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Seeking A Saner Food System, Three Times A Day

July 31, 2014 2:54 PM ET
Not all cows get to spend their days with soft green grass under hoof. For many, the picture isn't so pretty, according to the book Farmageddon.

Not all cows get to spend their days with soft green grass under hoof. For many, the picture isn’t so pretty, according to the book Farmageddon.

Justin Sullivan/Getty Images

“For Philip Lymbery, head of the U.K.-based Compassion in World Farming and his co-author Isabel Oakeshott, a visit to California’s Central Valley amounted to an encounter with suffering.

In Farmageddon: The True Cost of Cheap Meat, Lymbery and Oakeshott write that the mega-dairies of the Central Valley are “milk factories where animals are just machines that rapidly break down and are replaced.” At one huge dairy they visited, cows stood idly outdoors, some in shade and some in the sun. No grass cushioned their feet and certainly none was available to eat since, like almost all factory-farm cows, the animals were maintained on an unnatural diet of crops such as corn. The stench in the air was “a nauseous reek.”

The True Cost of Cheap Meat
by Philip Lymbery

This same scene was repeated “every couple of kilometres, all with several thousand cows surrounded by mud, corrugated iron and concrete.”

The hurt in Central Valley extends beyond cows to humans.

The 1.75 million cows in California generate, according to Lymbery and Oakeshott, more fecal waste than the human population of the U.K. Most of the waste matter flows to lagoons near the farms. But some escapes into the air as gas and into the ground (and water supply) through seepage. Water and air pollution, linked in part to the mega-dairies, is an immense worry for residents of the Central Valley, where, the authors report, children have a rate of asthma nearly three times above the national average and adult life expectancies are lower by up to a decade than the national average.

Similar disastrous circumstances surround mega-piggeries and industrial chicken farms in the U.S. And when those animals are turned into meat, there’s enormous wastage. The single saddest statistic I have read in the realm of animal welfare comes fromFarmageddon: the amount of meat discarded globally each year is equivalent to 11.6 billion chickens or 270 million pigs or 59 million cattle.

Lymbery and Oakeshott’s answer to “Well, what can we do?” hit home for me. Positive change is in our hands, they insist. In the U.K. where they live, the scale of industrial agriculture is not yet huge and, even in countries like the U.S. where it is huge, there’s hope. They write:

“Avoiding Farmageddon is easy as long as we buy products from animals reared on the land (free-range, organic), favour local producers or retailers that we trust, eat what we buy and therefore reduce food waste, and avoid overeating meat, we can fill our plates in ways that benefit the countryside, our health and animal welfare.”

“Easy” sounds too Pollyanna-ish to my ears, but I did love the mantra adopted in the book:

“Each of us has three great opportunities a day to help make a kinder, saner food system through the [meal] choices we make.”

It’s a simple yet powerful message: At every breakfast, lunch and dinner, we make food choices that move us either toward a saner food system or further away.

My review of Farmageddon, published last week in the Times Literary Supplement, was positive. Even so, I gave Lymbery and Oakeshott a bit of a hard time for avoiding the topic of vegetarianism.

No, I’m not suggesting that everyone become vegetarian (or vegan) or that people who don’t are somehow morally inferior. Though I don’t eat cows, pigs, chickens, turkeys, lambs, goats or cephalopods like the octopus, I do eat fish on occasion and I have recently sampled insect cuisine (cricket cookies and grasshopper tacos). I’m no purist on this topic.

And I remember from last year Tania’s “can’t we all just get along?” post: none of us benefits by judging others’ food habits (or worrying excessively that others are judging ours).

Still, in a book that tackles how we might eat smarter for the environment, for other animals, and for ourselves, I think it’s too timid to stop at “eat less meat” and not discuss the “eat no meat” option.

And what about “eat no fish”? On this topic, Farmageddon has something thought-provoking to say, as I noted in my TLS review:

“‘Fish farms are the forgotten factory farms under the water’, according to Lymbery, ‘and one of the fastest-growing sectors of intensive animal rearing.’ Cataracts and fish and tail injuries plague the farmed salmon and trout confined in tiny spaces. Around the world, about 100 billion fish are farmed every year, a number that exceeds all the terrestrial farm animals put together.”

