Tuesday, February 27, 2007

No working outside the home, or the kid gets it!

Via Huckleberries Online, an Idaho House committee killed potential legislation that would regulate daycares in Idaho. This being Idaho, I had guessed that the opposition would have had a "guv'mint outta my business" tone, but it turns out it's just the opposite.
"It's gut-wrenching for me," Rep. Tom Loertscher, R-Iona, said before the 6-5 vote against the bill. "What can we do to keep mom at home?" Loertscher said he "cannot imagine" ever taking a child to a day-care center and said, "There is no substitute, there is absolutely no substitute for families taking care of children." Rep. Steven Thayn, R-Emmett, said, "Being separate from your mother … there's reason to believe this could be harmful."
Got that, moms? Re. Steven Thayn has "reason to believe" that your working outside the home could be "harmful" to your child. Rep. Tom Loertscher is racking his brain as to how to keep Mom at home. And somehow, the best idea that these folks could come up with to push their anti-woman, classist agenda is to threaten the health and safety of Idaho's children. If you didn't want little Billy to be molested by his daycare provider, maybe you shouldn't have stuck with that job at Mcdonald's. If you didn't want your daughter to be hospitalized with food poisoning, maybe you shouldn't have let her eat food prepared by another woman.

Family values my foot.

Monday, February 26, 2007

That's...hot?

This (NSFW-ish) confuses the hell out of me. Homophobia intense enough to create something like that has got to make a person's sex life difficult.

Monday, February 19, 2007

Modern Jackass

I've been going through back episodes of This American Life lately, since I lately realized what a travesty it was that I generally am not in a position to be listening to the radio at 6 on a Saturday Night. One of my favorites I've heard since I've been digging through the archives is the recent episode "A Little Bit of Knowledge." Listen to it if you've got a pile of dishes that needs doing.

In the opening of the show, Ira Glass is recalling a time he and his friends were spouting off on a subject about which they actually knew nothing, and one finally says: "We sound like we're from a magazine. A magazine called Modern Jackass."

Talking about this with Andy, he made an excellent point: that would be a fantastic magazine. I would read Modern Jackass. I like the idea because I really think it's interesting the way people will pull strands of information together in a pinch - it can be really revealing. For instance, I have a coworker who grew up in China, and her spelling amazes/amuses me sometimes. At one point, she was asked to label something "B. anthracis," but she wrote it down as "B. antruas." It made me wonder exactly how articulately I am expressing my words, if that's what she heard. She'd obviously not seen the word enough times to simply remember by rote how it's spelled. It made me think about the way she must have pulled together the pieces of information she had - how people sound when they say "B. anthracis," or how one might go about understanding writing with a phonetic alphabet when you'd grown up writing with symbols.

I'd want the first cover feature to be written by Ted Stevens, explaining how the Internet works. I'd be interested to have Dawn Eden explain in detail her theory of the inner workings of the unchase feminist. I would demand that Jeff Wells of Rigorous Intiution be assigned to the MJ Washington bureau.

So many possibilities...

UPDATE: I'd also like to hear the writers of Heroes exaplain exactly what DNA is, what it does, and what the Human Genome Project is for. It'd be their first assignment on the biotech beat.

It's not a huge feat, but

I'm pretty sure I made this salad up. I realize that all salads - all food, really - are pretty derivative, so there's only so much credit I can take, but I still think it's pretty good. I usually spend Monday nights on my own, and I was determined to ignore my growling stomach long enough to put together a good dinner for myself tonight. I ended up making dijon-tarragon chicken, lemon-garlic fettucini, and this salad. Somehow, I'm not jealous of the Taco Bell my starving husband opted for on his way out the door.


The components of the salad are mixed dark greens, shallot, dates, havarti, and a balsamic vinegar and hazelnut oil dressing. I buy whole pitted dates and slice them along with the shallot. I haven't figured out a graceful way to deal with the havarti - I just somewhat painstakingly cut it into little rectangles, peeling each fragment off of the knife as it sticks there. There's got to be a better way to do it than that, so let me know if you have any ideas. The dressing is just a one-to-one ratio of balsamic vinegar and hazelnut oil with salt and pepper added before mixing.

