Countering HPV Vaccination Opposition Training for Ahecs

Countering HPV Vaccination Opposition Training for AHECs

Aubrey Villalobos, MPH, MEd Yamisha Rutherford, MPH Director Research Associate Comprehensive Cancer Control Comprehensive Cancer Control Learning Objectives

After viewing this webinar, participants will be able to: 1. Summarize the emergence and evolution of the anti-vaccine movement 2. Identify modern sources of anti-vaccine propaganda and misinformation 3. Confidently debunk vaccine myths and counter anti-vaccination arguments 4. Evaluate the validity of source information about vaccinations

GW Cancer Institute

• Founded in 2003 • Vision: A cancer-free world and health care that is patient-centered, accessible and equitable. • Mission: To foster healthy communities, prepared patients, responsive health care professionals and supportive health care systems through research, education, advocacy and translation of evidence to practice. GWCI Areas of Expertise

Comprehensive Patient Centered

Cancer Control Programs Policy & Engagement Programs Technical Assistance for Cancer Survivorship Access to Care CDC grantees

Health Care Advocacy Professional Education HPV Vaccination Research and Education Patient Engagement Patient Navigation

LGTBQ CBPR Areas Focus

Tobacco Cessation

Program Evaluation CDC Cooperative Agreement

• Title: “Improving HPV Immunization Rates on a National Scale Utilizing the National AHEC Network” • Timeframe: 2014-2019 • Purpose: Increase HPV vaccination rates among 11 and 12- year old boys and girls as well as administering “catch-up” vaccinations to older adolescents and young adults. HPV Resource Book & Environmental Scan Protocol

Available at: http://www.nationalahec.org/hpv/index.html http://tinyurl.com/HPVResourceBookEnvtlScan Modern Vaccine Origin

Edward Jenner (1796) – Vaccinus (from cows) – Early Opposition • Religion • Safety Skeptics • Natural Immunity

See detailed timeline at: Photo credit: Mezzotint by John Raphael Smith, from his pastel portrait exhibited at the Royal Academy in 1800, www.historyofvaccines.org reproduced from W. R. Le Fanu, A bio-bibliography of Edward Jenner 1749-1823, London: Harvey and Blythe, 1951. Vaccine Basics

Step 1. Exposure to killed or weakened germ Step 2. Body’s immune system produces antibodies Step 3. Immunity • Without illness • Eradication • Herd Immunity Illustration credit: CDC Anti-Vaccination Movement

1853 Vaccination Act of 1853 (England) London Anti-Vaccination League

1855 Mass. school vaccination requirement Vaccination Act 1867 (England) 1867 Anti- Compulsory Vaccination League (England) 1879 Anti Vaccination Society of America

18856 Anti-vaccination League of NYC

1898 Vaccination Act of 1898 (England) Premise for Vaccine Mandates

• 10th Amendment “police power” of states – Protect Public Health and Safety – Legal precedent Jacobsen vs Massachusetts (1907)

Read more: Public Health Strategy and the Police Powers of the State

• Impacts of Mandates – Increased coverage rates – Reduced disparities – Decreased incidence of infectious disease

Origins of Myths

1. Scientifically limited studies 2. Anecdotal reports 3. Coincidental timing 4. Low health literacy Early Influencer: Dr. Wakefield

Learn more from Khan Academy: Vaccines and the Autism Myth - Part 1 Vaccines and the Autism Myth - Part 2

Photo credits: http://briandeer.com/mmr/lancet-summary.htm http://www.callous-disregard.com/ http://topics.time.com/autism/ More Bad Science

• 2007 retraction of research into vaccine ingredients and autism by Drs. Mark Geier and David Geier • Data, ethical and conflict of interest issues

Photo credit: http://briandeer.com/wakefield/geier-retraction.htm Debunking Common Myths

MYTH: Vaccines don’t work • Clinical trials (FDA licensed) • Produce immunity • Rapid decline in incidence MYTH: Vaccines cause Autism • Dr. Wakefield and other articles retracted • Large scale studies found no causation MYTH: Vaccine toxic ingredients • Thimerosal (ethyl mercury not harmful) • Aluminum > in breast milk • Formaldehyde > in blood stream Debunking Common Myths