“The result of all this effort is bleak: consumers eat fatty, chemical-laden fish, and the farmed fish, when they escape (Lymbery describes ‘mass breakouts’), harm the wild fish stocks, through competition for food and places to spawn, and outright cannibalism.”

About my pescatarian diet, and the type of fish I choose now and again for lunch or dinner, I’m thinking twice.

And three times.


Barbara’s most recent book on animals was released in paperback in April. You can keep up with what she is thinking on Twitter:”

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Recognizing The Illusion Of ‘Homo Economicus’

Recognizing The Illusion Of ‘Homo Economicus’

July 20, 2014 6:41 AM ET

Standard economic theory assumes that humans behave rationally and are able to objectively calculate the value (or cost) of the different choices they are presented with. In fact, we pride ourselves on our rationality. Different from the animals, we humans have the unique capacity for logical thought and rational decision making. Or do we?

According to behavioral economist Dan Ariely, we should be less proud of ourselves. In his entertaining book Predictably Irrational, Ariely describes case studies of everyday irrational human behavior. His simple but clever scientific experiments often require nothing more than a box of chocolates. Subtle differences in the way these chocolates are offered to people can result in surprisingly irrational behaviors. Moreover, these irrational behaviors fly square in the face of what conventional economic theory, based on rationality, would predict.

Research into behavioral economics has shown, for example, that our assessment of what something is worth to us can be directly, and predictably, influenced. This is the illusion of the free lunch, something humans are known to fall for even when economic theory would clearly suggest we select a more valuable option at a small cost.

Ariely also beautifully elucidates how we sometimes operate on social norms, while other times we fall into market norms. The difference is in whether there is a price attached to something.

If a friend invites you over for dinner, she will probably appreciate it if you bring a nice bottle of wine along (social norms). However, if instead you slap $20 (the price of a nice bottle of wine) in cash on the table and say “thanks for a lovely dinner,” she would most likely be offended (market norms). Mixing social norms and market norms inappropriately often leads to irrational behavior and, possibly, even to conflict or misunderstanding.

Our irrational behavior is not just random though. The scientific experiments are repeatable. Each time we are faced with a similar situation, we tend to behave in a similarly irrational way. So, next to the bad news that we are not nearly as rational as we might have thought (or hoped), there is also good news in that we can understand and predict our irrational behavior, at least to some extent. This, in turn, can help us improve our decision making and change our behavior for the better. In other words, we can try to be more rational about our irrationality.

In short, behavioral economics shows us when and how we behave in irrational ways. However, it does not explain why we behave irrationally in the first place. For this, we have to look at another emerging scientific area that focuses on human behavior: human evolutionary psychology (a book with that title by researchers Dunbar, Barrett and Lycett provides a wonderful introduction).

Evolutionary psychologists try to explain human behavior as the result of our species’ long evolutionary history. During most of the existence of modern humans (roughly the past 200,000 years), and even before, we lived as hunter-gatherers in relatively small family groups where certain social interactions were crucial for survival and reproduction. Natural selection has shaped our brains and behaviors to cope with these social demands.

In contrast, market-driven and money oriented economies emerged only very recently, as a cultural phenomenon. Cultural evolution happens at a much faster pace than genetic evolution, and as a consequence our inborn social behaviors are not (yet) fully adapted to this modern way of life.

This explains much of our irrational behavior, also outside of the context of economics. For example, the sight of spiders and snakes induces a deep-rooted fear in most of us. The sight of a car does not produce nearly such a fearful reaction. Yet, these days many more people die from car crashes than from spider and snake bites combined. So why this irrational difference in fear response? It seems the only logical explanation is an evolutionary one, where spiders and snakes have been a realistic threat throughout most of human history, while cars and the threat of violent crashes are only a very recent phenomenon. Our brains have not been wired by evolution to respond in the same way.

Moreover, evolution is a “blind” force that acts without foresight or deliberate design. It just works with whatever it has available at any given time and tinkers with that by means of small (random) changes. In some cases, this leads to improvements which are then favored by natural selection over less successful variants. As a consequence, the products of evolution are not always the most perfect or efficient. This includes our own brain, which still leaves plenty of room for irrational behavior.

