In the wake of surprisingly widespread and vocal public opposition to Texas Gov. Rick Perry’s order on February 2nd that all girls who attend school in his state must receive the new vaccination for HPV (the sexually transmitted human papillomavirus) when they enter the sixth grade – a series of three shots that can cost a total of $360 or more and have, according to some critics, unknown health and medical impacts – the Texas House voted 119-21 on March 13th to support a bill by a Republican legislator that says the vaccine cannot be a condition for school entry. The corrective legislation will go next to the Texas Senate, which is expected to pass it, and then to the governor, who may veto it.

The nationwide momentum on the part of conventional physicians, drug industry lobbyists, and politicians to mandate the vaccine, called Gardasil and manufactured by Merck, for girls ages 10-12 has not slowed, however. On March 1st, Virginia's Democrat Gov. Tim Kaine announced that he would sign a bill that will require sixth grade girls to receive the HPV vaccine beginning Oct. 1, 2008. An indication of mainstream media spin is the Washington Post's editorial “A Shot of Common Sense” (March 9th), which says that Kaine's decision “brought some much-needed sense” to the “increasingly irrational national debate” about mandating HPV vaccines.

According to a story in Medical News Today on March 12th, “New Mexico is about to pass legislation making it compulsory for girls going into the sixth grade to be vaccinated against the Human Papillomavirus. A spokesman for NM governor Bill Richardson said he will sign the bill.” KNTV-TV San Francisco reported on March 13th that “Lawmaker [Democrat Assemblyman Ed Hernandez] Wants HPV Vaccine Mandatory In Calif.” At last count, according to the AMNews (March 12, 2006), “Twenty other states were considering mandates, according to the National Conference of State Legislatures.”

As reported by the Miami Herald (February 21st), “Merck stands to earn more than $1 billion from Gardasil next year.” During the past month, media reports have shed light on the large amounts of money spent by Merck around the country to lobby politicians to support making the HPV vaccine compulsory. New York Newsday, for example, reported on March 9th that Merck spent $500,000 lobbying for its HPV vaccine in New York state alone.

Typically, and quite inaccurately, the mainstream media have construed opposition to the mandatory HPV vaccine as coming mostly from people – parents, mainly – on the so-called Religious Right, for reasons having to do with not wanting to encourage promiscuous sex by young girls. A February 23rd report on PBS’ weekly news magazine NOW was representative, claiming, on three occasions, that “experts” favor the vaccine while opposition comes primarily from “social conservatives“ who “object to the government intruding, as they see it, into a private, family matter.”

Some of the best analysis of this vital and ongoing issue from a public and natural health perspective is available in the blog Vaccine Awakening by Barbara Loe Fisher. Fisher is the co-founder and president of the National Vaccine Information Center (NVIC) which maintains extensive online files on the HPV vaccine issue. When any opposition to the HPV vaccine other than religious-based is mentioned in media reports, it is most often attributed to Fisher and her group.

In the February 21st Miami Herald story, Fisher said “Merck's study of Gardasil involved too few girls ages 15 and under and was too short to measure long-term effects. . . We're mandating so many vaccines now we didn't used to, and there has been a dramatic increase in learning disabilities, asthma and autism.”

Where is Alt Med?

Unfortunately, what’s left of the alternative medicine community in the United States, its members and fellow travelers generally having taken protective cover in recent years under the safe and mushy labels of “CAM” (complementary alternative medicine) and “integrative medicine,” has not been visible on Gardasil at all, except perhaps to endorse it. A search on March 13th using Google.com and the keywords “Gardasil, naturopath, Bastyr,” for example (“Bastyr” is a leading accredited naturopathic medical school in the U.S., supposedly the flagship academic setting for natural health), yielded little or nothing to suggest that any licensed naturopaths have gone on the record opposing Gardasil.

 At one time, the licensed naturopathic community, represented by its trade group the American Association of Naturopathic Physicians, had an official position paper on “Childhood Vaccinations.” These days, the document, which can hardly be said to be a blanket endorsement of vaccinations, is apparently an artifact and can now only be accessed via the historical Web cache maintained at archive.org.

A naturopath on the Vaccine Advisory Committee

Back to the March 14, 2006 Google keyword search – interestingly, it led to the minutes of the July 13, 2006 quarterly meeting of something called the Vaccine Advisory Committee in Washington state. A new member of the committee was introduced that day, Gannady Raskin, M.D., N.D., representing Bastyr University (Raskin is the school’s dean of naturopathic medicine).

