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Bioethicists Miles and Caplan challenge Bachmann's HPV-vaccine claim

Bachmann attacked Texas Gov. Rick Perry during the last two debates for an executive order mandating HPV vaccinations.
REUTERS/Scott Audette
Bachmann attacked Texas Gov. Rick Perry during the last two debates for an executive order mandating HPV vaccinations.

Talk about throwing down the gauntlet.

University of Minnesota bioethics professor Dr. Steven Miles announced on Facebook Wednesday morning that he was offering $1,000 for “the name and medical records release of the person who Michele Bachmann says became mentally retarded as a consequence of the HPV [human papillomavirus]” vaccine.

Dr. Steven Miles
Dr. Steven Miles

Within hours, Arthur Caplan, former head of the U of M’s Center for Bioethics and current director of the University of Pennsylvania Center for Bioethics, had upped Miles’ challenge by $10,000, according to the Minneapolis Star Tribune.

Neither man believes he’s going to have to pay out any money. But they’re hoping their offers will catch the public’s attention and counter the fearmongering that’s now swirling around the issue of the HPV vaccine — and, indeed, all childhood vaccines.

The HPV firestorm began when Bachmann took Texas Gov. Rick Perry to task during the last two Republican presidential debates for an executive order he issued in 2007 that mandated that all sixth-grade girls in his state receive the HPV vaccine. (The Texas state legislature later overturned the order.)

But then, on Monday, after the second debate, Bachmann went beyond criticizing the mandatory aspect of Perry’s order. She suggested that the vaccine itself could cause mental retardation.

“There’s a woman who came up crying to me tonight after the debate. She said her daughter was given that vaccine,” Bachmann told Fox News. “She told me her daughter suffered mental retardation as a result of that vaccine. There are very dangerous consequences.” Bachmann then repeated the story on NBC’s “Today” show the following morning.

Miles was furious. He knew that once an anecdote like that gets into the public record, there is no way to erase it.

And this one deserved to be erased, for there is no good evidence that the HPV vaccine causes serious health problems, and especially not mental retardation, a neurological condition that’s almost always present from birth.

“Whenever someone googles HPV vaccine, the reckless link with mental retardation will occur,” Miles wrote in an e-mail statement to MinnPost. “This has happened before with the abortion-causes-breast-cancer canard and the measles-vaccine-causes-autism sham. A strong counterblow is better than the passive be-quiet-and-this-will-blow-over strategy.”

“The [HPV] anecdote is now important,” he added. “If false, it should be refuted. If true, it should be properly vetted as an adverse event. Ms. Bachmann has a civic duty to help us identify this mother.”

Arthur Caplan
upenn.edu
Arthur Caplan

Caplan, in a commentary he posted Tuesday on the MSNBC website, said all he wants to do is “rescue the HPV vaccine from harm at the hands of politicians willing to hurt girls to gain political advantage. … The vaccines are exceedingly safe, studies show. There have been very few reports of serious problems from them, none proven. It is simply a lie to say they can cause retardation.”

That’s also what Dr. Marion Burton, president of the American Academy of Pediatrics said in a statement Tuesday:

"The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

"The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity. In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer."

By Tuesday afternoon, Bachmann seemed to be trying to pull back from her earlier comments — at least about the vaccine and mental retardation. When asked by Sean Hannity on his radio show if the HPV vaccine was associated with mental retardation, she answered, “I have no idea. ... I’m not a doctor, I’m not a scientist, I’m not a physician. All I was doing is reporting what this woman told me last night at the debate.”

For more on Miles’ views on the ethical issues surrounding the HPV vaccine, see my interview with him from last Friday. Also, the Pharmalot blog has a good story on the headache Bachmann’s comments are causing for Merck, the pharmaceutical company that makes Gardasil, the leading HPV vaccine. (Merck’s often questionable marketing actions in regard to Gardasil have hindered more than helped public-health officials make the argument for HPV vaccination.)

