Yet another fascinating, informative installment from Team YLE. Thank you so much. The segment on HPV offered a really interesting window into how changes in practice can occur as the result of smart (!) research.
I also want to add a further note of applause to Team YLE for the incredibly helpful fall vaccine information sheet. I sent it out to friends and family and received thanks from many, in particular for the help it offered in trying to figure out what timing would be best for them. One person specifically noted how grateful he was for the information, as it saved his household such a lot of time trying to research this on their own. Well done, Team YLE!
Some/most CVS stores have the updated 2024-2025 Novavax Covid vaccine, yet when you book your appointment online, they don’t let you specify manufacturer. It’s hard to get through to the pharmacist to verify which vaccines they have on hand. Still, I was able to get the Novavax shot a few days ago, and the pharmacist was kind enough to let me see the box and syringe, both of which were clearly labeled “Novavax” and “2024-2025,” which gave me assurance I was getting the right shot. Added bonus: no vaccine hangover the next day.
Hi YLE! Thank you so much for your work, it’s been really helpful as I navigate COVID.
I hope you will update your language around gender and bodies - not only girls have cervixes. Trans people, non binary people, intersex people, and some boys do too! This includes many kids the age the HPV vaccine is targeted for. Using language like “people with cervixes” and “people without cervixes” is not only more welcoming and respectful, it’s more scientifically accurate. And it’s good public health since trans, non binary, and intersex people face so many health disparities. I hope you’ll consider being part of the solution and update this language to be more accurate.
Regarding polio: It’s a great accomplishment that wild type polio has been eliminated in all but two countries. The problem remains, however, that vaccine-derived poliomyelitis from use of oral polio vaccine (OPV) will continue. OPV-derived polio is paralytic and transmissible. We don’t use it here in the US anymore for this reason; we use IPV which is given by injection.
OPV will continue to be used in countries with more limited health-delivery infrastructure because it is much easier to administer, but it’s important to acknowledge that OPV is not the final answer to polio eradication.
Some oral cancers are also caused by HPV and the vaccines help to prevent those. This is not trivial since treating oral cancer can be very painful and tricky.
I came on here to say this too. HPV vaccine got the indication for oropharyngeal cancer prevention in 2020 (it did not get a lot of press at the time because of the pandemic). Because we can screen for cervical cancer, but not for oropharyngeal cancer, there are actually more cases of HPV-associated oropharyngeal cancers in men than cervical cancers in women in the USA.
Re: HPV and cancer. HPV also causes oral, pharyngeal and anal cancers.
There's no need to be coy, people have sex! There are many men whose oral cavities get exposed to cervical HPV during oral sex. There are men who have sex with men who get exposed to HPV and go on to develop anal cancer.
According to the NCI: "Based on national population-level observational data trends, HPV vaccination appears to decrease the risk of anal carcinoma in situ and invasive anal cancer among individuals aged 20 to 44 years after 2008 (when HPV vaccines were widely available)."
There are LOTS of reasons for boys to get the HPV vaccine!
I'm a 15-year survivor of a stage 4 head & neck cancer that was caused by HPV. Our son and daughter witnessed me go through treatment and recovery (ugly, painful, and followed by a lifetime of treatment-related sequelae) and they both asked for Gardasil-9 when our PCP offered it.
There's substantial high-quality evidence that vaccination against HPV has already resulted in a precipitous drop in cervical cancers. There's some evidence that anal and penile cancers are declining, and better evidence that the rate of genital warts is decreasing.
So far the evidence that the vaccine is decreasing the rate of head and neck cancers (which affect all sexes, but have a higher rate in males) is less strong, but not because the vaccine is less effective.
First, there isn't yet a widely-practiced routine screening protocol for head and neck cancers as there is for cervical cancers. This means that head and neck cancers are rarely discovered and diagnosed before stage 4.
Second, head and neck (oropharyngeal) cancers come in many different flavors - only about 60% are HPV-positive squamous cell carcinomas. The rest are (mostly adenocarcinomas) related to smoking and drinking. AFAIK global public health agencies like CDC don't yet track HPV-positive head and neck cancers separately, which means population-level epidemiological data on the effect of vaccination on the rate of oropharyngeal cancers is confounded by cancers for which the vaccine is ineffective.
