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Vaccine description | |
Target disease | human papillomavirus |
Type | Protein subunit |
Clinical data | |
Pregnancy cat. |
Legal status | |
Routes | injection |
Identifiers | |
CAS number | |
ATC code | J07BM01 J07BM02 |
(what is this?) (verify) |
Vaccine description | |
Target disease | human papillomavirus |
Type | Protein subunit |
Clinical data | |
Pregnancy cat. |
Legal status | |
Routes | injection |
Identifiers | |
CAS number | |
ATC code | J07BM01 J07BM02 |
(what is this?) (verify) |
Human papilloma virus (HPV) vaccines may prevent infections by certain types of human papillomavirus which are associated with the development of cervical cancer, genital warts, and other cancers.[1][2][3] The World Health Organization (WHO),[4] as well as public health officials in Australia, Canada, Europe, and the United States recommend vaccination of young women against HPV.[5] HPV vaccination is also effective in males to protecting their partners from HPV infections, as well as themselves from anal cancer and genital warts, and possibly other HPV associated cancers.
Two vaccines have market approval in many countries as of 2014 (called Gardasil and Cervarix in the US).[6] Both vaccines protect against the two HPV types (HPV-16 and HPV-18) that cause 70% of cervical cancers, 80% of anal cancers, 60% of vaginal cancers, and 40% of vulvar cancers.[7] These HPV types also cause most HPV induced oral cancers, and some other rare genital cancers. Gardasil also protects against the two HPV types (HPV-6 and HPV-11) that cause 90% of genital warts.[2] Both vaccines have been shown to prevent precancerous lesions of the cervix. Gardasil has been shown to prevent precursors to anal,[8][9] vulvar,[10] vaginal,[10] and penile[8] cancers. HPV vaccines are expected to protect against HPV induced cancers of these areas as well as HPV induced oral cancers.[11]
Worldwide, HPV is the most common sexually transmitted infection in adults.[3] For example, more than 80% of American women will have contracted at least one strain of HPV by age fifty.[12][13][14][15] Although most women infected with genital HPV will not have complications from the virus,[16] worldwide there are an estimated 529,000 new cases of cervical cancer and 275,000 deaths per year.[4] About 85 percent of cancers,[4] and 80% of deaths from cervical cancer occur in developing countries.[17] In the United States, most of the approximately 11,000 cervical cancers found annually[18] occur in women who have never had a Pap smear, or not had one in the previous five years[citation needed]. HPV is also the cause of cervical intraepithelial neoplasia (CIN).[19] CIN is a precursor to cervical cancer, and is painful and costly to treat.[20] It is not known how many women worldwide are diagnosed with CIN.[21]
Since the vaccine only covers some high-risk types of HPV, experts still recommend that women get Pap smear screenings even after vaccination.[22] In the US, Pap smears are typically recommended start at age of 21. Additional vaccine candidate research is occurring for next generation products to extend protection against additional HPV types.
Gardasil and Cervarix are preventative vaccines and do not treat HPV infection or cervical cancer. They are recommended for women who are 9 to 25 years old who have not been exposed to HPV. However, since it is unlikely that a woman will have already contracted all four viruses, and because HPV is primarily sexually transmitted, the U.S. Centers for Disease Control and Prevention has recommended vaccination for women up to 26 years of age.
HPV vaccines are approved for males in several countries, including Australia, South Korea, the United Kingdom, and the United States.
