Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts

Friday, October 16, 2009

Gardasil and What You Should Know



The controversial HPV vaccine distributed by the drug manufacturer Merck, is receiving a lot of negative publicity lately. The controversy actually began back in 2007 when the republican governor of Texas, Rick Perry, mandated that little girls receive the vaccine prior to starting the sixth grade. Governor Perry made the executive decision to require Gardasil to be a mandatory vaccine without allowing it to go to a vote before the Texas legislature. Perry’s former chief of staff was a lobbyist for Merck. Perry also had no qualms about accepting $6000 from Merck for his re-election campaign. The mandate had since been overturned by the Texas Legislature once the financial conflicts were discovered.

HPV is a sexually transmitted disease that is linked to cervical cancer. Many parents had issues with this vaccine being forced on their daughters. Texas law does allow for religious or philosophical objection but like many other states, there is no exemption for using good judgment in making important medical decisions for your children.

Here in the United States we trust that the FDA is looking out for us and for our children. That is not always the case. Dangerous side effects can be minimized for the sake of getting a new drug on the market and putting money in share holder’s pockets. The only thing standing between the pharmaceutical companies and us is FDA approval.

The best example of the FDA doing their job would be former FDA inspector Dr. Francis Kelsey. Germany introduced thalidomide in 1957 as a sleep aid. The manufacturer claimed that it was safe for pregnant women. It even helped with morning sickness; hence the thousands of women that took it in the first trimester of pregnancy while the baby’s limbs were forming. Thalidomide babies are distinguished by a condition called phocomelia. Phocomelia is a congenital malformation with shortening of the long bones of the arms and legs with seal-like flippers. Thousands of children were born with major birth defects because of a combination of inadequate testing, premature approval and greed.

Thalidomide was available over-the-counter in Germany and by the early 1960’s it was available all over Europe, Canada and many other countries. One month after starting her job with the FDA in 1960, Dr. Kelsey was assigned the request for approval to market Thalidomide in the US. Dr. Kelsey had serious concerns about the shortcomings of the studies submitted and refused to grant approval. The pharmaceutical manufacturer and supervisors at the FDA pressured her yet she refused to give in. At the time FDA approval was considered to be a given and Dr. Kelsey single-handedly prevented the tragedy of thalidomide in this country.

By 1962 the horror of thalidomide was known to the world. Dr. Kelsey was recognized by President John F. Kennedy. She was a recipient of the highest civilian award possible, the medal for Distinguished Federal Civilian Service. Dr. Kelsey retired in 2005. Unfortunately there currently is no one at the FDA that has the same ethical or scientific standards that she had. Merck easily gained approval for a vaccine that we know little about.

The FDA allows “fast tracking” of certain drugs that are considered important to human health. Gardasil was allowed through the system this way. This process allowed Gardasil to be available to the public within six months of development. This rush to market happened to coincide with a very heavy push from pharmaceutical giant Merck. Next on the agenda for Merck was to get their new “cash cow” mandated for young girls. Once a vaccine is on the list of required childhood immunizations, the government is responsible for providing it to low-income households. This is a windfall for a drug company, particularly one like Merck that had suffered financially after a previous fiasco with a fast-tracked drug failure. Vioxx was removed from the market after being linked with an increased risk of heart attack and stroke. Merck has had to defend hundreds of lawsuits, including multiple class actions since Vioxx was recalled in 2004.

Gardasil is the most expensive vaccine ever given approval by the FDA.

No one is going to argue that cervical cancer is not a serious concern but there are some facts that you need to know before opting to expose your daughters to Gardasil. Most importantly, Gardasil is not a cervical cancer vaccine. It is a vaccine for a sexually transmitted disease, human papillomavirus.

HPV is an extremely common sexually transmitted disease. It has been reported that almost 80% of people between the ages of fifteen and forty-nine have been infected with HPV. There are over one hundred strains of HPV, with at least fifteen that have the potential to cause cervical cancer. Gardasil will protect against just four strains of HPV. Of those four, two can cause cervical cancer and two may cause genital warts. To be fair, the two strains in the vaccine for cervical cancer are the two that cause seventy percent of cervical cancers.

