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NVIC Vaccine E-Newsletter - May 08, 2008

Examining the Science & Politics of HPV Vaccine

by Barbara Loe Fisher

It has been nearly two years since the FDA fast tracked the licensure of Merck's GARDASIL vaccine and the CDC's Advisory Committee on Immunization Practices (ACIP) recommended it for universal use by all 11 year old girls. Calls for state mandates for sixth grade entry soon followed with Merck leading an aggressive lobbying campaign with pro-forced vaccination proponents talking about 12 year old girls having sex. The National Vaccine Information Center countered by publicly framing the debate about GARDASIL mandates as a product safety and informed consent issue: the vaccine had only been tested in fewer than 1200 girls under age 16 followed up for less than two years.

Now, a leading HPV vaccine researcher has spoken out opposing mandates in a three-part series produced by CBS4-TV in Miami. Speaking to investigative journalist Michele Gillen Harper said "We don't know yet what's going to happen when millions of doses of the vaccine have been given and to put in process a place that says you must have this vaccine, it means you must be part of a big public experiment. So we can't do that until we have more data."

It takes a lot of courage for any scientist or physician to stand up and speak out about the need for government, industry and physicians to embrace the precautionary principle: First, do no harm. Dr. Harper has upheld high standards for scientific and ethical integrity by responsibly calling for rigorous post- marketing surveillance of licensed HPV vaccines and adherence to the informed consent ethic.

The National Vaccine Information Center has received nearly 100 reports of serious health problems following vaccination. NVIC issued three reports on GARDASIL adverse events reported to the federal Vaccine Adverse Events Reporting System (VAERS). In August 2007, NVIC called on the CDC to warn doctors that the safety of giving GARDASIL simultaneously in combination with other vaccines had not been proven safe.

A family support group for those who have reported HPV vaccine reactions to NVIC is being created. If you or a loved one has suffered an HPV vaccine reaction, you can make a report to NVIC's 26- year old Vaccine Reaction Registry by going to https://www.nvic.org/report/reaction.htm. Please indicate if you would like to participate in the HPV Vaccine Reaction Family Support Group.

***********************************************************

"According to Dr. Diane Harper, "the vaccine has not been out long enough for us to have post marketing surveillance to really understand what all the potential side effects are going to be. We feel it is very safe." However, she adds, "We don't know yet what's going to happen when millions of doses of the vaccine have been given and to put in process a place that says you must have this vaccine, it means you must be part of a big public experiment. So we can't do that until we have more data." Barbara Loe Fisher agrees. She took to the streets a grass roots fight credited with derailing many efforts around the country to mandate the vaccine. "It was the quickest effort I have ever seen in 25 years for a vaccine to be mandated," says Fisher. A mother of a son who she say was left with learning disabilities following a routine vaccination in the 1980's, Fisher is President and Co Founder of the National Vaccine Information Center. It is a non-profit independent clearinghouse for information on vaccines and disease. Fisher says her organization has been contacted by nearly 100 parents claiming their daughters have suffered some type of adverse reaction following a Gardasil shot - at times given in combination with other vaccines. She says many parents are frustrated in their search for answers and that they don't know where to turn. She tells Gillen "the National Vaccine Information Center is getting reports every week, mostly mothers, of what is happening to their 11-year old girls after receiving Gardasil." - CBS4-TV (Miami), Michele Gillen reporting (May 7, 2008)
http://cbs4.com/video/? id=54565@wfor.dayport.com

"Bell says she now finds herself on a search for answers as to what happened to her daughter, Brittney, just weeks following an injection of Gardasil and a tetanus shot. The former cheerleader and runner's left leg was mysteriously affected by paralysis. The family wants to know if the condition could have been triggered by the vaccines she received that day. Reported adverse events following vaccine injections, including Gardasil, have come under increasing scrutiny by parents reviewing them on the U.S. Vaccine Adverse Event Reporting System (VAERS)....."Brittany's case is at a quandary," said Sean Cronin, attorney for the Bell family. Cronin says it is an uphill battle trying to investigate whether the Gardasil shot played any role in what has happened to Brittney. Christina Bell says Brittney's pediatrician does not believe there is a link. Now the Bell family has learned that Merck can't be sued over its Gardasil vaccine because it has been added to a federal list of vaccines recommended by the government. The vaccine manufacturers are insulated from liability."
- CBS4-TV (Miami), Michele Gillen reporting (May 25, 2008)
http://cbs4.com/video/id =53934@wfor.dayport.com