So, what does all this have to do with economic theory?

Recall that the standard theory assumes that people behave fully rationally. It argues that, in a free market, prices will automatically converge to an optimum where supply and demand are balanced out and the market is in equilibrium (Adam Smith’s “invisible hand”).

However, as behavioral economics shows, in many situations our behavior is far from rational. Demand for a product, the choices we make, or the price someone is willing to pay, can all be easily influenced. Furthermore, evolutionary psychology shows that much of this irrational behavior is a consequence of our evolutionary history, which is often at odds with the modern money based society we now live in.

What this implies is that it is time to rethink economic theory. An economic system based only on market norms and assuming full rationality is clearly incomplete, even invalid.

History has shown time and again that societies acting mostly according to market norms and short-term monetary gains often cause their own decline (read Collapse by Jared Diamond). Homo economicus is perhaps nothing more than an illusion.

Instead, the mirror that behavioral economics and evolutionary psychology put in front of us shows us our real selves, social norms and irrational behavior included. It is imperative that our economic theory, and the policies and practices that are derived from it, reflect this reality.


Guest contributor Wim Hordijk is a computer scientist working in the areas of computational biology, evolutionary computation, bioinformatics and the origin of life. You can keep up with Wim on Twitter: @WanderingWim”

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At The Head Of Her Class, And Homeless

Rashema Melson lives in the D.C. General homeless shelter with her mother and two brothers. "Because you live in a shelter — that's not who you are, that's just where you reside at for the moment," she says.

“Rashema Melson lives in the D.C. General homeless shelter with her mother and two brothers. “Because you live in a shelter — that’s not who you are, that’s just where you reside at for the moment,” she says.”

Meredith Rizzo/NPR

“On Wednesday, Rashema Melson will graduate at the top of her class as the valedictorian of Anacostia High School in Washington, D.C. She’s headed to Georgetown University this fall on a full scholarship.

Melson has excelled at her homework — but for the past six years, she hasn’t had a home to do that work in. She currently lives in the D.C. General homeless shelter, along with her mother and two brothers. The shelter houses up to 300 adults and 500 children and has come under scrutinyfor its poor conditions.

Melson, 18, tells NPR’s Audie Cornish that after school, a typical night involves reluctantly heading back to the shelter around 9:30 p.m.

“I try to stay out as late as possible,” she says. “I wouldn’t say it’s my favorite place.”

Among the many frustrations of shelter life are long security checks and noise. Because of the second, she would often wake up in the middle of the night just to do her homework in peace. Melson says she didn’t keep her homelessness a secret from classmates — but didn’t offer up the information either.

 

“I don’t like sharing with kids because they start to pity you or they start to look at you in a different way,” she says. “And I feel like, ‘Hey, I’m just like the rest of you. I come in to get an education.’ “

Even Melson isn’t sure how she’s managed to successfully juggle school (a 4.0 GPA), athletics (cross-country, track, volleyball) and homelessness. “I just know when I have a goal, I try not to let anything get in the way,” she says.

That goal, even before becoming homeless, has been to graduate from medical school and become a forensic pathologist. She says her father’s murder when she was a baby inspired her to pursue the career.

But it’s never been easy.

“Along the way, we stumbled and we started struggling as a family,” she says.

When those struggles began, she considered quitting sports and getting a job. But her coaches and teachers convinced her otherwise.

“They were just like, ‘Don’t worry, you’re doing the best you can — keep it up, just do what you have to do,’ ” she says. “They were always there for me. They took a lot of stress from my mind.”

But she says she still worries about what will happen to her family after she heads off to college in the fall, even if the campus is just a few miles away. She’s hopeful her younger brother, who’s 14 years old and a talented athlete, will continue to find a haven in sports.

In the meantime, she has advice for other homeless kids: Don’t let your situation define you.

“I would just say keep your head up because you never know what’s going to happen,” she says. “You just have to have hope and faith and don’t let it change who you are. Don’t become ashamed and don’t be embarrassed. And just know who you are inside. Because you live in a shelter — that’s not who you are, that’s just where you reside at for the moment.”

She says it’s the best advice she can give; it’s what she tells herself.”