Gardasil has been shown to also be effective in preventing genital warts in males.[8][23][24] On 9 September 2009, an advisory panel recommended that the U.S. Food and Drug Administration (FDA) licence Gardasil in the United States for boys and men ages 9–26 for the prevention of genital warts.[25] Soon after that the vaccine has been approved by U.S. Food and Drug Administration (FDA) for use in males aged 9 to 26 for prevention of genital warts[8][23][24] and anal cancer.[9]
On October 25, 2011, an advisory panel for the Centers for Disease Control and Prevention (CDC) voted to recommend that the vaccine be given to boys ages 11–12. The panel's recommendation is intended to prevent genital warts and anal cancers in males, and possibly prevent head and neck cancer (though the vaccine's effectiveness against head and neck cancers has not yet been proven).[26] The Committee also made the vaccination recommendation for males 13 to 21 years who have not been vaccinated previously or who have not completed the three-dose series.[23][27]
In males, Gardasil may reduce their risk of genital warts and precancerous lesions caused by HPV.[8] This reduction in precancerous lesions might be predicted to reduce the rates of penile and anal cancer in men.[8] Since penile and anal cancers are much less common than cervical cancer, HPV vaccination of young men is likely to be much less cost-effective than for young women.[28]
From a public health point of view, vaccinating men as well as women decreases the virus pool within the population, but is only cost-effective if the uptake in the female population is extremely low.[29] In the United States, the cost per quality-adjusted life year is greater than $100,000 for vaccinating the male population, compared to the less than $50,000 for vaccinating the female population.[29] This assumes a 75% vaccination rate. In early 2013 the two companies who sell the most common vaccines announced a price cut to less than $5 per dose to poor countries, as opposed to $130 per dose in the US.[30]
As with females, the vaccine should be administered before infection with the HPV types covered by the vaccine occurs. Vaccination before adolescence therefore makes it more likely that the recipient has not been exposed to HPV.
Gardasil is in particular demand among MSMs, who are at higher risk for genital warts, penile cancer, and anal cancer.[31]
Harald zur Hausen's support for vaccinating boys (so that they will be protected and thereby women) was joined by professors Harald Moi and Ole-Erik Iversen in 2011.[32]
When Gardasil was first introduced, it was recommended as a prevention for cervical cancer for women that were 25 years old or younger. New evidence suggests that all Human Papillomavirus (HPV) vaccines are effective in preventing cervical cancer for women up to 45 years of age.[33]
In November 2007, Merck presented new data on Gardasil. In an investigational study, Gardasil reduced incidence of HPV types 6, 11, 16 and 18-related persistent infection and disease in women through age 45. The study evaluated women who had not contracted at least one of the HPV types targeted by the vaccine by the end of the three-dose vaccination series. Merck planned to submit this data before the end of 2007 to the U.S. Food and Drug Administration (FDA), and to seek an indication for Gardasil for women through age 45.[34]
Both Gardasil[22] and Cervarix[35] have been shown to prevent cervical dysplasia from the high-risk HPV types 16 and 18 and some protection against a few closely related high-risk HPV types.[36] However, there are other high-risk HPV types that are not affected by the vaccines.[37] The protection against HPV 16 and 18 has lasted 5 years after vaccination for Gardasil[1] and more than 6 years for Cervarix.[1][38][39][40] It is thought that booster vaccines will not be necessary.[41]
Gardasil also protects against low-risk HPV types 6 and 11, which do not cause cancer, but do cause genital warts.
A recent analysis of data from a clinical trial of Cervarix found that this vaccine is just as effective at protecting women against persistent HPV 16 and 18 infection in the anus as it is at protecting them from these infections in the cervix. Overall, about 30 percent of cervical cancers will not be prevented by these vaccines. Also, in the case of Gardasil, 10 percent of genital warts will not be prevented by the vaccine. Neither vaccine prevents other sexually transmitted diseases, nor do they treat existing HPV infection or cervical cancer.[1][2]
HPV types 16, 18 and 45 contribute to 94% of cervical adenocarcinoma (cancers originating in the glandular cells of the cervix).[4] While most cervical cancer arises in the squamous cells, adenocarcinomas make up a sizable minority of cancers.[4] Further, Pap smears are not as effective at detecting adenocarcinomas, so where Pap screening programs are in place, a larger proportion of the remaining cancers are adenocarcinomas.[4] Trials suggest that HPV vaccines may also reduce the incidence of adenocarcinoma.[4]
While the use of HPV vaccines can help reduce cervical cancer deaths by two thirds around the world,[42] not everyone is eligible for vaccination. There are some patient factors that exclude people from receiving Gardasil or Cervarix. There factors include:[43]
In the Gardasil clinical trials, 1,115 pregnant women received the HPV vaccine. Overall, the proportions of pregnancies with an adverse outcome were comparable in subjects who received Gardasil and subjects who received placebo.[45] However, the clinical trials had a relatively small sample size. Currently the vaccine is not recommended for pregnant women.[45][46] The long-term effects of the vaccine on fertility are not known, but no effects are anticipated.