"Christina Bell's daughter, Brittney, was one of the young girls who recieved the vaccine. Just weeks later, her life took a radical turn for the worse. Seemingly, in a moment's time, Brittney's left leg became paralyzed, her ankle swinging like a rag doll's. Even with a shoe brace, she walks with a limp. "It's hard for me to lift it up," Brittney told Gillen. Brittney's limb paralysis occurred shortly after the 12 year old went to the doctor for a routine tetanus shot for school.....Last February, the FDA told CBS4 that it was investigating reports of 13 deaths following an HPV vaccination. At the time, the agency said it was confident that none were tied to the vaccine and that reports of adverse events were under review but not considered anything out of the ordinary. An FDA spokeswoman told CBS4 this week that she could not provide an update on the number of reported events, including deaths. "I haven't seen updated numbers for several months. We monitor on a daily basis but we don't total it up. We are not seeing a problem," said Susan Cruzan, spokesperson for the FDA.....Brittney's mom said she can't find a doctor willing to report an adverse reaction following the administration of her daughter's vaccines. CBS4 informed her that parents, just like doctors, can report an adverse event and the Bell family has done just that."
- CBS4-TV (Miami), April 24, 2007
http://cbs4.com/video/? id=53899@wfor.dayport.com


==========================================

HPV Scientist Speaks Out

CBS4 - Miami
May 7, 2008

Michele Gillen reporting

http://cbs4.com/video/? id=54565@wfor.dayport.com

http://cbs4.com/iteam/Gardisil.Girls.Vaccin e.2.71859html 

(CBS4 - Miami) Gardasil. It is a first of its kind vaccine designed to prevent cervical cancer and approved by the Food and Drug Administration on June 8, 2006 for use in females aged 9 to 26. Within weeks the vaccine was unanimously approved by the CDC's Advisory Committee on Immunization Practices for 11 and 12- year old girls. What followed was a cascade of calls by legislators around the country, including in Florida, pushing for this new to the market vaccine to be mandated for scores of young girls.

"This is a real danger zone, " says Dr. Diane Harper.

Why might you care about what she says? Dr. Harper is one of the world's top experts on the Human Papilloma virus, HPV, which can lead to cervical cancer. In fact, she's one of the leading scientists the pharmaceutical industries turned to for help to conduct clinical trials - including those that led to approval by the US Food and Drug Administration of Gardasil - and the recommendations that followed.

Speaking out in her first such television interview with WFOR-TV Chief Investigative Reporter Michele Gillen, Dr. Harper expresses concerns over what she considers a rush to recommend and mandate the vaccination of very young girls with the vaccine. "It went too fast, it went too fast without any breaks," says Harper, who devoted nearly two decades of her career to research on HPV.

Dr. Harper says she believes the vaccine is safe but cautions that time is needed to study potential side effects in larger numbers of young girls before any consideration should be given to mandating such a vaccine.

According to Dr. Harper, "the vaccine has not been out long enough for us to have post marketing surveillance to really understand what all the potential side effects are going to be. We feel it is very safe." However, she adds, "We don't know yet what's going to happen when millions of doses of the vaccine have been given and to put in process a place that says you must have this vaccine, it means you must be part of a big public experiment. So we can't do that until we have more data."

Barbara Loe Fisher agrees. She took to the streets a grass roots fight credited with derailing many efforts around the country to mandate the vaccine. "It was the quickest effort I have ever seen in 25 years for a vaccine to be mandated," says Fisher. A mother of a son who she say was left with learning disabilities following a routine vaccination in the 1980's, Fisher is President and Co Founder of the National Vaccine Information Center. It is a non-profit independent clearinghouse for information on vaccines and disease.

