Diane Harper

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Diane Medved Harper
Fields Virology, vaccine development, cancer prevention
Institutions University of Louisville
University of Missouri Kansas City
Dartmouth Medical School
Alma mater Massachusetts Institute of Technology
Thesis The determination of diagnostic probabilities for human papillomavirus testing in the evaluation of an abnormal screening Papanicolaou smear (1995)
Known for Investigator for HPV vaccine clinical trials; later, commentator on HPV vaccine issues
Spouse Bill Harper[1]
Children Two sons[2]

Diane Medved Harper is a professor and chair of the department of Family and Geriatric Medicine at the University of Louisville.[3] From 2009 to 2013 she was a professor at the University of Missouri Kansas City's department of Biomedical and Health Informatics. From 1996 to 2009 she held a clinical, teaching, and research post at Dartmouth Medical School.[4][5] Her area of expertise is human papillomavirus (HPV) and the diseases associated with it, as well as colposcopy, and she was the principal investigator of the clinical trials of Gardasil and Cervarix, vaccines against HPV.[6] She has since made statements raising concerns about both vaccines, and she recommends that patients be more explicitly informed of the risks associated with them. She has also stated there is no data showing that Gardasil remains effective at preventing cervical cancer beyond five years,[7][8] and has written that vaccination efficacy must last at least 15 years – any less duration of efficacy and cervical cancers are merely postponed, not prevented.[8]

Early life[edit]

Harper grew up in Kansas City; her father was an electrical and mechanical engineer. Her mother died in July 1981 of breast cancer.[4]

Education, research and career[edit]

A graduate of the University of Kansas (where she completed a residency in family medicine), Harper also completed undergraduate and graduate degrees at the Massachusetts Institute of Technology in chemical engineering, her original choice of major, before attending Stanford University and Harvard University to receive her public health degree. Her decision to go to medical school instead of continuing to study engineering was made in 1981, when, on Thanksgiving Day, she called her dad and told him that her heart wasn't in engineering.[4] While at Stanford, she studied medical decision making and cost-effectiveness analysis. Harper's degrees include MD, MPH, and MS.[9]

Harper has co-authored clinical trials of HPV vaccines in journals including the New England Journal of Medicine[10] and The Lancet Oncology.[11]

Questioning the safety and efficacy of HPV vaccines[edit]

Although, in 2008, she stated that Gardasil "is a good vaccine and ... is generally safe,"[12] in recent years, mainly beginning in 2009, Harper has questioned the safety of Gardasil, and has appeared at the International Public Conference on Vaccination, a conference held by the National Vaccine Information Center, a U.S. anti-vaccine group that has consistently advocated against the use of vaccines.[13] She also appeared in The Greater Good, an anti-vaccine film.[14]

Pointing to research by Barbara Slade,[15] Harper states, "Gardasil has been associated with at least as many serious adverse events as there are deaths from cervical cancer developing each year. Indeed, the risks of vaccination are underreported in Slade's article, as they are based on a denominator of doses distributed from Merck's warehouse. Up to a third of those doses may be in refrigerators waiting to be dispensed as the autumn onslaught of vaccine messages is sent home to parents the first day of school. Should the denominator in Dr. Slade's work be adjusted to account for this, and then divided by three for the number of women who would receive all three doses, the incidence rate of serious adverse events increases up to five fold."[7]

In October 2009 Harper stated to the Guardian "I fully support the HPV vaccines," she says. "I believe that in general they are safe in most women."[16]

In the December 2009 issue of Current Opinion in Obstetrics and Gynecology, Harper published an opinion piece regarding the potential risks of both Gardasil and Cervarix, and concluded that, given the various limitations and risks of the vaccines, the benefits and risks of HPV vaccination must be weighed with the benefits and risks of HPV screening (Pap smears) to reduce cervical cancer in a cost-effective manner.[8] This paper was challenged by two scientists from Merck (the maker of Gardasil), who wrote, among other things, that it "contains inaccuracies and assumptions not supported by the currently available data" and that its methodology was flawed because "Efficacy estimates alone cannot be compared across studies and populations in order to infer differences in vaccine impact."[17]