No one knows how long Gardasil will be effective. It is possible that it confers a brief immunity for as little as two to three years. One of the dangers of Gardasil is that it might give a false sense of security to the girls that receive it. There are many other strains of HPV that the vaccinated population has no immunity for as well as all the other sexually transmitted diseases for which there are no vaccine.

Another concern is the clinical testing done by Merck. Here is that information from Judicial Watch:

An additional testing report shows that Merck tested Gardasil against an aluminum-containing placebo. While most placebos are saline based, the FDA allowed Merck to use a placebo with an undisclosed amount of aluminum in it. Gardasil itself contains 225 mcg of aluminum. Aluminum can cause many serious problems including temporary and permanent nerve damage. Using a reactive aluminum-containing placebo instead of a non-reactive saline base can make vaccines seem safer than they may actually be. While Merck has repeatedly stated that Gardasil is on a comparable safety rate with the placebo, if the placebo itself is responsible for adverse effects then it is more difficult to ascertain the vaccine’s safety. Merck’s testing report shows charts of clinical tests, and compares Gardasil with the aluminum-containing placebo. It is true that the adverse reaction rates are comparable in most of the tests, but since the vaccine is being tested against a reactive, potentially harmful substance, the numbers may overstate the vaccine’s safety and understate its adverse side-effects. The significant differences between the saline placebo and the vaccine raise questions as to how Merck's use of an aluminum-containing placebo may have affected the safety trials. The National Vaccine Information Center reports that “A reactive placebo can artificially increase the appearance of safety of an experimental drug or vaccine in a clinical trial,” adding that “although aluminum adjuvants have been used in vaccines for decades, they were never tested for safety in clinical trials.” It is difficult to draw an accurate conclusion from Merck's data, raising questions about Gardasil vaccine safety.

Gardasil is clearly going to be given to women of childbearing age. Here is what Merck told the FDA on that subject, “It is not known whether Gardasil can cause fetal harm when administered to a pregnant woman.”



The reported adverse reactions from Gardasil are increasing. There is an unusually high incidence of fainting from the vaccine. That has been written off as just teen girls being afraid of needles. However those same teen girls are not reacting that way to other common vaccines in that age group, such as Menactra for meningitis. There have been reports of girls breaking out with warts in various areas of their bodies with no previous history of such outbreaks. There are reports of seizures, blood clots and miscarriages. Guillain-Barre Syndrome has been reported with the majority of cases occurring within two weeks of Gardasil vaccination. There have also been at forty-four deaths reported thus far. Of those reported deaths, the CDC has confirmed twenty-seven. Seventeen reports remain unconfirmed due to missing names or contact information, preventing the CDC from obtaining further information.

Merck is producing and aggressively marketing a vaccine for young girls yet they have done no testing on Gardasil’s effects on fertility. Their only fertility tests were done with rats and even then it was only through a single fertility cycle. Although Merck recommends that pregnant women not receive the vaccine there is no mention of a mandatory pregnancy test prior to vaccination. Merck does have a healthy curiosity regarding what happens to pregnant women that receive the drug. They are hoping that we will keep them posted on that one. Here is what the CDC has to say about pregnant women and Gardasil:



Should pregnant women receive the HPV vaccine?

The vaccine is not recommended for pregnant women. There has been only limited information about how safe the vaccine is for pregnant women and their unborn babies outside of the clinical trials. For now, pregnant women should wait to complete their pregnancy before getting the vaccine. If a woman finds out she is pregnant after she has started getting the vaccine series, she should wait until after her pregnancy is completed to finish the three-dose series. Most importantly, she should continue her routine prenatal care and enroll in the registry the vaccine manufacturer is compiling of pregnant women who have received the HPV vaccine.
The Gardasil pregnancy registry has been established to collect information on the pregnancy outcomes of women who inadvertently receive the vaccine during pregnancy. The data collected will be used to monitor any effects the vaccine might have on pregnancies, so it is important that all eligible patients be enrolled. Individual patient information remains confidential.

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The following information is from VAERS, the Vaccine Adverse Event Reporting System.