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Comments (38)

I prefer to just pray away HPV.

Of course no one will really call her on it. They are willing to discuss the vaccine and its health effects but they won't back her into a corner on how she created this phony story. I would be willing to bet my car that there was no woman, that Bachmann purely made this up, or that some crazy on her campaign said some kind of "what if" thing and Bachmann turned it into this story. The Star Tribune said that either she was misinformed or it was a Prevarcation or something like that. They can't just use the word "lie" because everyone is covering their rear ends rather than being plain spoken.

Don't forget Bachmann once claimed to have direct knowledge of a secret plan of how Al Qaida was going to divide up Iraq. The media let her slip that one in without consequences too. Lies are lies and this woman keeps getting away with it and using "oh poor dumb me" escapes like she did this time.

It's a little bit of a cheat on Miles' and Caplan's part. There's no way an (apparently) mentally retarded minor is going to release their medical record. And it would be unethical for the parent of an (apparently) mentally retarded teenager to publically release the girl's medical records.

That being said, I think the reward can be gotten if the medical record was released and confirmed by an independent medical doctor given permission to pretty much state that yes, or no, the onset of the child's mental retardation was coincident with the HPV vaccine.

I don't think that anyone can conclude from ONE case that coincidence of the two, if true, can even be considered linkage, let alone cause, though.

This is all about sex, of course -- not about health or medicine or government control or anything else.

Fundamentalist Christians believe people should not have sex outside marriage. Therefore, any medical procedure they perceive as encouraging that is to be opposed.

Hence opposition to abortion, to contraceptives and now to HPV vaccination.

You do not see Bachmann coming out against polio vaccinations, measles vaccinations, mumps vaccinations, DPT vaccinations or any other kind of "government" vaccination. Only HPV.

Why? Because it involves the naughty bits, and therefore is suspect.

It shouldn't surprise anyone that Bachmann knowingly tells lies to further her political agenda.

What is surprising is that our media continues to give her a platform to spread those lies, and refuses to call her what she is: a liar.

It's no wonder the public doesn't trust the media: they've abdicated their responsibility to report facts; instead choosing to make everything an issue of "one the one hand", and "on the other hand".

That's no journalism; it's crony capitalism.

“I have no idea. ... I’m not a doctor, I’m not a scientist, I’m not a physician. All I was doing is reporting what this woman told me last night at the debate.”

The operative part of Mrs. Bachmann’s pitiful defense is, “I have no idea.”

She could – and should – add, “…about much of anything.”

Hey Susan, don't believe I have read your stuff, but you sound like you will fit in nicely there at MinnPost.

Bachmann said, "I’m not a doctor, I’m not a scientist, I’m not a physician. All I was doing is reporting what this woman told me last night at the debate.”

Bachmann's point at the debate, was to point out that parents should have the choice in the matter, and Perry had questionable ties to the drug.

If my neighbor told me what the lady told Bachmann, I would tell my daughter about ALL the consequences of having sex, and shy away from taking the HPV...we will gladly choose to take that direction. You, on the other hand can do what you want! This cervical cancer is not contagious!!!

Why should we be forced by law to do something that Gov Perry thinks is good...for a variety of questionable reasons!

Can you stop bashing Bachmann (and everyone else who is not a Democrat), and write about what the overall point they are making. In this case the freedom to choose. That freedom is ok when "killing babies", but not refusing a drug to prevent a non-contagious disease?? Please...

This vaccine is not for a

This vaccine is not for a non-contagious disease and the fact that you made that comment and have already decided your daughter won't be getting it makes me feel very sorry for your daughter. Cervical cancer may not be contagious but the virus that can cause it, HPV, which is what this vaccine is for, is very contagious. Most sexually active people in this country will have it at some point in their lives and many will never even know it. Men cannot be tested for HPV so even a responsible and monogamous couple can pass it to each other. It can be passed to the mouth, vagina or anus and does not require penetration, only sexual contact. It can cause several different types of cancer and genital warts. The only way to prevent your daughter from getting HPV with a sex talk is to tell her to never touch another human being in a sexual way, including kissing. I agree that you have the right to make the choice but maybe you should make sure you're not making an UNINFORMED choice. Your daughter's future health could depend on it.