Fisher says her organization has been contacted by nearly 100 parents claiming their daughters have suffered some type of adverse reaction following a Gardasil shot - at times given in combination with other vaccines. She says many parents are frustrated in their search for answers and that they don't know where to turn. She tells Gillen "the National Vaccine Information Center is getting reports every week, mostly mothers, of what is happening to their 11-year old girls after receiving Gardasil."

Fisher says she has heard from parents upset that their doctors are refusing to report reactions potentially tied to this vaccine they recommended, if not aggressively pushed.

"I think that this has caused a real crisis of trust in the hearts and minds of parents who are being more educated about vaccines and all types of products they give their children," says Fisher.

Harper says parents need to be armed with as much information as possible. She believes the vaccine should be an educated choice. She explained that many parents do not realize or are not being told by physicians, that their daughters might end up needing a booster shot. She says what can be considered key study trials lasted at most 5 years and that there is no way to know exactly how long the vaccine will be effective.

"I think the thought is that there probably will be efficacy for longer than 5 years but its probably not going to be lifetime efficacy. There probably will be some need for a booster. There will be some need for understanding when we going to need to be able to revaccinate those women. Those are all open questions," says Dr.Harper.

Given that it is unknown for how long the vaccine will be effective, Dr. Harper says she can't stress enough the need for pap tests throughout a woman's lifetime, even if she has received an HPV vaccine.

Dr. Harper understands why some parents are left wondering how young might be too young?

Gillen asked Dr. Harper what she thought the optimum age of a girl should be to receive the shot.

"I would have started at 15, and not at 12," explained they physican.

Fisher says she applauds Dr. Harper for being willing to address controversial questions regarding HPV vaccines and concerns by parents who say they want more information before deciding if the shot is right for their daughters.

"I think that Dr. Harper has done a tremendous public service to stand up," says Fisher.

Dr. Harper says she is convinced HPV vaccines can help prevent cancers in the long run. But that parents and women should have a choice. Dr. Harper has also served as a consulting researcher for study trials for another HPV vaccine named Cervarix, being developed by GlacoSmith Kline, GSK. "I am the first author on two of the GSK papers," she noted.

But again she expressed her disapproval for any potential effort to mandate a Cervex vaccine for young girls. As Dr. Harper explains " It's still like-wise with Gardasil. They haven't been out long enough , there isn't enough information to have a mandate that you can't go to school until you have this vaccine. It does not make any sense."

Dr. Harper served as a researcher on study trials for Gardasil and Cervarix while employed as a professor at Dartmouth College. The University was contracted by both Merck and Co.. and Glaxo Smith Kline for the HPV studies who paid for the studies. Dr. Harper has disclosed receiving speaking fees from both Merck and from GSK for speaking about the HPV vaccines, and has received consultation fees from both Merck and GSK for consulting about trial development and data interpretation, in addition to the monies paid to Dartmouth to conduct the trials.

In asking a representative from Merck. for a response to the WFOR-TV interview with Dr. Harper and the types of concerns she raised a Merck representative provided WFOR-TV with the following statement:

Merck's research program for GARDASIL® [Human Papillomavirus Quadrivalent] (Types 6, 11, 16, 18) Vaccine, Recombinant] spans more than 10 years of rigorous study of more than 25,000 individuals around the world and the labeling for GARDASIL reflects the extensive data available from our clinical trials.

In addition, the data from our clinical trials have been discussed in public settings by leading medical and policy experts, including an FDA Advisory Committee meeting in May 2006, publications in The New England Journal of Medicine and The Lancet and meetings of the CDC's Advisory Committee on Immunization Practices (ACIP).

In February of 2006 the U.S. Food and Drug Administration (FDA) accepted the Biologics License Application (BLA) for GARDASIL and designated the file for priority review. A priority designation is intended for products that address unmet medical needs and under the prescription Drug User Fee Act (PDUFA), the FDA's goal is to review and act on BLAs designated as priority review within six months of receipt.

