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	<title>Comments on: Trust Me</title>
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	<link>http://distractible.org/2009/01/23/trust-me/</link>
	<description>Thoughts of a moderately strange (yet not harmful) primary care physician.</description>
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		<title>By: Sally</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3545</link>
		<dc:creator>Sally</dc:creator>
		<pubDate>Tue, 03 Feb 2009 04:19:23 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3545</guid>
		<description>I&#039;m not worried about HPV evolving in the same way that bacteria become drug-resistant. I worry that some of the, what, 90-odd strains of HPV not targeted will fill the void to creat replacement diseases. That already happened with Prevnar, and it wasn&#039;t pretty, what with drug resistant strains getting a boost. What would we do--have even more shots to cover the new strains? Wouldn we get an annual shot, like a flu shot, guessing which strain&#039;s gonna be the biggie this year (or decade)? Or just give reformulated shots to new patients and forget the old ones who still have another few decades of HPV exposure ahead? 

Yeah, I get the pap smear thing. The only thing I worry about is that at some point my kids would stop getting regular exams, but I don&#039;t think that&#039;s likely with me nagging away. Gardasil seems more relevant to people that don&#039;t have the luxury of health care, but then, they probably can&#039;t afford the shot either.

I&#039;m not big on financial conspiracies, and I do think that many researchers genuinely want to fix diseases, and God bless them, they do some good work. But let me see, Merck does have stockholders and a massive Vioxx settlement to face--where&#039;s the Money? Vaccinations for everyone, or a genital wart cure for a relative few?</description>
		<content:encoded><![CDATA[<p>I&#8217;m not worried about HPV evolving in the same way that bacteria become drug-resistant. I worry that some of the, what, 90-odd strains of HPV not targeted will fill the void to creat replacement diseases. That already happened with Prevnar, and it wasn&#8217;t pretty, what with drug resistant strains getting a boost. What would we do&#8211;have even more shots to cover the new strains? Wouldn we get an annual shot, like a flu shot, guessing which strain&#8217;s gonna be the biggie this year (or decade)? Or just give reformulated shots to new patients and forget the old ones who still have another few decades of HPV exposure ahead? </p>
<p>Yeah, I get the pap smear thing. The only thing I worry about is that at some point my kids would stop getting regular exams, but I don&#8217;t think that&#8217;s likely with me nagging away. Gardasil seems more relevant to people that don&#8217;t have the luxury of health care, but then, they probably can&#8217;t afford the shot either.</p>
<p>I&#8217;m not big on financial conspiracies, and I do think that many researchers genuinely want to fix diseases, and God bless them, they do some good work. But let me see, Merck does have stockholders and a massive Vioxx settlement to face&#8211;where&#8217;s the Money? Vaccinations for everyone, or a genital wart cure for a relative few?</p>
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		<title>By: Calli Arcale</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3538</link>
		<dc:creator>Calli Arcale</dc:creator>
		<pubDate>Mon, 02 Feb 2009 21:35:07 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3538</guid>
		<description>One minor point about pap smears and cervical cancer -- pap smears do not prevent cervical cancer.  They merely provide a means of detecting it early enough to stand a good chance of curing the patient.  Note that in the case of cervical cancer, the cure is usually a hysterectomy.  So if all the advertising about Gardasil is to be trusted, then the vaccine is more effective, since it prevents some of the more common strains of HPV, which are themselves the leading cause of cervical cancer.

I don&#039;t think there&#039;s much risk of new diseases cropping up because of Gardasil, so the analogy to antibacterial soap may not be very apt.  I&#039;m not an immunologist, but I don&#039;t think it&#039;s one that&#039;s easy to evolve around, so to speak.

I&#039;m more worried about a subtler risk from Gardasil: that people will get the vaccine and then stop having Pap smears done because they think they are immune to cervical cancer.  They&#039;re not, and that&#039;s not all that Pap smears are good for.