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June 12, 2014 · 5:36 pm

This Is Not Just A Story About Prostitution

by COBURN DUKEHART

August 07, 2013 8:31 AM
  • Eden is a prostitute who was recently arrested and is awaiting a court hearing. Here, she waits outside the Richmond, Va., train station for her mother to pick her up.
     
    Courtesy of Alicia Vera
  • Tensions are high when Eden tells her mother about her work as a prostitute. It was the first time they discussed her profession at length.
     
    Courtesy of Alicia Vera
  • Eden's mother is upset about the idea of her daughter having sex for money.
     
    Courtesy of Alicia Vera
  • Despite their disagreements, Eden's mother loves and supports her daughter.
     
    Courtesy of Alicia Vera
  • Eden lies on the rooftop of her mother's home to reflect on old times in Lancaster, Va., and contemplate the possibility of going to jail.
     
    Courtesy of Alicia Vera
  • Eden hangs her work clothes out to dry.
     
    Courtesy of Alicia Vera
  • Eden gets ready for her court hearing.
     
    Courtesy of Alicia Vera
  • On the way to the court hearing in Annapolis, Md.
     
    Courtesy of Alicia Vera
  • Eden waits nervously outside of the courtroom as she rereads a speech she has prepared for the hearing.
     
    Courtesy of Alicia Vera
  • The prosecutor explains the court procedure to Eden and lets her know that she may postpone the hearing if she elects to hire a lawyer. She decides against it.
     
    Courtesy of Alicia Vera
  • Eden's mother waits outside of the courtroom.
     
    Courtesy of Alicia Vera
  • After court, her mother drives Eden to the Baltimore train station where she travels to Philadelphia and finally takes a taxi to the small town that she frequently works out of. Sad that they couldn't spend more time together, her mother kisses her daughter goodbye and wishes her the best.
     
    Courtesy of Alicia Vera
  • On the way to Philadelphia.
     
    Courtesy of Alicia Vera
  • Relieved about the outcome of the hearing, Eden takes a nap on the train to rest before a long night of work.
     
    Courtesy of Alicia Vera
  • After arriving in her hotel room, Eden quickly prepares the room and herself for customers.
     
    Courtesy of Alicia Vera
  • Eden gets ready for clients.
     
    Courtesy of Alicia Vera
  • Eden counts the money she has made in the past four days. Due to the manner in which the money was obtained, she is unable to deposit it into the bank and is forced to carry it around with her.
     
    Courtesy of Alicia Vera
  • Weekends are the slowest days of the week because customers find it hard to get away from their responsibilities. When not reading or writing, Eden often finds herself bored and alone in her hotel room.
     
    Courtesy of Alicia Vera
  • Because of Eden's unconventional work schedule, she takes frequent naps throughout the day in order to get rest. Her cellphone is always within reach so she doesn't miss a customer's call.
     
    Courtesy of Alicia Vera
  • Eden takes off her wig once a customer leaves the room, to return to her "real" self.
     
    Courtesy of Alicia Vera

“First, a word of warning: This story features photos about prostitution. But under the surface, it’s more than that. It’s a story about photographic access, and how a friendship led to an intimate portrayal of a taboo subject. These are not just photos about prostitution; they’re photos about a woman who goes by the name Eden. Taken by Alicia. Her friend.

When I was studying photojournalism in grad school, one of the most important lessons I learned was that you can’t make good pictures without understanding the story. And you can’t understand the story without getting to know the people you are photographing. You have to build relationships — and trust.

And in the case of these photos, Eden trusted photographer Alicia Vera enough to let her witness some extremely vulnerable moments.

Alicia is from Miami, and is the first member of her family to be born in the U.S. She took a basic photo class at Miami Dade College in 2004, and says she was always interested in photographing strippers. She went around to every strip club in Miami looking for access, but was always turned away.

She enrolled in a photo program in San Francisco, and later answered a Craigslist ad to work in a “nice office space doing social media” for the adult entertainment industry. That job eventually got her the access to strip clubs that she had wanted all along.

While photographing in the clubs, Alicia met Eden, who was 18 at the time. “I introduced myself — we just clicked,” she says. “We became really close friends.”

