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Just admit what's up

In a thread on a post by Bill Luse back in January, I discussed the strange argument given by some Christian groups and parents for giving their daughters the HPV vaccine Gardasil. To recap, here's how this argument I have run into goes: "Children have a stronger immune response than adults, even young adults. Therefore, by giving our eleven- and twelve-year-old daughters a vaccination for an STD, we aren't implying that we expect them to be sexually active in the immediately ensuing years! We are merely insuring that they have been vaccinated in the most effective way--namely, during childhood when they will have the strongest immune response--by the time they get married in their twenties, when they might marry men who might be, through regretted 'wild oats' in their earlier lives, carrying the virus."

As I pointed out, it is highly doubtful, to put it mildly, that our public health gurus would ever have recommended the widespread use of this vaccine for immediately pre-adolescent girls for that reason. On the contrary, it is quite clear that the reasoning was instead that these girls are expected to become sexually active en masse not very long after their twelfth birthdays and that the rush is to vaccinate them for an STD before it's "too late." Hence, parents whose daughters fall into a strikingly different reference class from those about whom this assumption is made have enormously less reason to have the vaccine for their daughters.

I also pointed out the possibility that the vaccine would not be effective ten or more years later and would require a booster, which vitiates the argument from strong childhood immune response. If that immune response has worn off by the time you expect it to be relevant, who cares if it was extra-powerful at the time when it was not needed?

Unbeknownst to me at that time, as far back as 2009, Dr. Diane Harper, the leading developer of the HPV vaccine, told an audience publicly, "[I]f you vaccinate a child, she won’t keep immunity in puberty and you do nothing to prevent cervical cancer.” It's unclear what Harper had to go on, concretely, since apparently in the same talk she stated that there were no studies of efficacy in girls under 15 (!) and that therefore it is unknown how much antibody resistance remains from childhood into puberty. Maybe she was just using this to hype sales of booster shots; certainly that was the conclusion Harper drew--booster shots are necessary because of uncertainty about the length of immunity. Nonetheless, from whatever source she was drawing, we do have something there rather straight from the horse's mouth: If you vaccinate a pre-pubescent girl, she will not have immunity even in puberty.

It's unclear how young of a "child" Dr. Harper had in mind. I would assume that by "a child" she meant an 11-year-old, since that is one of the ages at which vaccination is done. But let's take the long view and suppose that she was addressing some hypothetical notion (which no one has proposed to my knowledge) of vaccinating a much younger child--say, a 5-year-old. Still, her statement would mean that the immunity is not expected to last from that time until the girl is in puberty. If Harper is right, this also means that if you vaccinate an 11-year-old, the immunity is not expected to last ten years or more until she gets married in her early twenties. The word to doctors is that booster shots are definitely necessary.

There are a lot of other interesting statistics and cheerful admissions from Dr. Harper in the account of her 2009 lecture, including the statement that actually, widespread HPV vaccination is unlikely to lower cervical cancer in the United States to any very significant extent, considering the fact that cervical cancer rates are declining anyway. In fact, the only clear, concrete benefit of the vaccine Harper was able to cite was the prevention of abnormal PAP results and consequent "stress and anxiety."

But for me, the thing that really jumped out was the extremely strong admission of the need for booster shots rather than an expectation of long-term immunity from pre-puberty shots. This should pretty much destroy the silly "Christian" argument for vaccinating your 12-year-old with her later marriage in mind. We might as well just admit that this is all about expected sexual activity in teens, so much so that repeated booster shots are recommended from puberty onward to keep them protected against the virus.

So decide for yourself, Christian parents, whether you actually have that expectation for your teens, whether you really think you will "be the last to know," whether you believe that it's a good idea to be telling your teens, "Be chaste, but just in case you aren't, here's a shot (and a booster, and another booster) to keep you up-to-date protected against one STD (of many)."

But don't twist your own mind into a pretzel and insult the intelligence of other Christians by implying that this is all about getting that high-powered childhood immune system revved up when your little girl is twelve to protect her when she gets married at twenty-five. Don't bother. Just admit what's up.