BTW, I suspect a fast and easy cure for genital warts would be a very strong seller.  Cures always tend to do better than preventative medicine.  So I don&#039;t think it&#039;s a lack of financial incentive that keeps Merck from inventing that.  I think it&#039;s because it&#039;s actually not an easy problem to solve.</description>
		<content:encoded><![CDATA[<p>One minor point about pap smears and cervical cancer &#8212; pap smears do not prevent cervical cancer.  They merely provide a means of detecting it early enough to stand a good chance of curing the patient.  Note that in the case of cervical cancer, the cure is usually a hysterectomy.  So if all the advertising about Gardasil is to be trusted, then the vaccine is more effective, since it prevents some of the more common strains of HPV, which are themselves the leading cause of cervical cancer.</p>
<p>I don&#8217;t think there&#8217;s much risk of new diseases cropping up because of Gardasil, so the analogy to antibacterial soap may not be very apt.  I&#8217;m not an immunologist, but I don&#8217;t think it&#8217;s one that&#8217;s easy to evolve around, so to speak.</p>
<p>I&#8217;m more worried about a subtler risk from Gardasil: that people will get the vaccine and then stop having Pap smears done because they think they are immune to cervical cancer.  They&#8217;re not, and that&#8217;s not all that Pap smears are good for.</p>
<p>BTW, I suspect a fast and easy cure for genital warts would be a very strong seller.  Cures always tend to do better than preventative medicine.  So I don&#8217;t think it&#8217;s a lack of financial incentive that keeps Merck from inventing that.  I think it&#8217;s because it&#8217;s actually not an easy problem to solve.</p>
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		<title>By: Sally</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3526</link>
		<dc:creator>Sally</dc:creator>
		<pubDate>Fri, 30 Jan 2009 18:02:00 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3526</guid>
		<description>Thanks for clarifying on the two kids that had had the shots, and thanks for not telling me I&#039;m automatically a lunatic for not trotting out to get my kids every single vaccine that pops up.

I&#039;m kind of crabby old-school--I had ALL the childhood diseases, including mumps, measles and rubella; and my mom had TB so I got a good dose of that. So even though intellectually I do know that normal childhood diseases can kill etc., it seems far from the norm to me. I DID see more unpleasant side effects of disease when I lived in Africa, which is why I went along with most of the recommended vaccines. 

However, I also do what my parents did to bolster my kids&#039; immune systems (they did it unintentionally because we didn&#039;t have much money; I make an effort to do it): I feed my kids very little meat, tons of fruits and veggies, and make them go outside a lot. And build exercise into their days.

Although I believe that many medications etc. are a wonderful thing, I don&#039;t trust drug manufacturers to tell me, or my doctor, the whole truth. We already know that they bury studies that don&#039;t put theirdrugs in a favorable light, quietly sponsor trial write-ups in medical journals, and sometimes blatantly alter information. So I am forced to think about these things myself.

In the case of Gardasil, I have faced enormous pressure from the school, the pediatrician (we&#039;ve moved, and I sure miss my chicken pox hero); even the flipping soccer coach. I&#039;ve wavered about it endlessly. But at this point, I&#039;ve decided it&#039;s just not on. I&#039;m pretty sure I&#039;m not risking my two daughters getting cervical cancer- I&#039;m a strong believer in check-ups- and I think Merck would better serve us by working on a fast and easy cure for genital warts - of course, that wouldn&#039;t serve the stockholders so well as 3 shots plus, more than likely, booster shots, for every boy and girl in the world.

I see Gardasil as being like anti-bacterial soap--for the general population, an unecessary idea that has the potential to cause problems. I&#039;m just going to keep working on healthy immune systems.</description>
		<content:encoded><![CDATA[<p>Thanks for clarifying on the two kids that had had the shots, and thanks for not telling me I&#8217;m automatically a lunatic for not trotting out to get my kids every single vaccine that pops up.</p>
<p>I&#8217;m kind of crabby old-school&#8211;I had ALL the childhood diseases, including mumps, measles and rubella; and my mom had TB so I got a good dose of that. So even though intellectually I do know that normal childhood diseases can kill etc., it seems far from the norm to me. I DID see more unpleasant side effects of disease when I lived in Africa, which is why I went along with most of the recommended vaccines. </p>
<p>However, I also do what my parents did to bolster my kids&#8217; immune systems (they did it unintentionally because we didn&#8217;t have much money; I make an effort to do it): I feed my kids very little meat, tons of fruits and veggies, and make them go outside a lot. And build exercise into their days.</p>
<p>Although I believe that many medications etc. are a wonderful thing, I don&#8217;t trust drug manufacturers to tell me, or my doctor, the whole truth. We already know that they bury studies that don&#8217;t put theirdrugs in a favorable light, quietly sponsor trial write-ups in medical journals, and sometimes blatantly alter information. So I am forced to think about these things myself.</p>
<p>In the case of Gardasil, I have faced enormous pressure from the school, the pediatrician (we&#8217;ve moved, and I sure miss my chicken pox hero); even the flipping soccer coach. I&#8217;ve wavered about it endlessly. But at this point, I&#8217;ve decided it&#8217;s just not on. I&#8217;m pretty sure I&#8217;m not risking my two daughters getting cervical cancer- I&#8217;m a strong believer in check-ups- and I think Merck would better serve us by working on a fast and easy cure for genital warts &#8211; of course, that wouldn&#8217;t serve the stockholders so well as 3 shots plus, more than likely, booster shots, for every boy and girl in the world.</p>
<p>I see Gardasil as being like anti-bacterial soap&#8211;for the general population, an unecessary idea that has the potential to cause problems. I&#8217;m just going to keep working on healthy immune systems.</p>
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		<title>By: Rob</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3525</link>
		<dc:creator>Rob</dc:creator>
		<pubDate>Fri, 30 Jan 2009 15:31:26 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3525</guid>
		<description>As far as the two who got the immunization, one had not had the full course (was only 5 mos old and so protection is not as complete) and one had an immune problem.  