Sunday, February 18, 2007

What's wrong with hating fat people? They're fat!

Via the feministing.com Weekly Feminist Reader, I came across this defense of fat hatred, written (natch) by the author of a diet book, India Knight. It's written in the faux-gressive why-won't-you-liberals-tolerate-my-wish-to-stone-homosexuals-to-death style favored by bigots who simply can't grasp the meaning of the progressive language they're aping. Let's take a look at this excerpt for details:
It is clear that, by losing some of the weight, the women on our forum have regained some of their self-esteem and, by extension, regained their sense of self - which, like it or not, is for the majority of women tied to appearance as well as achievement. It's all very well bleating about how this is wrong, but actually I don't see that it's wrong at all. Why is it wrong to like what you see in the mirror, or to like your body? Why is it good to be pleased that you look like a pig? I believe unhappily fat women are doing themselves an injury - literally, in health terms, but also emotionally. And I don't think them wanting to stop injuring themselves is weird, or naff, or vain, or self-obsessed. I think it is triumphantly life-affirming. Heroic, too. I see the middle-aged woman on our forum, asking for tips about how to apply eyeliner because she's feeling better about herself, her trousers are looser, and she thought she might investigate the possibilities of make-up, and I cheer for her, just as I cheer for the woman whose husband puts her and her weight down every single day. One of these days, he's going to have to stop. One of these days, she and her new-found confidence aren't going to take it any more.
Emphasis mine. Knight just can't see why we should pretend that fat people aren't inherently disgusting. She's helping people find "confidence" with her diet plan, though coincidentally, the unconfident woman with the disparaging husband won't have to put up with his fat-hatred when she loses weight because at that point, she won't be fat. Somehow, we start out with the notion that a woman should feel comfortable in her own body and not stand for others' insults, but in the end, the only solution Knight can offer is to conform to the expectations of others. No one would tease the fat kid if kids weren't fat to begin with.

This kind of thinking pops out at me because it's the kind of intellectual and moral dishonesty that I engage in from time to time when excusing my own fat hatred - whether I apply it to myself or others. Sometimes, I imagine that if I would just stop obsessing about my weight and my calorie intake and my exercise habits, I'd be happy. And then, I'd be so comfortable with myself that I'd naturally, effortlessly lose weight and be that thin person who doesn't have occasion to worry about being fat anyway. It's a perversion of the self-confidence-building language that I've internalized, even when I'm using the same indefensible standards for judging myself all along.

Instead of showing any awareness of the hypocrisy in this kind of thinking, Knight goeas ahead and does the next best thing: tells her critics they're actually the ones hating on women, not her.
There exists a very bizarre, inverted kind of feminism (invoked by critics of dieting) that isn't about what you can achieve, but what you mustn't achieve. It's about not being things - not making any effort to improve yourself, not celebrating, or even noticing, what you look like and what your body can do. Its adherents write and speak as if being a woman consisted of being under constant siege from the male gaze (yeah, right - maybe one day, eh?), which rather misses the point that many of us dieters aren't particularly thinking about the male gaze. We are thinking about our own gaze, about what we want, and about what it does to our sense of ourselves to want things - weight loss, in this instance - and not to blame or punish ourselves for wanting them.
Get that? It's constructive criticism to compare your sisters to barnyard animals, but it's misogynistic to question narrow definitions of goodness and beauty if women are adhering to them.

The inter-feminist argument from which I believe Knight is drawing her inspiration is that flamewar favorite, the Fun Feminist. At first, I found myself thinking that the lesson Knight hasn't drawn from feminist-on-feminist fighting was that we're all vulnerable to the pressures of a patriarchal, sexist society, and that we all have to make our own compromises. But she's much further behind than that - she objects to questioning patriarchy and sexism in the first place.

