Talk:Gardasil/Archive 1

HPV and Cervical Cancer Prevalence

I believe that some information about HPV and Cervical Cancer rates in America should be mentioned clearly (such as the graph below). It is a popular belief that Cervical Cancer and HPV are one of the most common STDs and cancers in the United States.

The Center for Disease Control says that only 1.6% of the population has the four strains that Gardasil prevents (Strains 6, 11, 16, 18). "Overall, prevalence of types 6, 11, 16, and 18 was 1.3%, 0.1%, 1.5%, and 0.8%, respectively." Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr56e312a1.htm —Preceding unsigned comment added by 96.28.105.175 (talk) 03:56, 17 March 2008 (UTC)

Also, Cervical Cancer isn't even in the top 10 most common cancers. In fact, it is classified as one of the "most rare cancers."

Lung and Bronchus Cancer 23.5%
Breast Cancer 16.9%
Other cancers 21.7%
Colon and Rectum Cancer 12.1%
Ovary Cancer 5.2%
Pancreas Cancer 5%
Lymphoma Cancer 4.4%
Leukemia 3.6%
Brain Cancer 2.3%
Mult. Myeloma Cancer 1.8%
-->Cervix Cancer 1.9%
Stomach Cancer 1.6%

A graph like this one would really be helpful and educational. Most people do not realize that they have more of a risk to get brain cancer (which can randomly strike anyone who is around vinyl chloride (a chemical in plastics) than they do getting cervical cancer. Most adults believe cervical cancer is just as common as Breast Cancer.

Invention of HPV VLPs

As stated in the helpful review article, "Who Invented the VLP Cervical Cancer Vaccines?" (PMID 16595773), the development of the current virus-like particle (VLP) vaccines was an incremental process involving research in several different research groups. For example, Ian Frazer (note Z not S) and colleagues' first report concerning VLP production concluded that the major capsid protein L1 cannot self-assemble to form VLPs (see abstract of PMID 1656586). This major error was corrected by other groups who were ultimately awarded patents for the VLP technologies. Attributing the invention of the vaccine exclusively to Ian Frazer is at best a half-truth and clearly isn't NPOV. Retroid 20:57, 4 August 2006 (UTC)

Merge into "HPV Vaccine"?

Is there a need to have a separate article for each brand of a medicinal product? If we have an article for every brand of drug on the market, the amount of articles will be tremendous. Wouldn't it make more sense to merge Gardasil and the other brand of HPV vaccine, Cervarix, into the article HPV Vaccine? Jkpjkp 18:24, 25 November 2006 (UTC)

While I can appreciate not wanting a page for all medicines on the market, it is possible that people who want to find information will only know the name of the medicine. If these articles are merged, will a search bring people to the appropriate page? 71.233.8.90 21:50, 11 December 2006 (UTC)

It's also important to note that unlike, say, ibuprofen, for which the generic is basically identical to brands like Advil, Cervarix and Gardasil are actually different chemical compounds (and Gardasil protects against strains of HPV that Cervarix does not), so they're not just different brands of the same chemical. 67.180.143.202 08:17, 16 December 2006 (UTC)

I believe since Gardasil is so new, it should for the time being kept as a seperate listing because of the frequency of people that should be looking for specifically it, which is how i got to this page. I like the idea of every drug having their own page because as a medical professional I'm literally combing through those pages all day. Gardasil also should be kept in its own listing because of the perceived use and success rate expected from the drug, and it also will allow more thorough information to be listed on the single drug, like for example I need to innoculate a patient with the drug and found the innoculation regimen on Wikipedia, so yes I advocate leaving the article alone as well... —Preceding unsigned comment added by 69.17.18.2 (talk • contribs) merging policy issues (see also Talk:HPV vaccine#Merger proposal as in the merger proposal - Government & Public Health Mandates - does not seem reasonable to have coverage of policy in a product article, should be in the vaccine article --Jkpjkp 14:11, 27 August 2007 (UTC)

In reviewing the VAERS (Vaccine Adverse reactions website) from Jan-July 2007, I see tha there are 1855 adverse reactions to Gardasil, out of 13,414 total listings (approx 14%). No wonder someone out there wants to merge/hide the Gardsasil information with the other brand...they have a lot to be embarrassed about. Do you work for Merck? —Preceding unsigned comment added by 71.146.21.127 (talk) 00:21, 9 September 2007 (UTC)

The main concern I have with this article is it is so intensely one sided that it leaves me with the impression that I'm reading an advertisement for Gardasil and Merck & Co., Inc..Aaron-was-here (talk) 13:11, 28 October 2008 (UTC)

Only available to women

I understand this vaccine is new, but why is it restricted to young girls?? I am a young sexual assault survivor male at increased risk for HPV yet no doctor or clinic will administer the vaccine to me.

I hope it does not become discontinued like the Lyme disease vaccine (due to poor sales). Restricting a vaccine against a virus that infects 40 percent of the population makes absolutely no sense. This is a terrible way to introduce it to the market. —Preceding unsigned comment added by Tmthymllgn (talk • contribs) 6:32, 30 November 2006 (UTC)

To answer the question above, currently its use is retricted to adolescent women and young adults because that was the study group formed by the FDA at the time of the drug's clinical trials. I think in the long run Doctors will realize the drug is also beneficial to patients of both genders and upwards of 50 years of age who believe they may have recently contracted Genital Herpes, but as a full blown cure it probably will not have a similar therapeutic effect if the patient has been living with Herpes for some time. Unfortunately, the drug is restricted solely due to the study groups formed and evaluated by the FDA, and like most drugs will require time before a larger market is opened to it.

If it helps, this CNN article (http://www.cnn.com/2007/HEALTH/conditions/02/02/cancer.vaccine.ap/index.html) mentions that Merck is currently testing the vaccine on "older women and boys." I think that the beginning, it seems like it was just going to be something to prevent cervical cancer, and therefore they only tested on women. But I'm sure have now realized that since HPV can cause genital warts in both sexes, that it would be a good idea to get the vaccine to work for everyone. Alabasterchinchilla 00:03, 3 February 2007 (UTC)

We’re supposed to have this thing in modern western culture called gender equality after all. — NRen2k5 08:21, 3 October 2007 (UTC)

Adverse effects

I know that I'm not supposed to post things about myself on Wikipedia and am not suggesting anyone do, but want to share this for those who do write/edit the article. I posted a blog wondering about adverse affects from this vaccine and now have about 200 comments most of which are stories of serious events occurring after vaccination which the patient (or patient's parent) believe are adverse affects of the vaccine...many of them seizures, fainting, ongoing limb twitching, soreness to the point of being unable to use/limited use of limbs, and severe skin disruptions. (Most are at http://www.kkrasnowwaterman.com/blog/tabid/2962/bid/1691/HPV-Vaccine-fainting-seizures-and-other-side-effects.aspx and the remainder are spread as comments to a few other blogs.) I'm not a medical professional, don't normally write about medical topics, and have no way to judge whether these are verifiable adverse affects. Since Wikipedia is a common source of information and so many of the people who've written in to my blog say they wish they had better understood the controversy over what the side effects are, I'm writing to request that someone create a more complete description of the list of alleged side effects and an explanation of (or link to one) who will research and how long it normally takes to decide what is truly being caused by the vaccine. Kkraz (talk) 05:38, 22 March 2008 (UTC)

Why isn't there any mention of the reports filed involving seizures (some resulting in injury) following the vaccination? I would consider that an adverse reaction. There are two reports of Guillain-Barre Syndrome possibly related to the vaccine, neurological affects like temporary loss of vision, dizziness, and slurred speech. There are also reports about joint pains and fevers. None of this is mentioned. —The preceding unsigned comment was added by 83.108.244.64 (talk) 20:34, 9 February 2007 (UTC).

