Showing posts with label cervical cancer vaccine. Show all posts
Showing posts with label cervical cancer vaccine. Show all posts

Monday, February 16, 2015

Journalism wanted: how did the Toronto Star's HPV vaccine story end up being sensationalistic?

I recently wrote a blog post complaining about a Toronto Star article about HPV vaccination that presented the story very sensationalistically and failed to include necessary context.

This week's public editor column agrees with that assessment.  Public editor Kathy English says:
In looking at all of this, I have to wonder why the Star published this at all — especially at this sensitive time in public health. If there is no proof that any of the young women’s illnesses, or the 60 adverse reactions in the database, were caused by the vaccine, then what is the story?
In that same column, she says:
To be fair, in the Gardasil investigation, reporters David Bruser and Jesse McLean absolutely do not conclude or state that the vaccine caused any of the suspected side effects the young women talk about. The article was written carefully to try to impart to readers the message that there was no conclusive evidence.
Also, on CBC radio program As It Happens, Toronto Star publisher John Cruikshank said:
"We failed in this case. We let down. And it was in the management of the story at the top."
What I want to know: how did the front page layout and presentation and tone of the story turn out sensationalist if the public editor and the publisher both think this is inappropriate and it's not consistent with the reporters' stated intentions?

I know the writers don't write the headlines and aren't necessarily involved in layout, and I know that senior editors might not necessarily vet every single page layout in the whole newspaper every single day.  But you'd think they'd approve the front page!  You'd think they'd edit an article extra-carefully if it's going to be the first thing people see, and you'd think they'd look at the big, front-page, above-the-fold headline and make sure it reflects the writers' intended thesis.

It would be informative to readers to write a story about how this sort of thing comes about.

Thursday, February 05, 2015

Horrid journalism from the Toronto Star

The Toronto Star wrote very sensationalist front-page story about people who report having various illnesses after receiving a cervical cancer vaccination. 

As they mention in the subheadline (with some weird conjuction use), they found 60 people who reported illnesses, out of hundreds of thousands who have received the vaccine

The problem: they don't mention the statistics of these kinds of illnesses occurring in similar populations who have not recently be vaccinated.  We're talking tens of times among a sample size of hundreds of thousands, which is hundredths of a percent. It is certainly plausible that the number of illnesses reported are consistent with what would happen ordinarily in the general population. 

Back when I did my research before getting Gardasil, my research found just that: the number of reported conditions in the sample group was consistent with the number in the general population.  That could certainly be the case here.  But the Star doesn't provide the numbers!

If the number of illnesses found in this investigation is significantly higher than what would have occurred in the control group, then that is important information that supports the Star's thesis and they should include it.

But if it is not, then this is an irresponsible piece of journalism.

By failing to include these numbers, they've made the article non-credible in the eyes of the most-informed audience who will read it critically, while sensationalistically creating paranoia among the least-informed audience who will only skim the headlines.

The article ends with one of the interviewees saying “I am not against the vaccine, I want people to be responsible about Gardasil. I am trying to inform people.”

In order to inform people so that they can make responsible decisions about Gardasil, you need to include control group numbers!

Monday, October 22, 2012

Things They Should Invent: everyone who has ever been entitled to free cervical cancer vaccine is entitled to free cervical cancer vaccine

Fact: The cervical cancer vaccine is offered for free through school clinics in early adolescence.  (In Ontario, for example, it's offered for free to girls in Grade 8.)

Fact: Because of the students' age and the fact that it's offered through the school, parents can veto it, and many do.

Fact: The cervical cancer vaccine is expensive.  It cost me about $400 to get it 5 years ago.  And, in Ontario at least, it isn't covered by OHIP except for the school clinics for Grade 8 students.

Fact: The cervical cancer vaccine is not useful if you already have HPV.  People are generally considered to have been exposed to HPV if they are sexually active and are not certain are that every single one of their partners was HPV-free.

Fact: Many people become sexually active long before they're able to scrape together $400 to spend on a vaccine.