The purpose of the July 12, 2006 meeting, and all of the others held by this group, was to fast track vaccines to residents of Washington. In officialese: “The committee meets quarterly to discuss immunization practice-related issues and to develop recommendations. . . to the State Health Officer on appropriate medical interventions to control vaccine-preventable diseases.”

Gardasil was among the vaccines discussed at the July 12th meeting. Comments about Gardasil, not attributed to individual committee members in the meeting minutes, included “We need to get communication and education about this vaccine going with providers” and “We need to have a plan to get the vaccine out to providers and maximize uptake.” One comment, “Don’t forget internal medicine. The best way to get information to internists is short and to the point,” was followed immediately by “Naturopaths would appreciate information as well.” It seems a reasonable assumption that Raskin, the only naturopath on the committee, was the source of that last comment.

 In addition to committee members, drawn from Washington state's government immunization bureaucracy, the state department of health, and so on, the presence of a number of visitors was noted, including three representatives of Merck (the manufacturer of Gardasil) and four from another big drug company, GlaxoSmithKline (GSK). In April, GSK plans to file for FDA approval of Cervarix, its HPV vaccine.

Raskin may be an ideal naturopath (from the point of view of official medicine) to sit on a vaccine advisory panel. He is the co-author of a 2003 study, published in BMC Clinical Pharmacology (it's a “highly accessed” study at that – currently it's the fourth most viewed of all of the journal's online articles in the past thirty days) about the popular nutritional supplement niacin, titled “The safety of over-the-counter niacin. A randomized placebo-controlled trial.”

Curiously considering Raskin's profession as a doctor of natural medicine, the study bashes over the counter (OTC) nutritional supplements. The niacin study’s conclusions by Raskin et al: “In summary, this study (1) demonstrates the need for randomized trials to inform policy and patient choice about the safety of OTCs; (2) underscores the adverse public health impact of OTCs; and (3) likely underestimates the impact of adverse effects of OTCs in patients with comorbidities.”

Raskin appears to be a firm believer in integrated – as opposed to alternative – medicine. He co-authored a 2002 study in the University of Toronto Medical Journal, “Characteristics of Patients Attending a Naturopathic Medicine Teaching Clinic.” Raskin et al express concern about alternative therapies: “Considering the wide variety of CAM therapies available, a patient may be at risk of misinformation and treatment leading to harm.” Raskin and his co-authors also wrote: “The medical education of Naturopaths is structured on the conventional medical education. . . With increasing amounts [sic] of CAM therapies available and the training of practitioners varying widely, it is likely best to suggest that highly trained [naturopathic] practitioners integrate services within conventional healthcare settings.”

In a further insight into his thinking, Raskin, in an April 1, 2005 article published in the Puget Sound Business Journal (Seattle), wrote: “In Washington, the state Legislature is currently considering a bill that would expand the naturopathic doctor's scope of practice. Naturopathic doctors are asking permission to perform certain procedures and prescribe certain pharmaceuticals that are basic to primary care medicine and for which they have been trained. They do not want to be medical doctors. They simply want to practice their medicine (which has always included some pharmaceuticals and for which they have an excellent track record).”

“The VAC enthusiastically endorses the HPV vaccine”

On October 12, 2006, the next meeting of the Washington Vaccine Advisory Committee discussed the HPV vaccine at length and went on the record, according to the official minutes, as follows: “The VAC enthusiastically endorses the HPV vaccine.” Although committee member Raskin was in attendance, the meeting minutes do not mention any members expressing concerns about or critiquing the HPV vaccine.

A licensed naturopath from SCNM (Southwest College of Naturopathic Medicine in Tempe, AZ) has gone on the record about Gardasil. On August 28, 2006, after the FDA approved the drug, Jennifer Nevels, N.D., Assistant Professor and the Interim Chair (from February 2006 to February 2007) of the Women’s Integrated Medicine department at SCNM, in a report (“HPV vaccine doesn’t sit well with everyone”) at KTVK-TV’s Web site, commented about the HPV vaccine “I don't think it's a bad thing at this point.”

Another opinion on Gardasil came recently from Andrew Weil, M.D., a widely acknowledged leader in the field of integrative medicine. In a response to a question at his Web site about the safety of Gardasil, Weil gave the vaccine an unequivocal endorsement, writing “This is a big public health step forward. The vaccine undoubtedly will save millions of lives around the world among your daughter's generation and future generations of women.” Weil was also enthused that “Eventually, [Gardasil] may be recommended for teenage boys, men and older women; tests for efficacy in these groups are underway.”