HPV vaccine for all BC boys?
Great writing (Alan Cassels’ “Letter to Victoria soccer moms,” March/April 2017) and—wow—I am surprised that Focus published this article on HPV in the time of prohibited discussion of vaccine issues, but good for them! The Gardasil vaccine has been associated with many severe side effects and long-lasting immune system dysregulation, likely for several reasons:
First, the vaccine uses a novel, more immunogenic form of aluminum adjuvant. Aluminum is strongly immunogenic as well as neurotoxic and capable of inducing all sorts of auto-immune and neurologic disorders. For a list of research in this area, please see the Children’s Medical Safety Research Institute, cmsri.org.
Second, during trial phases of this vaccine, the control group received an injection containing all the adjuvants, including the novel aluminum adjuvant present in the vaccine, minus the antigens. This is completely unacceptable and unscientific, as the control group was given something that was anything but inert. The researchers concluded that the rate of side effects in the vaccine-treated group versus the control group was similar.
And last, there is evidence that the antigens in the Gardasil vaccine share many similarities with human proteins, increasing the likelihood of a cross-reaction, i.e. auto-immune disease. (Quantifying the possible cross-reactivity risk of an HPV16 vaccine, D. Kanduc, J Exp Ther Oncol. 2009;8(1):65-76.)
Therefore, the potent aluminum adjuvant, in combination with this particular antigen, creates an especially problematic vaccine.
Dr Anke Zimmermann, ND, FCAH
I appreciate you bringing the issue of vaccination against cancer-causing viruses to our community. As a carer who has witnessed the colossal suffering and deaths from cervical, tonsillar, laryngeal, tongue, anal and penis cancers, I have long dreamed of practical preventative approaches as opposed to the current “wait for it to get big enough to be detected then slam it with surgery, radiation and chemo” default which is always difficult and expensive, and sometimes unsuccessful. Whether you feel that these viruses are the “major risk factor” for these cancers (like many felt HIV was for AIDS) or the direct cause, there is no doubt immunization will reduce these diseases. While “90 percent of these infections are asymptomatic and resolve spontaneously,” with only a few going on to cancer, I would suggest the “crime against humanity” is more the lack of vaccination against preventable diseases rather than a family’s human rights suit to obtain the vaccine!
I was interested to read Alan Cassels’ idea [in "Letter to Victoria’s Soccer Moms”] that by vaccinating boys who identify themselves as being at “increased risk” for contracting the virus, we will have adequate coverage. Few grade 6 boys that I know would self-identify (“Sir, I am thinking of having high-risk sex in a few years”) just to have the joy of a needle in the arm. Years of biology and public health research suggests that vaccinating populations can bring “herd immunity” with drastic reductions in disease occurrence for all members if we can achieve high enough rates of acceptance. Vaccine refusal and failure will always ensure a reservoir of the virus, but going forward, women, too, will be protected by the vaccination of boys in terms of reduced exposure to these cancer-causing viruses.
Attacking governments and the pharmaceutical industry is easy pickings, as is citing case reports of possibly-linked adverse reactions, and while I respect much of Alan Cassels’ past work, the picture looks different form the vantage point of a front-line carer. I have not investigated the economics in terms of overall cost/benefit, but likely the government has, and if you want to attack the program on economic grounds, go ahead and present the case. I just know that I paid hundreds of dollars to get my kids immunized, as there was no government funding at that time, and I could never live with myself if they contracted one of these largely preventable diseases. The time has come for a more universal approach to preventing these cancers, and these vaccines are our best hope.
Dr Stephen Ashwell
Alan Cassels responds: While I can understand Stephen Ashwell’s earnest desire to use whatever means possible to tackle preventable diseases that cause a lot of suffering and death, I wish I could share his sense of certainty that the HPV vaccine will reduce these diseases. When he says there is “no doubt that immunization will reduce these diseases,” I, and many of my colleagues, beg to differ.