Problem: This means that people whose parents don't allow them to get the vaccine as adolescents may never be able to get the vaccine, because currently your only chance at a free vaccine is when you're in Grade 8.

Proposed solution: Anyone who was eligible for the free vaccine in Grade 8 (or whenever it's done in their jurisdiction) but doesn't get the vaccine at that point can get the vaccine for free from any health care provider (doctor, walk-in clinic, Student Health, Planned Parenthood) at any point in the future as long as it is not medically contraindicated.  You go in to get your first birth control pills, they also offer you Gardasil.

This won't cost any more to OHIP than they've already stated they're willing to pay (one vaccine per girl who has been in Grade 8 since the program started), and it will achieve the public health objectives far more effectively than leaving people whose parents were overprotective when they were 13 with the choice of delaying their entire sex life until they can scrape together more than a week's take-home pay at minimum wage or foregoing the chance to ever be immunized against the cancer-causing strains of HPV.  Eligibility would be easy enough to verify - it's a function of the patient's age and gender.  And normal medical channels could administer the vaccinations when the patients are willing but their parents are not, because medical professionals don't require parental consent to attend to minor patients' sexual health concerns.

This isn't intended to contradict my usual position that OHIP should pay for all health care that everyone needs at all ever.  However, it would serve as an effective interim measure that would better achieve the stated public health objectives without costing any more than OHIP has already stated they're willing to pay. Multi-win, no-lose situation.

Thursday, June 26, 2008

Cunt.

So Catholic bishops in Alberta are opposed to the cervical cancer vaccine because they think it will encourage girls to have casual sex.

You know, I got Gardasil last year - got my last shot in the fall - and now every time someone propositions me, I don't give a moment's thought to a single thing except pregnancy, HIV/AIDS, gonnohrea, syphillis, chlamydia, herpes, crabs, yeast infections, urinary tract infections, heartache, emotional drama, the durability of friendship, the possibility of unintentional adultery, penises that are too small, penises that are too big, inopportune latex allergies, recent advances in candid digital photography, the effect of readily-available pornography on certain individuals' sexual expectations, and my own personal sexual preferences!

Thursday, April 24, 2008

Why HPV vaccine is important

This article misses the point.

The thing about HPV, the thing that makes it different from all other STDs, is that a) you can't test for it when it's dormant, b) it can be spread while dormant, so you can carry and spread it without having ever experienced any symptoms, c) it can spread from skin-to-skin contact outside the areas covered by condoms, and d) it may or may not go away by itself, after a period of time that varies from person to person and in a process that medical science does not understand or know how to expedite.

So basically, unless you know the complete sexual history of every single person who has sex with every single person who has sex with every single person...[ad infinitum]...who has had sex with you, you have no way of knowing whether or not you've been exposed or whether or not you carry it.

AIDS you can test for. Herpes you can see if you've got an outbreak or not. But HPV you can't always tell. It's the biggest hole in our safety net. Oh yeah, and it causes cancer too. So something that will sew up I think it's 70% of this hole is significant.

Macleans magazine revved up the tone with a front-page story referring to our young girls as guinea pigs involved in a huge vaccination experiment to prevent a virus that a) most women are exposed to; and b) is easily cleared from a woman's system. Is this virus a problem? It's hard to say, but we know that the pap smear currently detects the early signs of cervical cancer so it's not clear how this vaccine would do much more.


Translation: "You're going to get it anyway, but it will probably go away by itself so don't worry your pretty little head about it. Besides, if you get a bunch of foreign objects stuck up your cunt on a regular basis, they'll probably be able to catch any cancer it causes before it kills you."

I dunno, personally I think not getting any STDs at all ever and not having to get my cervix scraped with a pointed stick every year are valid goals in and of themselves.