I added links to the FDA's product information and APIC's meeting on Gardasil. These are probably the most authoritative sources on adverse effects available now. You can summarize their findings in the article, if you'd like. --VAcharon 05:05, 14 February 2007 (UTC)

The de:Paul-Ehrlich-Institut has recorded 189 cases of adverse reactions after Gardasil vaccination in Germany in less than a year (which is still rare considering that 2.2 million doses have been sold, though sales started before official approval and IONO how much of the stuf has actually been used). There have been at least 2 cases of SADS in close temporal vicinity with Gardasil vaccination. There appears to be upcoming debate on whether the (expensive) vaccination is really worth the cost (i.e., how many cases of CC are actually prevented by it that could not have been prevented/discovered early and treated otherwise). If you know German, see the news article here. Dysmorodrepanis (talk) 12:35, 4 February 2008 (UTC)

Since the first SADS death mentioned in the news article, there seems to be some edit war going on on de:HPV-Impfstoff. Just thought I'd mention that, because there is the occasional useful nugget of information contained therein. Dysmorodrepanis (talk) 12:41, 4 February 2008 (UTC)

I added "in Uganda" at the top of the page for the first reference, and also added a link to a Guardian article about deaths. I wonder if they will mysteriously disappear. —Preceding unsigned comment added by 89.122.36.148 (talk) 18:56, 10 September 2008 (UTC)

Monopoly and Parental Concerns

I think we could stand to have a second section on the two controversies involved with this vaccine. The first is that parents object to its use on the idea that it will make their daughters more promiscuous. The second, mentioned in passing, is that MERCK currently has a monopoly on the vaccine and is lobbying for the states to make it mandatory. Many of the scientists who've said good things about the vaccine had research funded by MERCK. For all that I believe the parents are mistaken and the scientists telling the truth, it could stand a mention.

This article from the Washington Post might make a good source. It also adds Virginia to the list of states contemplating a requirement. http://www.washingtonpost.com/wp-dyn/content/article/2007/03/03/AR2007030301356.html Darkfrog24 17:33, 6 March 2007 (UTC)

Quite a few people have died from this vaccine, why does this article make no mention of that?BenW (talk) 00:17, 4 October 2009 (UTC)

Michigan not the first state to require vaccinations

This passage was misleading:

• Legislation has been introduced in the state of Michigan to make Gardasil mandatory. If passed, this would make it the first state to require that its school children be vaccinated. diff from 7 September 2006

It implies that no other state has any vaccination requirements. I think it's common knowledge that many (if not most) U.S. states require immunizations against measles, mumps, rubella, etc.

I wonder how an error like this can stay undetected in an encyclopedia article so long (6 months).

I added changed it to say, "vaccinated against cervical cancer". [1] --Uncle Ed 13:58, 13 March 2007 (UTC)

"Against HPV" seems to be implied by the context. However, it doesn't hurt to be clearer. Darkfrog24 16:12, 13 March 2007 (UTC)

The above comment is patently False: The truth is there is NO law anywhere in the country that requires any vaccines.Although some claim there is.It is untrue.The vaccines they claim are the law are in fact simply a school policy ,and all you must do is tell them that you are exempt for whatever reason,and they are required to provide a waiver form.If they continue to claim it is law then you have grounds for legal action based on using a principle known as color of law.

Texas and the cervical cancer vaccination

Schlafly wrote:

• Governor Perry issued an Executive Order requiring young girls to receive Merck's HPV vaccine in order to enter the sixth grade. [2]

Are there any other sources for this? --Uncle Ed 13:58, 13 March 2007 (UTC)

Yes, that source does seem a bit biased. Here's the Associated Press: [3]. Here's the LA Times: [4] And here's the Washington Post discussing similar events in Virginia: [5], [6]. —The preceding unsigned comment was added by Darkfrog24 (talk • contribs) 16:23, 13 March 2007 (UTC).

Note: HPV is not cervical cancer. It can cause it. Gardasil is NOT a "cervical cancer vaccine". It's an HPV vaccine. — NRen2k5 12:22, 2 November 2007 (UTC)

Source Needed

"It is worth mentioning that Rick Perry's former Chief of Staff is currently the head of Merck's Texas lobbying team, and that Perry recieved $6000 in campaign contributions from Merck. The high cost of Gardasil is to offset losses due to Vioxx settlements and an official-sounding recommendation by Perry would lead many to believe that vaccination in Texas is mandatory, thus creating a constant pool of customers for Merck and allowing them to regain their losses by Gardasil sales in Texas alone. Being a patent protected vaccine, Merck is Gardasil's sole producer."

An anonymous user left this. It's good stuff, but we need a source. I could see why Merck would raise Gardasil's price to offset Vioxx losses, but without a source it sounds like speculation. The same goes for the idea that a rec from Perry would make people think the vaccination was mandatory (which I'm fairly confident it is). And "patent-protected" needs a hyphen. Darkfrog24 21:33, 21 March 2007 (UTC)

Side Effects

While mentioning that we don't know the side effects of Gardasil is an excellent idea, the idea that these side effects would neccessarily affect all these women's descendants is a little excessive for a contribution with no source. Also, considering that the vaccine wouldn't alter these girls' ova, I can say with some confidence that it isn't true. I'll make some changes. Darkfrog24 00:25, 28 March 2007 (UTC)

Found an article that links HPV to throat cancer. What do you think?

http://www.nytimes.com/2007/05/10/health/10brfs-CANCERPROTEC_BRF.html?n=Top%2fNews%2fHealth%2fDiseases%2c%20Conditions%2c%20and%20Health%20Topics%2fHuman%20Papilloma%20Virus%20%28HPV%29 http://content.nejm.org/cgi/content/full/356/19/1944 Darkfrog24 21:09, 11 May 2007 (UTC)

South Dakota and Washington

I read in the NY Times that South Dakota and Washington are both considering voluntary programs like New Hampshire's, but I don't want to add them to the chart until I know the current state of the legislation (in committee, House, etc.). Does anyone know where I might find a source? Darkfrog24 17:52, 17 May 2007 (UTC)

Vandalism/Deletion - How to warn administrators?

