GOP Debate Recap: Night of the Texas two-step-stumble

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Speaking of Fast and Furious, it was once again skipped as a debate question — as were any major Obama scandals (Solyndra, Interior Department corruption, DOJ corruption).

Rick Perry lost big-time as he tried to do the Texas two-step on the Gardasil executive order and earned a wave of boos from the grass-roots Tea Party crowd on the Texas DREAM Act illegal alien student bailout.

Michele Bachmann, Ron Paul, and Rick Santorum effectively refuted Perry’s “err on the side of life” cop-out and offered powerful defense of parental sovereignty. Bachmann also astutely pointed out the Merck conflict of interest and Santorum emphasized the difference between vaccines for traditional communicable diseases vs. HPV. Watch the exchange here. Perry’s press team immediately sent out a rehashed press release “setting the record straight” within minutes of the exchange, prompting debate watchers to jibe that that’s what the debates are for.

…Perry’s second major stumble came on the DREAM Act — which he defended as a “states’ right” issue. Granting in-state tuition to illegal alien students incentivizes yet more illegal immigration at taxpayer expense. And mainstream Tea Party voters just ain’t buying it. Perry’s only saving grace was that he didn’t do as John McCain did and insult his critics as bigots.

Progress, I guess.

When he wasn’t sticking to economic issues, Ron Paul was singing from his worn “Blame America”/”Blame Israel” playbook.

Herman Cain was amiable, but stuck to his gimmicky 9-9-9 campaign line.

Jon Huntsman set off my auto-mute button every time he spoke.

Romney looked every bit the careful, calculating flip-flopper he was the last go-around and remains today.

Newt Gingrich plugged his books and websites, threw out some red meat, and prayed that the audience wouldn’t remember all his left-leaning, anti-Tea Party lurches over the last several years.

Bachmann’s strongest asset is her staunch, consistent opposition to TARP, Obamacare, and the debt-limit increase.

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Regarding Malkin — and Santorum’s “astute” biology lecture — no, it’s not a “parental sovereignty” issue, it’s a public health issue. Unvaccinated children are not simply more likely to get disease, they are more likely to spread disease. This goes for HPV as well as for pertussis.

If a given parent has a serious issue with vaccination, they can home school their kids or enroll them in a private school which doesn’t require vaccination.

HPV vaccination is important not simply for prevention of cervical cancer, but also for prevention of anal and oral cancer. HPV is currently the main cause of cervical, anal, and oral cancer. More than 2/3 of adults are infected with this virus by mid-life and there is the opportunity to dramatically reduce this (and therefore the associated cancers) through vaccination. The stakes are high and so is the opportunity.

Here’s a link to a table which shows the current status of HPV-related legislation on a state by state basis:

http://www.ncsl.org/default.aspx?tabid=14381

– Larry Weisenthal/Huntington Beach, CA

Larry, I will ask you again since you missed it last time. Does the HPV vaccine protect against all or even most strains? Also, what have you heard about the increased likelyhood of cancer if a woman that already has a strain of HPV is given the vaccine?
This is your area of expertise and I’m interested in hearing from you.

I would partly disagree with you about this being a public health issue. It’s not like you can spread HPV without sexual contact like you can with other illnesses.

Framing the DREAM act as a state’s rights issue was weird. I don’t question that the state of Texas had the *right* charge illegals in-state rates; the problem is that it’s a crappy idea and a slap in the face to Texas taxpayers.

@Larry: There are many measures that government could take to improve the health of the US public. For example, mandating a certain amount of physical exercise for everyone, especially those over age 50 (with exemptions and so on). But we don’t support them because there is still a recognition that people should be free to live as they please, even if that means dying at sixty from heart disease and a bad liver. Now in the case of infectious disease, exceptions are made because the danger is not just to oneself, but to others; so things like typhoid, smallpox, or whooping cough justify incursions into the public’s liberty, more or less in proportion to the threat presented (i.e. forcible quarantine in the case of smallpox, semi-mandatory vaccination in the case of whooping cough).
But in the case of HPV, you have a virus that is not passively transmitted. For the same reason that I didn’t support the isolation or mandatory public identification of AIDs patients (even though this was a very fatal disease twenty years ago), I don’t support mandatory HPV vaccination: it can be avoided with a little care (which at one time might have gone under the name of common virtue). If someone doesn’t care to avoid it, let them get the vaccine, then.

