Miss a day, miss a lot. Subscribe to The Defender's Top News of the Day. It's free.
The U.S. Department of Health and Human Services (HHS) is funding research at Rutgers University on how to increase uptake of the human papillomavirus (HPV) vaccine among Black adolescents, documents obtained by Children’s Health Defense (CHD) via a Freedom of Information Act (FOIA) request revealed.
HHS awarded the $600,000, three-year, grant, which will be administered by the National Cancer Institute (NCI), to Racquel Elizabeth Kohler, Ph.D.
It is one of nearly 50 grants identified by CHD in June — totaling more than $40 million — awarded by HHS to universities, healthcare systems and departments of public health to increase HPV vaccine uptake among adolescents.
The grant fits into a broader research program across HHS, including at the Centers for Disease Control and Prevention (CDC), to dedicate hundreds of millions of dollars toward creating “culturally tailored” strategies to increase vaccine uptake among “vaccine-hesitant” communities of color.
Kohler’s research seeks to overcome vaccine “hesitancy” by developing text messages, or “tailored interventions,” to send to Black families following an HPV vaccine recommendation by their provider.
The project hypothesizes that follow-up tailored text messages will increase vaccine confidence and motivate Black parents to vaccinate their children.
Kohler, who also is a co-investigator on a Merck grant to study “COVID-19 and vaccine confidence among underserved New Jersey communities,” received the funding as part of NCI’s Transition Career Development program, which helps develop skills for early career cancer researchers.
More than 80 lawsuits against Merck are pending in federal court for vaccine injuries associated with its Gardasil HPV vaccine.
Proposal builds on ‘announcement approach’ developed by Merck consultant
The proposal justifies the research based on the premise that black adolescents have the lowest rates of HPV vaccination relative to other racial and ethnic groups. But even the meta-analysis the application cites to support this claim said data supporting it are inconclusive.
And recent CDC data actually show Black adolescents have higher rates of HPV vaccination initiation and follow-through than white or Hispanic adolescents.
The proposal attributes the alleged low rates of HPV uptake to the problem of “vaccine hesitancy” among Black people, who have “low confidence in vaccine safety, low perceived HPV risk, lack of HPV knowledge, reliance on shared family decisions, high medical mistrust and racial discrimination experiences” that motivate their vaccination choices.
Other grant proposals analyzed by The Defender sought to develop and test the “announcement approach” as a primary method to overcome vaccine hesitancy.
In the “announcement approach,” providers skip having an “open-ended conversation” with families about whether they want their child vaccinated for HPV. Instead, they “presume” the family wants the vaccine and “announce” that the child will receive it as if it were a routine part of the office visit.
This research says the announcement approach has more limited efficacy with Black families, many of whom remain hesitant despite recommendations by healthcare providers because of “cultural beliefs” about vaccination and lower levels of trust in authorities than other racial or ethnic groups.
These claims match a large body of research on “vaccine hesitancy” among people of color that cites such “beliefs” that ought to be changed, instead of acknowledging that some people reject the vaccines on the basis of informed decision-making.
According to Kohler’s proposal, Black families that may not be responsive to the announcement approach alone are instead responsive to supplementary forms of communication — longer conversations with more information — and further interventions that follow provider recommendations in the office visit.
The grant implements a pilot study to develop text messages tailored to overcome “vaccine hesitancy” among Black families and aims to create a text intervention that can later be tested in a larger, definitive clinical trial.
Researchers will draft a bank of sample messages based on common concerns found to be held by Black “vaccine-hesitant” parents. Through focus groups with parents, researchers will identify the best prototype messages.
Parents will receive $50 for participating in the focus groups.
Next, researchers will conduct a randomized controlled trial comparing individually tailored interventions for Blacks against the untailored ones, collecting responses through online surveys for which parents will be compensated $25.
Follow-up interviews with parents will inform researchers’ understanding of which messages and supplemental resources were the most culturally appropriate, relevant and useful.
The researchers developed the intervention based on the “Increasing Vaccination” model, a psychological approach to increasing vaccine uptake that focuses on developing strategies for changing people’s thoughts and feelings to get them to take more vaccines.
This approach, like the announcement approach, was developed by Noel Brewer, the Merck Consultant and University of North Carolina behavioral psychologist who received millions in grant funding from the CDC, The Defender reported.
No proof HPV vaccines prevent cervical cancer
Kohler’s proposal cites 2014 CDC data showing Black women have the highest prevalence of HPV infection in the U.S., and a higher incidence and mortality rate of cervical cancer than white women.
But experts told The Defender there’s no proof that HPV vaccines reduce the risk of cervical cancer.
Studying HPV vaccine efficacy for eliminating cervical cancer is challenging due to the extended time — 23.5 years on average — between infection and the development of cancer, lack of adequate informed consent and the complex relationship between HPV infection and cervical cancer.
Vaccinated women, believing they are protected, may also engage in riskier behavior and therefore worsen the risk of cervical cancer.
For example, some research has shown that because the HPV vaccine targets only specific HPV strains, it has led to an increase in more lethal types of HPV, replacing the less lethal types targeted by vaccination.
Lyons also pointed to other research, published in the Journal of the Royal Society of Medicine, showing that Phase 2 and Phase 3 efficacy trials themselves have been rife with methodological problems that undermine efficacy claims.
That research also points out that none of the trials were designed to detect the vaccine’s effectiveness against cervical cancer. And most trials tested HPV outcomes for people much older than children ages 9-13, when vaccination is typically offered.
Research shows that in all countries that performed smear screening, the pre-vaccination period from 1989 to 2007 was marked by a significant decrease in the incidence of cervical cancer. And that since vaccination began, that trend has reversed.
Also, despite Merck’s marketing of the HPV vaccine as “safe and effective,” many recipients have experienced serious side effects.
Some of the signature impacts observed following HPV vaccination include permanently disabling autoimmune and neurological conditions such as postural orthostatic tachycardia syndrome, or POTS, fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome.
There have been thousands of reports of adverse events worldwide, peer-reviewed scientific literature from the U.S., Australia, Denmark, Sweden, France and Japan, and statistics published by public health agencies in each of these countries that demonstrate associations between HPV vaccination and autoimmune conditions.