-vaxxers and vaccine defenders. (The vaccine defenders have lost, for, as much as they say that no vaccine damage can ever be proven to have been caused by a vaccine, most people do not make important decisions like this on such a basis.)

@AK — ‘zackly.

When you equate pap smears with vaccines you’re mixing apples and oranges…hell, not even oranges.

So instead of preventing illness, people are saying it’s better to let the illness happen and detect it after it’s happened through an extremely uncomfortable, possibly embarrassing (a STRANGER is poking around in there) and quite painful procedure that has to be repeated over and over again.

Just so that it can be treated early.

Instead of preventing it.

Because treating it is better than preventing it.

Can I just say, what the EVER-LOVING HELL.

Khani…you haven’t lived until you’ve had a Navy flight surgeon do your pap.

(He was the only doc available at the time and he was inflnitely more embarassed about it than I was).

Apparently she’s going to “address the controversy” on tomorrow’s episode. For some reason that fills me with dread.

Orac-as the all knowing computer, can you tell me why my posts to AoA’s site almost always get blocked but when people from AoA post here, they never get blocked? And why do they call us the bullies when we can’t play in their yard?

Oh great, a cia parker invasion (don’t miss her flying monkey droppings in Amazon reviews of virtually any book that is factual and rational on the subject of vaccines).

it’s part of the typical antivaxer shtick to emphasize relatively low odds of worst case scenarios (cancer and/or death) and ignore suffering, permanent disability, inconvenience and high medical costs associated with avoiding preventative medical care that includes immunization. For instance, we currently have no way of knowing which HPV infections are going to be cleared by the body without progressing to high grade dysplasia and cancer, so repeat testing, colposcopy and invasive and painful medical procedures which can result in sterility and other complications are necessary to prevent invasive cancer. But cia parker evidently thinks that’s way preferable to Evil Vaccination which prevents HPV infection from taking hold in the first place.

“Pap smears do not detect HPV induced adenocarcinomas of the cervix.”

As a pathologist, I’d amend this to “Pap tests aren’t that reliable at picking up pre-invasive glandular lesions of the cervix”, at least in comparison to their record in detecting squamous lesions.

Pap tests have saved a ton of lives, but depending on them to the exclusion of a valuable means of _preventing_ HPV infection (vaccines) makes no sense.

And that’s another stupid trope (“Immunity only lasts 5 years!”)
Firstly, the studies (as Orac points out) indicate that these time limits indicate how long studies have stretched out for (and at that time interval immune responses remain at more that 90%, so are likely to be durable for many years beyond that), but the stupid idiots have failed to appreciate that even if immunity is shown to significantly wane, then you can easily get a booster at that stage.
Duh!

CIA Parker comes here spreading her brain droppings about Gardasil vaccine.

Why is it so difficult for Parker to understand that the quadrivalent Gardasil vaccine is protective against 70 % of the serotypes of HPVs, implicated in cervical cancer?

Why is it so difficult for Parker to understand that prevention of precancerous and cancerous lesions are far more beneficial for a young woman, than having to undergo colposcopy procedures that impact the ability of a young woman to carry a fetus to term…rather than multiple pregnancies that result in fetal loss?

Parker, why do you want young woman to die from cervical cancers and why do you want young woman to be rendered unable to carry pregnancies to term?

But lilady, CIA Parker says that folic acid can cure cervical lesions when they occur! She wouldn’t have said that if it wasn’t true, would she? Would she? /sarcasm

Another thing to consider is that immunity for five years is nothing to sneeze at.

Suppose for the sake of argument that immunity lasts for 5 years, no more, no less. Let’s also say that that’s five years out of a period of sexual activity lasting, say, 35 years. Furthermore, let’s say that the vaccine is only 90% effective (just pulling these figures out of the air) and that only 90% of the sexually active population gets it.

That’s still preventing over 11% of HPV transmission. How much HPV transmission is prevented by Pap smears? Uh, NONE.

@ Chris Hickie:

Well, I’m not an all-knowing computer** but….
perhaps so that they can then say that you refuse to answer the questions they put to you?
Which they do.