Comments (18)

Have they even proven that this virus does, in fact, cause cancer- is there a verified mechanism by which this occurs, or is it simply an association? If it is an association, one can suspect it is lifestyle that creates that increases the likelihood for both rather than one causing the other.
Vaccines are a product, so there is a marketing campaign for this just like anything else. There are also various protections for makers of vaccines written into federal law- this creates an environment that encourages more risk taking with regard to the creation and deployment of new vaccines.
The people who take these vaccines are therefore at a higher risk than they would be if this were a free market.

I've not investigated the full range of the evidence. I gather it's a pretty strong association and that the theory regarding the mechanism is that the cancer is caused by long-term irritation of the cells involved (the cells of the cervix) by some especially "bad" strains of the virus. Rather like long-term irritation of or repeated damage to the skin by repeated deep-tanning can cause skin cancer. That's the theory. It's never been interesting enough to me to investigate deeply how strongly supported that theory is.

Is parental permission required in the USA?
In Britain, thanks to the notorious Frazer guidelines, our kids can be given the vaccination without parental consent. We won't even be informed.


I will note that this resembles the effort to encourage and popularize circumcision in the early 20th century. I remember reading in a Medical Journal from between the 1890- 1919 period the use of circumcision as a means to reduce the transmission of sexual disease, which is also the same argument used for it today.

As far as I am aware, the vaccination only covers 2-4 types of the virus, which are currently responsible for 70% of cervical cancers. Two worries expressed by health professionals.

1) The "seat-belt effect". People become more complacent about screening; people feel that they are safe to lead more promiscuous life styles. Teens, in particular, are more prone to "risky" behaviour.
2) Selective pressure on other HPV types leads to the evolution of other cancer causing strains.

So it's best to keep parents out of the loop on this one, obviously. Couldn't have us disagreeing with government experts about what's best for our children...

Graham, I'm pretty sure that parental consent requirements vary from state to state. I think Wesley J. Smith had a post on that question before he moved to National Review Online. It shd. still be in the archives, and I'll should try to find it.

Obviously, home schooling helps a lot. None of this business of sending your children off to have whatever done by a bunch of other adults for eight hours five days a week and just hoping maybe you'll be told.

Graham, it appears that the situation you describe is the legal situation in California:


In some other states there is a parental opt-out, but that might only arise if the parents knew it was going on!

Some states, such as Michigan, recommend the shot but don't have it generally required for school children.

Again, parents who don't expect their children to be engaging in sexual behavior _soon_ have no reason whatsoever to have a child vaccinated, because after years have passed a booster will be recommended anyway. Immunity apparently is more or less expected to wear off. It is a sign of the decadence of our society that I can't simply say, "C'mon, people, are you really saying that all parents should just be expecting their 12-year-old daughters to be having sex in the *next few years*?" Because if I say that, I'll get a lot of sanctimonious droning on about how "parents can't control everything" and "parents are always the last to know." In other words, yes, they are saying, we _do_ expect the vast majority of 12-year-old girls to be sexually active within just a few years at most thereafter, and there really isn't much you parents can do about it! And if you think otherwise you are self-deceived.

Some of us prefer to opt out, not just of the vaccine, but of the social system that creates such outrageous and self-fulfilling expectations for our kids.

We might as well just admit that this is all about expected sexual activity in teens

Once you get past the pharmaceutical pseudo-scientific boosterism that suppositions of efficacy rest on, it probably is.

a lot of sanctimonious droning on about how "parents can't control everything" and "parents are always the last to know."

I'll give any school official out there who wants to use that line on me 2-to-1 odds that I CAN have a direct, beneficial impact on the age at which my kids engage in sex, to a later than statistically normal age; and that if they put 20 teens from a wide range of backgrounds in front of me and let me observe them for a week in all situations (something the parents should be able to do) I will pick out roughly the age order in which they first have sex with better than "guesswork" accuracy. Parents who let their kids do half the things they do let them do are "the last to know" either because they simply don't care when their kids start having sex, or because they don't want to know about something that they don't want to have responsibility for fixing (preventing). They don't want to have to say "no".

Once you get past the pharmaceutical pseudo-scientific boosterism that suppositions of efficacy rest on, it probably is.

In my experience, the CDC and even the pharma companies are more honest about this than are Christians who want to pretend to themselves that they don't really think their kids will be having sex but have a good reason for getting the shot anyway. The CDC has reworded its discussion of this somewhat, but I have a record of what their page used to say:

Why is the vaccine recommended for girls 11 to 12 years of age? It is important for girls to get HPV vaccine before they become sexually active. The vaccine is most effective for girls/women who get vaccinated before their first sexual contact. It does not work as well for those who were exposed to the virus before getting the vaccine. However, most women will still benefit from getting the vaccine because they will be protected against other virus types contained in the vaccine.