The bad news is that the annual number of HPV-positive head and neck cancers diagnosed in the US is comparable to the number of cervical cancers - 25,000 to 30,000 a year. This is an expensive problem, as treatment runs $300,000 to $500,000 per case. The good news is that the prognosis for survival with treatment is very high compared to other cancers - some sources put the 5-year survival rate at over 90%.
Sorry for what you went through, John. I appreciate your post so that other people can be aware of it. I am really happy both your son and your daughter got vaccinated.
Might be better off to stick to the science, statistics and math of epidemiology. The inherent partisanship of politics, which you cannot hide, will surely disappoint and disturb segments of your readership. Your original intent of reaching the most with important information will be jeopardized.
It's really impossible to separate politics and public health, this has been going on for centuries. If you will notice, SCOTUS had made rulings that affect science, regulations and medicine.
No, that would be an inaccurate assumption on your part. Reproductive healthcare includes a wide range of health care having to do with people’s reproductive systems. To have any moral consistency or standing one must consider the sanctity of women’s lives too. Where state laws have criminalized procedures that could in any way be related to abortion, women who miscarry or have other problems in a wanted pregnancy are unable to get lifesaving and fertility-saving care because doctors are scared of going to jail. Women are abandoned to bleed out in pain and terror because they can’t access meds or procedures to resolve a miscarriage in process. They can’t get an ectopic pregnancy (these are never viable and the idea that an ectopic fetus could be transferred to a uterus is false and impossible) removed before it ruptures the fallopian tube, a massive and life-threatening trauma.
When you criminalize abortion care these are the results. You torture and murder women and force doctors into morally impossible violations of their oaths and ethics.
There are a LOT of ways to reduce the need for abortion if that - and not control over women’s bodies, sexuality, and life choices - is actually your primary goal. You make accurate sex education and contraception readily available so people who don’t want to have a baby don’t have barriers to preventing a conception. You provide free / affordable health care, parental leave, child care, food and education for children, so no one is driven to choose abortion by economic forces and so the sanctity of born children’s lives is protected with the same zeal. You work to end misogyny and rape culture and domestic abuse, so women who don’t want a baby are not impregnated against their will, and women who find themselves in abusive relationships (where a child would be unsafe and would make the woman’s escape more difficult) have support and resources to get out.
To criminalize abortion while refusing to take these obvious and morally necessary steps to minimize the need for it gives the lie to your purported priorities. Legislate for the things that save women’s and children’s lives, not
Violet, many thanks for your well-reasoned, compassionate and insightful reply regarding women’s and children’s health. You gave words to my thoughts. Way too many of us have lost the will to embrace critical thinking and nuanced complexity. You have not. Again, thank you!
Thank you, Violet. You make many interesting points. Certainly if men got Pregent life would be very much different. Would you support limiting pregnancy termination to the situations you describe?
I don’t think it’s possible to ethically or practically approach the situation in that way. Decisions about reproductive health care belong between women and their doctors. Government can do many things, some of which i described, to remove as much as possible many of the reasons abortions are needed. Provide education, contraception, health care, nutrition support, child care, empower women to be safe and avoid or leave abusive situations, pay women equally for equal work…. Respect the sanctity of women’s and children’s lives with the same vigor.
Some of these would require significant systemic social changes which, honestly, seem to be greatly at odds with the anti-choice agenda. If you’re trying to legally limit medical choices you’re going at it the wrong way. I don’t think there’s any way to try to impose restrictions that wouldn’t interfere with the ability of doctors to provide the best care and therefore endanger women’s lives. Those restrictions inevitably miss the reality of the situations people who feel they need abortion care find themselves in.
I personally think bodily autonomy is essential to human dignity and to impinge on it is unconscionable. The idea that women’s bodily choices need to be regulated by law posits that they will make frivolous and thoughtless choices about serious important matters that have huge impact on their lives and health if not prevented. Can you hear how unrealistic and offensive that is? Do you actually know any women who would not much prefer not to get pregnant in the first place than to have an abortion, or who don’t desperately want to be able to carry a wanted pregnancy to term and have a healthy child? I don’t. So why try to impose restrictions on them?
Tom: my mom died during my birth. Because of her pregnancy with me. I am 44, and my birthday is painful EVERY year, as it is the anniversary of her death. And, of course, there is the daily pain of never knowing my mother. Had my health been at risk during either of my pregnancies, I would terminated in a heartbeat to save my life. You truly cannot imagine. Abortion is not black and white. And honestly, it is a healthcare decision between a woman and her provider. People who are truly pro-life, as I am, understand that.