At any rate, I can’t understand how people without enough training to be able to evaluate medical research themselves can dismiss someone like you when it comes to children’s health or like Orac when it concerns cancer- as well as for general scientific information. Yet they hang on antivaxxers’/ woo-meisters’ every word.

Now if their car wouldn’t work would they go to an MBA or a nutritionist? No, they would go straight to a mechanic who specialised in the type of car they owned or in the particular problem they had. Cars are apparently valuable.

Perhaps they feel uncomfortable having an expert in charge of health issues and would prefer someone who is as ill-educated as they themselves are. Doesn’t hurt their self-esteem.

At AoA, you are the new star whipping boy along with the newest target of choice, Dorit Reiss.They are so angry at you two that they’ve almost forgot lilady. And I haven’t heard very much about that journalist, BD, either.

** just a know-it-all android.

@ Christine ( the Public Servant Christine):

Believe it or not, I seem to recall that there is research that implicates high dosage of b-vitamins like folic acid in cancer.( @ Harriet Hall)

Ms. Parker: ” (The vaccine defenders have lost, for, as much as they say that no vaccine damage can ever be proven to have been caused by a vaccine, most people do not make important decisions like this on such a basis.)”

Like the decision you made to assume your child had encephalopathy, but never ever called a doctor, much less take her to a neurologist.

As a parent of a child who has had seizures, I have absolutely no respect for your “decisions” and opinions.

I’m finding myself hoping that the vigorous, informed pro-vaccine response – thank you, Orac – will give us a chance to publicize the new data on this vaccine’s safety and effectiveness and help point out the incredible weakness of the stories, some of which – as pointed out above – not only have no evidence they were caused by the vaccine, but have other, more plausible causes (thank you for the information about heart conditions, Chris). Maybe this new attention to the HPV is an opportunity in disguise to dispel the false claims that have had the stage for so long and highlight its safety and effectiveness.

Or maybe that’s optimistically naive. But I was impressed by the strong, informed, quick respond from so many directions.

Make that informed response from mainstream sources. The extreme anti-vaccine sites and people, of course, repeated their usual claims.

Dorit: “Or maybe that’s optimistically naive. But I was impressed by the strong, informed, quick respond from so many directions.”

There seems to be a bit of fallout from all sorts of mainstream news sources like the LA Times, and this beauty from Time Magazine: Is Katie Couric The Next Jenny McCarthy?.

And about the heart issues, it was certainly a learning experience for us when he was diagnosed when he was fourteen years old. There is a website about that particular genetic heart condition, and it has a forum. I read the forum once, and have never been back. It was too depressing since it had too many stories of their children suffering “sudden cardiac death”, sometimes in their sleep.

But it makes so grateful we caught it in time, and that last year he had surgery for it. He is doing so much better. It has been almost two years without a 911 call to our house!

I can’t imagine how scary that could be. And I wish some of the parents who lost their girls would be open to listening to you. Because blaming the vaccine is as bad for them as it is for those thru scare from it: they must feel guilty, betrayed and angry all at once. And they don’t deserve that, on top of the pain of losing a child.

Oh, but we got to go to the Mayo Clinic in Minnesota!

Okay, it is a very strange place and I could have lived without going there. There is a reason that “may you live in interesting times” is actually a curse. (Though the folks in Rochester, MN do their best to make sure your stay is as pleasant as it can be under very stressful conditions!… especially both of their travel agents!… who work in a small windowless office off of a twisty little passage way)

So in all sincerity, thank you.

@ORAC

Couric’s producers and Couric herself were far more interested in “human interest” and controversy ratings and advertising revenue than actual medical and scientific accuracy.

@CIA Parker:

Gardasil is an extremely dangerous vaccine,

Citation needed, and from a valid source.

which has already been rejected in the court of public opinion.

Citation needed.

It includes only two cancer-causing serotypes, 16 and 18

Which are known to be the most dangerous, and other vaccines targeting more serotypes are in development.

clinical trials, vaccinated women got more precancerous lesions than women in the control group, just not types 16 or 18.

Citation DEFINITELY needed. And nothing from Tomljenovic or Shaw.