In fact, I’d argue that what we do have is a lot of doubt around the ultimate effectiveness of HPV vaccines. As you know, cancers can take many decades to grow, and exposure to the human papilloma virus is only one of many potentially causal factors. I admit that, on this one, I remain old-fashioned and ultra-conservative, believing that we do need to have solid proof that a vaccine will do what its proponents claim before we start offering it, en masse, to the entire population. If there is one thing I’ve learned in studying drug policy, it’s that technology bites back, and the history of medicine is littered with numerous instances where the early, enthusiastic embrace of a new medical technology often involves unforeseeable downsides.
While those in the oncology community may say my caution is irresponsible, I think it is equally irresponsible to write off the mounting global numbers of case reports of adverse reactions. As Anke Zimmermann correctly points out, major questions around the safety of the HPV vaccine that linger—particularly the risk of auto-immune diseases associated with them—cannot be ignored. Worldwide, we have witnessed girls who appear to have been hurt by this vaccine, and thankfully those numbers seem small, but we also know it has been administered to those girls without any definitive proof it affects the rates of cervical cancer it is supposed to reduce. I wonder what is the proper response to parents who say: “I could never live with myself if my child was hurt by an as-yet-unproven vaccine?”
I thank both Stephen Ashwell and Anke Zimmermann for taking the time to weigh in with their thoughts, because I think our “best hope” is a global conversation about new technologies and whether they may involve more harm than benefit.
In your last edition of Focus you have an article by Mr Alan Cassels recommending that we do not vaccinate boys against the Human Papilloma Virus (HPV). This is the virus that is the cause of cervical cancer in women. The argument is that as men do not have a cervix, they cannot get cervical cancer.
During the South African War, the British Army had the greatest loss of life due to disease. The prime cause was enteric fever, which killed more men than the enemy action. Research into this matter by Sir Almroth Wright identified the cause, and a vaccine was produced. Since then, every British soldier has been vaccinated as part of his initial training. During WWI, there were six deaths due to enteric fever. Enquiry showed that these six were men who “knew better” and had managed to dodge the needle.
In my early professional career, because of a distressing family history I was determined to know something about cancer, so I became a house surgeon at the (then) Royal Cancer Hospital in London.
Young women would be diagnosed with cervical cancer often at their first visit to confirm a pregnancy. Treatment then would involve a radiotherapist packing the vagina, under anaesthesia, with packets containing radium needles. Then, knowing the amount used, he would calculate the dose and when the radium would have to be removed. This was my job, regardless of when the time came for the removal. It was often in the middle of the night.
The immediate result was a miscarriage as she suffered the effects of the radiotherapy. She would be sterile, and subsequent treatment was often disappointing. We knew that the cancer virus had been brought into her body by a penis, but this was never mentioned.
Vaccination has now almost eradicated smallpox from the Earth. Poliomyelitis is now rare: it persists in some countries as a result of ignorance and prejudice. Please let us eliminate this cruel and horrible cancer of young women.
With regard to the high cost of drugs, research is very expensive because everything must be tested and retried. M&B 693, the first drug to have any effect against syphilis, was named because it was the 693rd medication to be tested against the disease. How much do you think that research cost? Who paid for it?
As a student, I was told that the penicillin doses we were injecting into really sick patients cost 600 British pounds a shot. In those days, it was a green mould growing in a flask and had to be cultivated, collected, extracted and condensed.
But it saved lives. A little later, a penicillin tablet could be purchased for a few cents. Is not life worth the cost?
Dr Donald North
Alan Cassels responds: I think the key point made by Dr North is that we have seen great advances with vaccines in terms of eradicating the threat of smallpox and polio. I agree and we should be thankful we have those vaccines.
At the same time, if we had any proof that there were similar lifesaving effects of the HPV vaccine, which was the subject of my article, I would be very pleased to see those vaccines used. The problem is that worldwide experience is pointing in the other direction and sometimes medical preventative treatments can harm. If the vaccine turned out to save lives of women dying of cervical cancer, yet injured many thousands of girls along the way, we would hardly say this is a huge medical advance. Life is priceless, but a vaccine that may protect your boys from genital warts seems a stretch to me.