Thank you for all of the help you provide by explaining science in plain language to us all. You are really gifted at it. I believe that another reason for including boys in the HPV vaccine is that there is an increase of throat cancer among men, presumedly from them performing oral sex. I am glad we are protecting them! My wife and I had our boys vaccinated.
Interesting, I just posted my substack piece today on many of the same things covered today. For the Missouri case, raw milk and dairy products has been ruled out. I have questions also. Did he go to a state or county fair? Pet any animals at petting zoo? Also, the patient have a number of underlining medical conditions which would explain the hospitalization. Florida has 31 cases of locally acquired cases of the Dang Dengue, so they are well on the way to endemic 'break bone fever'. Glad you covered 988, also reported the MMWR on the subject of suicide. Interesting breakdown of insurance coverage.
"This law allows parents to peacefully spend the last few hours with their child without wires and machines."
My ex-wife and I did this, all those years ago. However, it turned out to be mere seconds, no, not even that, after the machines were turned off that he died. He was essentially dead already: a mere zombie kept alive by bleeping machines.
About the 'weather report'. I'm at an 'interesting' crossing. At age 83, I am battling high blood pressure with five focused medications twice a day. They work well, as long as I take them on a definite 12-hour rotation.
Then came the new Moderna Covid-19 Vaccine, at around 11 AM. In the evening, I took my evening heart meds as usual, and went to bed at the usual time. Shortly after midnight, I started feeling really ill with symptoms and measurements of very high blood pressure at a nasty level. Did not manage to measure my temp. At some point, I fell asleep with this going on.
In the morning, I woke with a a lesser level of misery, took my morning heart meds, and by late AM I felt and measured fine with my blood pressure.
So, I'm guessing that the reaction to the vaccine somehow augmented my BP issues beyond what the BP meds could handle.
I would think that this kind of reaction is not solely with me.
Yet another fascinating, informative installment from Team YLE. Thank you so much. The segment on HPV offered a really interesting window into how changes in practice can occur as the result of smart (!) research.
I also want to add a further note of applause to Team YLE for the incredibly helpful fall vaccine information sheet. I sent it out to friends and family and received thanks from many, in particular for the help it offered in trying to figure out what timing would be best for them. One person specifically noted how grateful he was for the information, as it saved his household such a lot of time trying to research this on their own. Well done, Team YLE!
Thanks for the great update.
Some/most CVS stores have the updated 2024-2025 Novavax Covid vaccine, yet when you book your appointment online, they don’t let you specify manufacturer. It’s hard to get through to the pharmacist to verify which vaccines they have on hand. Still, I was able to get the Novavax shot a few days ago, and the pharmacist was kind enough to let me see the box and syringe, both of which were clearly labeled “Novavax” and “2024-2025,” which gave me assurance I was getting the right shot. Added bonus: no vaccine hangover the next day.
Congrats!
Hi YLE! Thank you so much for your work, it’s been really helpful as I navigate COVID.
I hope you will update your language around gender and bodies - not only girls have cervixes. Trans people, non binary people, intersex people, and some boys do too! This includes many kids the age the HPV vaccine is targeted for. Using language like “people with cervixes” and “people without cervixes” is not only more welcoming and respectful, it’s more scientifically accurate. And it’s good public health since trans, non binary, and intersex people face so many health disparities. I hope you’ll consider being part of the solution and update this language to be more accurate.
Regarding polio: It’s a great accomplishment that wild type polio has been eliminated in all but two countries. The problem remains, however, that vaccine-derived poliomyelitis from use of oral polio vaccine (OPV) will continue. OPV-derived polio is paralytic and transmissible. We don’t use it here in the US anymore for this reason; we use IPV which is given by injection.
OPV will continue to be used in countries with more limited health-delivery infrastructure because it is much easier to administer, but it’s important to acknowledge that OPV is not the final answer to polio eradication.
Some oral cancers are also caused by HPV and the vaccines help to prevent those. This is not trivial since treating oral cancer can be very painful and tricky.
I came on here to say this too. HPV vaccine got the indication for oropharyngeal cancer prevention in 2020 (it did not get a lot of press at the time because of the pandemic). Because we can screen for cervical cancer, but not for oropharyngeal cancer, there are actually more cases of HPV-associated oropharyngeal cancers in men than cervical cancers in women in the USA.