Are these guys Perry apologists or just defending the government's right to mandate vaccinations against sexually communicable diseases?

I'm pretty sure they're doing

I'm pretty sure they're doing neither of those things. The article is about a politician possibly killing people by spreading lies about a vaccine that saves lives. People are idiots, as this thread makes clear and they listen to the media and politicians instead of doctors when it comes to healthcare. Look at what Jenny McCarthy did to the MMR vaccine. Now frightened parents are refusing to safeguard their children because they think it's the right thing to do. People in the spotlight need to realize their words have very far reaching consequences.

I prefer to pray away Michele Bachmann

It is unfortunate that the real issue Bachmann started out talking about was whether the government has a right to mandate vaccination (safe or not) against a disease that is not casually communicable. I was absolutely floored to find that I had ANY common ground with Bachmann, and was disappointed that instead of opening up a very interesting topic for debate effectively turned it into a circus with her off-the-cuff comments.

Talk now; think later (if at all).

Three quotations say it all:

"It's very clear that crony capitalism could have likely been the cause[.]"

Forced to take an injection of "what could potentially be a very dangerous drug".

"It can have very dangerous side effects."

So much for "I was just reporting what I was told!"

[As for Rick Perry, does no one else think it odd that he was offended by the amount for which Ms. Bachmman feels he could be bought, as opposed to his availability on the Texas free market?]

Virtually all of these “vaccines cause ____” are pure hokey. There were cases during the Swine Flu epidemic, but even those were extremely rare. However, there are a ton of otherwise reasonable people who believe them because there can be an appearance of cause and effect – this happened to my child a week after that. But I would like to think that someone running for president would be a LOT more informed on the issue than what you would get listening to a single anguished mother of an unfortunate child.

And whoever said this is about sex is correct. Almost all social conservatives are fascinated by what other people do with their genitalia.

To #3, #6, #7, this is about nothing but lying. The "I'm not a doctor" stuff was said after the debate to hide her lie. She knows everyone will go off on the tangent just like you all did and forget that it all started with a lie. Doesn't matter what the original issue under debate was. The only, ONLY reason for the lie is to make points, get votes, gain power. She's not a fundamentalist Christian because if she truly believed the Bible she wouldn't intentionally lie, she would defend her position honestly. Her pretending to be something she is not is another lie, a lie no one seems willing to prove. This article seems like a way to acknowledge what most readers must know, that the candidate spoke BS, but at the same time protect her by following the path she points to even while acknowledging the falsehood.

Liberals have been falling for this phony trick at least since the beginning of the Iraq war.

Dennis in #8, there are other reasons besides the two you name, how about "defenders of honesty".

Actually, few people are "bashing" Rep. Bachmann for raising the issue about Gov. Perry's mandating the use of the vaccine and pointing out that he may well have done so in exchange for campaign contributions from Merck, the manufacturer of the vaccine.

What Rep. Bachmann is being "bashed" for is telling people that the vaccine is dangerous - based on an unamed person who claimed her daughter became "retarded" after using the vaccine. Without any review of the allegation, she reports it as factual. Rep. Bachmann has repeatedly used very, very poor judgement in this regard. Someone tells her an anecdote or story she wants to believe, she immediately is giving credence to it. One would a expect of member of Congress to have learned that while their are many opinions out there, they are not all factual or truthful.

@Fritz Dahmus:

"Why should we be forced by law to do something that Gov Perry thinks is good...for a variety of questionable reasons!"

Oh, gee, because all sorts of other things are forced on your for the good of the public, even if you want to believe otherwise.

