The “selling sickness” model is in full display in pushing grade 6 boys towards a questionable vaccine.
DESPITE THE TITLE, be assured I am addressing this to all busy parents—both moms and dads who juggle households, careers and kids in sports—in the hope that you might take a few minutes to learn about a decision you will soon be asked to make.
If you are the parent of a middle-school boy in the fall of 2017, you will be asked to get your son vaccinated for the human papilloma virus (HPV) that is linked to cervical cancer. Since your son doesn’t have a cervix, you might be wondering, uh, WTF?
To which I would say, haven’t you heard of the worldwide epidemic of anal and penile cancers, not to mention an incredible rise in HPV-related genital warts? I know this because I follow health media closely and followed a huge bolus of vaguely familiar scare stories passing through the digestive system of the media last fall. These stories featured the same prominent patient “spokespeople” telling us that we need to be worried about the genital health of our boys. Clearly this was a textbook disease-mongering campaign, where the marketers know that raising the spectre of a horrific epidemic of something (in this case it’s a virus, but it could be your cholesterol or bone density) will often drive you to the doctor to demand something to deal with or avoid it.
Well, the BC government decided last month they might as well just give in and submit to the corporate-sponsored media messages linked to the HPV vaccine makers Merck and GlaxoSmithKline, two of the world’s biggest pharmaceutical companies. Along for the ride were the Canadian Cancer Society and assorted industry-linked cancer researchers who were all playing their part in the lobbying machine designed to get the government to subsidize the vaccine for boys. Promotions even featured a 13-year-old boy from BC who apparently was part of a human rights complaint against the BC government because they only paid for the HPV vaccine for girls. Sheesh. Using kids for a pharma-sponsored marketing schtick strikes me as a crime against humanity.
But I digress. At the very least, the $400 vaccine becomes a seamless way to transfer our tax dollars to two big pharmaceutical companies via your boy.
I’ve been a professional chronicler of selling sickness for over 20 years. Selling Sickness is the name of the 2005 book I wrote with Australian journalist Ray Moynihan. Way before there was even an HPV vaccine, Ray and I were documenting the pharmaceutical industry’s thorough involvement in the creation and selling of disease in order to expand markets for their products. From pumping up a little-known risk factor into a disease, then funding the care and feeding of researchers and specialists, while enlisting the professional media to drive interest, and fuelling the legislative campaigns to get a new drug covered, we’ve seen it all before—because that’s how the model works.
In the marketing of the two HPV vaccines which target a few strains of the virus believed to lead to some forms of cancer, they often downplay one simple fact: The vast majority of us will get HPV in our lives and clear it like the common cold virus.
Gardasil, the first vaccine for HPV, started being recommended for girls in 2006, despite the lack of any proof it has prevented a single case of cervical cancer. Persistent HPV infections may increase a woman’s risk of cervical cancer and a man’s risk of HPV-related anal, penile, mouth and throat cancers (especially if they sleep with other men). Even though the Centres for Disease Control (CDC) recognizes over 40 distinct types of HPV infection which can infect the genital tract, they say “about 90 percent of infections are asymptomatic and resolve spontaneously within two years.”
Then why is there such a push to vaccinate all boys? (Boys with “increased risk” because they have sex with men, are questioning their sexual orientation, are street-involved, infected with HIV, or are in care or in custody, are already eligible for free vaccination.)
Well, the two vaccine makers are doing what drug companies do best: They are trying to expand their markets and bring increased profits to shareholders. That means selling the disease. One study that came out last month said half the men in the US are infected with HPV, yet only “11 percent of men and 33 percent of women have been vaccinated.” This is a classic tactic in selling sickness: point out the incredible underserved population. The companies have already developed the vaccine, now they just have to get more and more people to think about the spectre of genital warts—and get governments to pay for it.
As a parent, you might have had your daughter immunized with the HPV vaccine. I hope that went ok, but let me tell you, it hasn’t been ok for some parents. Did you know that the vaccine is highly controversial, and that, for example, the Japanese government withdrew its recommendation of the HPV vaccine back in 2013, citing serious vaccine-related adverse effects. You probably don’t know about groups in places like Spain, Denmark and France that are petitioning governments to remove the HPV vaccine due to what they see as a large number of young girls suffering serious adverse events following an HPV vaccination (e.g. headache, nausea, fainting, fatigue, loss of memory and numbness in their hands and legs).