GARDASIL received its U.S. FDA approval on June 8, 2006 and on June 29, 2006 received a universal ACIP recommendation for use in 9-26 year old girls and young women.

We began discussions of data from the clinical trials with the ACIP's HPV Working Group as early as 2004. It is important to note that the three week time period between FDA licensure and the ACIP recommendation in June of 2006 does not represent the total amount of time the ACIP Working Group and full ACIP membership actually discussed the data and potential recommendation for GARDASIL - this time period was more than two years.

Since FDA licensure in June 2006 GARDASIL has been approved in 101 countries around the world and through March 31, 2008 more than 26 million doses have been distributed globally.

We are very confident in GARDASIL, and look forward to continuing to lead in the fight against cervical cancer. Here are some additional milestones you may be interested in as you complete your story.

· By 1996, Merck started production of the HPV-16 targeted prototype of GARDASIL.

· Merck filed an Investigational New Drug Application and started Phase I clinical trials of the HPV-16 prototype in 1997.

· Phase II trials of the prototype began in 1998.

· In 2000, Merck conducted the first dose-ranging trial of a vaccine to protect against HPV types 6, 11, 16 and 18.

· The first pivotal Phase III trial of GARDASIL, FUTURE 1, started in 2001.

· November 2001: An FDA Advisory Committee agreed on clinical trial design.

· The results from the first phase II trials of the HPV-16 prototype were published in NEJM in 2002.

· Merck presented results from the pivotal Phase III trials of GARDASIL at the Infectious Diseases Society of America (IDSA) meeting in October 2005.

· In December, 2005, Merck submitted its first license application for GARDASIL to the FDA. FDA later grants priority review. Merck also begins to file regulatory applications worldwide.

· May 2006: An U.S. FDA Advisory Committee unanimously agrees that the clinical data support the efficacy and safety of GARDASIL.

· June 8: U.S. FDA approves GARDASIL.

· June 29, 2006: In the U.S., the Center's for Disease Control (CDC's) Advisory Committee on Immunization Practices (ACIP) unanimously recommended broad vaccination with GARDASIL - routine for girls and women ages 11-26, with 9- and 10-year-old girls vaccinated at their physicians' discretion.

· Since July 2006: GARDASIL receives approval in more than 70 countries worldwide, including Canada, those in the European Union, Australia, New Zealand, Brazil, Peru, Taiwan and two countries in Africa.

· Nov. 1, 2006 - GARDASIL is added to the CDC's Vaccines for Children (VFC) Program

· In January 2007, GARDASIL was added to 2007 U.S. Childhood and Adolescent Immunization Schedules released jointly by the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).

· Recommendations have since been made by health agencies in other countries (i.e. Canada's National Advisory Committee on Immunization (NACI) on Jan. 30, 2007 and by the Australian Government in November 2006) and funding and reimbursement for GARDASIL is also becoming available in additional countries as well (i.e. Austria, Germany).

· In March 2007 the CDC finalized the provisional recommendation of its Advisory Committee on Immunization Practices (ACIP) for the use of GARDASIL. These vaccination guidelines were published in the March 23, 2007, issue of the CDC's Morbidity and Mortality Weekly Report (MMWR).


 
CBS4 I-Team: Vaccine Concern Part 2

MIAMI (CBS4)
April 25, 2008

Michele Gillen Reporting

http://cbs4.com/video/? id=53934@wfor.dayport.com

http://cbs4.com/health/vaccine.gardasil.i.2.708478.html

MIAMI (CBS4) ¯ The Gardasil television commercial is a popular one which markets a vaccine that is considered a major breakthrough in a fight the U.S. federal government is convinced can prevent cervical cancer. Within weeks of approval by the FDA, the Centers for Disease Control immediately recommended it for every 11 and 12-year-old girl.

Christina Bell, like many mothers, found her pediatrician recommending it for her daughter.