Thursday, August 23, 2007

Just because it's statistically improbable doesn't make it trivial

I have a kind of personal confession to make. There's something in my sexual history that's apparently rather unusual. Some of you may have guessed this by now - I have alluded to before - but I've never stated it outright until now because I do prefer to be rather circumspect about my private life. But to make the point I want to make today, I'm going to have to just come out and say it bluntly:

I am 26 years old. I am not a virgin. I have never been married. And I have never, not once in my life, had an STD or even an STD scare.

I know, I didn't think it was that wild either. But apparently this is highly statistically unlikely, and epidemiology doesn't think or doesn't care that I exist.

That's why articles like this piss me off. So much of the discourse surrounding the HPV vaccine focuses on who is statistically likely to have had HPV, to the extent of ignoring people who haven't had it despite their demographics, and even being dismissive of the desire to avoid it even if you are statistically likely to have had it.

"The vast majority of those who have had skin-to-skin contact in a sexual experience, heterosexual, lesbians, whatever, have already had it, cleared it and gone on with their lives," says Abby Lippman, an epidemiologist at McGill University and chair of the Canadian Women's Health Network.


So maybe they have had it, treated it, and gotten on with their lives. Maybe it really isn't a big deal and can in fact be spoken of so dismissively. But I wouldn't know because I haven't had it, and I'd like very much to stay that way. The fact that the majority of people in my demographic group have had it doesn't mean that I should have to accept it as inevitable. Just because everyone in the office has a cold doesn't mean that I shouldn't keep washing my hands. Just because my fertility is statistically likely to have peaked doesn't mean that I shouldn't keep abreast of new developments in birth control. And just because I'm statistically likely to have had HPV doesn't mean that my desire to avoid it is trivial.

One of my standards for safe sex is that all parties must have full STD testing before any sex occurs. Thing is, HPV is the big hole in this line of defence. HPV doesn't show up in a blood test. The only way to tell if you have it is if you have genital warts. However, people can carry it and even transmit it without showing any symptoms whatsoever. So it's quite possible to do everything right, get every test humanly possible, and still not know that you're carrying HPV. But by making me immune to HPV, Gardasil fills the vast majority of that hole in my defences. For me, this is huge! It might not be statistically significant in the world as a whole, but to me it represents probably the most major breakthrough possible in terms of my sexual health.

So please, stop trivializing it, and stop trying to change policy to make it harder for us to get the vaccine. For those of us who've never had it, it is a major thing.

Thursday, April 19, 2007

Cervical cancer vaccine acquired (at age 26)

Despite the fact that I'm too old, my doctor has consented to administer the HPV vaccine!

I was in her office for a scheduled appointment for another matter when I asked her whether there was any possibility of giving me the vaccine. She said we'd need to schedule another appointment to discuss my risk factors, so I did so. That appointment was today. She asked me about whether I've had abnormal pap smears and about my sexual history, and in light of the information acquired there said that she could allow me to have it. Then she brought up the fact that my future risk of acquiring HPV is low, so is the vaccine really necessary. I asked what specific risks there were to taking this vaccine, and she said that there were none that they know of (apart from the usual potential for your body reacting to the vaccine) but long-term effects are still unknown. She didn't have anything specific to warn me about and didn't seem to be trying to dissuade me, she just seemed to be making sure I had all the information. It felt like she was leaving the decision up to me.

So I decided to do it, she gave me the prescription, and I will be getting my first shot in early May.

I'm not going into detail about my personal risk factors, because I don't know how different risk factors would affect one's chances of getting the vaccine. That's really something to talk to your doctor about.

So how do you get in to talk to your doctor? (If you haven't been following my saga, that was the first problem - I'd been trying since last August but couldn't get past the receptionist because she'd never heard of it.) If you're having the same problems as me, don't ask the receptionist about the HPV vaccine or Gardasil or the cervical cancer vaccine, just get into the doctor's examining room by whatever means necessary, and then ask the doctor there. I know it's considered necessary to tell the receptionist why you need the appointment, but if that doesn't work the receptionist's attitude isn't necessarily the same as the doctor's. I was just completely unprepared for the receptionist not knowing what I was talking about and then limiting her actions based on her own knowledge.