Yesterday, CDC and FDA researchers published an analysis of the side effects associated with the human papillomavirus vaccine - which has been linked to 32 deaths since 2006 - in the Journal of the American Medical Association (JAMA). As of June 1, 23 million doses of Gardasil have been distributed, and there was an average of 53.9 complaints filed with the government for every 100,000 vaccine doses, which ABC News reports is similar to the number of complaints filed for other vaccines.

Experts say the complaint data is limited because anyone can file one and the reports are not verified, but only 6.2 percent of the reported complaints were considered serious and lead to hospitalization, permanent disability or death. Compared to other vaccines, users of Gardasil were more likely to report fainting or blood clots, but the JAMA study showed 90 percent of the 56 women who reported developing blood clots had other risk factors like smoking, being overweight, or using oral contraceptives. "Although the number of serious adverse events is small and rare, they are real and cannot be overlooked or dismissed without disclosing the possibility to all other possible vaccine recipients," Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at University of Missouri told ABC News, "The rate of serious adverse events is greater than the incidence rate of cervical cancer."

The FDA and CDC continue to recommend the vaccine for women ages 9 to 26, but now the consensus in the medical community is that doctors need to be more educated about the risk of cervical cancer and the vaccine's side effects. Dr. Joseph Zanga, chief of pediatrics at the Columbus Regional Healthcare system in Columbus, GA, told ABC News that HPV infections may clear up on their own and that routine pap smears are still the best prevention against cervical cancer. He added:

"Perhaps the most important, currently missing 'warning' is that the vaccine may not be forever... we know that it protects for 5-7 years so that a girl getting the series at [age] 11-12 will enter the time of her most likely sexual debut unprotected but believing herself to be."

But finding unbiased information on Gardasil's side effects may have been complicated by the vaccine's manufacturer. A separate article published in the Journal of the American Medical Association reported that at least three medical associations promoted the vaccine using money provided by Merck. The analysis of the pharmaceutical company's marketing techniques by Columbia University public health experts revealed that the American College Health Association, the American Society for Colopscopy and Cervical Pathology, and the Society of Gynecologic Oncologists used the same strategies as Merck to promote the vaccine and did always not disclose that they were accepting money from the company, The Washington Post reports. Merck and the three medical societies say it was not inappropriate for the groups to each accept about $200,000 to $300,000 from the drug company because they money funded education programs about the vaccine but didn't influence their content.

In the JAMA article the Columbia researchers say that the medical societies used arguments that were very similar to Merck's marketing approach, which downplayed the vaccine's potential side effects and overemphasized the threat of cervical cancer to adolescents. According to the American Cancer Society, 11,000 women in the U.S. develop cervical cancer every year, and 4,070 die from it, but USA Today reports that many of the deaths are among poor white women in Appalachia, black women in the South, and Latinas along the Texas-Mexico border. Since cervical cancer can be detected by regular pap smears, these women without access to medical care are most likely to die from it. Dr. Sheila Rothman, the article's co-author, wrote that Merck "practically ignored" these at risk groups, and focused instead on the message that all women are equally at risk, helping the company reach as many customers as possible.

A representative for Merck said that there are several programs that make the vaccine available to poor women, but the JAMA report says these facts were not emphasized in the medical society's marketing material, which often failed to mention that they received Merck funding. "It screeched the message, 'all women are at equal risk, protect yourself from cervical cancer, and this is the way to do it,'" said Rothman, "The fact that the medical societies repeated this message is what concerns us."

Gardasil HPV Vaccine Faces Safety Questions [ABC News]
Medical Groups Promoted HPV Vaccine Using Drug Company Money [The Washington Post]
Report: HPV Vaccine May Be Going To The Wrong Women [USA Today]

Pharmaceutical company Merck has had a human papillomavirus vaccine for males in the works for some time and is currently seeking FDA approval for the vaccine. In women, HPV causes genital warts and can lead to cervical cancer, which about 10,000 women are diagnosed with each year. For men, the vaccine also prevents HPV, which can cause penile and anal cancer, and cancer of the mouth and throat. About 7,500 men are diagnosed with these cancers per year and vaccinating boys also helps prevent the spread of the virus to men's sexual partners.

Though there have been concerns raised about the safety of the vaccine for girls, the debate has centered mostly on whether being vaccinated against the STD would make girls more likely to have sex. Now that there is a male vaccine people are focusing on whether it's safe and cost effective to have boys vaccinated, especially when they can't get cervical cancer, reports The Washington Post. The prospect of boys sleeping around hasn't entered into the debate. "We are still more worried about the promiscuity of girls than the promiscuity of boys," said Susan M. Reverby, a professor of women's studies and medical history at Wellesley College. "There's still that double standard."