Hi, I'm not sure who the administrator is for this page, but 68.62.0.97 has deleted all the "External Links" and "References" from the page. --Justine4all 22:12, 5 September 2007 (UTC)

Not 2nd cause of cancer death in U.S.

"Cervical cancer is the second leading cause of death from cancer in the United States"

Cervical cancer isn't the second most common cause of cancer death in the U.S. (For the white population, it's No. 13.) The Washington Post article said it's the second most common cause of cancer death worldwide (because underdeveloped countries don't have good pap screening or surgery). But for Gardasil, the relevant reference is to the U.S. rate (because women in underdeveloped countries who can't get screening or surgery aren't going to get Gardasil either).

Cancer
Volume 107, Issue 8, Pages 1711-1742
Published Online: 6 Sep 2006
Annual report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic/Latino populations

http://www3.interscience.wiley.com/cgi-bin/fulltext/112777119/main.html,ftx_abs#TBL7

Table 7. Age-adjusted Incidence Ratesa for the Top 15 Cancer Sitesb for each Sex by Race/Ethnicity in the Selected Areasc in the United States, 1999-2003

I'm not changing it now because of the comment in the article. Nbauman (talk) 16:12, 29 January 2008 (UTC)

Those of us accustomed to reading medical literature recognise that it is almost a prerequisite in the opening paragraphs of any medical journal article to emphasise (if not exaggerate) the epidemiological importance of the subject of rest of the article. Nonetheless, misleading statements undermine the reliability of the rest of the piece, and so I concur that it is unhelpful and not honest to describe, to the Wiki audience, that cervical cancer is the second leading cause of cancer death in the US. In Western women the cumulative lifetime incidence of cancer of the cervix is around 1 in 80, whereas the risk of breast cancer is around 1 in 11 and bowel cancer 1 in 23. Perhaps a dozen other cancers have a lifetime cumulative incidence greater than that of cancer of the cervix. That is not to understate the importance or value of this vaccine. The risk:benefit ratio of Gardasil is irrefutably and overwhelmingly positive. But the global medical profession has a history of spin-doctoring the data it gives patients on a particular issue with some Macchiavellian flavour i.e. the end (getting everyone vaccinated) justifies the means (overselling the benefits and underselling the risks of the vaccination). This simply serves to alienate and disillude those few members of the medical laity who can perceive the "spin"; hence the ascension of anti-immunisation lobbies. Cervical cancer is hugely important in terms of loss of QALYs, and because its prevention is so simple and expeditious in comparison to other cancers. We need not exaggerate its raw incidence in order to convince patients honestly of the value of immunising against it.Drpeachy (talk) 13:09, 11 February 2008 (UTC)

Emphasize (if not exaggerate), indeed. Non-profit organizations that deal with a particular disease have a financial incentive to come up with statistics that exaggerate the importance of that disease. These exaggerated statistics get carried over to web sites about those diseases.

If you can make a simple statement that is relevant to the disease, like "Cervical cancer is the largest cause of cancer death in the developing world," then it belongs in the introduction. But if it takes a long statement of qualifications and distinctions, then it detracts from the purpose of the introduction, and doesn't belong in the introduction.

I think that statement about how cervical cancer ranks in the cause of death is irrelevant and detracts from the purpose of the introduction. Developing countries won't get Gardasil any time soon (which is worth a discussion further down). It should be deleted and discussed further down in the entry. If nobody raises any objection -- and they haven't so far -- I'll delete it.

I also think that complicated explanation of HPV types, and cancer types, are too unfamiliar for the general reader to belong in the introduction (although it could go further down). Wikipedia is written to be accessable to the general reader. You shouldn't have to be a medical professional to understand it. Nbauman (talk) 17:54, 11 February 2008 (UTC)

Nbauman, I completely disagree with pretty much everything you just wrote. You exaggerate the length and the complexity of the first paragraph. By including the strains of HPV that are covered by the vaccine, we a noting that not all strains of HPV are covered by the vaccine, and at the same time acknowledging the strains which are covered are the most virulent. In addition, the fact that cervical cancer is the leading cause of cancer deaths in developing countries is of the utmost relevance, particularly if we are going to make the usual Wikipedia effort to make the article global in scope. I cannot see how it would not belong in a prominent part of the article article. --IronAngelAlice (talk) 18:31, 11 February 2008 (UTC)

IronAngelAlice, let's take your objections one at a time.

I agree that Wikipedia is an international encyclopedia.

I agree (for purposes of argument, though I haven't checked it) that cervical cancer is the second most common cause of cancer worldwide.

However, I don't see the connection between cervical cancer death worldwide and Gardasil. According to NEJM, BMJ, Science, and everything else I've seen, no one is proposing to use Gardasil in the underdeveloped world in the forseeable future. It costs $600 for a series of vaccinations, and that's several times the per capital budget for health care in most of the countries in which cervical cancer is a major cause of death. (They're even having trouble with polio vaccinations, which is a higher priority.) In those countries, the public health people are dealing with cervical cancer by pap smears and surgery (cervical cancer is also one of the most curable cancers, if it doesn't get too advanced), which is much cheaper. In those countries, cancer isn't a major cause of death. Their major causes of death are infectious diseases.

Gardasil is not intended to prevent cervical cancer worldwide. So why include the worldwide incidence? Nbauman (talk) 19:06, 11 February 2008 (UTC)

I've read in several places that one of the main uses for Gardasil will be in developing countries since access to annual screenings is severely limited.

• http://www.cnn.com/2007/HEALTH/conditions/09/20/cancer.vaccine.ap/index.html
• http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47621
• http://www.merck.com/newsroom/press_releases/product/2007_0926.html
• http://www.emaxhealth.com/48/16526.html
• http://www.bio-medicine.org/medicine-news/Developing-Nations-to-Get--Gardasil-at-Lesser-Rates-from-Merck-Soon-16787-1/

--IronAngelAlice (talk) 19:21, 11 February 2008 (UTC)

The Wikipedia article "Cervical Cancer" claims that this cancer is the FIFTH deadliest in women worldwide, citing the World Health Organisation's Fact sheet No. 297 from July 2008 (http://www.who.int/mediacentre/factsheets/fs297/en/index.html). According to the WHO document, cervical cancer comes behind breast, lung, stomach and colorectal cancer.