Yeah, losing weight has the potential to make people happy, and it's nice to be happy even if you know it's for the wrong reasons. But I can say that dieting makes me an unhappy crazy person. It causes me physical and emotional pain, and if Knight had her way, my only other option would be to go through life being a "pig," "fraudulent," and "miserable." It's perfectly understandable that it's difficult to be happy and fat, but it's immoral to enforce the pressures that make being fat and happy such a challenge, even if doing so has the potential to make a woman happy.

Thursday, February 15, 2007

Correspondence

Dear Joan Walsh,

No one (but Garance Franke-Ruta) believed Salon's story about the Edwards blogger firings because it sounded like a load of crap. Saying, "They were fired - and then immediately rehired. Yeah, that's it!" and including denials from the campaign really isn't very convincing. Even if it were true (and I have no way of actually knowing), it's not really news if the bloggers were only "fired" for a few hours.

Sincerely,
Sara Anderson

But we need a theme...how about misogyny?

Hasn't that been done to death? Apparently not. Check out this gem of an event being hosted by a Florida radio station.

Yes, that's what you read. A "pig roast" being held in "memorial" to recently deceased pinup model Anna Nicole Smith. You might want to email the show's hosts, or the rest of the staff of the station, and let them know exactly what you think of their plans. It's nice to see the thanks a woman can expect for devoting her life and career to pleasing men.

Wednesday, February 14, 2007

Par-tay


Before I head out to work, I thought I'd upload the only decent picture I took from the birthday party last night. Really, it's the most important one anyway.

Tuesday, February 13, 2007

Yes, even nuns have vaginas

Via Andrew Sullivan, I really enjoyed this defense of the Vagina Monologues written by an anonymous nun. An excerpt:
Wouldn’t it be wonderful to present Mary as a model to women who fully experienced the blessing of motherhood? Can we fully accept the fact that Jesus was human in every way that we are, as the book of Hebrews tells us, and that this included the fact that he experienced a birth just like we do? This alone would give women the message that every part of her is sacred, most especially those parts of her body that actively participate in God’s creative plan, because not only were they created by God who proclaimed that everything He made was good, but that God Himself touched them intimately.

Monday, February 12, 2007

Little Drinking Liberally is growing up!

It's been determined that Moscow's Drinking Liberally group has been meeting for a year now, so we've decided to celebrate our birthday. Tomorrow at 8:00 at the Coeur d'Alene Brewery Alehouse in Moscow, we'll eat buffalo left-wings and chocolate cupcakes, and if we can get the bartender to play along, be downing a Moscow Mule or two (Get it? We live in Moscow, a mule is pretty close to a donkey which is the Democrats' mascot, and to top it all off, UI scientists were the first to ever clone an equine - the famous racing mule, Idaho Gem! Perfect, eh?) . Any Moscow-area readers ought to come down and introduce themselves to the gang if they haven't already.

You can email moscow(at)drinkingliberally.org for more info, but all you really need to do is drop by and say hello.

Thursday, February 08, 2007

"Women" vs. Women

I've seen this kind of legislation proposed before, and I can see how it's both good- and bad-intentioned, but mostly it makes me roll my eyes.
Rep. Bob Nonini, R-Coeur d’Alene, persuaded the committee to introduce his bill to outlaw the use of threats or physical force to dissuade a pregnant woman from giving birth. The measure also prohibits threatening to do “anything that the person does not have the legal right to do against the pregnant woman.” That could include employers threatening to withhold a job or promotion or “a school counselor maybe describing to a young person that by having this baby you have no future, those kinds of acts,” Nonini told the panel, Howell reported. Under the measure, it does not matter if the woman has the abortion.
Emphasis mine. So with the passage of this bill, you won't be able to do illegal things. Crazy! Of course, there doesn't seem to be any discernment between advising - or even suggesting - to abort and coercing to abort, so what we have brewing here is yet another adventure in costing Idaho taxpayers money for the sake of unconstitutional anti-abortion bills.

Thinking about it, I wonder how this kind of legislation would interact with parental consent laws - another issue on which Idaho politicians aren't concerned with abiding by the Constitution. If this bill were written with actual freedom of choice in mind - where it would be a crime to forcibly keep a woman from aborting a pregnancy as well as when forcing her to abort - I think it might work nicely in tandem with parental consent legislation.