Since the male vaccine was proposed, people have wondered if parents would be willing to vaccinate their sons. "For girls, you can go right to protection against cervical cancer. That's a powerful argument," said Gregory D. Zimet, a professor of pediatrics and psychology at Indiana University. "For boys, you have to make several arguments. Part of it is an altruistic argument. I think it's persuasive, but it's more complex." Debbie Stein of Maryland says she would have her 11-year-old son vaccinated. "My feeling is it's a serious virus that causes cancer, and there's no reason not to vaccinate him," she said. "I think it will protect him and protect his wife in the future. I don't want to see him when he's 35 or 40 have a wife die of cancer."

Merck says they won't launch another big (and ultimately unsuccessful) push to have schools require boys be vaccinated like they did after the FDA approved Gardasil for girls in 2006. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices is currently examining the results of a study presented last month on the safety of the vaccine for boys. If the panel endorses it, that will influence whether schools require the shot, and if insurance companies will cover the costs.

In June the committee will consider several cost-benefit analysis, since the vaccine costs about $500 for three shots. Though vaccinating boys will reduce the amount of virus that is transmitted back to girls, some are questioning if it's worth it since boys are less affected by cancers associated with HPV. Professor Zimet says questions of cost shouldn't be what's driving public health policy. "This is a vaccine that principally benefits women's health. I wonder if it was the reverse, and there was a vaccine for women that helped prevent prostate cancer in men, this would be as much of an issue," he said.

A Vaccine Debate Once Focused on Sex Shifts as Boys Join the Target Market [The Washington Post]

Earlier: Drugmaker Seeks FDA Approval For Gardasil For Males
Gardasil For Guys: Will Boys Get It?

Gardasil first hit the market in 2006 and was initially recommended for girls and young women, ages 12-26. Due to aggressive marketing, Gardasil quickly became one of Merck’s top-selling vaccines, with sales of $1.5 billion in 2007 (which were perhaps aided by the high cost- $360 for a three-dose regimen). Despite becoming a requirement for immigrant women, sales slowed in 2008 after a government-funded Harvard study found that it was not cost-effective to administer Gardasil to women in their 20s.

Gardasil for men is not a new idea. Merck has long planned to release a vaccine specifically for males, which seems like a great idea considering that men are more than simply the carriers of HPV. Men infected with HPV run the risk of getting cancer of the genitals or mouth, not to mention genital warts. In Merck’s initial testing, Gardasil prevented 90 percent of cases of penile cancer and genital warts in the 4,000 males, ages 16-26, who received the vaccine.

But before Gardasil for men becomes available to the general public, the FDA must approve Merck’s request, a process that can take up to a year to complete. And while Gardasil is effective at preventing certain types of cancer, the vaccine is not without controversy. In 2008, reports of several deaths that were believed to be linked to the Gardasil vaccine surfaced, leading several news outlets to claim that Gardasil was a factor. While the CDC contends that the deaths are unrelated to Gardasil shots, there is a lingering resentment against the vaccine, which is currently requirement for all immigrant women seeking their green cards. A rival (and less costly) vaccine called Cervarix is available in many foreign markets, but has yet to be approved for use in the U.S.

Drugmaker Merck Seeks Gardasil Approval For Boys [USA Today]
Cervical Cancer Vaccine- For Boys? [CBS News]
Merck Seeks FDA Approval for Gardasil in Boys [WSJ Health Blog]

Related: Experts Appalled At Gardasil Requirement For Immigrant Women, CDC Finds Deaths Unrelated To Gardasil Shots

In fact, when compared to other vaccines, those receiving Gardasil shots reported fewer "serious adverse events." The Journal reports that 6% of Gardasil complaints were "serious," while "most vaccines have reported serious adverse events rates between 10% and 15%."

Even with these findings, immigrant advocates are still not happy that immigrant women between the ages of 11-26 are required to get the Gardasil shot before receiving their green cards. As we reported earlier, the expense of this shot is a serious barrier, and the L.A. Times reported yesterday that some experts think the shot could be fairly ineffective. "Many women will very likely get this only for the purpose of the visa," according to Kate Bourne of the International Women's Health Coalition. "Quite likely they will be at the upper end of the age range, which means they are more likely to already be sexually active, and this vaccine is useless to them." The only group of women and girls required to get the Gardasil vaccine beyond immigrants is residents of the state of Virginia, because as we all know, Virginia IS for lovers, despite what Nancy Pfotenhauer says.