Why doesn't the Gardasil entry cite a reputable source like that? Its reference is merely a Washington Post article about the Merck vaccine, not about cervical cancer in general, and it's not clear where the WP journalist (Andrew Bridges) got his information that cervical cancer is "the No. 2 cancer killer in women." —Preceding unsigned comment added by Mateeva (talk • contribs) 14:43, 7 October 2008 (UTC) Mateeva (talk) 14:50, 7 October 2008 (UTC)

ineffectiveness

"Vaccination with GARDASIL may not result in protection in all vaccine recipients." from here. So, what does this means? Is there any data on the percentage of the vaccines' ineffectiveness? Rosa 19:01, 8 April 2008 (UTC)

Worldview

This article is good, but I think it needs more information on takeup in countries other than the USA. I believe that it is commonly used in government funded compulsory vaccination programmes for teenage girls in some EU countries, but need to find more information about this. Also, there are press reports that the UK government chose rival vaccine Cervarix over Gardasil for its compulsory vaccination campaign in order to save money, despite the fact that Cervarix protects against fewer strains of HPV. [7] —Preceding unsigned comment added by Saluton (talk • contribs) 14:58, 18 July 2008 (UTC)

Please note that much of the material that was in the "Government & public health mandates" section has been moved to the HPV vaccine article, per the discussion on merger there Talk:HPV vaccine#Merger proposal. (Just haven't finished merging in the material on the US.) Since most of the policy material deals with HPV vaccination, rather than a specific vaccine, it makes more sense in the general article.

I am not sure to what extent specifics on who using what should be in the individual Gardasil/Cervarix articles, vs. being in the overall HPV vaccine article. I don't oppose including more information about usage, but it would be nice to minimize duplication/overlap. Zodon (talk) 20:03, 18 July 2008 (UTC)

"Free" vs. The truth.

Look, I don't care if a secondary source says something that isn't true. The primary source, i.e.: The State of Alaska, clearly says where the funding for their vaccination program comes from...

Federal funding to boost Alaska’s vaccine program The Alaska Department of Health and Social Services announced today that an increase in federal funding will make it possible for all Alaska girls ages 9 through 18 to receive Gardasil ®, the vaccine to prevent cervical cancer, at no cost. This boost in federal aid will enable more Alaska girls to receive Gardasil.

It's very clear that Federal Funds (i.e.: Taxpayer Dollars) are being used to pay for this program. This isn't about some libertarian agenda, it's about the truth. The truth is clearly and correctly sourced (I don't think anyone would argue that a official State of Alaska press release is a bad source).

Can someone provide me with a reason as to why the source of funding for this program does *not* merit inclusion in the article, and, instead, a general "no-cost" or incorrect "free" statement should remain? TheUncleBob (talk) 23:39, 20 July 2008 (UTC)

Note that the sentence you have repeatedly edited is talking about New Hampshire, the reference you have been citing is about Alaska, and says nothing about funding for New Hampshire. It turns out the appropriate reference is also in the article, and it indicates that the funding is part federal and part insurance. The Alaska reference indicates that part of the funding for making the vaccine available "at no cost" comes from Federal funds, but does not say where the rest of the funding came from. So saying that the funds are solely Federal is contradicted by the references. Zodon (talk) 01:46, 21 July 2008 (UTC)

The article states the Alaska plan is similar to the NH plan. Therefore, it's a reasonable conclusion that they're funded similarly. TheUncleBob (talk) 13:30, 21 July 2008 (UTC)

Also the assertion made above and in some of the edits that such funds come from taxpayer dollars is not mentioned at all in the references and appears to be WP:OR. Zodon (talk) 01:46, 21 July 2008 (UTC)

As opposed to the federal funds that come from pixies and Santa? TheUncleBob (talk) 13:30, 21 July 2008 (UTC)

There is nothing "untrue" about saying that the vaccines are available at no charge. That is one of the things that the cited references say, so it appears to be verifiable. Zodon (talk) 01:46, 21 July 2008 (UTC)

Except the fact that someone *is* being charged for them. Saying that they're avaaliable at no charge could lead people to think that Merck is donating the vaccines. There is nothing wrong with wanting to add clarity to the article TheUncleBob (talk) 13:30, 21 July 2008 (UTC)

I don't think it is worth including the source of funding because of undue weight. There is nothing particularly unusual about the source of funding, many countries provide similar levels of health care support by similar means.

Since there isn't much here yet about cost-effectiveness, saying that these programs are paid for by Federal funds/taxpayer dollars/whatever may also be misleading, since by preventing other expenses, the vaccine might actually save such funds. Without a complete analysis to give perspective, it isn't clear that focusing on where the funds come from temporarily aids understanding.

The article is about Gardasil; the source of funding for a few states in one country doesn't seem that important to understanding the vaccine and its place in the world. Zodon (talk) 01:46, 21 July 2008 (UTC)

If the source of funding isn't important, then the "at no cost" or "free" statement should be removed completely. If a few states in one country isn't important, then let's remove the section completely. TheUncleBob (talk) 13:30, 21 July 2008 (UTC)

Wikipedia follows a process, and a major part of that process is WP:RS. You can't write something because you think it's true, you can only write it if somebody else, who is a reliable source, thinks it's true. Most of what you're saying above is guesswork and speculation about details of funding that aren't explicitly stated in the sources. Any editor is free to challenge those facts and remove them, and we have done so. If you want to put them in, you have to find a WP:RS to support them.

This process is enforced by the WP:3R rule, which you seem to have violated. My inclination is to let it go, but if you continue to make changes without discussing them first in Talk, and getting consensus, we would use the WP:3R rule to get you blocked. It's nothing personal, but we can't let people damage Wikipedia.

Even if you did find a source, there would be a question of WP:WEIGHT, and I tend to agree with Zodon. I'd have to know why you think it's so important to mention in that place that the vaccinations are subsidized by federal money, since it's stated elsewhere in the entry.

I don't see the purpose of a state-by-state compilation of regulations, which was more important when Gardasil was first introduced but isn't important now. However, I wouldn't delete it without getting a consensus on talk. I'd want to know first why people think it belongs. Nbauman (talk) 15:52, 21 July 2008 (UTC)

In response to TheUncleBob's comments above:

One can't assume various states use same funding without verifying. (Since the editors who inserted the material didn't talk about the sources of funding, there is no reason to expect that they thought the programs were necessarily similar in that respect.)

I don't know the extent of federal funding from the sources you mention, I suspect that more funding comes from e.g. leasing or sale of public resources, fees, fines, interest, etc., but whatever the source claimed, it would need verification and a reference that ties it to providing Gardasil vaccinations before it reasonable to consider putting in the article.

All it says is that the recipient isn't charged. Nothing there indicated donation of vaccines. As to who ultimately foots the bill, as noted before that is complicated and without even the beginnings of a thorough answer, better to keep out of it. For those interested in the immediate sources of funding, the references were and are a couple of clicks away, hardly obscure or misleading.