But that's not what this is about. This is the same women-can't-make-decisions claptrap that the Feminists for Life keep trying to sell, which conveniently wastes the time of pregnant women interested in abortion - who are working to a deadline, after all.

The FFL come from a (demonstrably untrue) perspective where women are unable to consent to abortion. It's an essentially misogynistic perspective, that completely sidesteps the concern that the FFL says they have at their core - female experience of pregnancy, motherhood and abortion. What compounds the anti-woman effect is the way it deprioritizes actual women's voices in favor of the voices that enforce patriarchy. This same mechanism works to trivialize and excuse rape; if women can't be trusted to make their own decisions about their bodies in cases of pregnancy, why should they have any more authority in the area of sexual activity? How can we pin down their actual consent to sexual activity outside of marriage? How can she withhold consent within marriage?

How can we believe women at all?

UPDATE: It was pointed out to me that I sound like I'm saying Nonini and the FFL are unconcerned with rape. I don't believe that. I do believe that this is an example of lazy, deterministic thinking (in which feminists have also indulged from time to time) that uses a predetermined moral order to ascertain what people want and how people feel, instead of actually asking them. It's a sin to abort, it's a sin to have sex outside of marriage, and it's a sin to disobey your husband; therefore any good woman cannot choose abortion, cannot consent to sex outside of marriage, and will not refuse her husband's sexual advances. It's a convenient way to cram the square peg of reality into the round hole of ideology, but it's intellectually dishonest and when wielded by legislators, dangerous.

Wednesday, February 07, 2007

This goes on your permanent record, young lady

Commenter howard at TAPPED makes a really good point about the criticism of Edwards' hiring of Marcotte and McEwan:
meanwhile, the notion that bloggers don't belong in campaigns is quite ludicrous. there are loads of people with strongly held opinions who either were candidates themselves (did any of the various stupid things ronald reagan wrote or uttered in radio broadcasts keep him from being elected first governor and then president) or policymakers (greg mankiw basically disowned his own frickin' economics textbook when he worked for bush) or spokespeople (let's take a look at tony snow's history in print, shall we?).
In case you hadn't heard, Tony Snow, Whitehouse Press Secretary, is an actual, factual freeper. He's called a few names and disagreed with his boss in his day - why should he get away with it?

And Ezra is right to ask: what kind of precedent is this setting?

Bewildering

If this is true, I'm going to be very disappointed. If Edwards will bow to this kind of nontroversy, he can count on the loss of netroots and feminist support immediately - and look like a kowtowing wimp to everyone else. He does not need to court the conservative martyr complex crowd, and he needs even less to drag two prominent bloggers through the mud to do it.

Tuesday, February 06, 2007

That's more like it

Washington State is offering the HPV vaccine to girls for free. In the article, Gov. Christine Gregoire says:

Addressing the Washington State Medical Association's annual legislative assembly and again in a news conference Monday, Gov. Chris Gregoire said such action [requiring the HPV vaccine for entry into school] seemed premature.

"I told the medical association that I was reticent to dictate when I think there is a lot of public education that needs to go on," Gregoire said. "To go out and start just saying everybody mandatorily has to have this is a little bit troublesome for me.

If I were Merck, I'd be scrambling to get the takers to participate in a study on the long-term effects of the vaccine. If, in 2 or 5 or 10 years the country decides to buy into requiring the HPV vaccine, Merck will still stand to make a mint. If they really believe in Gardasil's potential, they can wait.

You know what might be a better superpower for Nathan Petrelli to have?

The ability to keep it in his pants. What's wrong with that guy?

Monday, February 05, 2007

Leaning in a new direction

In case it wasn't obvious in the last posts I've written about it, my first reaction to the news that the HPV vaccine is going on a roster of required vaccinations for school in Texas was, "Heck yes!" Cervical cancer kills, genital warts are a drag, and yearly pap smears are no party either. I'm not a doctor or a public health expert, but the information about Gardasil's efficacy and safety make it look like a pretty good bet for eradicating most cases of cervical cancer.