The more I listen to Santorum, the more I like him. Perry didn’t do very well in my opinion, he is not the Tea Party savior that the press was making him out to be. Did you notice how Wolf B. identified the first person with a question as a Tea Party “activist?” Think they have an agenda? Bachmann has that irritating voice and she wouldn’t look Perry in the eyes when she was bitch slappin him. Huntsman needs to be replaced by Buddy Roemer, he is a better candidate that the Rhino Huntsman. Perry needs to do some homework.

@bbartlog, #3:

Good public health policy decisions are based on an understanding of how human beings actually behave, rather than on how we would prefer that they behave. In my opinion Perry’s HPV vaccination decision was a sound and responsible one.

@Greg:

Darn it greg, I just replaced the last irony meter you destroyed. Now my new one is on it’s way to China like the first.
I should also mention you just blew up my hypocrisy meter too.

If science came up with a vaccine (or sets of vaccines) that protected people from HIV (AIDS) and syphilis and gonorrhea and each of the other sexually transmitted diseases, WHEN would be the optimal point in a person’s life to take the shot?
The logical answer is before they begin to be active sexually, whether voluntarily or by force.
Since child molestation exists it would make sense to vaccinate children on the parent’s say rather than wait until the person is an adult and gives his/her own say.
I don’t see where this differs from every other vaccine parents make sure their children have.

The average age of first sexual intercourse is 17 years in the United States. That generally isn’t with a note granting permission from the parents.

Hi Hard, BBart:

Firstly, to Hard: I did address your question the previous time. Just looked it up. Here’s what I said:

Hi Hard:

I’m not familiar with the potential risks you quote. If you can provide a source or link, I’ll be happy to review it/them.

I offer the following in support of Governor Perry’s position on Gardasil and on my position that it should be extended to boys, as well:

http://www.ncbi.nlm.nih.gov/pubmed/21288094

http://www.ncbi.nlm.nih.gov/pubmed/21198715

http://www.ncbi.nlm.nih.gov/pubmed/21142263

http://www.ncbi.nlm.nih.gov/pubmed/20686784

Now, you are quoting something with which I’m not familiar. To wit:

increased likelyhood of cancer if a woman that already has a strain of HPV is given the vaccine?

I’m not familiar with that. Again, if you can provide a link, I’ll be happy to read and evaluate it. But this is actually a further argument for vaccinating children prior to the age of sexual activity.

To address BBart’s comments:

We aren’t talking about adults taking responsibility for their own behavior. We are talking about children. For goodness sake, even the daughter of St. Sarah became pregnant as a teenage minor — presumably that means that she was sexually active. How many partners did she have before hooking up with Levi? Did she pass HPV along to Levi, who passed it along to others?

That’s why it’s a public health problem. It’s no different than any other serious, communicable disease. If a parent wants to be irresponsible with respect to the way that he/she raises her child, with regard to poor diet and lack of exercise, that’s not the same as being irresponsible in allowing their child to become a reservoir of infectious disease, that can be and is transmitted to other members of the community.

– Larry Weisenthal/Huntington Beach, CA

As of to date, we thought it was the best of the debates so far. Which did surprise all of us. Our gang is not into watching sports, but politics , and the debate amongst ourselves. I was glad to see to have to sweat it out on the illegal immigration issue, but I think that both him and Romney did well with their political sparring. I like the New and Improved Newt, but its too little too late. Bachman did much better this time too. Unless a miracle happens the rest of them are just side dishes to go with the main course. But the desert was watching Palin on Greta! She is still dancing around the “if I will run or not”. But she is asking all the right questions at least. I would love to see her run just to see if she would tackle the “cronyism” amongst the Republicans. An issue that all the other candidates follow the eleventh commandment for the most part. But an issue which is actively destroying our political system, the trust in politicians and government, and helping to bankrupt our nation fiscally and socially. Bachman did make Perry uncomfortable with the $5,000 for campaign contributions. But how can any of them honestly debate that issue? And that stuff about the old koot Ron Paul blaming 9/11 on us? we know he blamed the attack of the USS Cole on America, but I had no idea he had went that far.

@openid.aol.com/runnswim:

Let me see what I can find. I read it on a non-anti-vaccine site, but I’ll have to look for it.
EDIT- Good info and worth reading the whole bit of info in the link.