Providing vaccination at no cost to the recipient is one way of promoting vaccination/public health. Since the US is unlike many industrialized nations in not providing health care for all its citizens, instances where such services are provided are somewhat worthy of note. Rather than constantly trying to reassert the edit might be more productive to, e.g. check to see if these states still offer the vaccination free of charge. Since the funding sources appeared in some cases to be temporary, if a source indicated that the programs are no longer available, e.g., then the whole business could certainly be deleted.

In the absence of further information, rather than just deleting it I think it should be merged into HPV vaccines, as noted in the section and discussed in Talk:HPV_vaccine#Merger_proposal. I have done much of the merger, but this little snippet still needs working into the rest, and possible abridgement. Zodon (talk) 18:13, 21 July 2008 (UTC)

Blah, blah, blah... Don't quote reliable sources to me - THE FRICKIN' STATE OF ALASKA WEBSITE IS A RELIABLE SOURCE FOR THE STATE OF ALASKA'S PROGRAM. Second, I didn't break the 3RR first. I made the initial change, it was reverted by Zodon. I put the change back in, clarifying that there was a source, already in the article. Nbauman made the second revert. I then clarified the wording a little (changing "Taxpayer" to "federal") to which *you*, Nbauman, made the THIRD REVERT. You want to make threats about getting someone blocked for constantly reverting changes without bringing them to the talk page? You were the one guilty of it, Nbauman, with Zodon making a fourth revert, also without bringing the discussion to the talk page.

It appears to me that you two are completely uninterested in improving and clarifying the wording within this article, choosing to use phrasing that is clearly ignorant of the facts - "free" isn't free when it's being paid for - anyone with a basic education can make sense of that.

You claim to be worried that stating the correct funding for the program violates NPOV, yet doing something as simple as leaving it out violates NPOV *AND* leave the article with false information in it. I'm out - good luck destroying the article and the truth even more. I don't know if you do it by choice or if it's just plain ignorance of the facts, but either way, you win. TheUncleBob (talk) 03:50, 22 July 2008 (UTC)

The source problem is not a question of reliability of the sources given, but you asserted things that the given sources did not say.

As far as changes and reverts WP:BRD might help.

As you say, anyone with a reasonable degree of sophistication realizes that someone is paying the price for something that is provided at no charge. Since this is always the case ("There's no such thing as a free lunch."), saying that something is provided at no charge is not misleading or false. In this case there was nothing especially different/interesting about the source of funding, so not much reason to include it. Zodon (talk) 06:14, 22 July 2008 (UTC)

Only four strains?

So the vaccine uses virus-like particles to induce the body to produce antibodies for HPV. Does this definitely only protect against these four strains, or does it actually protect against any strain with a similar capsid? I am wondering if they only spent money on tests for these four strains, and so those are the only ones they can legally say it prevents, while it might prevent others, too. —Preceding unsigned comment added by 71.167.65.247 (talk) 19:51, 4 September 2008 (UTC)

You might want to take a look at the entry on Cervarix, if memory serves they had some evidence of some effectiveness against related strains. Don't know to what extent that would apply to Gardasil - since they use similar technology it might. Zodon (talk) 04:04, 5 September 2008 (UTC)

Merck marketing?

Is this entry in Wikipedia dedicated Merck to do marketing and censorships? All entries seams to be deleted, pure vandalism! Entries seams to be deleted based on censorship... ? IDNaa (talk) 02:46, 27 October 2008 (UTC) ````

IDNaa, Wikipedia articles need to have good sources WP:SOURCE. Judicial Watch is not a reliable source. You put aluminum adjuvant in a safety section but you do not say why it is relavent for safety, if you do not have source, that is original research, WP:OR. And we try and assume good faith, WP:FAITH about other editors like not saying they are doing marketing and censorships from Merck except we have good evidence for it. RetroS1mone talk 03:20, 27 October 2008 (UTC)

Your pointers are appreciated - thanks. As a side point to good faith; Please also see related to 'SSP' for "problem might merely have been caused by a mistaken login or other absent-mindedness" so "ask the user.." (and I could have told you). (I asked for Meck, because the topic is a trademark name).IDNaa (talk) 18:40, 28 October 2008 (UTC)

IDNaa, Consider also WP:BRD. If edit summaries don't make it clear enough why a particular edit was removed/changed (and you think it worth pursuing) consider making courteous inquiry for further input on the particular item on the article's talk page. Zodon (talk) 08:16, 27 October 2008 (UTC)

Why is Judicial Watch not a good source in the given context? JW has an entry in Wikipedia, as I pointed to. This is a generic question: Can JW not be used as source for what they do? For aluminum adjuvant under "safty": I had a link to aluminum. (I guess I did not get your point?)IDNaa (talk) 18:40, 28 October 2008 (UTC)

1 Aluminum adjuvant under safety:

• • The source you gave made no link between the aluminum adjuvant and safety. So putting it in the safety section was misleading and/or WP:OR.

2 Judicial watch:

• • The general activities of Judicial Watch are not really relevant to this article, more appropriate to the article about the group.
  • The external link did not appear to be appropriate under WP:EL (again, more appropriate to the Judicial Watch page).

By Wikipedia quality standards WP:RS, or the standards for WP medical articles they would not rank high in the scale of quality sources. (e.g. articles in reputable peer-reviewed journals, college level textbooks, etc.) My own observation has been that many of the publications by Judicial Watch [that I have seen] have been biased[unbalanced], poorly sourced and poorly researched. Often one can find better sources.

3 As for the item about percent of VAERS reports (which was attributed to Judicial Watch)

• • The edit lacked a citation
  • The edit didn't provide enough information to interpret the number (it was just here's a number) and since it was under safety that implied that it had something to do with safety. (For it to be meaningful would need something for comparison - how compares to other vaccines, how compares to number of doses, etc.)
  • Upon investigation, the only source I could find for the Judicial Watch thing also did not provide any of the necessary background to make useful content out of it, or to track back source for the number. (e.g. when was that percentage calculated).
  • The percentage of VAERS reports they gave for Gardasil differed significantly from the current figure (i.e. being larger than the current figure by 1/4 -- VAERS figures via CDC Wonder, 26 October 2008). (so it was incorrect and potentially misleading)

Zodon (talk) 23:57, 28 October 2008 (UTC)

Zodon; Thanks for BRD pointer.