In a 2011 NPR interview, she argued against mandatory HPV vaccines for schoolchildren, saying "Ninety-five percent of women who are infected with HPV never, ever get cervical cancer."[18] In an article in the 2013 book Vaccination Controversies: A Reference Handbook, she argued further against HPV vaccine mandates for schoolchildren, because "Population health models show that if the HPV vaccine does not last for at least 15 years, no cancers will ever be prevented; women will just get the cancers at a later time in life after the vaccine has worn off" and that Gardasil and Cervarix have only been shown to last for 5 and 9.4 years respectively.[19] In 2012 she told Women's Health that "[I]t's critical to note that more than 70 healthy young girls have died from a neurological reaction that occurred soon after getting Gardasil; you can avoid the risks by opting for a lifetime of Pap smear screening rather than vaccination."[20] In a July 2013 interview, she stated that she advocates personal choice and an individualized approach to HPV vaccination, saying that she provides "a balanced picture to my patients and their families and am not at all upset if they refuse the vaccine, especially at younger ages."[21] Harper appeared on a December 2013 episode of Katie Couric's show Katie devoted to the HPV vaccine, and stated that newly developed pap screenings that combine HPV testing and cytology have a nearly 100% ability to detect pre-cancers and cancers; she noted that Gardasil doesn't last long enough to prevent cervical cancer and that there are some harms associated with it.[22][23]

Honors[edit]

In 2006, while she was on the faculty and staff of Dartmouth Medical School, the New Hampshire Academy of Family Physicians named Harper the New Hampshire Family Physician of the Year.[24]

In May 2013 Harper received the Prix Monte-Carlo Woman of the Year award in Monte Carlo for her contributions and discoveries defining the role of HPV in the pathology of cervical cancer.[25][26]

In May 2013 Harper also received the Society of Teachers of Family Medicine Excellence in Education Award for her "excellence in education at every level from medical students, family medicine residents, residents in obstetrics and gynecology, national and international meetings, and to the public and national audiences via television, including an appearance on the Dr Oz show ...." The award also noted that Harper "helped establish the US national guidelines for the nomenclature of cytology and the screening and management of abnormal cytology and histology reports" and "consulted for the World Health Organization on the use of prophylactic HPV vaccines".[27][28]

References[edit]