Your objections to Varicella and Gardasil are not totally off-base.  There is a lot we still don&#039;t know.  The only way to know what will really happen with a vaccine is to study it for the full lifetime of a person.  Personally, I don&#039;t think it is wise to wait for 80 years to see what the need for boosters is.  With varivax it became clear that there was a need for it.  Now we do two vaccines.  The same happened with many of the other shots we give.  Presently, the pertussis vaccine is being recommended in adults who are around children, and I have a feeling it will be required for all.  Pertussis is more common in adults than we realized.

Does that mean the immunizations are bad?  No.  It is just the normal process with vaccines.  There is no way to answer all of the questions.

My girls are getting Gardasil, but more data wouldn&#039;t be bad.  The way it was pushed by Merck made me a little nervous.</description>
		<content:encoded><![CDATA[<p>As far as the two who got the immunization, one had not had the full course (was only 5 mos old and so protection is not as complete) and one had an immune problem.  </p>
<p>Your objections to Varicella and Gardasil are not totally off-base.  There is a lot we still don&#8217;t know.  The only way to know what will really happen with a vaccine is to study it for the full lifetime of a person.  Personally, I don&#8217;t think it is wise to wait for 80 years to see what the need for boosters is.  With varivax it became clear that there was a need for it.  Now we do two vaccines.  The same happened with many of the other shots we give.  Presently, the pertussis vaccine is being recommended in adults who are around children, and I have a feeling it will be required for all.  Pertussis is more common in adults than we realized.</p>
<p>Does that mean the immunizations are bad?  No.  It is just the normal process with vaccines.  There is no way to answer all of the questions.</p>
<p>My girls are getting Gardasil, but more data wouldn&#8217;t be bad.  The way it was pushed by Merck made me a little nervous.</p>
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		<title>By: Sally</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3524</link>
		<dc:creator>Sally</dc:creator>
		<pubDate>Fri, 30 Jan 2009 15:19:14 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3524</guid>
		<description>WHAT clarification about the kids who&#039;d been immunized and got the disease anyway? Did I miss it?

I&#039;m not neurotic about vaccines. My kids had most of the recommended vaccines, although I drew the line at the chicken pox vaccine (their pediatrician shrugged and said, frankly, I wouldn&#039;t get it for my kids either--which is why I trusted him whenever he recommended something). They had the pox, and guess what, so did most of their schoolmates who&#039;d had the vaccinations, albeit with milder cases. And yes, those of us whose kids hadn&#039;t had the vaccine did have chicken pox parties.

And forget Gardasil. I don&#039;t think the benefits outweigh the risks. I don&#039;t think there&#039;s been sufficient follow-up. And I think Merck has a massive financial/shareholder motive, exacerbated by the Vioxx debacle, that perhaps wasn&#039;t as big of a pressure when older childhood vaccines were developed. 