CBS4 Chief Investigative Reporter Michele Gillen asked Bell if it seemed like a no-brainer.

"I thought so," Bell told Gillen.

However, Bell says she now finds herself on a search for answers as to what happened to her daughter, Brittney, just weeks following an injection of Gardasil and a tetanus shot. The former cheerleader and runner's left leg was mysteriously affected by paralysis. The family wants to know if the condition could have been triggered by the vaccines she received that day.

Reported adverse events following vaccine injections, including Gardasil, have come under increasing scrutiny by parents reviewing them on the U.S. Vaccine Adverse Event Reporting System (VAERS).

"I think it's a marvelous addition to the scope of therapy I can offer kids," said Dr. Lorena Siqueira, Director of Adolescent Medicine at Miami Children's Hospital.

She says she believes the vaccine is safe and well worth prescribing for adolescents.

"Fortunately, I have no reports of serious reactions. I have seen occasional fainting episodes," Dr. Siqueira told Gillen.

Dr. Siqueira says she believes the fainting episodes are not tied to just the Gardasil vaccine but is the reaction of certain adolescents to an injection. Because of concerns over some girls who have reportedly fainted and injured themselves falling, the National Vaccine Information Center recommends that girls receive the shot lying down and that they be observed for 15 minutes after the injection.

"Brittany's case is at a quandary," said Sean Cronin, attorney for the Bell family.

Cronin says it is an uphill battle trying to investigate whether the Gardasil shot played any role in what has happened to Brittney. Christina Bell says Brittney's pediatrician does not believe there is a link.

Now the Bell family has learned that Merck can't be sued over its Gardasil vaccine because it has been added to a federal list of vaccines recommended by the government. The vaccine manufacturers are insulated from liability.

It's a fact many parents, and even some doctors, may not be aware of.

"You can't sue Merck over Gardasil," Gillen told Dr. Siqueira. She replied, "It's because vaccines are protected."

------------------

Statement from Merck regarding the GARDASIL vaccine:

Merck actively monitors adverse event databases throughout the world, including the U.S. Vaccine Adverse Event Reporting System (VAERS). An event report does not mean that a causal relationship between an event and vaccination has been established - just that the event occurred after vaccination.

The labeling for GARDASIL reflects the extensive data available from our clinical trials. The data, including safety information, have been thoroughly reviewed and discussed by medical experts.

Since its FDA approval in June 2006 through March 31, 2008, Merck has distributed more than 26 million doses of GARDASIL worldwide.

Merck will continue to evaluate all reports in the context of our own post-marketing adverse experience database and our clinical trial database. Post- marketing adverse event reports received by the Company are sent to regulatory authorities worldwide in accordance with regulatory requirements, and Merck updates its product labels with new safety information as appropriate.

Merck encourages healthcare providers and consumers to report any potential adverse experiences following vaccination with GARDASIL to the Company and to adverse event reporting systems.
 


 
CBS4 I-Team: Vaccine Concern Part 1

MIAMI (CBS4)
April 24, 2008

Michelle Gillen Reporting

http://cbs4.com/video/? id=53899@wfor.dayport.com
http://cbs4.com/iteam/vaccine.gardasil.i.2.708 105.html

MIAMI (CBS4) ¯ If you are the parent of a young girl you most likely have heard of a first of its kind vaccine named GARDASIL, developed to protect against the viruses which can cause cervical cancer.

The FDA's approval of the vaccine triggered efforts in Florida and across the nation to mandate its use for 11 and 12 year old girls. CBS4 Chief Investigative Reporter Michele Gillen has learned there is an increasing concern over the use of the vaccine.

Christina Bell's daughter, Brittney, was one of the young girls who recieved the vaccine. Just weeks later, her life took a radical turn for the worse.

Seemingly, in a moment's time, Brittney's left leg became paralyzed, her ankle swinging like a rag doll's. Even with a shoe brace, she walks with a limp.

"It's hard for me to lift it up," Brittney told Gillen.