Pt [Patient] admitted to hospital with chief complaint of
ascending weakness bilaterally, upper and lower
extremities . . . Severe form of Guillain-Barre syndrome
after HPV vaccine . . . Respiratory failure with prolonged
mechanical ventilation and tracheostomy tube
Placement . . . vital capacity deteriorated on day 3 . . . able
to move only jaw and eyes.
VAERS ID: 268143-1 (S)

A 19-year-old female with no previous medical history
reported, who on 19-Sep-2007 was vaccinated with the 1st
dose of Gardasil . . . On the morning of 12-Oct-2007, the
patient was found dead in her bed . . . Contraception was
stopped 3 months before vaccination. No reason for the
death was detected in autopsy.
VAERS ID: 299377-1 (D)

Information has been received from a physician’s assistant
concerning a 12-year-old female with no reported medical
history who on approximately 15-Sep-2007 was vaccinated
with Gardasil . . . On 06-OCT-2007 the patient died in her
sleep. No further information was provided.
VAERS ID: 297528-1 (D)

Sudden unattended death [February 22, 2007] . . . patient
[17-year-old female with no medical history or known
allergies] last seen in office by nurse only on 2/20 for HPV
#3 . . . The autopsy was negative for all findings. Scene
indicated sudden death from collapse and fall.
VAERS ID: 305606-1 (D)


An 18-year-old female patient was vaccinated with the first
dose of Gardasil . . . In the evening of the same day she was
found unconscious (or liveless) [sic] by the mother.
Resuscitation was performed by the emergency doctor but
was unsuccessful, i.e. the patient finally died . . . The cause
of death of this patient remains totally unclear.
VAERS ID: 300741-1 (D).


An 11-year-old female was vaccinated “within the
past month” in approximately May 2007 with a first
dose of Gardasil. Subsequently, 3 days after
vaccination the patient presented to an ER . . . the
physician from the hospital said that “the death was
due to an anaphylactic reaction to Gardasil.”
VAERS ID: 280163-1 (D)


[19 year old female] given Gardasil vaccine dose #1 [on]
3/12/07 . . . Collapsed and died on 3/26/07 . . . autopsy
done at Medical Center . . . states from Death Certificate
COD [cause of death] is sudden cardiac death and
pulmonary embolism. Echocardiogram revealed very
enlarged right ventricle & small left ventricle as well as
large blood clots within both the right atrium & right
ventricle.
VAERS ID: 275438-1 (D)


Information has been received . . . concerning a female
patient who was vaccinated with a dose of Gardasil. The
PA [physician’s assistant] reported that “the patient died of
a blood clot 3 hours after getting the Gardasil vaccine.”
VAERS ID: 275990-1 (D


Information has been received . . . concerning a 22-year-old
female patient with no pertinent medical history or drug
allergies who on 21 May 2007 was vaccinated IM with a
0.5ml dose of Gardasil . . . Concomitant therapy included
hormonal contraceptives (unspecified). On 23 May 2007,
the patient died suddenly. The cause of death was
unknown.
VAERS ID: 287888-1 (D).



Information has been received from a physician’s assistant
concerning a 12-year-old female with no reported medical
history who on approximately 15-Sep-2007 was vaccinated
with Gardasil . . . On 06-OCT-2007 the patient died in her
sleep. No further information was provided.
VAERS ID: 297528-1 (D)



Sudden unattended death [February 22, 2007] . . . patient
[17-year-old female with no medical history or known
allergies] last seen in office by nurse only on 2/20 for HPV
#3 . . . The autopsy was negative for all findings. Scene
indicated sudden death from collapse and fall.
VAERS ID: 305606-1 (D)



Information has been received from a physician concerning
a 20-year-old female with no medical history reported, who
on 01-APR-2008 was vaccinated with a dose of Gardasil.
On 05-APR-2008, the patient died four days after receiving
Gardasil . . . An autopsy was performed which ruled out
suicide and anything suspicious. The cause of death is
currently unknown.
VAERS ID: 310262-1 (D) 49



Please take a minute to watch the CBS report on Gardasil. Click here to read the CBS story about Gardasil and see why one of the doctors that helped develop it thinks that the vaccine could be more dangerous than previously thought. Click here for the "New York Times" story on the marketing of Gardasil.

Friday, October 02, 2009

Baby Passes Out; Mom Almost Passes Out




Yesterday Marin was jumping on Claire’s bed and yelling, “Jumping! Me jumping!”
Then she said, “Help me.” Evidently she thought it was my job to assist her with jumping on the bed. She forgot that my job is to try to prevent kids from jumping on the bed, which leads to falling off the bed and then someone is crying. Mothers can predict the future.