There's nothing questionable about preventing cervical cancer; either you prefer your children to not get it, or you prefer them dead. But you can't have it both ways.

Since having sex is not required to contract HPV, all you so-called conservatives need to abandon that line of thinking as your reason for opposing the welfare of your children. Getting the vaccine causes no problems, and it doesn't condone or promote sexual activity among children.

@Fritz: The entire point of the vaccine is to protect against transmission of the virus which is undertood to be a primary cause of cervical cancer. That virus is contagious and is transmitted by sexual contact. So, ultimately, cervical cancer is contagious.

@Dennis: None of the comments made have defended Perry; all have gone after Bachmann on the basis of her statements regarding the vaccine itself.

I happen to agree with Bachmann that Perry's executive order was out of line, although I suspect that the $5,000 contribution had much less to do with that decision than did Perry's hubris.

There are, in my opinion, diseases which merit mandatory vaccinations. Polio is one. AIDS would be another, in my mind, if one with acceptable levels of risk existed. HPV is not, based on my understanding of the data available from the CDC.

http://www.cdc.gov/hpv/

While I see no evidence of an intentional lie by Bachmann, this and many other documented factual errors on her part over the years provide ample evidence that she is prone to talk now and think later (if at all). Most of the after-thought appears to go toward finding a way out of the most recently self-excavated hole in which she finds herself.

Parties and philosophies aside, Michele Bachmann is no more qualified for the presidency than anyone posting here. Her suitability for Congress becomes more apparent every week. (That's not a compliment.)

My youngest had the vaccinations. Now she's in med school. Coincidence?

Mrs. Bachmann can make a story out of this trumped-up cause/effect, too, but she wouldn't because it doesn't serve her purpose.

@#7 Mr. Dahmus,
You are right. Her point DURING the debate was about choice. And *gasp* I agree with her on that. However, there are two OTHER issues here.

1. Her point AFTER the debate is BS, plain and simple. She does not know and the supposed lady with a retarded daughter does not know the cause of the woman's daughters retardation. Period. And there is NO scientific evidence that the vaccine causes it. It is full-on crap. She's created and/or perpetuated a lie.

2. While I am inclined to say that the HPV vaccine should be an outright choice due to the nature of the disease, I also think it's foolish to "shy away" from it. The best time for vaccination with this particular vaccine is prior to sexual activity. You might not think 11 or 12 is an appropriate age, but all the birds and bees talk does not prevent many kids from having sex. And then it's too late. And if your kid is thinking about having sex, waiting to get the vaccine until that moment is also too late because vaccines are not instant protectors. And if your kid promises not to have sex before they're 18 (or 20 or 21 or 25 or 30) or promises to find that one forever monogamous relationship with another virgin, even if THEY keep their promise, that does not mean that your child will not be assaulted against their own will. And then, not only is she humiliated and scarred, it's too late to prevent the HPV infection she very well could get through no fault of her own. In light of all of that, it would seem smart to have the vaccination, though it probably shouldn't be mandated.

Oh, and by the way, while the cervical cancer itself is not contagious, it is caused by HPV16/18, which IS contagious. Cervical cancer has an overall 5-year survival rate of 73%. Sure, odds are a woman diagnosed with cervical cancer will live...if it's caught early enough...but she also has to go through cancer treatment, which is a trial unto itself.

For what it's worth, HPV16/18 is also linked to penile cancer and head and neck cancers, so the incidence of cancer in the population as a result of HPV infection may be underestimated.

Fritz, I think you are confusing the issue. No, cervical cancer is not contagious, but HPV is, and can lead to cervical cancer. The vaccination in question is against HPV, with the goal of preventing the cervical cancer which may follow.

It is not "bashing" Michelle Bachmann to point out that she has repeated this story as if it were fact, as evidence for her argument that HPV vaccinations can be harmful, when there is no proof at all that what she's saying is true. Bachmann makes statements that are questionable at best on a very regular basis. I'm very glad to hear that these bioethicists are calling her out on this one.