MYTH: My child is too young for vax

MYTH: Natural immunity is best • Dangerous gamble • Resurgence (Measles outbreak) • Herd Immunity MYTH: Vaccines are not safe • Minor side effects • Clinical trials (FDA licensed)

American Cancer Society (ACS) HPV VACs: Myth Busting

Download this handout in the webinar files pod ACS HPV VACs: Myth Busting

MYTH: People already know about the HPV vaccine and will ask for it if they want it

FACT: Up to 60% of parents have no prior knowledge about the HPV vaccine

TALKING POINT: A strong provider recommendation is the single best predictor of vaccination

ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine is unsafe

FACT: Clinical trials and ongoing monitoring ensure safety

TALKING POINT: The vaccine has been rigorously tested and is safe ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine causes serious side effects including death

FACT: All vaccines can have some side effects. Reactions after HPV vaccination are similar to other vaccines

TALKING POINT: The vaccine has been rigorously tested and is safe

ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine is ineffective

FACT: Clinical trials and ongoing monitoring have shown the HPV vaccine to be highly effective

TALKING POINT: The HPV vaccine is highly effective in preventing HPV-caused cervical, anal, and penile cancers, as well as genital warts

ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine is unnecessary unless you’re sexually active

FACT: Vaccines are for prevention, not treatment

TALKING POINT: HPV vaccine produces a high immune response in preteens

ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine is only for females

FACT: HPV affects both males and females

TALKING POINT: The HPV vaccine is strongly recommended for males and females ACS HPV VACs: Myth Busting

MYTH: The HPV vaccine encourages sexual activity

FACT: HPV vaccination during the recommended ages not associated with an earlier onset of sexual activity or an increase in sexual activity-related outcomes

TALKING POINT: Experience shows that the HPV vaccine does not increase sexual activity CDC Resources for Clinicians

• Tips and Time-savers for Talking with Parents About HPV Vaccine • You are the Key to cancer prevention website: HPV Vaccine Resources for Healthcare Professionals

Modern Propaganda

Celebrities Websites

Social Media PhD & MD

Celebrities & Public Figures

• Barack Obama • Donald Trump • Bill Gates • Jenny McCarthy • Selma Hayek • Jim Carrey • Jennifer Garner • Alicia Silverstone • Amanda Peet • Erin Brockovich

26 Social Media

• Twitter – #CDCwhistleblower – #AntiVax – #VaxCauseAutism • Facebook • YouTube – Video clippings – Power points

Case Study: Kristen Bell & Dax Shepard

Read more stories: http://www.voicesforvaccines.org/category/antivax-to-pro-vax/ Anti-Vaccination Websites

• www.Naturalnews.com • www.Vaclib.org • www.Sciencebasedmedicine.org • www.Nvic.org • www.Vaxtruth.org • www.Antiantivax.flurf.net • www.GreenMedInfo.com • www.LivingWhole.org • www.wesupportandywakefield.com Photo credit: http://drleonardcoldwell.com • healthimpactnews.com & vaccineimpact.com • www.mercola.com Pro-Vaccination Websites

• www.cdc.gov/vaccines • www.immunize.org • www.ecbt.org • www.voicesforvaccines.org • www.niaid.nih.gov/topics/vaccines/ • www.hhs.gov/nvpo/nvac/ Anti-Vax Doctors (PhD & MD)

Photo credits: https://antivaccine.wordpress.com & www.skepticnorth.com Strategies for Validating

News and Journal Articles 1. Who wrote it? 2. How was the study conducted? 3. How were conclusions made? 4. Who paid for the study? 5. What study limitations (biases) exist?