Brittney's limb paralysis occurred shortly after the 12 year old went to the doctor for a routine tetanus shot for school. That is when Bell says the doctor suggested Brittney also have the GARDASIL vaccine on the same day. And she did.

GARDASIL is a first-of-its-kind vaccine approved by the U.S. Food and Drug Administration (FDA) for girls as young as nine. The vaccine is profiled on the FDA website with the headline, "New vaccine prevents cervical cancer."

In trials, the vaccine was shown to prevent pre- cancerous lesions due to certain types of Human Papillomavirus (HPV).

In searching for answers as to why her daughter now suffers from a limb paralysis, Christina Bell says she couldn't shake the idea that it might somehow be tied to the HPV vaccine. She hasn't found a doctor to agree with her, including the pediatrician who recommended the shot.

"He doesn't believe it has anything to do with the shot at all," said Bell.

She says he stopped returning her calls. When the CBS4 I-Team tried calling him, he didn't return the calls.

Bell began to research the vaccine herself and what she found startled her - government-compiled reports, filed from around the country, of adverse events that occurred sometimes within hours, other times within weeks, of a GARDASIL vaccination.

While they don't prove a link, they do document that in some cases an adverse event occurred following an injection. These types of events have been reported to VAERS, a federal vaccine reporting system.

"We've seen reports of] paralysis, convulsions, seizures in young girls. It's very, very, scary and very unfortunate," said Irene Garcia, spokesperson for Judicial Watch, a government watchdog group that obtained the VAERS records from the FDA through the Freedom of Information Act and posted them on the Internet.

When the data was finally released, Garcia said she felt outraged.

"It was outrage because all that I had seen publicly in the media and on television and from pediatricians was positive," said Garcia.

Last February, the FDA told CBS4 that it was investigating reports of 13 deaths following an HPV vaccination. At the time, the agency said it was confident that none were tied to the vaccine and that reports of adverse events were under review but not considered anything out of the ordinary.

An FDA spokeswoman told CBS4 this week that she could not provide an update on the number of reported events, including deaths.

"I haven't seen updated numbers for several months. We monitor on a daily basis but we don't total it up. We are not seeing a problem," said Susan Cruzan, spokesperson for the FDA.

In some states across the U.S., it is mandatory to report a suspected reaction to VAERS. But in others, it isn't.

"It varies by state and there is no blanket federal law, unfortunately," said Garcia.

Brittney's mom said she can't find a doctor willing to report an adverse reaction following the administration of her daughter's vaccines. CBS4 informed her that parents, just like doctors, can report an adverse event and the Bell family has done just that.

"It might always be that people will say you can't prove that this is linked," Gillen told Bell.

"I am still going to speak and tell everybody what I think. I tell everybody," replied Bell.

"What do I want today? I want my daughter back to normal," said Bell.

In a response to this report Merck, which makes the GARDASIL vaccine, issued the following statement:

Merck actively monitors adverse event databases throughout the world, including the U.S. Vaccine Adverse Event Reporting System (VAERS). An event report does not mean that a causal relationship between an event and vaccination has been established - just that the event occurred after vaccination.

The labeling for GARDASIL reflects the extensive data available from our clinical trials. The data, including safety information, have been thoroughly reviewed and discussed by medical experts.

Since its FDA approval in June 2006 through March 31, 2008, Merck has distributed more than 26 million doses of GARDASIL worldwide.

Merck will continue to evaluate all reports in the context of our own post-marketing adverse experience database and our clinical trial database. Post-marketing adverse event reports received by the Company are sent to regulatory authorities worldwide in accordance with regulatory requirements, and Merck updates its product labels with new safety information as appropriate.

Merck encourages healthcare providers and consumers to report any potential adverse experiences following vaccination with GARDASIL to the Company and to adverse event reporting systems.
 


 
National Vaccine Information Center

NVIC is funded through the financial support of its members and does not receive any government subsidies. Barbara Loe Fisher, President and Co- founder.

Learn more about vaccines, diseases and how to protect your informed consent rights
www.nvic.org

 

 

 

 
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