Side Effects Not Linked To Gardasil [WSJ]
Immigrants' Advocates Decry Cervical Cancer Vaccine Order [LAT]

Earlier: Experts Question The Cost Effectiveness Of HPV Vaccine
Experts Appalled At Gardasil Requirement For Immigrant Women

The CDC says they were unaware of this consequence, and Dr. Jon Abramson, head of the CDC's Advisory Committee for Immunization Practices, tells the Journal, "If we had known about it, we would have said it's not a good idea…We don't want someone coming into the U.S. who hasn't been vaccinated against measles or chickenpox, [but] HPV can only be communicated by sexual contact…This is not something that endangers kids in a school setting or puts your population at risk."

Even Merck, the company that manufactures Gardasil and has been accused of overly aggressive lobbying tactics, isn't particularly fond of the requirement. A spokesperson for Merck tells the Journal, "We were not aware of the policy and we did not lobby for this provision in any way." In addition, Gardasil has encountered its fair share of controversy over its efficacy and potential side-effects since becoming widely recommended. The National Association of Pacific American Women's Forum's Priscilla Huang likened the Gardasil requirement to using immigrants as "test subjects" because the research on the vaccine is thought to be incomplete by some. (And with rumored disturbing side-effects.)

Requiring the vaccine — one of the priciest on the market — could cost immigrants as much as $360, and in addition to the $500 or more new United States residents must spend on application fees, the cost is pretty prohibitive. Immigration advocate Tuyet Duong says the requirement "is outrageous; it's creating an economic barrier." The Journal was hard-pressed to find anyone who resoundingly supported forcing immigrants to get the vaccine, and it notes that 'a government official said the cervical vaccine's inclusion on the list might be reviewed." Your bureaucracy at work!

UPDATE: A tipster who works in immigration law writes in: "To make your story even a little worse, the fee for a green card application is $1010. It more than doubled in the summer of 2007. (It is $600 if you are under age 14.) This is not counting the costs of the medical exam, including the vaccines, which must be paid to the doctor in cash."

U.S. Requiring Controversial Vaccine [The Street]
Gardasil Requirement for Immigrants Stirs Backlash [WSJ]

Earlier: Experts Question The Cost Effectiveness Of HPV Vaccine

Yesterday, an article in the New York Times pointed out that there is a finite amount of funds available in countries that provide universal healthcare, and that shelling out vast sums of cash for a drug whose efficacy is still in question is potentially bad policy. "Some of our provinces are running out of money to provide primary care," Dr. Abby Lippman, a professor at McGill University told the Times. "I'm not against vaccines, but in Canada and the U.S., women are not dying in the streets of cervical cancer."

However, the Times also notes that, "giving the vaccine to 12-year-olds would cost $43,600 for every 'quality adjusted year of life' it saved by preventing a cancer death; that price would often be considered acceptable by health officials in wealthy countries, experts say."

In the end, it appears that researchers need more time to analyze the cost and effects of HPV vaccines before making any sort of definitive statement about them. If you've already received the shots, there's no real evidence that they're destructive, so don't freak out, Chicken Littles. If you haven't had the shot, keep following the research as it emerges, and always ask your doctor as many questions as you need or want to.

Researchers Question Wide Use of HPV Vaccines [NYT]
Drug Makers’ Push Leads To Cancer Vaccines’ Rise [NYT]
Adult Cancer Shot May Not Be Worth High Price [AP via MSNBC]

Earlier: Sore Subjects

Assuming that UTIs don't count as STDs (even though it's very similar to Chlamydia, since it's just bacteria, right?), my first STD was the herp. God only knows who I caught it from, but I'm pretty sure it was from one of three bartenders from the same bar I was sleeping with at the time. But it also could've been this dude from this band. Or this 22-year-old unemployed skater dude. Or this other unemployed dude who was a friend of a friend. (I know how to pick 'em!) Anyway, I felt a burning when I peed, which wasn't particularly out of the ordinary, especially for back then, when I was seemingly always recovering from chronic UTIs. I ignored it. Then I noticed this like pimple-y blister thing on my right lip. I was like, FUCK, but, heavily in denial, insisting that it might just be an ingrown hair. But when I was reduced to putting homemade ice packs on my vadge to soothe it and unable to sleep through the night because of the pain, I decided to face my fears and looked at my vadge with a hand mirror. The whole thing was inflamed. I made an emergency appointment to see my gyno, who gave me some Zovorax cream, Valtrex (just a week's worth, never do that one-a-day shit 'cause it'll kill your immune system), and some Ambien.