I wrote that "Gardasil has not been evaluated for the potential to cause carcinogenicity or genotoxicity" with a pointer to Merk's product information which has been published. You deleted this (27/10) with 'Gardasil was shown to STOP carcinogenesis'. Your source? IDNaa (talk) 19:27, 28 October 2008 (UTC)

Nor has Gardasil been evaluated for the potential to cause your penis to fall off. What's your point? 98.235.79.121 (talk) 13:16, 30 May 2009 (UTC)

I didn't make the comment, but thought I would drop in with a few sources anyway. Try Lowy [1], FDA [3], Quadrivalent vaccine ... [7], ROBERTS [9], NCI HPV vaccine Q&A [16], etc. (# in brackets is current citation number in the article). Zodon (talk) 00:10, 29 October 2008 (UTC)

None of your links contradict that Merck's own "Gardasil Product Monograph" (Which is included in the "external links" has this disclaimer "13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility: GARDASIL has not been evaluated for the potential to cause carcinogenicity or genotoxicity. This can also bee obtained from [8] which refer to article published in Lancet. What I also found is that there are evidents that Polysorbate 80 MSDS may be a carcinogenic, (cause cancer), as well as a mutagenic (birth defects). There are also info. in PubMed.Gov a service of the U.S. Library of Medicine and the National Institute of Health related to the topic. For aluminum: CDC has a link [9] to Toxicological Profile for Aluminum. Question: Where should Merck's disclaimer be, if not under safty? And where to you want to have the vaccine's content written? tx,IDNaa (talk) 12:56, 29 October 2008 (UTC)

"What I also found" is original research. IDNaa you should have a source or that is WP:OR saying polysorbate or aluminum in Gardasil is carcinogenic. Trace amounts of this stuff is not hurting people, you can say something else when you have a good source but there is not now. Here is why, example, polysorbate 80 is a additive in ice cream and stuff. It was tested on cancer in rats. More then half all tested chemicals, you give them enough of it the rat gets a tumor. Well it helps they use rats prone to get cancer. OK polysorbate 80, I looked up four experiments on rats, three said it is not carcinogenic one said equivocal. You get a TD50, that is the dose of the chemical in milligrams per kilogram every day for the whole life of the rat and the rat's chance from being tumor free is cut in half. So TD50 on some of the experiments can't get calcullated bc there is no dose response, does not, matter how much you give rats they don't get more cancer. Some experiments, get a TD50 when you look at a sight like liver or lung, they are from 2.5 grams/kilogram/day to 300grams/kg/day.

A teen girl that gets Gardasil is may be 50kg? So 50kg times 2.5 grams, that is the lowest TD50 in the experiments, is 125 grams per day, she halfs her chance from NOT having adrenal medulla tumor in her live. 125 grams per day polysorbate 80 that is alot of ice cream!! Or Gardasil, Gardasil has 50 micrograms in dose, a thousand doses is 50 milligrams, a million doses is 50 grams so you can give the girl the polysorbate in 2.5 million doses of Gardasil every day for the rest of her life to half her chance from not having adrenal medulla tumor. That is enough doses for most teenage girls in France!! And give it to one girl in a day every day, sorry that is not carcinogenic.

So long explanation but that is why you can not say, Gardasil has safety problem bc it has polysorbate or some thing. All though, you may be look into it, I hear Gardasil has dihydrogen monoxide in it, that is proven on causing millions of deaths and specially sailers ;) RetroS1mone talk 02:32, 30 October 2008 (UTC)

The point of the references was to point out that Gardasil is a vaccine to prevent cancer (among other things). Therefore it has been established that it prevents carcinogenesis or pre-cancerous lesions for specific cancers.

No obvious special reason to include Merck's disclaimer. This is an encyclopedia, not the PDR. Those who want all the details can get the prescribing information from the references or external links. (i.e. before considering where to include it, why include it?)

If one were to include the cautions, etc., probably important to have it from a reliable non-primary source which could also offer interpretation/context. (i.e. what does it mean, is it standard required language, is there any reason to suspect that such would or wouldn't be a factor.) Without the background and context it is easy to take a caution or an ingredient and misinterpret it or blow it out of proportion, so including perspective from reliable sources is important.

RetroS1mone - nice image with the ice cream. Zodon (talk) 04:07, 30 October 2008 (UTC)

Under EU law, Merck is not allowed to marketing Gardasil as a "cancer vaccine", but have to stick to the correct statement. I will add the EU statement in the text.IDNaa (talk) 22:19, 20 November 2008 (UTC)

What do you mean correct statement? Gardasil is a vaccine for HPV. RetroS1mone talk 03:54, 21 November 2008 (UTC)

Use in men

THe article states: In the UK HPV vaccines are already licensed for boys aged 9 to 15 and for females aged 9 to 26.[14] However, this reference does not support the cliam that the UK has licensed the vaccine for boys. Are there other references for this fact? Or should this line be removed from the article? EBMdoc (talk) 01:11, 23 December 2008 (UTC)

The reference cited says "Gardasil is licensed for boys and girls aged nine to 15." (Start of sixth paragraph, just before the heading "Strong demand") In what way does that not support the assertion that it is licensed for boys? Zodon (talk) 04:06, 23 December 2008 (UTC)

Hmm... I see that now. Don't know how I missed it. I don't think that is correct - but I may be wrong. I've contacted Merck to find out more information. I'll share it when I get their reply. Happy new year. EBMdoc (talk) 14:46, 31 December 2008 (UTC)

I did a little hunting, found a couple of other pages that say similar things to the cited article, but nothing clearly authoritative. As far as I can tell in the regulatory documents, immunogenicity has been demonstrated in 9-15 year olds of both sexes, but efficacy only in females. [10] (See section 4.1 and section 5). Perhaps it is in some middle ground (permitted, but not recommended)?

At this point, the UK public health immunization program appears to only provide vaccines for females. Zodon (talk) 06:59, 2 January 2009 (UTC)

Thanks Zodon for this extra research! Merck has not yet returned my inquiry?!?? . That is unusual for them. EBMdoc (talk) 00:44, 12 January 2009 (UTC)

All the studies have been done on women because women are more likely to become infected with HPV, and women carry the risk of cervical cancer. The cost/benefit calculations are much more favorable for immunizing girls than immunizing boys, and the consequences of not immunizing girls are much worse (cervical dysplasia and cancer) than the consequences of not immunizing boys. And the (financial) costs are pretty high, $360 in the U.S. The British don't like to do things without good outcomes studies, and the U.S. companies are forbidden by F.D.A. regulations from promoting drugs for off-label uses, so Merck might not get back to you. I think there was a good discussion of the reasons for not vaccinating boys yet in NEJM. It's not a symmetrical situation; you can't say, if they do it for girls, they should do it for boys. When you do computer models, vaccinating girls works much better than vaccinating boys. Nbauman (talk) 01:41, 12 January 2009 (UTC)

Safety issue in the News

The Health Ministry of Spain ordered a halt of the use of a batch of Gardasil. Use of batch NH52670 was suspended after health authorities in Valencia region reported on Feb. 6 that two girls had become ill after receiving the injection

That's what was reported. A recall on a batch of vaccine is a fact. Wikipedia is about facts, from valid sources.

