|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|
Diane Medved Harper is a professor and chair of the department of Family and Geriatric Medicine at the University of Louisville. 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. Her area of expertise is human papillomavirus (HPV) and the diseases associated with it, as well as colposcopy, and coordinated clinical trials of Gardasil, a vaccine against HPV. 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, although she is a co-author of a 2009 study in The Lancet that found "excellent long-term efficacy" of the vaccine for at least 6.4 years. More recent data extended this to at least 8 years, and studies are ongoing.
Harper grew up in Kansas City; her father was an electrical and mechanical engineer. Her mother died in July 1981 of breast cancer.
Education, research and career
|This section requires expansion. (October 2013)|
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. While at Stanford, she studied medical decision making and cost-effectiveness analysis. Harper's degrees include MD, MPH, and MS.
Questioning the safety and efficacy of HPV vaccines
Although, in 2008, she stated that Gardasil "is a good vaccine and ... is generally safe," 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. She also appeared in The Greater Good, an anti-vaccine film. As evidence that the vaccine may be unsafe, she points to research by Barbara Slade, stating,
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.
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. 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."
In an interview with the Huffington Post published December 28, 2009, Harper stated that pap smears alone prevent more cancer than vaccines alone.. She has also argued that HPV vaccination may be unnecessary because "Ninety-five percent of women who are infected with HPV never, ever get cervical cancer," although this statement implies that 5% of women infected with HPV may get cervical cancer. She also stated, without any evidence, that "The combination of HPV vaccine and screening in the U.S. will not decrease the incidence of cervical cancer to any measurable degree at the population level." Harper has 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." Harper has also stated that "more than 70 healthy young girls have died from a neurological reaction that occurred soon after getting Gardasil." Regarding HPV vaccine mandates, she has gone on record saying that they should not be mandatory for school attendance because "Population health models show that if the HPV vaccine does not last for at least 15 years, no cancers will ever be prevented..." and that Gardasil and Cervarix have only been shown to last for 5 and 9.4 years respectively.
In December 2013, when Katie Couric aired a special episode of Katie about the HPV vaccine, Harper appeared on the show, where she said that the HPV vaccine only offers protection against cancer for five years. However, after many people criticized Couric's show for being too anti-vaccine, Couric wrote an article for the Huffington Post, in which she pointed out that while an early study suggested that the vaccine was only effective for five years, that "more recent research indicates the protection lasts for at least eight years, and potentially well beyond that."
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".
- "School of Medicine Professor Recognized Internationally". Faculty and Staff News. University of Missouri Kansas City. 24 May 2013. Retrieved 7 October 2013.
- Durgin, Jennifer (Fall 2006). "Dream Work: Diane Harper, M.D., M.P.H.". Dartmouth Medical School. p. 2. Retrieved 30 January 2014.
- Scoggins, Jill (26 August 2013). "Missouri professor named family, geriatric medicine chair at UofL". University of Louisville. Retrieved 30 January 2014.
- Durgin, Jennifer (Fall 2006). "Dream Work: Diane Harper MD MPH". Dartmouth Medicine. Retrieved 13 August 2013.
- Attkisson, Sharyl (29 August 2009). "Gardasil researcher speaks out". CBS News. Retrieved 8 August 2013.
- 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.
- "Studies Demonstrate Gardasil® Has Long Duration of Protection From HPV Disease".
- "Diane Medved Harper". Second Opinion (TV series). Retrieved 13 August 2013.
- 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.
- 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.
- Chustecka, Zosia (9 August 2008). "HPV Vaccine Deemed Safe and Effective, Despite Reports of Adverse Events". Medscape Today. Retrieved 8 August 2013.
- Gorski, David. "The Greater Good: Pure, unadulterated anti-vaccine propaganda masquerading as a 'balanced' documentary".
- 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.
- 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.
- Yerman, Marcia (28 December 2009). "An Interview with Dr. Diane M. Harper, HPV Expert". Huffington Post. Retrieved 8 August 2013.
- Knox, Richard (19 September 2011). "HPV Vaccine: The Science Behind the Controversy". NPR. Retrieved 8 August 2013.
- "HPV: A Complicated Vaccine". MDNews. 1 July 2013. Retrieved 9 August 2013.
- Rhodes, Maura (9 May 2013). "The HPV Vaccine: Risks vs. Rewards". Women's Health. Retrieved 11 August 2013.
- Newton, David E. (2013). Vaccination Controversies. ABC-CLIO. pp. 137–141. ISBN 978-1-61069-311-0.
- Marcotte, Amanda (4 December 2013). "Katie Couric Hands Her Show Over to Anti-Vaccination Alarmists". Slate. Retrieved 31 January 2014.
- Couric, Katie (10 December 2013). "Furthering the Conversation on the HPV Vaccine". Huffington Post. Retrieved 31 January 2014.
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