Still, I've come to the conclusion that I don't think it's wise to require vaccination against HPV in schoolchildren at this point. Loquacious commenter stickdog - who has an axe to grind, but I was wrong to call a troll - has given every possible reason to oppose widespread HPV vaccination, and while I'm not buying all of it, my change in position has definitely been guided by the info stickdog has brought.

I really, really want Gardasil to work, and nothing that I've learned about its approval process has set off alarm bells in my head. But the fact remains that there isn't a huge body of evidence supporting Gardasil's long-term efficacy and safety, and the health problems associated with HPV don't seem pressing enough that we ought to embrace Gardasil so enthusiastically. The current system of keeping a close watch on American cervices has failed many, but in my view, not so many that we couldn't take our time in evaluating Gardasil. Think of it this way: if we're going to be instituting a large and expensive public health program aimed at preventing cervical cancer, we might as well devote the money to access to the medical care that already works pretty well (say, refunding this program) as we wait to get a better picture of what Gardasil has the capacity to do.

I predict that Gardasil will be a valuable tool in eradicating cervical cancer in America. On the other hand, responsibly prioritizing public health spending means that if we're going to make an investment in a new tactic, we ought to be as sure that it will work as we can afford to be. If Gardasil is used on a country-wide scale and it flops, we'll be stuck with not only a huge bill and an unimproved HPV rate, but we'll have also spent money that could have been used to address other public health concerns. Considering the relatively low urgency of the problem that HPV presents for Americans overall, I think it would be smarter to wait for more information to roll in as people voluntarily vaccinate.

Sunday, February 04, 2007

I told you so

Idaho, was this what you wanted to happen with your hate amendment? Because this is what we get:

Public universities and governments can't provide health insurance to the partners of gay employees without violating the state constitution, the Michigan Court of Appeals ruled Friday.

A three-judge panel said a 2004 voter-approved ban on gay marriage also applies to same-sex domestic partner benefits.

So - forget attracting the professors who have same-sex or unmarried partners. We'd like to be a homo-hating, domestic violence-excusing backwater, thanks.

(Via Andrew Sullivan.)

Questioning Gardasil

Maia at Alas, A Blog, as well as brownfemipower at Woman of Color Blog, are voicing some concerns about the idea of requiring the new HPV vaccine Gardasil for entry into public school, and as someone with a little training and knowledge in biology and public health, I thought I might weigh in with a few ideas.

Consider this from Maia's post:
As I understand it the only way a vaccine can be available to all, and publicly funded in America is if it is compulsory before a child can attend school (there are exemptions available to parents for conscience reasons). I can understand the public health argument which says that a kid must be immunised from certain infectious diseases before they start school (I don’t necessarily agree with it, but I understand it), disease can travel very quickly among unorganised children at school and this can cause an epidemic. But this logic does not apply to the HPV vaccine, HPV is a lot harder to contract than measles, so it isn’t going to spread round a school in the same way (it is clear that the vaccine is as important for later in life as it is for 6th grade, unlike other vaccines) and any genuine worry about the disease spreading would require both boys and girls to be immunised. There appears to be two reasons to support compulsory vaccination, either because your in the pay of the drug company, or you believe that it’s important that poor women get access to the vaccine (or both). Neither of these are based on genuine health concerns.
There are a couple of reasons to vaccinate children against HPV before they enter school. It's a good way to reach most children, and as they're entering school, they're young enough and have been isolated enough that it's not likely they've been exposed to the diseases they're going to be immunized against. Maia's right that going to school isn't what exposes a kid to HPV, but most kids go to junior high, and most kids haven't been exposed to HPV as they're entering junior high. We don't know whether Gardasil will confer lifetime immunity, but from what we know now, it is likely to have a protective effect on a woman through the time in her life when she is most likely to have multple partners.

Maia is also right that if we're going to try for herd immunity against the strains of HPV against which Gardasil protects, the most effective way to do it would be to vaccinate everyone - but there's also the consideration of cost, too. You can see my post I wrote about it earlier for details, but last month there was a study released that looked at the costs versus benefits of different vaccination strategies with Gardasil, and it was in fact vaccinating only girls that had the best cost-to-benefit ratio. It wasn't perfect, but they did predict a 78% reduction in HPV transmission, at a fraction of the cost of vaccinating people of all genders.