Victoria’s iconic, world-class blunder
The comparison of France’s Milau Viaduct, which came in on time and on budget, to the disastrous Johnson Street Bridge fiasco was very interesting. Closer to home, the Tsable River Bridge, 15 kilometres south of Courtenay on the Inland Island Highway, is another excellent example of a well-designed bridge, engineered to fit a unique river crossing, that was completed in 27 months and within a budget of $15.3 million. The 400-metre-long, 4-lane bridge reaches a height of 60 metres above the valley floor. Construction of the bridge took place between 1996 and 1998. Several construction options were considered to meet Provincial specifications, which included protection of the Tsable River salmon spawning runs, a forest floor with trees up to 60 metres high, and seismic strengthening requirements. A cast-in-place design was chosen over a heavier steel structure. Besides coming in on-time and on-budget, this bridge won an Association of Canadian Consulting Engineering Award of Excellence in 1999. Properly managed, large bridge projects can be completed on time and on budget, as was the case with the Tsable River Bridge.
In the Spring issue of This England magazine there is a small article about operating the Tower Bridge in England. Some statistics mentioned were that it was built 120 years ago and sees 40,000 people go over it every day: motorists, cyclists and pedestrians. The bridge is lifted, on average, 15 times a week and the lifting mechanism is much more complex than Victoria’s Blue Bridge. Everyone can visit The Tower Bridge Exhibition and it has its own website. It is a true icon of England. Will we say the same thing about our new bridge?
The power of words
I admire Focus very much, and I always feel relieved when I read the articles you publish, because I feel strongly that they represent me! I just want to draw your attention to something that seems small, but that has come to bother me more and more. The subtitle in your article “The refugee crisis” reads, “America is slamming its door...” The United States is not America. It is in North America, a continent that includes Mexico, United States and Canada. As a Chilean-born person, I have been tolerating the appropriation of the name of our huge continent, America, by one of its countries, the United States, for a long time! Specially now, with Donald Trump at the helm, with his racism and arrogance, it feels even worse.
America (including North America, Central America and South America) is a wonderful, exciting , diverse continent that includes many languages, ethnicities and cultures. We, as a continent, are great because of our diversity, and hopefully we will succeed in living, collaborating and understanding each other peacefully.
Again, my congratulations for the wonderful work you do. We are so lucky to have you in Victoria!
Lina de Guevara
Tales of two booksellers
Ross Crockford calls a couple of bookstores in Victoria “monuments to the written word” and Timothy Vernon reportedly said about one of them that it was a “temple to the life of the mind.” Crockford’s comment is a monument to the written exaggeration and Vernon’s speech is a temple to the life of his own hyperbole. I have nothing against Munro’s Books and Bolen Books, but I am all for Russell Books. This is because the best books are used books; all used well, but not all used up. Anyone who goes to Amazon but not Munro’s and Bolen will not hug a tree. Yet anyone who goes to Munro’s and Bolen but not Russell cannot let it be.
The sewage treatment issue
The president of the James Bay Community Association recently circulated a document stating that our new sewage plant’s standards to reduce odour will not be consistent with best practice.
The document states the “no odour promise is no longer believed as the Esquimalt agreement shifted from a best practices approach to outdated odour maximum targets, with the plant to be constructed to a standard of 5 Odour Units; 5 on a 10 maximum scale. Other jurisdictions are constructing plants to a 3 Odour Unit standard in non-residential areas and 1 Odour Unit when residences are nearby. If the plant emits an odour of 5 OU during a period of dominant westerly winds, there is a serious risk of a very unpleasant odour spreading across the harbour.”
If this information is correct, the CRD must act immediately to correct the problem. Otherwise we will live with the results of bad planning for generations to come.