At the time, Eden told Alicia that she was never going to do “extras” — exchanging sex for money. But she later apprenticed herself to a working prostitute, learned the trade, and started working out of a small town in Pennsylvania — which is where she got arrested.

Alicia, who is now living in Mexico City, asked if she could photograph her in court.

“We have a really, really close relationship. She had seen the work I had done on strippers and knew that I wouldn’t portray her in a negative light. She’s really excited about the photos — she loves them, she understood the photographic process,” Vera said on the phone.

The result is the photo essay above, which was shot in March over a period of a week. The full edit (containing photos we can’t publish here) can be seen on Vera’s website, along with a longer story about Eden.

“I was surprised by how businessy it was,” said Alicia. “Most of the time she was bored, reading, writing, smoking and posting ads. I began to see it as just another job.”

Eden now lives in San Francisco but commutes back to Pennsylvania to work as a prostitute. Eden told Alicia she can make up to $20K in just five days of work. She puts it away in a savings account, and says she plans to quit by the time she’s 25.

“She’s a really creative girl,” said Alicia. “That’s part of the reason why I was attracted to her — she was different than the other girls. I wanted to show that not every prostitute or stripper has just one story.”

And that is the story we present to you today. One of friendship, intimacy, access and trust.”

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August 8, 2013 · 9:47 pm

How To Fight Racial Bias When It’s Silent And Subtle

July 19, 2013 3:26 AM
Researchers say it may be possible to temporarily reduce racial biases.

Researchers say it may be possible to temporarily reduce racial biases.

Images.com/Corbis

 

“In the popular imagination and in conventional discourse — especially in the context of highly charged news events such as the shooting of Trayvon Martin — prejudice is all about hatred and animosity.

Scientists agree there’s little doubt that hate-filled racism is real, but a growing bodyof social science research suggests that racial disparities and other biased outcomes in the criminal justice system, in medicine and in professional settings can be explained by unconscious attitudes and stereotypes.

Subtle biases are linked to police cadets being more likely to shoot unarmed black men than they are unarmed white men. (Some academics have also linked theresearch into unconscious bias to the Trayvon Martin case.)

Calvin Lai and Brian Nosek at the University of Virginia recently challenged scientists to come up with ways to ameliorate such biases. The idea, said Harvard University psychologist Mahzarin Banaji, one of the researchers, was to evaluate whether there were rapid-fire ways to disable stereotypes. Groups of scientists “raced” one another to see if their favorite techniques worked. All the scientists focused on reducing unconscious racial bias against blacks.

“Within five minutes, you have to do something to somebody’s mind so that at the end of those five minutes you will now show a lower association of black with bad. And so this was run really like a competition to see which ones of them might work to reduce race bias and which ones don’t,” Banaji said.

The results were as surprising for what they didn’t find as for what they did. Teaching people about the injustice of discrimination or asking them to be empathetic toward others was ineffective. What worked, at least temporarily, Banaji said, was providing volunteers with “counterstereotypical” messages.

“People were shown images or words or phrases that in some way bucked the trend of what we end up seeing in our culture,” she said. “So if black and bad have been repeatedly associated in our society, then in this intervention, the opposite association was made.”

Banaji, who has been a pioneer in studying unconscious biases, said she has taken such results to heart and tried to find ways to expose herself to counterstereotypical messages, as a way to limit her own unconscious biases.

One image in particular, she said, has had an especially powerful effect: “My favorite example is a picture of a woman who is clearly a construction worker wearing a hard hat, but she is breast-feeding her baby at lunchtime, and that image pulls my expectations in so many different directions that it was my feeling that seeing something like that would also allow me in other contexts to perhaps have an open mind about new ideas that might come from people who are not traditionally the ones I hear from.””

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July 24, 2013 · 5:53 pm

‘Eating On The Wild Side:’ A Field Guide To Nutritious Food

July 10, 2013 2:27 PM

Eating on the Wild Side
 
Eating on the Wild Side

The Missing Link to Optimum Health

by Jo Robinson and Andie Styner

We like to think that if we eat our recommended daily allowance of fruits and vegetables, we’re doing right by our bodies. Think again, says health writer Jo Robinson.