An example from the field I work in - animal health - would be vaccination against Brucella abortus in cattle. B. abortus is a bacterium that causes abortion in cattle (and is also transmissible to humans; Florence Nightengale is thought by some to have suffered from Brucellosis, aka "undulant fever," during her last decades as an invalid), and is transmitted through fluids such as milk or semen. Female calves are the only ones vaccinated against Brucella, and through this regimen all but two states in the US are considered Brucellosis-free by the USDA. One, Texas, is a state that imports many animals from countries that have different animal health requirements. The other, Idaho, borders on Yellowstone park, whose bison populations carry Brucella.

brownfemipower wonders why we're simply accepting the idea that HPV causes cervical cancer, and I think the answer is pretty simple: we have good data backing up the assertion, as well as a good idea of how it could be true. If HPV is a virus that can direct your body's cells to divide uncontrollably but benignly as genital warts, it's not a difficult leap to the idea that other strains could cause your body's cells to multiply uncontrollably and malignantly, as is cancer's m.o. She says that she suspects her use of Depo-Provera as contributing to her own cervical cancer, but I don't think that Depo-Provera in itself could reasonably be suspected to cause cervical cancer. There are higher incidences of cervical cancer in users of Depo - and of oral c0ntraceptives - but it's widely suspected that this statistical finding reflects the fact that people already using one type of contraception are less likely to use condoms. If you're still having sex but you're not using condoms, you're still at risk to contract std's.

In the comments to my post about vaccination strategies, I attracted some sort of push-spammer (who came by after looking up Gardasil on Technorati) who left me a nice, organized, bulleted list about the "dangers" of Gardasil that actually left me feeling a little more secure about Gardasil to begin with. I imagine that "stickdog" has been spreading this list all over the blogosphere, so I'll go ahead and address the points one by one, just to have it on the record.
1. GARDASIL is a vaccine for 4 strains of the human papillomavirus (HPV), two strains that are strongly associated (and probably cause) genital warts and two strains that are typically associated (and may cause) cervical cancer. About 90% of people with genital warts show exposure to one of the two HPV strains strongly suspected to cause genital warts. About 70% of women with cervical cancer show exposure to one of the other two HPV strains that the vaccine is designed to confer resistance to.

Well, great. Gardasil is targeted towards the most virulent strains of HPV, the ones most likely to cause cervical cancer and genital warts.
2. HPV is a sexually communicable (not an infectious) virus. When you consider all strains of HPV, over 70% of sexually active males and females have been exposed. A condom helps a lot (70% less likely to get it), but has not been shown to stop transmission in all cases (only one study of 82 college girls who self-reported about condom use has been done). For the vast majority of women, exposure to HPV strains (even the four "bad ones" protected for in GARDASIL) results in no known health complications of any kind.
So far, so good.
3. Cervical cancer is not a deadly nor prevalent cancer in the US or any other first world nation. Cervical cancer rates have declined sharply over the last 30 years and are still declining. Cervical cancer accounts for less than 1% of of all female cancer cases and deaths in the US. Cervical cancer is typically very treatable and the prognosis for a healthy outcome is good. The typical exceptions to this case are old women, women who are already unhealthy and women who don't get pap smears until after the cancer has existed for many years.
Here's where things veer off course. It is true that cervical cancer deaths have declined sharply due to widespread detection of precancerous lesions through pap smears, but cervical cancer is still the second-most common cancer amongst women. Cervical cancer is treatable, though treatment can be drastic, with removal of the cervix and/or uterus, and I don't see any reason to worry less about "old women, women who are already unhealthy and women who don't get pap smears."