The FDA has classified the HPV vaccine as a pregnancy Category B, meaning there is no apparent harm on the fetus in animal studies. HPV vaccines have not been causally related with adverse pregnancy outcomes or adverse effects on the fetus. However, data on vaccination during pregnancy is very limited and vaccination during the pregnancy term should be delayed until more information is available. If a woman is found to be pregnant during the three dose series of vaccination, the series will be postponed until pregnancy has been completed. While there is no indication for intervention for vaccine dosages administered during pregnancy, patients and health-care providers are encouraged to report exposure to vaccines to the appropriate HPV vaccine pregnancy registry.[43][44][47]
HPV vaccines are approved for use in over 100 countries, with more than 100 million doses distributed worldwide. Extensive clinical trial and post-marketing safety surveillance data indicate that both Gardasil and Cervarix are well tolerated and safe.[48]
A cohort study of approximately 1 million girls found no evidence supporting associations between exposure to quadrivalent human papillomavirus vaccine and autoimmune, neurological, and venous thromboembolic adverse events.[49]
Gardasil is a 3-dose (injection) vaccine. As of 8 September 2013[update] there have been more than 57 million doses distributed in the United States, though it is unknown how many have been administered.[50] There have been 22,000 Vaccine Adverse Event Reporting System (VAERS) reports following the vaccination.[51] Ninety-two percent were reports of events considered to be non-serious (e.g., fainting, pain and swelling at the injection site (arm), headache, nausea and fever), and 9 percent were considered to be serious (death, permanent disability, life-threatening illness and hospitalization). There is no proven causal link between the vaccine and serious adverse effects; VAERS reports include any effects whether coincidental or causal. The CDC states: "When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. VAERS receives reports on all potential associations between vaccines and adverse events."[51]
As of 1 September 2009[update], there have been 44 U.S. reports of death in females after receiving the vaccine.[51] None of the 27 confirmed deaths of women and girls who had taken the vaccine were linked to the vaccine.[51] There is no evidence suggesting that Gardasil causes or raises the risk of Guillain-Barré Syndrome. Additionally, there have been rare reports of blood clots forming in the heart, lungs and legs.[51]
As of 8 September 2013[update] the CDC continues to recommend Gardasil vaccination for the prevention of four types of HPV.[51] Merck, the manufacturer of Gardasil, has committed to ongoing research assessing the vaccine's safety.[52]
According to the Disease Control and Prevention (CDC) and the FDA, the rate of adverse side effects related to Gardasil immunization in the safety review were consistent with what has been seen in the safety studies carried out before the vaccine was approved and were similar to those seen with other vaccines. However, a higher proportion of syncope (fainting) were seen with Gardasil than are usually seen with other vaccines. The FDA and CDC have reminded health care providers that, to prevent falls and injuries, all vaccine recipients should remain seated or lying down and be closely observed for 15 minutes after vaccination.[2]
According to the Centers for Disease Control and Prevention, by the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV.[53] Both men and women can be carriers of HPV.[18] HPV is the most common sexually transmitted infection in the US.[53] A large percentage of the American population is infected with genital HPV[54] because HPV is highly communicable. As a result, American public health experts recommend widespread HPV vaccination.[55]
At a given time, the overall prevalence of high-risk (cancer causing) HPV types was 15% of female participants; the prevalence of the types covered by the vaccine were 1.5% (HPV-16) and 0.8% (HPV-18). The overall prevalence of low-risk (wart causing) types was 18%, the two types covered by the vaccine were found in 1.3% (HPV-6) and 0.1% (HPV-11) of the population. Overall, the types prevented by the vaccine were found in 3.4% of female participants.[13]
Only a small percentage of women with high-risk HPV develop cervical cancer.[56] However, each year between 250,000 and 1 million American women are diagnosed with cervical dysplasia, which is caused by HPV and is a precursor to cervical cancer. Cervical dysplasia is painful and costly to treat.[20]
About 11,000 American women are diagnosed with cervical cancer every year, and about 4,000 die per year of the disease.[18] Most cancers occur in those who have not had Pap smears within the previous five years.