Re: HPV and cancer. HPV also causes oral, pharyngeal and anal cancers.
There's no need to be coy, people have sex! There are many men whose oral cavities get exposed to cervical HPV during oral sex. There are men who have sex with men who get exposed to HPV and go on to develop anal cancer.
According to the NCI: "Based on national population-level observational data trends, HPV vaccination appears to decrease the risk of anal carcinoma in situ and invasive anal cancer among individuals aged 20 to 44 years after 2008 (when HPV vaccines were widely available)."
There are LOTS of reasons for boys to get the HPV vaccine!
I'm a 15-year survivor of a stage 4 head & neck cancer that was caused by HPV. Our son and daughter witnessed me go through treatment and recovery (ugly, painful, and followed by a lifetime of treatment-related sequelae) and they both asked for Gardasil-9 when our PCP offered it.
There's substantial high-quality evidence that vaccination against HPV has already resulted in a precipitous drop in cervical cancers. There's some evidence that anal and penile cancers are declining, and better evidence that the rate of genital warts is decreasing.
So far the evidence that the vaccine is decreasing the rate of head and neck cancers (which affect all sexes, but have a higher rate in males) is less strong, but not because the vaccine is less effective.
First, there isn't yet a widely-practiced routine screening protocol for head and neck cancers as there is for cervical cancers. This means that head and neck cancers are rarely discovered and diagnosed before stage 4.
Second, head and neck (oropharyngeal) cancers come in many different flavors - only about 60% are HPV-positive squamous cell carcinomas. The rest are (mostly adenocarcinomas) related to smoking and drinking. AFAIK global public health agencies like CDC don't yet track HPV-positive head and neck cancers separately, which means population-level epidemiological data on the effect of vaccination on the rate of oropharyngeal cancers is confounded by cancers for which the vaccine is ineffective.
The bad news is that the annual number of HPV-positive head and neck cancers diagnosed in the US is comparable to the number of cervical cancers - 25,000 to 30,000 a year. This is an expensive problem, as treatment runs $300,000 to $500,000 per case. The good news is that the prognosis for survival with treatment is very high compared to other cancers - some sources put the 5-year survival rate at over 90%.
Sorry for what you went through, John. I appreciate your post so that other people can be aware of it. I am really happy both your son and your daughter got vaccinated.
Might be better off to stick to the science, statistics and math of epidemiology. The inherent partisanship of politics, which you cannot hide, will surely disappoint and disturb segments of your readership. Your original intent of reaching the most with important information will be jeopardized.
It's really impossible to separate politics and public health, this has been going on for centuries. If you will notice, SCOTUS had made rulings that affect science, regulations and medicine.
May I assume "reproductive healthcare" is a euphuism for killing the unborn?
No, that would be an inaccurate assumption on your part. Reproductive healthcare includes a wide range of health care having to do with people’s reproductive systems. To have any moral consistency or standing one must consider the sanctity of women’s lives too. Where state laws have criminalized procedures that could in any way be related to abortion, women who miscarry or have other problems in a wanted pregnancy are unable to get lifesaving and fertility-saving care because doctors are scared of going to jail. Women are abandoned to bleed out in pain and terror because they can’t access meds or procedures to resolve a miscarriage in process. They can’t get an ectopic pregnancy (these are never viable and the idea that an ectopic fetus could be transferred to a uterus is false and impossible) removed before it ruptures the fallopian tube, a massive and life-threatening trauma.
When you criminalize abortion care these are the results. You torture and murder women and force doctors into morally impossible violations of their oaths and ethics.
There are a LOT of ways to reduce the need for abortion if that - and not control over women’s bodies, sexuality, and life choices - is actually your primary goal. You make accurate sex education and contraception readily available so people who don’t want to have a baby don’t have barriers to preventing a conception. You provide free / affordable health care, parental leave, child care, food and education for children, so no one is driven to choose abortion by economic forces and so the sanctity of born children’s lives is protected with the same zeal. You work to end misogyny and rape culture and domestic abuse, so women who don’t want a baby are not impregnated against their will, and women who find themselves in abusive relationships (where a child would be unsafe and would make the woman’s escape more difficult) have support and resources to get out.
To criminalize abortion while refusing to take these obvious and morally necessary steps to minimize the need for it gives the lie to your purported priorities. Legislate for the things that save women’s and children’s lives, not
that kill and torment them.