According to a little-known June 2010 CRD impact study, the massive trench required to adequately bury the 4-foot wastewater pipeline from Clover to Ogden Points will follow the Dallas Road right-of-way, which dissects Beacon Hill Park. This was confirmed in a September 27, 2012 CRD procurement document.
However carefully the work is done, it will have an enormous impact on the park, whose lands were first set aside by James Douglas in 1858. Founded by the City of Victoria in 1882, the park has been subject to 25 applications for major projects since 1882: All have been denied.
Where in the Dallas Road right-of-way (rights-of-way are usually 66 feet wide) is there room for the pipeline?
The pipeline, according to award-winning wastewater engineer John Motherwell, would need to be buried 12 feet deep to avoid existing underground services and achieve a one-foot underlying protective bed.
However, WorkSafeBC requires that unless shored, a trench of this depth must be at least 40 feet wide to protect workers from collapse. There must also be room to deposit the huge mounds of excavated soil and the heavy equipment. Heavy equipment placed in the park will destroy the fragile vegetation. Then, along the inner side of the Dallas Road waterfront, homes are virtually on the curb, with no boulevard, most of the way from Clover Point to Ogden Point.
Third, excavating the trench along the ocean side of Dallas Road would require the removal of many ancient trees and the distinctive seaward-slopes scrub close to the curb.
This permanent transformation of Victoria’s scenic marine drive would be unacceptable if not intolerable to many residents.
Fourth, tearing up the 36-foot-wide pavement of Dallas Road to accommodate the 40-foot trench for the 3.3 kilometres to Ogden Point would cost an estimated 35 percent more. (Installed asphalt now costs approx. $300 per square metre.)
Now to the archaeology.
These lands were for centuries the home of the Lekwungen (Songhees) people, who lived in a defensive village on Finlayson Point directly below Beacon Hill. Their burial cairns marked the hillside and the park preserves this sacred Songhees area in perpetuity.
Museum Curator of Archaeology Dr Grant Keddie reports there was a second defense location at Holland Point near the southwest corner of the park, and a third on the bluff at the northwest corner of Clover Point. Carbon-dating of the midden at Finlayson Point shows that the site was first occupied about 1000 years ago.
Accordingly, Victoria’s 165-acre jewel gained heritage status in 2009 and “is considered one of the most significant Canadian public parks of the nineteenth century, comparable to Mount Royal Park in Montreal.” According to Senior Heritage Planner Steve Barber: “The heritage designation will provide an appropriate level of protection and recognition and provide a mechanism for heritage values to be considered in future changes to the park.” (Planning Report, October 8, 2009).
Seemingly oblivious to this, and lacking transparency, the land-based sewage planners have called for at least four registered archaeological sites to be intersected by the pipeline between Clover and Ogden Points; indeed the whole proposed route through the park is believed to have archaeological potential. Then there is the flora and fauna.
The park preserves much native flora: Friends of Beacon Hill Park list 51 wildflowers, noting that these are vulnerable to soil compaction. In the giant field where the totem stands, over a million blue camas bloom each May; present also are shooting stars, wild bleeding heart, and the rare yellow prairie violets.
The park is home to 72 bird species (Christmas bird count 2010), and to raccoons, squirrels, river otters, and deer.
The proposed noisy ongoing construction cannot fail to stress the park’s flora and fauna, perhaps driving species away, as indeed three eagles drove dozens of herons away from their nests in 2007.
According to a CHEK-TV poll last week, over 80 percent of local residents believe that “brakes should be applied” to this project. CFAX polls have consistently shown that two-thirds of people are opposed, raising questions as to why there has been no referendum for the largest mega-project ever conceived for the capital region.
The CRD plan is not the solution to a low-risk ocean problem. It is time to insist that the provincial and federal governments take a close look at the science and do comparative cost-benefit analyses and environmental impact studies on the existing vs the proposed sewage treatment project. Before one back hoe hits the ground. Before the CRD makes costly and irreparable mistakes.
Board Member, ARESST