There are 19 "high-risk" HPV types that can lead to the development of cervical cancer or other genital/anal cancers; some forms of HPV, particularly type 16, have been found to be associated with a form of throat cancer.[58] Studies have found that human papillomavirus (HPV) infection is responsible for virtually all cases of cervical cancer.[56][59]
Condoms protect against HPV, but do not completely prevent transmission.[60][61][62] College freshmen women who used condoms consistently had a 37.8% per patient-year incidence of genital HPV, compared to an incidence of 89.3% among those who did not.[60][61][62]
No data is kept by the U.S. government on genital wart incidence rates.[63] It is estimated that in the U.S., at any one time about 1% of adults who have had sex have genital warts.[64] It is estimated that about 20 million people are presently infected with HPV, and there are about six million new cases of HPV every year in the United States.[64]
In August 2012, the Medscape website released a slides presentation about HPV and cancer risk. The following table shows the incidence of HPV associated cancers in the period of 2004–2008 at US.[65]
Cancer area | Average annual number of cases per year | HPV attributable (estimated) | HPV 16/18 attributable (estimated) |
Cervix | 11,967 | 11,500 | 9,100 |
Vulva | 3,136 | 1,600 | 1,400 |
Vaginal | 729 | 500 | 400 |
Penis | 1,046 | 400 | 300 |
Anus (women) | 3,089 | 2,900 | 2,700 |
Anus (men) | 1,678 | 1,600 | 1,500 |
Oropharynx (women) | 2,370 | 1,500 | 1,400 |
Oropharynx (men) | 9,356 | 5,900 | 5,600 |
Total (women) | 21,291 | 18,000 | 15,000 |
Total (men) | 12,080 | 7,900 | 7,600 |
Worldwide, cervical cancer is the fourth most deadly cancer in women.[4] There were an estimated 529,000 new cases of cervical cancer, and 275,000 deaths in 2008.[4] Due to the success of Pap smear screening programs at reducing cervical cancer in more developed countries, the majority of cervical cancers (85%) and deaths (80%) occur in less developed parts of the world.[4][17][57]
The National Cancer Institute states "Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds, if all women were to take the vaccine and if protection turns out to be long-term. In addition, the vaccines can reduce the need for medical care, biopsies, and invasive procedures associated with the follow-up from abnormal Pap tests, thus helping to reduce health care costs and anxieties related to abnormal Pap tests and follow-up procedures."[22]
Current preventive vaccines protect against the two HPV types (16 and 18) that cause about 70% of cervical cancers worldwide.[66] Because of the distribution of HPV types associated with cervical cancer, the vaccines are likely to be most effective in Asia, Europe and North America.[66] Some other high risk types cause a larger percentage of cancers in other parts of the world.[66] Vaccines that protect against more of the types common in cancers would prevent more cancers, and be less subject to regional variation.[66] For instance, a vaccine against the seven types most common in cervical cancers (16, 18, 45, 31, 33, 52, 58) would prevent an estimated 87% of cervical cancers worldwide.[66]
Only 41% of women with cervical cancer in the developing world get medical treatment.[67] Therefore, prevention of HPV by vaccination may be a more effective way of lowering the disease burden in developing countries than cervical screening. The European Society of Gynecological Oncology sees the developing world as most likely to benefit from HPV vaccination.[68] However, individuals in many resource-limited nations, Kenya for example, are unable to afford the vaccine.[69]
In more developed countries, populations that do not receive adequate medical care, such as poor or minorities in the United States or parts of Europe also have less access to cervical screening and appropriate treatment, and are similarly more likely to benefit.[4] Comments made by Dr. Diane Harper, a researcher for the HPV vaccines, were interpreted as indicating that in countries where Pap smear screening is common, it will take vaccination of a large proportion of women in order to further reduce cervical cancer rates.[70] She has also encouraged women to continue pap screening after they are vaccinated and to be aware of potential adverse effects.[71]