In her new bookEating on the Wild Side, Robinson argues that our prehistoric ancestors picked and gathered wild plants that were in many ways far healthier than the stuff we buy today at farmers’ markets.

But this change, she says, isn’t the result of the much-bemoaned modern, industrial food system. It has been thousands of years in the making — ever since humans first took up farming (some 12,000 years ago, more or less) and decided to “cultivate the wild plants that were the most pleasurable to eat,” she writes. More pleasurable generally meant less bitter and higher in sugar, starch or oil.

“Basically,” Robinson tells Fresh Air‘s Dave Davies, “we looked around at all this wild food that we had been eating for millennia, forever, and we kind of said to each other, ‘We’re getting tired of eating this bitter, chewy, fibrous, low-sugar food, and we can do better than that!'”

But over the centuries, Robinson says, those choices in human agriculture led to a dramatic loss in the nutrient value of the plants we eat most commonly — something she says we had no way of knowing until recently, when modern technology made it possible to do so.

But Robinson isn’t arguing that we should all go back to foraging for our dinner. Rather, she calls her book “a field guide to nutritious food.” Drawing on hundreds of scientific studies, she uses her book to lay out which commonly available foods offer the best nutritional bang for the bite.

We learn, for example, that longer cooking can boost tomatoes’ health benefits. And that broccoli begins to lose cancer-fighting compounds within 24 hours of harvest — that’s why it’s one of the foods that Robinson suggests people eat “as fresh as possible.”

On prehistoric bananas

“To peel them you had to get a machete or something similar to that to take off the skins, so we looked around and one of our remote ancestors came upon a mutant banana. This was nature’s mutant — nature is making mutations all the time — and that’s how we get all of the varieties that we have in our fruits and vegetables. Well, this particular mutation did away with the seeds, so that the seeds had been diminished to tiny black dots, and if you look at the bananas in our supermarket, that’s what you’ll see: no viable seeds but just these little dots.”

On her focus on ‘phytonutrients’

“These are molecular nutrients; they’re not macronutrients, and the reason that I’m focusing on them is that we’re just beginning to realize that these plant compounds — the technical name for them is ‘polyphenols’ [but] I call them ‘phytonutrients’ — they play a role in every cell and system of our bodies, and every month, new information is published showing these phytonutrients are really essential for optimum health. … [T]hese are the things we’ve reduced more than any of the other nutrients.”

On why we should eat dandelions

For 15 years, author and journalist Jo Robinson has been researching the foods we eat and the nutritional losses they've undergone over thousands of years.

For 15 years, author and journalist Jo Robinson has been researching the foods we eat and the nutritional losses they’ve undergone over thousands of years.

Frances Robinson /Little Brown and Co.

“[G]o out and find a dandelion leaf, rinse it well, and take a bite, and pay attention to your senses. For the first 10 seconds you won’t sense much at all, except you’ll notice that the leaf is hairy, and quite dense, quite chewy. Then, this bloom of bitterness [will] come at the roof of your mouth and go down your throat, and it’s going to stay there for about 10 minutes. And many of the wild plants that we used to eat had levels of bitterness similar to that dandelion. … Compared to spinach, which we consider a superfood, [a dandelion] has twice as much calcium, and three times as much vitamin A, five times more vitamins K and E, and eight times more antioxidants.”

On maximizing the nutrients in lettuce

“If you take your lettuce right from the store and rinse it and dry it and then, if you rip it into bite-sized pieces before you store it, you’re going to increase the antioxidant activity … fourfold. The next time you eat it, it’s going to have four times as many antioxidants.”

On which produce you should eat as fresh as possible

“There [are] fruits and vegetables that also burn up their antioxidants and their sugar at a really rapid rate, and they happen to be those superstars of nutrition that we’re all encouraged to eat. So I’m just going to give you a list of things you should get as fresh as possible, perhaps from a farmers’ market, which … is going to be probably fresher than from the supermarket, and eat as soon as possible. So it would be artichokes, arugula, asparagus, broccoli, Brussels sprouts, kale, lettuce, parsley, mushrooms and spinach. …
I think you should have an ‘Eat Me First’ list on your refrigerator of those [foods] that you should eat the day you bring them home, or the next day. It could [make] a measurable difference in your health.””