The comparable paragraph now is:

Why is HPV vaccine recommended at ages 11 or 12 years? For the HPV vaccine to work best, it is very important for preteens to get all 3 doses (shots) long before any sexual activity with another person begins. It is possible to be infected with HPV the very first time they have sexual contact with another person. Also, the vaccine produces higher antibody that fights infection when given at this age compared to older ages.

I'd say the implication that teens are expected to be having sex is pretty clear, there.

What they are less honest about is the need for boosters. Despite Harper's clarity on this, the word "booster" doesn't come up in a search on that CDC page.

It is my understanding that all strains of HPV increase the risk, yet Gardasil only covers a handful of them (that has been established). Therefore, you aren't even doing much to prevent cervical cancer via HPV anyway. It also doesn't help their arguments at a) it only increases the risk, b) most of the strains of HPV cannot be detected in men (no genital warts) and c) HPV can be transferred during child birth. Therefore the correct response is tell your daughter to be chaste and pray.

This is what bothers me- if you are studying any particular virus it may be harmful, it may not, perhaps it's HPV and you are getting a certain amount of money, fame, etc...
If your virus causes cancer, well, you shall get more.
This is not to say that no virus ever causes cancer, rather, what I am saying is that the researchers have a very large incentive to leap to conclusions. They may very well be presenting this idea as fact, and indeed even believe it to be fact, because it is so helpful to them, rather than it actually being a fact.

It sends a message to teens that we expect them to be sexually active; yet, statistically this would not be the norm. This message hardly equips teens to resist pressure to engage in sexual activity.
From what you're saying Lydia, I'm not sure that Christian parents realise how brutal the sexual revolution has been, or how ruthless it can be.


"[We] do have something there rather straight from the horse's mouth: If you vaccinate a pre-pubescent girl, she will not have immunity even in puberty."

Do you trust this particular horse? As far as I can tell, the length of immunity is unknown. Or at least: persists as long as has been studied. So suppose that this horse is not to be trusted and booster shots are really unnecessary. Then your argument that childhood vaccinations can only be justified on the assumption that teens will be sexually active is damaged. It may well be a good idea to vaccinate at 11. Is there any reason to doubt that children generally respond to vaccination more effectively than older people? Cheers.

I hasten to add, of course, that I would want my children protected against cervical cancer should they be so foolish as to have sex as teens. So the existence of another justification for early vaccination is gratuitous for me.

If booster shots are going to be generally recommended later, the point is moot. The medical community is supposed to tell us that we cannot and should not count on immunity's persisting over the long term. In that case, a girl who is going to remain chaste in her teens might as well wait and have the shot (which can have real side effects) only if necessary later. As I have pointed out elsewhere, we would never vaccinate a child for a disease that he would be exposed to only if he engaged in foreign travel on the grounds that he might, ten years later, engage in foreign travel! The greater amount of childhood immune response would not be regarded as a controlling factor. The shot would be regarded as prima facie unnecessary if he were only going to be exposed to the virus if he went abroad. You wouldn't vaccinate your ten-year-old for it because he might join the Peace Corp at age twenty.

My point is that the reason, in fact, that these vaccinations are being recommended for 11-12-year-olds is because *in fact* the people doing the recommending expect the teens to be sexually active shortly thereafter.

If you have strong reason for contrary expectations, and if you know that a booster *is going to be recommended anyway* after some years have passed, you have good reason to wait.

Also, if we're to go by generic information about immune response to other vaccinations (e.g., to argue that childhood immune response is generally higher), we might as well refer to immunizations for tetanus, diptheria, and pertussis, the immune response to which apparently _is_ known to wear off over time. Of course, in those cases, children can be exposed via casual contact, which is why childhood vaccination makes sense. Nobody is recommending vaccinating people for something that they are *expected not* to be exposed to for ten years! Not even on the grounds that they will probably have a stronger immune response _initially_ as a child to the (then-unneeded) vaccination.

The known fact that other immunizations do wear off and require boosters is presumably why Harper and others are so concerned about the question and are recommending booster shots.

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