The HPV vaccines are based on hollow virus-like particles (VLPs) assembled from recombinant HPV coat proteins. The virus possesses circular double stranded DNA and a viral shell that is composed of 72 capsomeres. Every subunit of the virus is composed of two proteins molecules, L1 and L2. The reason why this virus has the capability to affect the skin and the mucous layers is due to its structure. The primary structures expressed in these areas are E1 and E2, these proteins are responsible for the replication of the virus.[72] E1 is a highly conserved protein in the virus, E1 is in charge of the production of viral copies is also involved in every step of replication process.[72] The second component of this process is E2 ensures that non-specific interaction occur while interacting with E1.[72] As a result of these proteins working together is assures that numerous amounts of copies are made within the host cell. The structure of the virus is critical because this influence the infection affinity of the virus. Knowing the structure of the virus allowed for the development of an efficient vaccine, such as Gardasil and Cervarix. The vaccines target the two high-risk HPVs, types 16 and 18 that cause the most cervical cancers. Gardasil's proteins are synthesized by the yeast Saccharomyces cerevisiae. Its protein makeup allows it to target four types of HPV. Gardasil contains inactive L1 proteins from four different HPV strains: 6, 11, 16, and 18. Each vaccine dose contains 225 µg of aluminum, 9.56 mg of sodium chloride, 0.78 mg of L-histidine, 50 µg of polysorbate 80, 35 µg of sodium borate, and water. The combination of ingredients totals 0.5 mL.[73] Together, these two HPV types currently cause about 70 percent of all cervical cancer.[66] Gardasil also targets HPV types 6 and 11, which together currently cause about 90 percent of all cases of genital warts.[56]
Gardasil and Cervarix are designed to elicit virus-neutralizing antibody responses that prevent initial infection with the HPV types represented in the vaccine. The vaccines have been shown to offer 100 percent protection against the development of cervical pre-cancers and genital warts caused by the HPV types in the vaccine, with few or no side effects. The protective effects of the vaccine are expected to last a minimum of 4.5 years after the initial vaccination.[37]
While the study period was not long enough for cervical cancer to develop, the prevention of these cervical precancerous lesions (or dysplasias) is believed highly likely to result in the prevention of those cancers.[74]
In work that was initiated in the mid-1980s, the vaccine was developed, in parallel, by researchers at Georgetown University Medical Center, the University of Rochester, the University of Queensland in Australia, and the U.S. National Cancer Institute.[75] Researchers Ian Frazer and Jian Zhou at the University of Queensland have been accorded priority under U.S. patent law for the invention of the HPV vaccine's basis, the VLPs.[76] In 2006, the U.S. Food and Drug Administration (FDA) approved the first preventive HPV vaccine, marketed by Merck & Co. under the trade name Gardasil. According to a Merck press release,[77] in the second quarter of 2007, it had been approved in 80 countries, many under fast-track or expedited review. Early in 2007, GlaxoSmithKline filed for approval in the United States for a similar preventive HPV vaccine, known as Cervarix. In June 2007 this vaccine was licenced in Australia, and it was approved in the European Union in September 2007.[78] Cervarix was approved for use in the U.S. in October 2009.[79]
Harald zur Hausen, a German researcher who initially suspected and later helped to prove that genital HPV infection can lead to cervical cancer, was awarded half of the $1.4 million Nobel Prize in Medicine for his work. Verification that cervical cancer is caused by an infectious agent led several other groups (see above) to develop vaccines against HPV strains that cause most cases of cervical cancer. The other half of the award went to Françoise Barré-Sinoussi and Luc Montagnier, two French virologists, for their part in the discovery of HIV.[3]
zur Hausen went against current dogma and postulated that oncogenic human papilloma virus (HPV) caused cervical cancer.[2] He realized that HPV-DNA could exist in a non-productive state in the tumours, and should be detectable by specific searches for viral DNA.[3] He and others, notably workers at the Pasteur Institute, found HPV to be a heterogeneous family of viruses. Only some HPV types cause cancer.[2]
Harald zur Hausen pursued his idea of HPV for over 10 years by searching for different HPV types. [3] This research was difficult due to the fact that only parts of the viral DNA were integrated into the host genome. He found novel HPV-DNA in cervix cancer biopsies, and thus discovered the new, tumourigenic HPV16 type in 1983. In 1984, he cloned HPV16 and 18 from patients with cervical cancer.[3] The HPV types 16 and 18 were consistently found in about 70% of cervical cancer biopsies throughout the world.[2]
His observation of HPV oncogenic potential in human malignancy provided impetus within the research community to characterize the natural history of HPV infection, and to develop a better understanding of mechanisms of HPV-induced carcinogenesis.[2]