“The new vaccines target HPV types 16 and 18, which cause about 70% of the cases of cervical cancer. However:

The vaccines do not protect a woman who is infected withe vaccine strain of HPV infection before she is vaccinated—that is, vaccine needs to be administered prior to exposure to the virus.
They do not protect against other high risk (cancer causing) strains not in the vaccine—therefore, they will not eliminate all HPV-caused cancers. Thus, screening and treatment programs will still be needed to reduce cervical cancer deaths.”

http://www.immunizationinfo.org/issues/hpv-vaccines/mandatory-hpv-immunization-middle-school-girls

Here’s a link (that I’m not too sure of) that claims a potential for increased cancer risk if the person already has a strain of HPV when vaccinated.

FDA documents reveal HPV vaccine may increase your risk of cancer if you already have HPV. In trials, Gardasil increased risk by 44.6% of developing high-grade precancerous lesions in women who are already sero-positive and PCR-positive for vaccine-relevant genotypes of HPV. However, pre-screening for HPV infections has not been included in the vaccination program.

http://vran.org/in-the-news/hpv-human-papilloma-virus-cervical-cancer-vaccine-mercks-gardasil%C2%AE/

This is intersting
Cervical cancer incidence can increase despite HPV vaccination

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70182-1/fulltext

Here is a more credible source for the cancer risk/HPV issue.
Does Gardasil Vaccine Increase Cancer Risk?

http://www.gardasilhpv.com/2008/11/does-gardasil-vaccine-increase-cancer.html

Hi Hard: Thanks for the links. – Larry W (comments to follow tomorrow)

P.S. I read the links. This won’t take as long as I thought.

To respond to the points made in your last several comments:

1. No, the vaccine doesn’t protect against all strains of HPV. But it protects against about 70%. This is a case of not letting the perfect be the enemy of the good. Parenthetically, if one of the objections to vaccinations is that it will encourage sexual promiscuity, then having the vaccine be merely good but not perfect would actually seem to be an advantage, with respect to not creating the illusion of absence of risk (recalling also that vaccination against HPV doesn’t protect against HSV, HIV, hepatitis, and other STDs).

2. The most credible of your links (actually the only credible one) was the Lancet link, but this was making only a theoretical argument. Let me explain.

The incidence of cervical cancer has gone way down, since the introduction of the pap smear. HPV infection first causes dysplasia before it causes frank cancer. Dysplasia is sort of a transitional state between normal cells and cancer. Pap smears are very effective at identifying dysplasia before frank progression to cancer. When dysplasia is identified, the women are then followed more frequently (e.g. every three months, as opposed to once per year). Oftentimes, the dysplasia resolves on its own. In some cases, it progresses to early cancer, which is highly curable with a local surgical procedure which preserves the ability of the woman to have children later on.

The theoretical risk is that vaccination would lead to complacency. Vaccinated women would then, in theory, stop getting their yearly pap smears. In theory, this could increase the incidence of cervical cancer, by missing the opportunity to diagnose and cure it at an early stage.

This is an entirely appropriate caution. But the solution is not to eschew vaccination; the solution is to emphasize the importance of sticking to the traditional yearly pap exam.

With regard to the comment that vaccinating women who already had HPV infection increased cervical cancer by 44%, this is mentioned twice, but there isn’t a scientific source for this. That is, it’s an unsourced assertion. Supposedly buried in a drug company’s files, or whatever.

The FDA gets criticized all the time for being TOO stringent in protecting the public from alleged harmful effects of drugs and vaccines. If there were anything at all to this seemingly apocryphal assertion, it would, at minimum, appear as a “black box” warning on the label and it would be required that patients be screened for pre-existing HPV before receiving the vaccine.

I can’t think of a plausible mechanism, and I can’t imagine that there is anything at all to this assertion.

In any event, as I wrote before, even if this were true (which I very strongly doubt), it would be a strong argument in favor of vaccination of pre-adolescents (vaccinate them before they get infected).

– Larry Weisenthal/Huntington Beach, CA

@openid.aol.com/runnswim:
Thanks for the response. There was a bit of a stir after the HPV vaccine became mandatory in some states. There were articles about how it didn’t cover even most of the problem strains, but that appears to have been the usual media ignorance at work.
I am familiar with how the manufacturers are required to report everything in the trials even if it’s probably not the fault of the medication.
One of my favorite examples-Viagra
May cause back pain and muscle soreness.
Um yeah, it’s not the fault of the medication. 🙂