A few days ago I was in the kitchen cooking with my friend Andrea and Marin fell off the couch and hit her head. Everyone knows that toddlers are always having minor mishaps due to the fact that coordination and good judgment are outweighed by pure enthusiasm.

I went to check on the extent of the injury since triage is also a big part of parenting. Marin was crying so I picked her up to try and determine where she was hurt. She passed out in my arms. Andrea wanted to rush her to the hospital but then Marin woke up. She remained very sleepy and I got on the phone with the pediatrician’s answering service. The first one to call back was a nurse. She wanted Marin to go to the ER but I explained that Katie had the same episodes when she was a toddler. I didn’t think that Marin had lost consciousness because it was a severe injury, just that she comes from a family of fainters.

When Katie had it happen the first time, she was about 18 months old. She had stopped breathing and her lips were turning blue. I was trying to dial 911 but couldn’t because my hands were shaking too badly. By the time I could dial she was already waking up. Katie was checked out at the ER but we declined the CT scan since she didn’t even have much of a bump on her head. We took her home and watched her closely and she was fine.

She went on to have another episode, which terrified me again. Her doctor scheduled her for testing. She had an MRI, EEG, EKG, and an echocardiogram. That was a difficult day. Katie had to be drugged so she would hold still for the EEG. They had her drink chloral hydrate, which should have made her really sleepy. Instead it made her really combative. My toddler resembled a mean drunk. Then she had to have the IV sedation prior to the MRI and it took an entire team to hold her down for that. She finally went to sleep for the MRI but woke up disoriented and angry. I could not even carry her. I had to sit in a wheelchair and restrain her while a nurse wheeled us out to the car. It took both of us to strap her into her car seat and she screamed for the entire forty-minute drive home.

Katie’s most likely diagnosis is something called Reflex Anoxic Seizures. She went on to have more episodes, terrorizing all of us that witnessed them. She has grown out of it now and hasn’t had one for two years. I had almost forgot about it and then Marin passed out.

Most of you are probably unfamiliar with RAS. It is fairly uncommon affecting about 2 in a 1000 pre-schoolers. RAS is not epilepsy and it is not a true seizure. It affects more girls than boys. It is most commonly brought on by pain but in some cases in can be brought on by fear, etc. What typically happens is that the child has an injury, their eyes roll up in their head, the arms and legs might jerk a bit, they become very pale and they lose consciousness. They wake up within a minute or two but it seems like forever when it happens to your baby. The scariest part is that their heart actually stops briefly and that is the cause of the pale appearance. After they wake up they tend to be very sleepy.

Not all doctors are familiar with the condition. One of the most important things a parent can do is accurately describe what happens. This is mostly a diagnosis made by ruling out other conditions and the history of the event will lead a good doctor to suspect RAS. Children with RAS for the most part will simply outgrow it. There is a danger of a well-intention doctor prescribing anti-convulsants which will not be of any benefit to a child with RAS. Children with frequent episodes can be treated with a pacemaker or atropine. Neither are without risks and both are reserved for severe cases.

If Marin keeps it up I’ll see if they can just go ahead and fit me with the pacemaker.

Tuesday, January 20, 2009

Just a Little Misunderstanding

A few days ago I had an appointment with my gynecologist. I am still having some trouble driving since the surgery on my right knee. I asked my teenage son, N., to drive me. N. didn’t ask any questions and I directed him to the doctor’s office. He waited patiently in the waiting room with the baby. I didn’t volunteer what kind of doctor that I was seeing but I kind of thought that it might be obvious, what with all the pregnant women.

When we left the office N. questioned me about my visit.

N.-“So, what did the doctor say?”
Me, caught off guard- “Huh?”
N.-“Well, how’s it doing?”
Me- “How’s what doing?”
N.-“Your knee, how’s it look?”
Me-“Oh, that. It looks fine.”

I had a hard time not laughing the entire time I was in the doctor’s office because all I could think of was ‘pajinas’. By the way, I spelled ‘pajina’ phonetically to make it obvious how it’s pronounced. Everyone knows that pajina is actually supposed to be spelled with a ‘g’.

I have another follow-up with the orthopedic surgeon today. N. is going with me. I guess I’ll have to make up a story about this being a different knee specialist….

Wish me luck. I'm afraid today is the day for some scary injections into the joint.