Health authorities in Valencia (Spain) reported on Feb. 6 that two girls had become ill after receiving the injection. Where would you add it to the article? FX (talk) 05:43, 13 February 2009 (UTC)

Efforts to change what the source actually reported have been noted. Stick with the source, Wikipedia is not about your opinion of the matter. Use the talk page to discuss your objections. FX (talk) 18:57, 14 February 2009 (UTC)

A news report about one batch and illness in two people that is not connected on vaccine is not going to top of safety section. A peer review report about Gardasil is better, that is not showing much safety problem. You can say about it but stop putting it at the top. RetroS1mone talk 20:38, 14 February 2009 (UTC)

At this point I question putting the item in about halting use of the vaccine batch, on the basis of undue weight. One batch out of 40 million doses (maybe 0.2% of doses), especially when there is no clear evidence that there is anything wrong with the batch, does not seem particularly significant for an encyclopedia. Appears to be wp:recentism.

On the other hand, the information that 40 million doses have been distributed seems worth including. Zodon (talk) 21:05, 14 February 2009 (UTC)

Sorry, your original research doesn't trump a valid source. The problem with the vaccine, or batch of vaccines, isn't known yet. Lets stick with the facts, and avoid trying to make wikipedia reflect your view. Thanks. FX (talk) 05:20, 16 February 2009 (UTC)

News reports today state Gardasil is being used again in Valencia region of Spain. The suspect batch is still recalled, and they are trying to figure out what is wrong with it.

http://www.reuters.com/article/rbssHealthcareNews/idUSLG21940220090216

From the very limited report it seems two girls fell ill, in the same manner, right after receiving injections from the same batch of the drug. FX (talk) 21:54, 16 February 2009 (UTC)

It seems to you? RetroS1mone talk 12:46, 17 February 2009 (UTC)

Statistical evidence for possible safety issue

http://www.businesswire.com/portal/site/google/?ndmViewId=news_view&newsId=20090209005358&newsLang=en

February 09, 2009 07:30 AM Eastern Time NVIC Vaccine Risk Report Reveals More Serious Reaction Reports After Gardasil

Comparing serious adverse event reports to the federal Vaccine Adverse Events Reporting System (VAERS) following Gardasil (HPV) and another vaccine for meningococcal (Menactra), the National Vaccine Information Center (www.NVIC.org) found that there are three to 30 times more serious health problems and deaths reported to VAERS after Gardasil vaccination.

I find it humorous, darkly humorous that some people want so much for Gardasil to be completely safe, that they try to ignore the VAERS reports, which are there to alert concerned parties that there might be a problem. Reporting systems are there to alert us to a possible bad batch of vaccine, a contamination problem, or other health risks. To completely deny and ignore the system, because of some irrational desire to believe that there can be no problem, is insanity.

It is as bad as those who want all vaccines to be dangerous. Both are as far from NPOV as you can get.FX (talk) 05:26, 16 February 2009 (UTC)

All that being said, I know damn well that if that link and info was added to the article, those who want Gardasil to not have any possible negative reporting about it, (you know who you are) would simply delete it. Which is why I put it here. FX (talk) 05:28, 16 February 2009 (UTC)

Yes, there are a fair number of analyses of VAERS data of dubious merit, like the one above. Interesting to note that they don't indicate how many doses of either vaccine were administered. Since Menacta is adiministered in a single dose to either gender, whereas Gardasil is administered in 3 doses to girls only, there is no reason to expect that the number of doses administered would be similar. But they made no effort to correct for the number of doses.

Best to stick with peer reviewed journals, etc.WP:MEDRS. Zodon (talk) 08:30, 16 February 2009 (UTC)

Your original research is noted. Sadly, Wikipedia isn't interested in original research. If you have any sources for your original commentary, it would help improve the article to note them.

The NVIC report is online, and of course they used statistical data to form conclusions. http://www.nvic.org/Downloads/NVICGardasilvsMenactraVAERSReportFeb-2009u.aspx

The relative numbers are what the report reports, not total numbers. But, it might be a waste of time to try and explain it. If you have any other sources, (after all, you said there are a "fair number of analysis of VAERS data", please show us. Using your original research to delete sources and information, well, doesn't that seem against the guidelines here? FX (talk) 17:34, 16 February 2009 (UTC)

Hi FX pls, talk page is not for your activism against vaccines try find a blog. RetroS1mone talk 12:45, 17 February 2009 (UTC)

This is really ridiculous. Two certain users here keep not only deleting all changes that might be deemed negative to Merck and Gardasil, no matter how sourced they are, but also specifically write in language that the drug is not harmful. Apparently Judicial Watch, consumer rights advocates, and even critical medical surveys are not academic, but Merck's own internal research is. For whom do you really work? Don't be a coward, come out and say it. For whom do you work? —Preceding unsigned comment added by 129.177.236.113 (talk) 18:33, 17 February 2009 (UTC)

Yes, it is obvious that a few people have an agenda. Old problem on Wikipedia.

What to do when someone is trying to force their view on a Wikipedia article? Now that is another old problem.

All Wikipedia articles and other encyclopedic content must be written from a neutral point of view, representing fairly, and as far as possible without bias, all significant views that have been published by reliable sources. This is non-negotiable and expected of all articles, and of all article editors

.

Obviously Merck doesn't want anything at all published that would cast even a shred of doubt on the safety issue. FX (talk) 18:39, 17 February 2009 (UTC)

The report on the NVIC web site is the one I was responding about - no rates, no adjustment for different demographics, no statistical comparison (no analysis for statistical significance, not a p-value in sight). As you said, not a source worth spending time on.

Not sure that commentary on the various poorly done stats would be apropos in this article, but I will bear the suggestion in mind if I come across a good source. Zodon (talk) 02:33, 18 February 2009 (UTC)

129.177.236.113 - if you aren't sure about reliable sources, check WP:RS and WP:MEDRS for general guidelines. (e.g. News sources don't typically rank high in reliability on medicine and science topics).

To find sources you might try searching medline via pubmed, while not everything indexed there is of equal quality, more likely to find reliable sources there than in general web sites.