Public health authorities in the US maintain the vaccine is safe, yet as of December 2016 the Vaccine Adverse Event Reporting (VAER) system in the US lists 49,033 adverse events linked to the HPV vaccine and 300 deaths. Remember, these are associations, not proven causation. Experts almost always call adverse event reports made to regulators “anecdotal,” but does that mean we should ignore them altogether? Does that mean the vaccine will be perfectly safe for boys?
Global concern over the many unexplained adverse effects of the HPV vaccine was so high that the European Medicines Agency ordered a review of the HPV vaccine. This extensive study eventually reported that it was generally “safe.” Unfortunately that EMA assessment is most certainly flawed, according to Dr Tom Jefferson, who works with the Cochrane Collaboration and Oxford’s Centre for Evidence Based Medicine. He understands why European countries were questioning the HPV vaccine’s safety, writing that “there is a possible association between exposure of young women to human papillomavirus (HPV) vaccines and two ‘dysautonomic syndromes’ (a collection of signs and symptoms thought to be caused by autoimmunity)—complex regional pain syndrome (CRPS) and postural orthostatic tachycardia syndrome (POTS).” There have been reports of girls developing weird autoimmune disorders and a range of other symptoms. Dr Jefferson has examined the EMA’s evaluation in great detail and found this “safety review” was hardly an independent assessment as it mostly relied on manufacturer-supplied data. This is like letting the kids mark their own papers.
Meanwhile, that EMA report is cited by public health officials, including our own Provincial Health Officer Dr Perry Kendall, as proof of the vaccine’s safety. Of the HPV vaccine, he said in a news release, “Vaccine safety monitoring continues to show the safety of the HPV immunization,” adding that “it’s just as effective in preventing HPV-related cancers in males as it is in females, and the benefits are long-lasting.”
I hope he’s right. But hang on, “long lasting benefits”? C’mon, even the highest-ranking doctor in BC doesn’t have any access to data on the long-term effects of these vaccines. No one does. Remember, soccer moms and dads, HPV is an incredibly common virus, which happens to spread mostly (but not always) through sexual contact, and more than 90 percent of people clear the virus on their own with no problem.
You may find yourself asking: Why haven’t I heard about this before? Some of you might have caught wind of parts of the controversies, but the guiding hand of pharma’s marketing machine, their influence on the media, patient groups, physicians, researchers, and politicians is professional, thorough and mostly invisible.
Given the many unanswered questions, you might wonder why the BC government is now interested in paying for the HPV vaccine for boys. Lori Cascaden, a spokesperson at the BC Ministry at Health, wrote me to say: “when a new or improved vaccine is approved for use, BC considers it for inclusion in the publicly-funded schedule using a number of factors to inform the decision, including: efficacy, burden of illness, cost-effectiveness, feasibility of delivery, and public acceptability.”
Sounds good, except to say on all those factors, immunizing our boys with the HPV vaccine simply doesn’t pass muster.
Me? I’d prefer if the Ministry just admitted what is really going on. Why don’t they tell us that despite the $2.2 million (plus “operational costs”) this decision will cost us, everyone who has a prominent opinion on HPV is in on the lobbying game. The Canadian Cancer Society, for instance, proudly displays Merck’s logo on its website and tells us that they, “along with 25 other health organizations, submitted a letter to BC Health Minister Terry Lake in early June requesting an expansion of BC’s vaccination program to include all genders.” Is it worth noting that in 2016 the Society received a one-million-dollar contribution from Merck, the maker of Gardasil, to create a new website about the latest scientific discoveries in cancer?
So, soccer parents, you’ve got a few months to think about this decision and do some research. Try to steer clear of the HPV propaganda if you can, and remember, in this government where “pharma-friendly” should be the logo of the Ministry of Health, your boys are a really convenient way to transfer money to the pharmaceutical companies—which have also donated generously to the BC Liberal Party. Health policy is something we all need to consider as we head towards the May 2017 provincial election.
Alan Cassels is a Victoria author and pharmaceutical policy researcher. He has written four books on the medical screening and pharmaceutical industry including the latest, The Cochrane Collaboration: Medicine’s Best Kept Secret.