Violet, many thanks for your well-reasoned, compassionate and insightful reply regarding women’s and children’s health. You gave words to my thoughts. Way too many of us have lost the will to embrace critical thinking and nuanced complexity. You have not. Again, thank you!
Thank you, Violet. You make many interesting points. Certainly if men got Pregent life would be very much different. Would you support limiting pregnancy termination to the situations you describe?
I don’t think it’s possible to ethically or practically approach the situation in that way. Decisions about reproductive health care belong between women and their doctors. Government can do many things, some of which i described, to remove as much as possible many of the reasons abortions are needed. Provide education, contraception, health care, nutrition support, child care, empower women to be safe and avoid or leave abusive situations, pay women equally for equal work…. Respect the sanctity of women’s and children’s lives with the same vigor.
Some of these would require significant systemic social changes which, honestly, seem to be greatly at odds with the anti-choice agenda. If you’re trying to legally limit medical choices you’re going at it the wrong way. I don’t think there’s any way to try to impose restrictions that wouldn’t interfere with the ability of doctors to provide the best care and therefore endanger women’s lives. Those restrictions inevitably miss the reality of the situations people who feel they need abortion care find themselves in.
I personally think bodily autonomy is essential to human dignity and to impinge on it is unconscionable. The idea that women’s bodily choices need to be regulated by law posits that they will make frivolous and thoughtless choices about serious important matters that have huge impact on their lives and health if not prevented. Can you hear how unrealistic and offensive that is? Do you actually know any women who would not much prefer not to get pregnant in the first place than to have an abortion, or who don’t desperately want to be able to carry a wanted pregnancy to term and have a healthy child? I don’t. So why try to impose restrictions on them?
Tom: my mom died during my birth. Because of her pregnancy with me. I am 44, and my birthday is painful EVERY year, as it is the anniversary of her death. And, of course, there is the daily pain of never knowing my mother. Had my health been at risk during either of my pregnancies, I would terminated in a heartbeat to save my life. You truly cannot imagine. Abortion is not black and white. And honestly, it is a healthcare decision between a woman and her provider. People who are truly pro-life, as I am, understand that.
Oh - I am so sorry to learn this! Thanks for sharing though this personal story.
Thank you for all of the help you provide by explaining science in plain language to us all. You are really gifted at it. I believe that another reason for including boys in the HPV vaccine is that there is an increase of throat cancer among men, presumedly from them performing oral sex. I am glad we are protecting them! My wife and I had our boys vaccinated.
Interesting, I just posted my substack piece today on many of the same things covered today. For the Missouri case, raw milk and dairy products has been ruled out. I have questions also. Did he go to a state or county fair? Pet any animals at petting zoo? Also, the patient have a number of underlining medical conditions which would explain the hospitalization. Florida has 31 cases of locally acquired cases of the Dang Dengue, so they are well on the way to endemic 'break bone fever'. Glad you covered 988, also reported the MMWR on the subject of suicide. Interesting breakdown of insurance coverage.
Are you getting a sneak peep of my post? (LOL)
Appreciate your and your team's work so much! I'm very interested in your perspective on this opinion piece from Kathleen Parker in the Washington Post concerning late-term abortions: https://www.washingtonpost.com/opinions/2024/09/20/late-abortion-colorado-doctor/
"This law allows parents to peacefully spend the last few hours with their child without wires and machines."
My ex-wife and I did this, all those years ago. However, it turned out to be mere seconds, no, not even that, after the machines were turned off that he died. He was essentially dead already: a mere zombie kept alive by bleeping machines.
You never forget
About the 'weather report'. I'm at an 'interesting' crossing. At age 83, I am battling high blood pressure with five focused medications twice a day. They work well, as long as I take them on a definite 12-hour rotation.
Then came the new Moderna Covid-19 Vaccine, at around 11 AM. In the evening, I took my evening heart meds as usual, and went to bed at the usual time. Shortly after midnight, I started feeling really ill with symptoms and measurements of very high blood pressure at a nasty level. Did not manage to measure my temp. At some point, I fell asleep with this going on.
In the morning, I woke with a a lesser level of misery, took my morning heart meds, and by late AM I felt and measured fine with my blood pressure.
So, I'm guessing that the reaction to the vaccine somehow augmented my BP issues beyond what the BP meds could handle.
I would think that this kind of reaction is not solely with me.
Sorry, that is 3 meds AM, 4 meds PM.