In regards to Mr. Dahmus' comments above:
If all Bachmann had done was to question Mr. Perry's requiring all 6th grade girls in Texas to get the vaccine, then there's no issue with that. Frankly, Mr Perry's order seems to me at odds with the typical small-government position of Republicans. Informed debate about policy is the foundation of our democratic republic. I agree with the freedom to choose, assuming one has truthful information to base the decision on.

Ms. Bachmann's claim, however, that "someone once told me" that HPV caused mental retardation is the problem. It may be true that the woman told her this, but she's using a very sly and dirty tactic to cause doubt that, frankly, doesn't exist in the medical community; the point being to undermine Mr. Perry. So she's either creating a false claim or repeating one to score points with voters. Either way, it's dirty pool and the reason Ms. Bachmann needs to be called out, not because she's questioning the right to choose.

"Bachman bashing" looks like just presenting the facts. She did lie. There was no "mandate." Parents could opt out and let their daughters contract and die of cervical cancer at some future day.
The trouble with this is, as the writer says, the lie goes viral and thousands and thousands of people believe it and act on it. They don't hear her backing away from it. They don't hear her excuses. THEY should listen to the doctors etc. but they probably won't.
It's a huge lie she promoted in order to help her candidacy, and she glommed onto it without checking any facts or evidence of any kind. Who in this world with a loud voice would stand up and say, "my neighbor told me . .. " etc. and base a policy position on it.
It's just Bachmann as usual, lying and trying to cover up her falsehoods and her lack of knowledge in much of anything.

The HPV vaccine is to be given to patients older than 9 years of age.

There NEVER, repeat, NEVER has been any incident where anyone could say that their child (9 years or older) suffered from "mental retardation" days after receiving the HPV vaccine.

To say so is just making s*** up. No way around that.

It's the same as saying you saw a purple unicorn walking by. Couldn't happen. didn't happen, will never happen.

And if Bachmann didn't make it up and was actually told that--that person was lying and Bachmann is a credible fool who lacks the power of reason.

The coincidence of vaccines and the onset of symptoms of "retardation" have only been reported in early childhood vaccines (in the first couple years of life).

Their money is safe! Bachmann does not speak with facts. She is strictly driven by the spotlight and what ever fiction is running around in her head at the time. She has such a frenetic pace there is no way she would have time to engage her brain before speaking. Now if we can find a way to turn off her spotlight so we don't hear her anymore that would be great. She does fit right in with the republican slate of candidates because they are for nothing and against everything even though they were for it before.

#8 Neither of the above. There are two good reasons to dislike Governor Perry's order: one is that it was an executive order, not a legislative mandate (the executive should not have that kind of power), and the other is that it looks suspiciously like a payback for a $30,000 (not $5,000) contribution). as others have noted, if Rep. Bachmann had stopped there, she would have made legitimate, if perhaps debatable, points. I could even have agree with her on those.

The real point is her willingness either to embrace junk science, in the form of an anti-vaccination bias that is, at best, unproven. She is neither a physician nor a scientist, so maybe she should not stick her neck out so far when she admits she doesn't know what she's talking about (side note: that means, of course, that all her pronouncements on global warming or mercury in lightbulbs can be taken as hogwash). A secondary point is whether this person she "quotes" actually existed or if she was just making her up out of thin air.

Bachmann, as seems to be her norm, takes a good point (parents should be informed consumers in control of their childrens' health care decisions, not forced to conform to a government mandate) and twists it way out of whack with this silly and unsupported contention about vaccines and retardation.

People, people. Pay attention. Republicans could not afford to pay for the level of distraction Michele Bachmann provides from real, major issues. This is straight out of the Republican playbook. Distract, divert, divide, and watch everyone scramble.