4. Merck's clinical studies for GARDASIL were problematic in several ways. Only 20,541 women were used (half got the "placebo") and their health was followed up for only four years at maximum and typically 1-3 years only. More critically, only 1,121 of these subjects were less than 16. The younger subjects were only followed up for a maximum of 18 months. Furthermore, less than 10% of these subjects received true placebo injections. The others were given injections containing an aluminum salt adjuvant (vaccine enhancer) that is also a component of GARDASIL. This is scientifically preposterous, especially when you consider that similar alum adjuvants are suspected to be responsible for Gulf War disease and other possible vaccination related complications.

No, not really. It is difficult to do drug testing involving children, so I don't think that the small proportion of young people involved is very unusual, nor do I think that using a component of Gardasil that is not the active ingredient is a poor control. Test controls need to be selected such that they isolate variables, and removing only the components that confer immunity seems to me the ideal control to use in the test.

5. Both the "placebo" groups and the vaccination groups reported a myriad of short term and medium term health problems over the course of their evaluations. The majority of both groups reported minor health complications near the injection site or near the time of the injection. Among the vaccination group, reports of such complications were slightly higher. The small sample that was given a real placebo reported far fewer complications -- as in less than half. Furthermore, most if not all longer term complications were written off as not being potentially vaccine caused for all subjects.

Okay - so what? Injection-site irritation or infection are very minor complications and were apparently distributed across the control and test subjects.
6. Because the pool of test subjects was so small and the rates of cervical cancer are so low, NOT A SINGLE CONTROL SUBJECT ACTUALLY CONTRACTED CERVICAL CANCER IN ANY WAY, SHAPE OR FORM -- MUCH LESS DIED OF IT. Instead, this vaccine's supposed efficacy is based on the fact that the vaccinated group ended up with far fewer cases (5 vs. about 200) of genital warts and "precancerous lesions" (dysplasias) than the alum injected "control" subjects.
Is this capitalized because it's good news? Cervical cancer is a very preventable disease, and we're seeing exactly how that's true with the point above. It would have been extremely unethical for doctors to have allowed any precancerous lesions to have progressed to cancer or even death, no matter how much more convincing the data would have been for stickdog. The fact is that cervical cancer is not satisfactorily prevented by the CDC recommending that all women have yearly pap smears. Some can't afford to go; some don't want to go, some precancerous lesions fall through the cracks. Women are still dying of cervical cancer, with women of color and poor women represented disproportionately amongst the dead. If Gardasil stands to have a better effect than what we've been able to manage with our flawed health care system and pap surveillance, let's go with Gardasil.
7. Because the tests included just four years of follow up at most, the long term effects and efficacy of this vaccine are completely unknown for anyone. All but the shortest term effects are completely unknown for little girls. Considering the tiny size of youngster study, the data about the shortest terms side effects for girls are also dubious.
As a highly skeptical reading of the data, this is fair enough, though it can be said for any number of drugs that are approved in the US. Vaccines do have the advantage of being small doses that aren't taken every day or every week, so they avoid some of the potential problems that are present with drugs that are used continuously.
8. GARDASIL is the most expensive vaccine ever marketed. It requires three vaccinations at $120 a pop for a total price tag of $360. It is expected to be Merck's biggest cash cow of this and the next decade.
Pap smears are also expensive, and need to be undertaken every year. Additionally, they do not have the advantage of taking possible disease vectors out of the game. I have medical insurance and have been able to have yearly pap smears since I became sexually active. Once, a smear came back with bad results, and while things worked out okay for me, there's really no telling who might have contracted HPV from me, and maybe given it to someone who wasn't insured and doesn't have the opportunity to get yearly pap smears. If I'd been vaccinated against HPV, I would be just as safe, but so would my past sexual partners, and my partners' partners.

Furthermore, the sad fact is that large drug companies deal only in cash cows, and that drug manufacturing is a business that demands profit. It's entirely possible that there are cheaper ways of preventing the spread of HPV, but Gardasil has the advantage of being available right now.

Skepticism is healthy, and I'm sympathetic to Maia and bfp's perspectives. Both of them must know a lot more about racism in medicine and race and gender issues when it comes to reproductive rights than they do about how vaccines work and public health practices. That's fine - we can't specialize in everything. My training in science and inexperience with race and class issues probably make me a little Polyannaish about these issues. Luckily, each of our perspectives can inform the others', and we can thank the blogosphere for facilitating that.

