This story shows many strengths, and wisely sets a single research report from the New England Journal of Medicine inside a larger debate about whether thousands of young men should receive the costly vaccine Gardasil.
The story wades into discussions of sexual orientation and even at what age an individual knows this truth about him or herself. These difficult topics are germane to the epidemiology of the many human papillomaviruses, and which people of both sexes are at highest risk from infection.
Bravo for reading the editorial that accompanied the study article, and chasing down its author on deadline to get her comments.
Bravo for asking “why” when confronted with the seemingly contradictory news that Gardasil can prevent genital warts but is not recommended by the CDC for universal prevention in young men.
Since Gardasil (and competitor, Cervarix) debuted a few years ago, there have been heated disagreements about the price and most helpful distribution of the vaccines and whether both sexes should receive them.
This major study, demonstrating effectiveness in young men, adds important information to complex questions of cost and prevention.
But it needs to be reported in a way that provides some of the history and context for readers. HPV infection is transmitted sexually, so questions of prevention within the entire US population of men and women involve potentially vaccinating both sexes. However, both sexes are not at the same level of risk for potentially deadly cancers years later. Women bear the brunt of the health risks, but men can pass the infection to their partners and can suffer from cancerous and non-cancerous effects of the virus.
This new study provides additional information for the ongoing discussion about the public health role of immunizing young men against HPV.
We wish the story had provided the cost of roughly $375 for the Gardasil vaccine involved in the study. But the story did a much better job on deadline than the competing HealthDay story of posing the deeper question of the overall dispute and society-level debate over universal vaccination.
It quotes one researcher saying only: “The main disadvantage is cost, because thus far the vaccine appears to be safe. It’s less cost-effective because most of the serious diseases such as cervical cancer occur in women, not men.”
So why not provide the cost figures?
This short story packed a lot of nuance into a small space, giving readers the ability to see into the muddy waters around the risk and benefit discussion for vaccinating young men. But the story did not give actual numbers for the benefit, and may
have left an overly optimistic impression of the study results.
The story provides a single comment about the potential harms of the vaccine (“…thus far the vaccine appears to be safe.”). Additional information concerning injection site reactions would have been useful. But we give the story credit for doing a good job of discussing the risks vs. benefits in the wider subject of universal vaccination of young men.
The information provided is both inadequate and what is provided is incorrect. Through clumsy wording, the story suggests that the entire sample of 4065 boys and men received vaccine. Only half the subjects received vaccine.
A thoughtful and careful discussion of the potential risk for genital warts, and the still-uNPRoven connection between the viruses
and the development of penile and anal cancers in men. All of this does relate to the number of sexual partners, which the storyr explains.
The sources included one of the study researchers and additional perspective from the author of an editorial in the New England Journal of Medicine. It did not point out that Merck, the manufacturer of Gardasil, contributed to the money for this study. We’ll call it barely satisfactory.
Althought far from perfect as a preventive, the use of condoms should have been given some space in the story; along with limiting the number of sexual partners or abstinence.
The story makes it clear that Gardasil is avaialble and has been approved for use in girls and young women as well as in their male counterparts.
Good history and context given about the two vaccines – Gardasil and Cervarix. Better than competing HealthDay on this count.
The quotes from several experts demonstrate independent reporting.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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