I&#039;m concerned about replacement diseases and I&#039;m concerned about the complete unknown of necessary booster shots. How long will Gardasil be effective? Merck doesn&#039;t know, even though our kids will likely be exposed to HPV throughout their lives. We&#039;ll make do with regular Pap smears, thank you very much.</description>
		<content:encoded><![CDATA[<p>WHAT clarification about the kids who&#8217;d been immunized and got the disease anyway? Did I miss it?</p>
<p>I&#8217;m not neurotic about vaccines. My kids had most of the recommended vaccines, although I drew the line at the chicken pox vaccine (their pediatrician shrugged and said, frankly, I wouldn&#8217;t get it for my kids either&#8211;which is why I trusted him whenever he recommended something). They had the pox, and guess what, so did most of their schoolmates who&#8217;d had the vaccinations, albeit with milder cases. And yes, those of us whose kids hadn&#8217;t had the vaccine did have chicken pox parties.</p>
<p>And forget Gardasil. I don&#8217;t think the benefits outweigh the risks. I don&#8217;t think there&#8217;s been sufficient follow-up. And I think Merck has a massive financial/shareholder motive, exacerbated by the Vioxx debacle, that perhaps wasn&#8217;t as big of a pressure when older childhood vaccines were developed. </p>
<p>I&#8217;m concerned about replacement diseases and I&#8217;m concerned about the complete unknown of necessary booster shots. How long will Gardasil be effective? Merck doesn&#8217;t know, even though our kids will likely be exposed to HPV throughout their lives. We&#8217;ll make do with regular Pap smears, thank you very much.</p>
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		<title>By: Should parents who refuse to vaccinate their children be held accountable? &#124; Telecom News</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3523</link>
		<dc:creator>Should parents who refuse to vaccinate their children be held accountable? &#124; Telecom News</dc:creator>
		<pubDate>Fri, 30 Jan 2009 05:07:46 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3523</guid>
		<description>[...] Rob Lamberts tries to understand the mindset of such a parent: &#8220;These parents probably thought, [...]</description>
		<content:encoded><![CDATA[<p>[...] Rob Lamberts tries to understand the mindset of such a parent: &#8220;These parents probably thought, [...]</p>
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		<title>By: The Business of Health Blogging &#171; Mind, Soul, and Body</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3519</link>
		<dc:creator>The Business of Health Blogging &#171; Mind, Soul, and Body</dc:creator>
		<pubDate>Thu, 29 Jan 2009 22:31:06 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3519</guid>
		<description>[...] The internet is a largely unregulated frontier.  The information is spotty, often misleading.  Many people have harmed their own and their children&#8217;s health taking actions they thought were protecting [...]</description>
		<content:encoded><![CDATA[<p>[...] The internet is a largely unregulated frontier.  The information is spotty, often misleading.  Many people have harmed their own and their children&#8217;s health taking actions they thought were protecting [...]</p>
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		<title>By: OK so I&#8217;m not really a cowboy. &#187; Vaccine Hysterics on Both Sides</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3513</link>
		<dc:creator>OK so I&#8217;m not really a cowboy. &#187; Vaccine Hysterics on Both Sides</dc:creator>
		<pubDate>Thu, 29 Jan 2009 11:55:34 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3513</guid>
		<description>[...] a clear focus on advocacy and education (both us and patients). Recently he posted an entry about vaccines which I felt to compelled to comment on. I was going to reply to his but it got out of control long [...]</description>
		<content:encoded><![CDATA[<p>[...] a clear focus on advocacy and education (both us and patients). Recently he posted an entry about vaccines which I felt to compelled to comment on. I was going to reply to his but it got out of control long [...]</p>
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		<title>By: Pfeniks</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3505</link>
		<dc:creator>Pfeniks</dc:creator>
		<pubDate>Wed, 28 Jan 2009 16:32:47 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3505</guid>
		<description>And while you&#039;re checking that your vaccines are up to date, check to see when was the last time you donated blood, marrow or plasma?  You can donate blood every 8-9 weeks.  And do you intend to be an organ donor?  Does your family know?  Take care of all these things at once!  You&#039;ll rest easier, and so will your family!</description>
		<content:encoded><![CDATA[<p>And while you&#8217;re checking that your vaccines are up to date, check to see when was the last time you donated blood, marrow or plasma?  You can donate blood every 8-9 weeks.  And do you intend to be an organ donor?  Does your family know?  Take care of all these things at once!  You&#8217;ll rest easier, and so will your family!</p>
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		<title>By: Pfeniks</title>
		<link>http://distractible.org/2009/01/23/trust-me/comment-page-1/#comment-3504</link>
		<dc:creator>Pfeniks</dc:creator>
		<pubDate>Wed, 28 Jan 2009 16:30:26 +0000</pubDate>
		<guid isPermaLink="false">http://distractible.org/?p=2060#comment-3504</guid>
		<description>The benefits of approved vaccine far outweigh the alleged consequences.  

I was one of the first on board to get the new vaccine for young women, even though I am in a healthy marriage.  I was also one of the first in my college to get the meningitis vaccine which was offered there.  That is a scary, scary disease.  By the time someone realizes you have it, you&#039;re already racing the clock to survive-or already dead.

I understand fears of the unknown.  But, for one thing, autism is not a death sentence.  Of course you do not want your child to struggle, but many children with autism are brilliant, loving people.  And no one can prove it is caused by vaccines!!!

Children AND adults should keep up to date with vaccines.  When was the last time YOU had a tetanus shot, for example?  Or meningitis shot?  Check your own records as well as your children&#039;s!  You might be missing something.</description>
		<content:encoded><![CDATA[<p>The benefits of approved vaccine far outweigh the alleged consequences.  </p>
<p>I was one of the first on board to get the new vaccine for young women, even though I am in a healthy marriage.  I was also one of the first in my college to get the meningitis vaccine which was offered there.  That is a scary, scary disease.  By the time someone realizes you have it, you&#8217;re already racing the clock to survive-or already dead.</p>
<p>I understand fears of the unknown.  But, for one thing, autism is not a death sentence.  Of course you do not want your child to struggle, but many children with autism are brilliant, loving people.  And no one can prove it is caused by vaccines!!!</p>
<p>Children AND adults should keep up to date with vaccines.  When was the last time YOU had a tetanus shot, for example?  Or meningitis shot?  Check your own records as well as your children&#8217;s!  You might be missing something.</p>
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