As Dr. Harper stated, 10-15% of girls have preexposure to HPV through vertical transmission from the mother or through horizontal, nonsexual skin contact…yet no effort is made to screen them out before vaccination, as it would be very expensive

Probably the first accurate thing you’ve said in your screed.

and it’s so easy just to deny that whatever damage may occur was caused by the vaccine.

Citation needed for your claim that the vaccine causes damage.

HPV is not enough to cause cancer on its own

CItation DEFINITELY needed.

most sexually active people contract the virus, and over 99% of those clear it from their bodies with no treatment.

Citation needed.

[O]ne can instead follow the new protocol of regular Pap tests combined with HPV DNA testing, and, if found early, these lesions have a 100% cure rate

I’ve read the comments on this thread. I’m really glad that I will never need to undergo a pap smear. Secondly, how regular is regular? Finally, “if found early”. In a lot of cases, the lesions are not found early.

Katie’s web site now has hundreds of comments by families whose who erroneously believe that their children were severely damaged or killed by the vaccine.

FTFY. Anecdotes are not data, Cia.

@Denice

Fortunately, he (Mike Adams) is excreting these poisons through his hair which already has contributed to a “brain awakening” and weight loss.

If his Mike Adams’ brain woke up, it would probably try to escape.

I wonder if he manged to acquire a toxic load of heavy metals via Ayurvedic potions or some “natural” crap or whether the grifter has himself been conned one of those bogus lab tests the woosters use. The ones that guarantee a positive result every time.

Um, yes, we vaccinate.

My feeble engineer mind thinks it is better to prevent than to treat.

Anyone with contrary evidence are welcome to post their peer reviewed scientific literature. But I will tell you from personal anecdotal evidence that having a mom die when one is only is eleven years old truly sucks. It is not something I would recommend.

If his [Mike Adams’] brain woke up, it would probably try to escape.

LOL! Love it Militant Agnostic!

CIA: As the parent of a child whose first seizure occurred in the NICU when he was 20 hours old, which required resuscitation, I have no respect for you and your labeling of your child as “vaccine damaged”.

Scroll down this page to see where Katy Couric’s representative states that Katie will be addressing the controversy that her HPV program generated, on Friday December 6th’s show:

http://www.latimes.com/entertainment/tv/showtracker/la-et-st-katie-couric-hpv-vaccine-20131204,0,4561911.story#axzz2mfeIbsKk

“Updated at 1:08 p.m. Dec. 5: A representative of “Katie” said that Couric will address the controversy on Friday’s show.”

…oh, crud, I can’t do family finances since my eyes are clouded with tears.

Do not ever think the pain from losing one’s mother fades after several decades. It does not. I am turning off my financial computer (most of the time I post from the kitchen computer), and going to go read a library book. Though it depends on how much I can see through the tears.

Just for splitting hairs, regardless of the actual degree of true of the statement itself:

most sexually active people contract the virus, and over 99% of those clear it from their bodies with no treatment.

Since a lot of people are sexually active (all the ones who had children, for a start), 1% of this number is still an awful lot of suffering people.
But as long as it’s no-one you like, I guess it’s OK.

They also think that 1/500 to 1/1000 chance of dying or being left permanently vegetative from measles is just hunky dory, too. They think this of course because they are (all on their own, of course, because everyone else is just not as smart as brilliant as they are) battling something that’s 1 in 150 or was it 1 in 110 or 1 in 88 or 1 in 30 or whatever damn number they feel like making up now–so who cares about all those other things that might happen to people.

Flying monkey alert!

Over at Huffington Post, there’s an article on the front page about how the CDC is reporting a sharp upward spike of measles cases this year — something like 170 rather than a typical 60 or so — and the comments section is predictably starting to light up.

When I saw that blog post last month I almost had a stroke. Dr. Bob left out the part where there have only been 2 major outbreaks this year because the rest of us are vaccinated, so the parasites should be grateful.

OT, but is anything ever really OT here: I just discovered Andy is on Twitter. Did we know that?

@Chris of course he doesn’t mind measles – because in his little world it’s only ‘other people’s children’ that get it (never mind the obvious).

He is so disconnected from reality it’s truly astonishing.

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