The reason Republicans don't muzzle that woman is that she's the bright, shiny object that gets people frothing with impotent rage. Michele fiddles while Washington burns. That kind of thing.

Michele Bachmann is the gift that keeps on giving. And now there's Rick Perry, her Tweedledee.

Liberals need to break this hold, become relentlessly pro-active, seize the debate and stop spending so much time reacting. Seriously.

I may be wrong, but as I remember, the big complaint about the vaccine was it was effective for only ONE of the ~ twenty varieties of the HPV that can cause cancer - along with the age they were talking about requiring these girls to have it. Have not heard anything about that in these comments.

The vaccine protects against

The vaccine protects against four strains actually. Two are the highest risk for causing cancer and the other two are the highest risk for causing genital warts. The vaccine is given at 11 or 12 because that's when the immune system reacts most favorably to it, not to mention teenagers are becoming sexually active much younger these days but 11 or 12 will catch most girls before that point in their lives.

@#28 Ms. Noren
That has been one of the tidbits of misinformation/distractions out there. The most common vaccine (Gardisil at over 35 million vaccinations) is directed at 4 strains of HPV. These strains include HPV 16 and 18, which cause 75% of all cervical cancers and an increasing number of other cancers. It also includes the two HPV strains that cause 90% of genital warts.

Though there are probably about 12-20 of them that are linked with cancers, most of them are not common enough to create a vaccine. Effective vaccines are difficult to make, and the more targets you are trying to hit, the more expensive it gets. Adding more strains simply provides diminishing returns.

Besides, most of these strains cause little or no known disease in relatively healthy people. They can pop up to cause severe problems in people with compromised immune systems, though.

For what it's worth, being infected with HPV can put a person at risk of contracting HIV (at least in men), even when matched for risky behavior, so the HPV vaccine MAY have secondary beneficial effects.

She told a lie. Own it and move on. I have worked with lots of people with developmental disabilities and none have claimed to have had an overnight onset. It just doesn't happen and to repeat such a claim is negligent and irresponsible.
My cousin has recently been diagnosed with cancer attributed to the HPV virus. For those of us who live the reality, it really sucks.

The HPV vaccine can cause brain damage because it, like all vaccines, can trigger an encephalitic reaction, and as a result brain damage.

That risk resides will all vaccines, it is just a matter of how many.

The gift that keeps on giving. No wait, I meant Ms. Bachmann.

To the people who are complaining about mandated vaccinations: I understand that the idea of mandated vaccinations makes people uncomfortable. To be honest, I don't love the idea either. Of course, if you've ever sent a kindergartner to public school, you know that mandated vaccinations are not unusual. Some people cannot be vaccinated for medical reasons. The reason we mandate vaccines is because these people are protected by herd immunity. If we don't hit a certain percentage of vaccinated people in the population, herd immunity does not work, and anyone who isn't vaccinated is in danger. It may be unpleasant, but mandated vaccinations are important to public health, something the government is supposed to be protecting. The measles outbreak in France this year is a direct result of the refusal of French parents to vaccinate their children. And if you think that HPV should somehow be treated differently simply because it is often contracted through sex, then you have bigger issues to deal with.

The real dialogue should have been the discussion that 1/3 of all oral cancers are HPV postiive. The alarming increase in oral cancer, in non-smokers, with a HPV + pathology could be related to sexual activity. The NCI is considering that boys and girls should receive the HPV vaccine.

This challenge is a charade. Bachmann has had no contact with the doctors at all. They are moral exhibitionists playing to their Team Obama media base, which as falsified Bachmann's position. She simply reported what a woman told Bachmann, who made not other claims.
The doctors and the media are aware of that fact, but, for political reasons, they have falsely attributed to Bachmann far reaching and non-existent claims about the HPV virus.
Take a look at the youtube video of Bachmann on TV the day after the debate and you will see that the media and the doctors have perverted Bachmann's clear statement.