  1. ^ "School of Medicine Professor Recognized Internationally". Faculty and Staff News. University of Missouri Kansas City. 24 May 2013. Retrieved 7 October 2013. 
  2. ^ Durgin, Jennifer (Fall 2006). "Dream Work: Diane Harper, M.D., M.P.H.". Dartmouth Medical School. p. 2. Retrieved 30 January 2014. 
  3. ^ Scoggins, Jill (26 August 2013). "Missouri professor named family, geriatric medicine chair at UofL". University of Louisville. Retrieved 30 January 2014. 
  4. ^ a b c Durgin, Jennifer (Fall 2006). "Dream Work: Diane Harper MD MPH". Dartmouth Medicine. Retrieved 13 August 2013. 
  5. ^ http://www.umkcfm.org/Faculty/bioHarper.html
  6. ^ Yerman, Marcia (28 December 2009). "An Interview with Dr. Diane M. Harper, HPV Expert". Huffington Post. Retrieved 8 August 2013. 
  7. ^ a b Attkisson, Sharyl (29 August 2009). "Gardasil researcher speaks out". CBS News. Retrieved 8 August 2013. 
  8. ^ a b c Harper, D. (2009). "Current prophylactic HPV vaccines and gynecologic premalignancies" (pdf). Current opinion in obstetrics & gynecology 21 (6): 457–464. doi:10.1097/GCO.0b013e328332c910. PMID 19923989.  edit
  9. ^ "Diane Medved Harper". Second Opinion (TV series). Retrieved 13 August 2013. 
  10. ^ Garland, S. M.; Hernandez-Avila, M.; Wheeler, C. M.; Perez, G.; Harper, D. M.; Leodolter, S.; Tang, G. W. K.; Ferris, D. G.; Steben, M.; Bryan, J.; Taddeo, F. J.; Railkar, R.; Esser, M. T.; Sings, H. L.; Nelson, M.; Boslego, J.; Sattler, C.; Barr, E.; Koutsky, L. A.; Females United to Unilaterally Reduce Endo/Ectocervical Disease (FUTURE) I Investigators (2007). "Quadrivalent Vaccine against Human Papillomavirus to Prevent Anogenital Diseases". New England Journal of Medicine 356 (19): 1928–1943. doi:10.1056/NEJMoa061760. PMID 17494926.  edit
  11. ^ Villa, L. L.; Costa, R. L.; Petta, C. A.; Andrade, R. P.; Ault, K. A.; Giuliano, A. R.; Wheeler, C. M.; Koutsky, L. A.; Malm, C.; Lehtinen, M.; Skjeldestad, F. E.; Olsson, S. E.; Steinwall, M.; Brown, D. R.; Kurman, R. J.; Ronnett, B. M.; Stoler, M. H.; Ferenczy, A.; Harper, D. M.; Tamms, G. M.; Yu, J.; Lupinacci, L.; Railkar, R.; Taddeo, F. J.; Jansen, K. U.; Esser, M. T.; Sings, H. L.; Saah, A. J.; Barr, E. (2005). "Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: A randomised double-blind placebo-controlled multicentre phase II efficacy trial". The Lancet Oncology 6 (5): 271–278. doi:10.1016/S1470-2045(05)70101-7. PMID 15863374.  edit
  12. ^ Chustecka, Zosia (9 August 2008). "HPV Vaccine Deemed Safe and Effective, Despite Reports of Adverse Events". Medscape Today. Retrieved 8 August 2013. 
  13. ^ Specter, Michael (2009). Denialism : How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives. PenguinPress. p. 7. 
  14. ^ Gorski, David. "The Greater Good: Pure, unadulterated anti-vaccine propaganda masquerading as a 'balanced' documentary". 
  15. ^ Slade, B. A.; Leidel, L.; Vellozzi, C.; Woo, E. J.; Hua, W.; Sutherland, A.; Izurieta, H. S.; Ball, R.; Miller, N.; Braun, M. M.; Markowitz, L. E.; Iskander, J. (2009). "Postlicensure Safety Surveillance for Quadrivalent Human Papillomavirus Recombinant Vaccine". JAMA 302 (7): 750–757. doi:10.1001/jama.2009.1201. PMID 19690307.  edit
  16. ^ http://www.theguardian.com/science/2009/oct/10/ben-goldacre-cervical-cancer-jab?guni=Article:in%20body%20link
  17. ^ Haupt, R. M.; Sattler, C. (2010). "HPV vaccine continues to be safe and effective, and its benefits continue to outweigh its risks". Expert Review of Vaccines 9 (7): 697–701. doi:10.1586/erv.10.56. PMID 20624041.  edit
  18. ^ Knox, Richard (19 September 2011). "HPV Vaccine: The Science Behind the Controversy". NPR. Retrieved 8 August 2013. 
  19. ^ Newton, David E. (2013). Vaccination Controversies. ABC-CLIO. pp. 137–141. ISBN 978-1-61069-311-0. 
  20. ^ Rhodes, Maura (9 May 2013). "The HPV Vaccine: Risks vs. Rewards". Women's Health. Retrieved 11 August 2013. 
  21. ^ "HPV: A Complicated Vaccine". MDNews. 1 July 2013. Retrieved 9 August 2013. 
  22. ^ "Was the HPV Vaccine Responsible for One Girl's Death?" (video). Katie. December 4, 2013. KatieCouric.com.
  23. ^ "Should Your Son or Daughter Get the HPV Vaccine?" (video). Katie. December 4, 2013. KatieCouric.com.
  24. ^ http://geiselmed.dartmouth.edu/news/publications/roundup/roundup_sep2006.shtml[full citation needed]
  25. ^ http://www.prixmontecarlofda.com/2013_3758264.html[full citation needed]
  26. ^ http://royalcorrespondent.com/2013/05/08/tshs-prince-albert-ii-and-princess-charlene-of-monaco-attend-the-2013-prix-femme-de-lannee/[full citation needed]
  27. ^ https://www.stfm.org/about/awards_2013winners.cfm[full citation needed]
  28. ^ http://info.umkc.edu/news/school-of-medicine-professor-recognized-nationally-and-internationally[full citation needed]

External links[edit]