Qualms about HPV Vaccination

Here are a few data points about negative attitudes towards HPV vaccination:

Core vs. Non-Core Reasons

People who decline vaccination may have several reasons of varying strengths, i.e. some of their objections may go away once they know more, while others may be so strong that no amount of additional knowledge can change them.

Here are a few of what seem to the most frequent core, or very strongly held, reasons some people object to HPV vaccination.

Conservative Attitudes towards Sex

As a sexually transmitted virus, HPV seems to push some peoples' buttons.

A 2003 survey of Americans found 50% believe it is a sin for unmarried teens to have sex, 7% feel that sex education should not be taught at all in schools, and 7% feel that girls really will wait until 18 or marriage to have sex.

These attitudes may have evolved over the aeons to protect against disease; see this excerpt from "Evolution, Culture, and the Human Mind" by Mark Schaller.

These people are likely to be uncomfortable with children, especially girls, being vaccinated against HPV.

Here's an example blog post:

In all the commercials I have seen for this GARDASIL and HPV, never once have I heard or seen them talk about abstinence as the number 1 prevention technique against HPV and cervical cancer. Instead, the "One Less" campaign is about getting an unnecessary vaccine, which won't give you 100% protection, so all these so-called strong, responsible women can still go around having promiscuous sex.
i.e. people who do not expect their children to be having sex may believe that their children are not at risk for HPV, and therefore do not need the vaccine.

Here's an example post from a Christian anti-abortion/sexual sin site:

Giving this vaccine to girls... suggests to our daughters that we expect them to be sexually active and that we condone such behavior. (The detrimental affects of communicating such values to our children is an important component to the STD epidemic as well as the high number of pregnancies outside of marriage and the occurrence of abortion.)

i.e., people who believe that premarital sex is a sin may not welcome premarital sex being made safer.

Mistrust of Medical/Scientific Establishment

Trust is a fragile thing. A safe, effective, and ethical vaccine can quickly become unpopular if enough people claim it is unsafe. And searching the web for gardasil and depopulation, nazi, or gestapo finds a disturbing number of hits, so there is already quite a bit of distrust out there.

A wave of public concern about vaccines in the late 1970s and early 1980s led to the creation of the current systems for ensuring vaccine safety (see the CDC's page, History of Vaccine Safety).

"Could it happen here? Vaccine risk controversies and the specter of derailment" (Health Aff., 2005) describes the fall and rise of trust in the MMR vaccine in England over the last decade, which might have some lessons for today.

Paul Offit's 2011 NIH talk about vaccine education has some tips about how and how not to try to educate people about vaccine safety. His book, "Deadly Choices: How the Anti-Vaccine Movement Threatens Us All", may also be of interest.

Failure to correctly understand risks

As Skeptical Mothering writes, people aren't really experienced with comparing really small probabilities. Vaccine information sheets say something like "very small chance of injury or death", but that sounds scarier than the average person's personal knowledge of the disease the vaccine is supposed to prevent, so unsurprisingly many people decline the vaccination.

This is an innate human feature, so it's "core" in that sense, but it might be more amenable to education than the other reasons listed above.

Incompatible Belief Systems

Naturopathy and homeopathy are non-evidence-based belief systems which reject mainstream science and/or medicine. People who subscribe to these belief systems may bring up numerous objections to vaccination, but even if all of these objections are disproven, they will continue to object to vaccination simply because it's based on conventional medicine.

There are many web sites that oppose vaccination and endorse naturopathy and homeopathy. For instance:

The web sites of both NVIC and Sane Vax feature pictures and stories of girls who are said to have been injured by vaccination.

Mistrust of Government

Some people believe the government should not be involved in healthcare. These people are likely to view public vaccination campaigns with suspicion, and may welcome reports that government-funded HPV vaccination is unsafe.

Several organizations encourage people to oppose government-funded or government-mandated HPV vaccination. For instance:

Judicial Watch was formed in 1994, and claims to be a conservative, non-partisan organization. As a mostly political organization, science and medicine are not their main fields of interest, but they have taken an interest in Gardasil. Curiously, they sued the government for HPV-related records already publicly available from VAERS, and filed press releases touting their efforts.

Postmodernism

A few people are still fighting the Science Wars, and contend that scientists doesn't really reveal truths about the world any more than, say, art critics do, and that science itself is political and biased. They make bafflingly counterfactual statements like "HIV doesn't cause AIDS" (debunked at aidstruth.org) and "The majority of Australians are not at risk of cervical cancer." See e.g. Henry Bauer and Judy Wilyman.

The essay "The Poverty of Postmodernism" (in a postmodernist Science Studies journal!) gives some insight into where these critics are coming from.

Bad Statistics

Some people try to draw conclusions from insufficient data. For instance, this page points to the ATHENA study and says
The authors reported that in a sub group of 12,852 young women, the HPV vaccine reduced HPV-16 infections only 0.6% in vaccinated women vs. unvaccinated women.
Even that little quote contains three errors: only about 1100 vaccinated women were in the study, not 12,852; the vaccine reduced HPV-16 infections from 8.7% to 8.1%, which is more accurately described as an 8% drop, not a 0.6% drop; and the data not statistically significant. Also, the study was not designed to test whether the HPV vaccine worked, so it did not control for the age at vaccination.

Related pages

Studies of vaccine refusal: There are several blogs that critique the anti-vaccine movement from a scientific point of view: There are others; try searching for gardasil on The Skepticator.

Other pages/sites/books that touch on the subject:


Copyright 2011, 2012, 2013, 2014 Dan Kegel
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