Strategies for Validating

Health On the Net (HONcode) Principles: Learn more: www.healthonnet.org Authority Justifiability Gives qualifications of authors Justification of claims/ balanced and objective claims Complementarity Information to support, not Transparency replace the doctor-patient Accessibility, provide valid contact relationship details

Attribution Financial Disclosure Cite the sources and the dates of Provide details of funding medical information Advertising Confidentiality Clearly distinguish advertising Respect privacy of site users from editorial content

Can You Evaluate the Validity? Can You Evaluate the Validity? Photo credit: www.somethingawful.com/photoshop-phriday/antivaccination-ads-mccarthy Photo credit: www.somethingawful.com/photoshop- phriday/antivaccination-ads-mccarthy Photo credit: www.facebook.com/allthesesheeple Questions? Comments?

Aubrey Villalobos Director, Comprehensive Cancer Control [email protected] 202-994-2680 Website: www.CancerControlTAP.org Thank you! Twitter: @GWCancerInst Email: [email protected]

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References

• Saraiya M, Unger E, Thompson T, Lynch C et al. US Assessment of HPV Types in Cancers: Implications for Current and 9-Valent HPV Vaccines. Journal of National Cancer Institute. 2015; 107(6):1-12. • Measles Cases and Outbreaks. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/measles/cases- outbreaks.html. Published n.d. Updated February 23, 2015. Accessed August 14, 2015. • Centers for Disease Control and Prevention. (2014) HPV Vaccine-Questions & Answers. Retrieved from http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm • Human Papillomavirus (HPV) Vaccine. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/vaccinesafety/Vaccines/HPV/hpv_faqs.html. Published August 18 2014. Updated September 25, 2014. Accessed January 07, 2015. • Bill and Melinda Gates Pledge $10 Billion in Call for Decade of Vaccines. Bill and Melinda Gates Foundation Web site. http://www.gatesfoundation.org/Media-Center/Press-Releases/2010/01/Bill-and-Melinda-Gates-Pledge-$10-Billion-in-Call-for- Decade-of-Vaccines. Published n.d. Updated n.d. Accessed September 03, 2015. • UNICEF, Pampers and Salma Hayek take aim at maternal and newborn tetanus elimination. UNICEF Web site. http://www.unicef.org/corporate_partners/index_45847.html. Published n.d. Updated October 6, 2008. Accessed August 13, 2015. • Jenny McCarthy, Jim Carrey, and “Green Our Vaccines”: Anti-vaccine, not “pro-safe vaccine”. Science-Based Medicine Web site. https://www.sciencebasedmedicine.org/jenny-mccarthy-jim-carrey-and-green-our-vaccines-anti-vaccine-not-pro-safe-vaccine/. Published June 09, 2008. Updated n.d. Accessed August 5, 2015. • Alicia Silverstone’s New Parenting Book is Anti-Vaccine and Filled With Crazy Talk. The Wrap Covering Hollywood Web site. http://www.thewrap.com/alicia-silverstones-new-parenting-book-anti-vaccine-filled-crazy-talk/. Published April 25, 2014. Updated n.d. Accessed August 30, 2015. • Actress and Mother Jennifer Garener Joins American Lung Association to Encourage Americans to Get an Influenza Vaccination. PR Newswire Web site. http://www.prnewswire.com/news-releases/actress-and-mother-jennifer-garner-joins-american-lung- association-to-encourage-americans-to-get-an-influenza-vaccination-58735397.html. Published November 12, 2015. Updated n.d. Accessed September 4, 2015. • Kristen Bell: I Didn’t Think I would Be Pro-Vaccination Before I had Kids. ET Web site. http://www.etonline.com/news/160062_kristen_bell_i_didn_t_think_i_would_be_pro_vaccination_before_i_had_kids/ Published February 20, 2015. Updated n.d. Accessed August 28, 2015. • Pellegrino, P., Carnovale, C. , Pozzi, M. et al. On the relationship between human papilloma virus vaccine and autoimmune diseases, Autoimmunity Reviews. 2014; 13(7):736-741. • Collingnon, P., Doshi, P., and Jefferson, T. Adverse events following influenza vaccination in Australia-should we be surprised? , British Medical Journal. 2011

References

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