My second STD was Chlamydia. Boring, and easily treatable. Happened about three months after the herp. Then two weeks after that, I got a call from the dude that gave me Chlamydia, to tell me that he had gonorrhea, aka "the clap", aka "the drip." I'd decided that I must've dodged that bullet, but about eight hours after receiving that call, I was squatting over a public toilet and felt something fall out of me and heard a loud thud. I looked down and saw this big, clumpy brownish/yellowish creamy thing on the toilet seat. I called my doctor the next morning and she gave me 500 mg of Cipro and that shit went away right quick. (Seriously, if you're going to get an STD, pray that it's gonorrhea.) Anyway, I took it in stride. I'd already popped my STD cherry with herpes, so everything after that was no biggie. I even made up songs about gonorrhea to the tune of "Make It Clap" by Busta Rhymes featuring Sean John, changing the words to "I got the clap!" And then also, I changed the words of "Da' Dip" by Freak Nasty to "I put my hand up on your hip, when I drip, you drip, we drip."

Earlier: Contrary To Popular Belief, Herpes Is So Whatevs

Manhattan real estate broker Lisa Lippman says she will certainly vaccinate her sons because it is her social responsibility. "If there was a vaccine I could take that would get rid of prostate cancer, why wouldn't I?" Lippman told the Times. "If there was a vaccine that sons could get that would get rid of breast cancer, most parents wouldn't hesitate. But cervical cancer is the 'sex cancer.' " Other mothers are not as enlightened as Ms. Lippman. Massachusetts interior designer Madeline Cattell says she would be hesitant to inoculate her boys because "You don't want to say it's just the girls' problem... But my sons won't contract cervical cancer. And genital warts are treatable. I'm very skeptical. What risks will I expose them to?"

Even though the parents of young boys might not be eager to vaccinate their children, Gardasil might be an easier sell amongst college-age males. According to the Times, Baruch Fischhoff, a professor of decision sciences (???) at Carnegie Mellon, "Being able to say to a girl, casually, that you had the shots, boys might think, 'If I can slip that into the conversation, it makes me less of a risk and seem like more of a humanitarian.' " And it might allow them to slip their penis in a young woman's vagina, if you know what I mean.

Vaccinating Boys For Girls' Sake? [New York Times]

Earlier: Cervical Cancer Vaccine "Burns," But Genital Warts Burn More
Gardasil For Men? New Study Of The Drug Focuses On Gay Men, Ass Cancer

These girls better get used to the sting anyway, since reports from last fall show that Gardasil might not be permanently effective, and some researchers are suggesting a vaccine booster after the ten year mark. As my mom would say: if you think Gardasil stings, try childbirth. There's never really any good comeback to that one.

Ouch! Cervical Cancer Shots Painful [Associated Press]

Earlier: Gardasil For Men? New Study Of The Drug Focuses On Gay Men, Ass Cancer
On Women: What To Do About HPV?
Female Trouble

i am not being unfair. and while i am driven by revenge and anger, i am also driven by the desire to stop drew (and other people) from knowingly spreading STDs around.

Who says that this guy even knew he had herpes? It's very possible he was asymptomatic. This is the shit that happens when you fuck strangers. Especially when you don't wear a condom. But she has an excuse for that, too!

you have let a guy rub his dick against you, not quite putting it in, but certainly loitering very very close to the goal posts. and i think we have all been in the situation where we have already succumb to this pre-sex near penetration and when a guy can't keep it up with a condom and you just want to get laid and he's like, c'mon it's basically been in you anyway, you have inevitably and against your better judgement said yes. and usually nothing bad happens to you.

Williamsburg's STD All-Stars
Related: Williamsburg "Herpes Avenger" Is Fighting STDs With Fliers [Gawker]
Earlier: Contrary To Popular Belief, Herpes Is So Whatevs

We took note of those rude comments some of y'all made in that Jessica Alba/Derek Jeter herpes post from last week. The whole point of that post, for us, was to be like, "Stars! They're just like us!" Sure, our Valtrex prescription isn't something we'd hang up on the fridge with pride, but we're not gonna be made to feel bad about it anymore either.
Genital Herpes: Stigma Still Strong [CBS]
Earlier: Did Derek Jeter Gave Poor Jessica Alba Herpes?