Medscape reversal—Gardasil is great again

Last week, Orac reported on Medscape’s execrable article regarding Gardasil. As a reminder, the article spouted every antivaccination lie imaginable. The link subsequently disappeared, although a poll later appeared that parroted the article’s misinformation.

Well, today Medscape has a new Gardasil article. It’s definitely an improvement, but still has some problems…

The article appears with the following note:

Editor’s note: This article replaces “HPV Vaccine Adverse Events Worrisome Says Key Investigator,” which was posted on July 26, 2008, and was removed after editorial review.

Not all that informative, eh? Well, if you read all the good blogs, you’re in the loop.

Medscape is aimed primarily at physicians, so I would expect a certain type of writing. For example, jargon is more acceptable, given that the audience is medically knowledgeable. First, the article is very clear at the beginning—the title is “HPV Vaccine Deemed Safe and Effective, Despite Reports of Adverse Events”.

But it suffers from “both side-ism”, that is, the tendency among some journalists to think that every issue has “two sides”. In my field, for example, journalists sometimes feel the need to present “both sides” of the vaccine issue, as if there were actually two sides. In fact, there is only one side—the truth. The rest is just noise. It’s almost like presenting “both sides” of the “syphilis issue”. Presenting a settled scientific issue as a simple dichotomy both legitimizes fringe beliefs and buries real avenues of inquiry. We shouldn’t be asking if vaccines cause autism—it’s already settled. We should be asking how we can make better vaccines for more diseases.

In the course of presenting “the other side”, this article cites the National Vaccine Information Center (NVIC), and crank infectious disease promotion organization (or so I like to call it).

The NVIC, self-billed as “America’s Vaccine Safety Watchdog,” has also accessed VAERS reports and made them available in a searchable database on its Web site. These data show that during 2008, reports about Gardasil have accounted for 20% to 25% of all VAERS reports on all vaccines, Ms. Fisher said.

This is an extremely deceptive statement. Reports of serious reactions via the VAERS system are significantly lower for Gardasil than for other vaccines (although whether VAERS data actually means anything in this context is debatable).Via the CDC:

Among the U.S. reports, more than 94% were reported as non-serious adverse events such as brief soreness at the injection site and headache. Less than 6% were reports of serious adverse events, about half of the average for vaccines overall.

Perhaps the reporter could have done a little more homework, you know, like verifying the source data. “All reports” vs. “serious reports” is a rather important distinction. Then there is the plausibility factor:

In addition, the NVIC has been running its own private vaccine reaction registry for the past 26 years, and it currently has about 140 reports on Gardasil, Ms. Fisher said. “These include reports of injury and death, and we are seeing a pattern of what we have termed ‘atypical collapse,’ ” she commented. “These include cases where a girl suddenly passes into unconsciousness either immediately or within 24 hours of vaccination and then revives feeling weak and unable to speak properly or exhibiting other neurological signs. What we are concerned about is that girls are not aware of this possibility and could be crossing the road or driving a car and suddenly pass out.”

Any “data” collected by an infectious disease promotion group is pure bunk. “Atypical collapse” is an invention of the anti-vax folks. There is no physiologic reason to think that a vaccine can cause fainting, except a vaso-vagal response (“swooning”) upon seeing a needle enter the skin. Any fainting that occurs later is very hard to justify as “caused by” the vaccine.

I’m glad Medscape pulled the original article, but on close inspection, this one isn’t much better. Rather than being a blatant anti-vaccination screed, it is a poor piece of health reporting that still gives the impression of a scientific (rather than social) controversy where none exists.