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July 11, 2013 · 3:09 pm

Vaccine Against HPV Has Cut Infections In Teenage Girls

June 19, 2013 3:10 PM
A 13-year-old girl gets an HPV vaccination from Judith Schaechter, a pediatrician at the University of Miami, in 2011.

A 13-year-old girl gets an HPV vaccination from Judith Schaechter, a pediatrician at the University of Miami, in 2011.

Joe Raedle/Getty Images

 

“A vaccine against human papillomavirus — the most common sexually transmitted infection and the cause of almost all cervical cancer — is dramatically reducing the prevalence of HPV in teenage girls.

The first vaccine against HPV, Merck’s Gardasil, was approved by the Food and Drug Administration in 2006. Cerverix, from GlaxoSmithKline, was approved in 2009.

In the first four years of immunizations, infections from the four strains of human papillomavirus targeted by the vaccines plummeted by more than half among 14-to-19-year-olds in the United States.

Federal health officials say they were surprised by the number since only about 1 in 3 girls in this age group has received the full three-dose course of the vaccine. About half have received a single dose.

Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, acknowledges that the number of girls who have gotten the HPV vaccine is “very disappointing” and “certainly not good enough.”

Still, Frieden says, “The vaccine works and works very well.” The findings of the CDC study were released Wednesday in the Journal of Infectious Diseases.

The vaccine has been controversial, with some parents worried about possible health risks, and others worrying that vaccination could encourage earlier sexual activity.

The study didn’t find a decrease in the HPV strains covered by the vaccine in other age groups, a clue that the vaccine is responsible for the decrease among teenagers.

 

Researchers also didn’t find any decrease in sexual activity among girls in the target population that might explain why HPV prevalence is down, from nearly 12 percent to just over 5 percent.

 

The current recommendation is that girls get the HPV vaccine when they are 11 or 12, before the initiation of sexual activity, when the vaccine produces the best protection. Females up to age 26 are urged to get the three-shot course if they have not received the vaccine earlier.

The recommendation is similar for boys, in whom HPV can cause genital warts along with penile and anal cancers, except that the so-called catch-up vaccination is recommended for males only up to age 21.

The vaccine costs between $128 and $135 a dose, or around $400 for the full course, on the private market. Many insurers cover HPV vaccination, and the federally sponsored Vaccines for Children program provides it free of charge for qualified patients.

CDC officials say they intend to use the new results to press for wider use of HPV vaccines. The goal is to get 80 percent of adolescents fully vaccinated.

Frieden says the payoff will be tens of thousands of fewer cases of cervical cancers and deaths.

“Of girls alive today between the ages of zero and 13, there will be 50,000 more cases of cancer if we don’t increase the rates to 80 percent,” Frieden says. “And for every single year we delay in getting to 80 percent, another 4,400 women are going to develop cervical cancer in their lifetimes — even with good screening programs.”

CDC officials say that HPV vaccines have a very good track record for safety following distribution of 56 million doses in this country.

“We have a very clear idea of the safety,” Frieden says. “We’ve looked at all the adverse events that have been reported. Virtually all have not been serious. Among the serious events, the main issue has been fainting, redness and swelling at the injection site and other temporary symptoms.”

Last week Japanese health officials suspended their recommendation to vaccinate girls between 14 and 19 against HPV after some reports of pain and numbness following injection. Japanese officials say they want to investigate a possible link.

“The outcomes they were concerned about are things we have looked for in our data system here in the U.S.,” says the CDC’s Dr. Cindy Weinbaum. “We found a total of about a dozen reports that related to something like regional pain syndrome such as Japan was reporting.”

Weinbaum says the CDC found “really no consistency among them that would suggest anything specifically related to the vaccine.”

The CDC has investigated 42 reports of deaths among HPV vaccine recipients.

“The cause of these deaths has been very varied,” Weinbaum says. “It’s everything from cardiovascular to infectious, neurologic and hematologic. Again, there’s no consistent pattern of deaths that have occurred after vaccination that would give us any cause to be concerned” that the vaccine was responsible.”

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June 20, 2013 · 5:43 pm