Thoughts?

Saturday, February 03, 2007

Just so you know

Pan's Labyrinth is not an appropriate movie for kids. Don't be confused, like I was. It's gory and scary and I'm sure it takes a few years' reading practice to keep up with movies that have subtitles.

It's also really good and I'm not sorry I drove an hour and a half in a snow storm to see it.

Friday, February 02, 2007

Coincidence?

In the same week, three large North American meat producers have announced the phasing out of animal-raising practices that have long drawn criticism from animal rights advocates. Smithfield Farms and Maple Leaf Foods, Inc. have both announced that they will no longer use "sow gestation" stalls in their pork production facilities, and Marcho Farms has announced that it will stop the pratice of tethering veal calves.

I don't have the time to investigate now, but I wonder - what's going on here? I don't think it makes me hugely cynical to raise an eyebrow when industry leaders make a seemingly spontaneous flip-flop on controversial policies.

Thursday, February 01, 2007

Herd Immunity

I saw this conversation at feministing about the CDC's recommendation to add the HPV vaccine Gardasil to the regimen of immunizations required for children enterting public schools, and it turned out to be part of a happy coincidence. It just so happens that a lot of the questions being asked in the thread were addressed in a study in a copy of Emerging Infectious Diseases that I picked up today. (The happiest part of the coincidence? It gives me a chance to brag. The cover paper in the issue is something to which I actually contributed a minor amount of elbow grease. It's like I'm a real scientist, kind of!)

The paper, entitled Model for Assessing Human Papillomavirus Vaccination Strategies, by Elbasha et al, took a statistical look at the possible costs and benefits of different HPV vaccination strategies. The cheif concern is preventing HPV-associated cervical cancer, though check out this first sentence:
Human papillomavirus (HPV) causes cervical intraepithelial neoplasia (CIN); cervical, anal, penile, vaginal, vulvar, and head/neck cancers; anogenital warts; and recurrent respiratory papillomatoses, resulting in disease and death in both women and men (1).
So, worry not wingnuts: we're not just trying to save women's lives here.

Feministing commenters wondered why boys and men aren't recommended to be vaccinated. See the paper's abstract:
We present a transmission dynamic model that can assess the epidemiologic consequences and cost-effectiveness of alternative strategies of administering a prophylactic quadrivalent (types 6/11/16/18) human papillomavirus (HPV) vaccine in a setting of organized cervical cancer screening in the United States. Compared with current practice, vaccinating girls before the age of 12 years would reduce the incidence of genital warts (83%) and cervical cancer (78%) due to HPV 6/11/16/18. The incremental cost-effectiveness ratio (ICER) of augmenting this strategy with a temporary catch-up program for 12- to 24-year-olds was US $4,666 per quality-adjusted life year (QALY) gained. Relative to other commonly accepted healthcare programs, vaccinating girls and women appears cost-effective. Including men and boys in the program was the most effective strategy, reducing the incidence of genital warts, cervical intraepithelial neoplasia, and cervical cancer by 97%, 91%, and 91%, respectively. The ICER of this strategy was $45,056 per QALY.
By their metrics, every quality-adjusted year added to each American's life by ppting for the strategy of vaccinating both males and females would cost almost ten times as much as the less-effective-against-disease strategy of vaccinating girls 12 and under with a "catch-up" program for females up to the age of 24. This only augments the case that Ann lays out in her TAPPED piece about the opportunity for public health that Gardasil presents; there's much to be gained, but there's also much to be spent. Elbasha et. al. use the amount of $360 per vaccination regimen in their calculations, an amount that would be difficult to come up with on a less-than-living wage job. With excessive pork-barrel spending adding up by the second in Washington, public health officials would be irresponsible not to take the relative bargain in the female-only vaccination strategy.

A 78% reduction in cases of cervical cancer would mean 2886 fewer deaths in the United States per year (according to these stats).

UPDATE: More conversation about Gardasil inspired me to write another post about other issues people are debating. See it here.