As far as consumer groups - depends on the group. Some of them are more reliable than others. Zodon (talk) 05:46, 18 February 2009 (UTC)

Yes, there are a fair number of analyses[sic] of VAERS data of dubious merit, like the one above. Zodon

Your opinion that it is of dubious merit is noted, but it has no place here. Stick to NPOV. FX (talk) 05:26, 19 February 2009 (UTC)

Since Menacta is adiministered[sic] in a single dose to either gender, whereas Gardasil is administered in 3 doses to girls only, there is no reason to expect that the number of doses administered would be similar. Zodon

Again, your original research is not a counter to a published source, please avoid pushing your agenda here. Thanks.FX (talk) 05:26, 19 February 2009 (UTC)

Erin Brockovich VS MERCK

According to her website, Erin Brockovich is preparing to take on Merck about Gardasil.

http://www.brockovichblog.com/2008/08/gardasil.html

I wonder where that should go in the article?FX (talk) 17:38, 16 February 2009 (UTC)

Um no where bc it is from a blog. Check wp:rs. RetroS1mone talk 12:44, 17 February 2009 (UTC)

Attorney Tom Girardi and Erin Brockovich interviewed about Gardasil on Lawyer2Lawyer.

http://www.legaltalknetwork.com/modules.php?name=News&file=article&sid=334

http://www.legaline.com/lawsites_archive/2008_12_01_lawsites_archive.html

http://www.girardikeese.net/attorney_details.aspx?attorneyID=1 FX (talk) 05:15, 18 February 2009 (UTC)

Is there a rs in it some where? That looks like commercial sites, you know lawyers that want to make money. That is not rs for Wikipedia and nonmedrs for medical article. RetroS1mone talk 06:37, 18 February 2009 (UTC)

Your opinion does not matter. Wikipedia content is intended to be factual, notable, verifiable with cited external sources, and neutrally presented. FX (talk) 14:46, 18 February 2009 (UTC)

Her opinion on whether a blogsite is a reliable source certainly does matter, and I agree with her. Please remember WP:CIVIL. Aunt Entropy (talk) 16:05, 18 February 2009 (UTC)

Talk pages are not for discussing users, or user opinions, but to improve an article. If you have a valid source for your information (objections) please provide it. Thanks.FX (talk) 16:09, 18 February 2009 (UTC)

You mean talk pages are for editor's opinions on how to improve the article. You seem to be confusing editorial discretion with article content.

The source for objections to blogsites is WP:RS. Aunt Entropy (talk) 21:37, 18 February 2009 (UTC)

Wikipedia does not publish original research or original thought. This includes unpublished facts, arguments, speculation, and ideas; and any unpublished analysis or synthesis of published material that serves to advance a position. This means that Wikipedia is not the place to publish your own opinions, experiences, or arguments. Citing sources and avoiding original research are inextricably linked: to demonstrate that you are not presenting original research, you must cite reliable sources that are directly related to the topic of the article, and that directly support the information as it is presented. Thanks. FX (talk) 05:18, 19 February 2009 (UTC)

I've removed the statement from Erin Brokovich's blog. The entry itself is dubious, though she would count, IMO, as an acceptable source. However, upon reading the entry, it's clear that her math is incorrect. Her entry reads "4/103 strains that cause 70%" of cervical cancer cases and somehow comes up with a "91% vulnerable" figure, which is unexplained. Gardasil vaccinates against 2 strains that cause 70% of cervical cancers, which would leave, if anything, individuals 30% "vulnerable" (which is already dubious considering that commonality of those other strains isn't factored in either). Additionally, with the other two strains comprising 90% of genital warts cases, I still fail to understand her math. Therefore, it's been removed. The second statement was removed because it uses POV terminology and has no accessible source, while the third statement has no source at all. Until sources can be provided, those statements have been removed (and would require retooling if readded, anyway).Luminum (talk) 22:27, 25 July 2009 (UTC)

Discriminating between conspiracy theories and information-control

Does anyone remember when rBST was the gold standard, and "no link could be found between rBST and human health problems" in report after report? What changed that? It wasn't hard-hitting research by major universities and groups of scientists: it was journalism, blogs, and people's then unsubstantiated paranoia, which then led to that research. Is it possible to strike the right balance between informing the public of its own concern, and sourcing this article with reliable studies?

Right now, this page sounds like a Merck safety notice, not an up-to-date, aware, and all-knowing examination of the current state of what's going on. Wikipedia is where we bring reliable truth to the average person in an accessible way - but I think over reliance on funded research (no neutrality, nor usefulness here - effect may take decades to show up), and government reports (no foresight here) is crippling this article. It is useless to a concerned parent trying to research Gardisil to learn whether there might be, today or tomorrow, too high a chance that it's going to hurt their daughter. —Preceding unsigned comment added by 69.121.5.18 (talk) 13:58, 4 May 2009 (UTC)

So you recommend we stick to hearsay, anecdotes, blogs, and unfunded research?

"It is useless to a concerned parent trying to research Gardisil to learn whether there might be, today or tomorrow, too high a chance that it's going to hurt their daughter." You could say the same about just about anything you deliver to your daughter's body. Fact is there are risks associated with life and every action we perform has ramifications or repercussions. We don't know exactly what those risks are at any given time. 98.235.79.121 (talk) 13:25, 30 May 2009 (UTC)

My concern about this article is that the "Safety" section is just matter of factly not truthful. It is claiming that there "are no major side effects". Additionally, I believe that the politics of Gardasil is a legitimate subject for inclusion into this article, or in an article to which this links. As it sits, to me, the article violates Wikipedia standards on several scores. It is certainly NOT a balanced article: it is perilously close to being fraudulent. I want to address this at a later time when I have more time to go into depth. But I do not intend for this just to sit here. Something must be altered about this article to keep it from violating Wiki standards.Lizmichael (talk) 01:13, 15 June 2009 (UTC)

If you have a significant number (to avoid weight issues) of reliable secondary source asserting there are major side effects, you are welcome to include them. Similarly if you are if you have a significant number of reliable secondary source discussing the politics of Gardasil you are welcome to include them. If you lack, these, then it is you that is violating wikipedia rules if you try to add unverified nonsense to the article. Nil Einne (talk) 09:14, 28 June 2009 (UTC)

from June 9 2009 FDA has orded Merck to extend the labeling of the vacine to include (in the Warnings and Precautions section alerts healthcare providers)that tonic-clonic (jerking) movements and seizure-like activity can occur after vacination. — Preceding unsigned comment added by 62.237.32.178 (talk) 22:24, 28 June 2009 (UTC)

History education significance

The following item was added to the history section recently.

A licensed HPV vaccine first appeared in June 2006, before the first "phase 3 trials of the HPV vaccine with clinically relevant end points" were published in May 2007. Merck funded educational programs with medical professional associations, including the Society of Gynecologic Oncology, the American Society for Colposcopy and Cervical Pathology, and American College Health Association, to promote the vaccine.

It is unclear what the historical significance/importance of this is, so moved it here for discussion/improvement. The significance of the timing of the vaccine approval versus when a trial results were published is also unclear. In the United States it is quite common for drug makers to fund professional education programs. So why are these significant to the history of Gardasil? Zodon (talk) 20:26, 11 September 2009 (UTC)

The use of professional societies to market new drugs was the focus of a couple articles in JAMA - doesn't that suggest that it's somewhat significant? The edit itself was did not unduly hype the use of these professional associations - it simply noted that they were used. I don't see how that's inappropriate. It's an interesting, relevant fact on the history of how Gardasil was initially marketed. II | (t - c) 04:29, 10 October 2009 (UTC)

Neutrality tag removal

I do not see any activity on the talk page that indicates there is continued debate about the neutrality of this article.--IronAngelAlice (talk) 21:53, 7 October 2009 (UTC)