There are high-risk HPV types, that are not affected by the vaccines.[37] Ongoing research is focused on the development of HPV vaccines that will offer protection against a broader range of HPV types.[80] One such method is a vaccine based on the minor capsid protein L2, which is highly conserved across HPV genotypes.[81] Efforts for this have included boosting the immunogenicity of L2 by linking together short amino acid sequences of L2 from different oncogenic HPV types.[82]
There is also substantial research interest in the development of therapeutic vaccines, which seek to elicit immune responses against established HPV infections and HPV-induced cancers.[83]
In addition to preventive vaccines, such as Gardasil and Cervarix, laboratory research and several human clinical trials are focused on the development of therapeutic HPV vaccines. HPV-associated diseases have become an ideal test of antigen-specific immunotherapy due to the expression of viral oncoproteins that provide tumour-specific non-self antigenic targets.[citation needed] The relative accessibility of the lower genital tract makes it easier to study the effect of therapeutic vaccines on the systemic circulation and the target tissue.[citation needed] In general these vaccines focus on the main HPV oncogenes, E6 and E7. Since expression of E6 and E7 is required for promoting the growth of cervical cancer cells (and cells within warts), it is hoped that immune responses against the two oncogenes might eradicate established tumors.[84]
There is a working therapeutic HPV vaccine that has been clinically tried in Mexico. Developed by Ricardo Rosales. It has gone through 3 clinical trials and has been approved for use by the Mexican government. It is a MVA based vaccine with an e2 bovine protein added in. It has been shown to completely eliminate HPV to the point that patients test negative for the presence of HPV in blood tests. The vaccine is officially called the MEL-1 Vaccine but also known as the MVA-E2 vaccine. The vaccine has proven to be safe as far as is known there have been no side effects or other documented issues. The Vaccine is administered locally to the infected areas and also given in the arm if the infection is mild.[85][86][87][88][89][90]
In developed countries, the widespread use of cervical "Pap smear" screening programs has reduced the incidence of invasive cervical cancer by 50% or more. Current preventive vaccines reduce, but do not eliminate the chance of getting cervical cancer. Therefore, experts recommend that women combine the benefits of both programs by seeking regular Pap smear screening, even after vaccination.[91] The European Centre for Disease Prevention and Control (ECDC) has recommended all European teenage girls to be vaccinated however Bulgaria, Cyprus, Czech Republic, Estonia, Finland, Lithuania, Poland, Slovakia and Turkey currently do not have a vaccination programme in place.
With support from the GAVI Alliance, a number of low-income African countries have begun rollout of the HPV vaccine, with others to follow. In 2013 Ghana, Kenya, Madagascar, Malawi, Niger, Sierra Leone, and the United Republic of Tanzania begin implementation of the vaccine. In 2014, Rwanda will begin nationwide rollout, and demonstration programs will take place in Mozambique and Zimbabwe.[92]
In April 2007, Australia became the first country to introduce a government funded National Human Papillomavirus (HPV) Vaccination Program to protect young women against HPV infections that can lead to cancers and disease.[93] The National HPV Vaccination Program is listed on the National Immunisation Program (NIP) Schedule and funded under the Immunise Australia Program.[94] The Immunise Australia Program is a joint Australian, State and Territory Government initiative to increase immunisation rates for vaccine preventable diseases.
The National HPV Vaccination Program for females was made up of two components: an ongoing school-based program for 12–13-year-old girls; and a time-limited catch-up program (females aged 14–26 years) delivered through schools, general practices and community immunisation services, which ceased on 31 December 2009.
During 2007–2009, an estimated 83% of females aged 12–17 years received at least one dose of HPV vaccine and 70% completed the 3-dose HPV vaccination course.[93] Latest HPV coverage data on the Immunise Australia website show that by 15 years of age, over 70% of Australian females have received all three doses. This has remained steady since 2009.[95]
Since the National HPV Vaccination Program commenced in 2007, there has been a reduction in HPV-related infections in young women. A study published in The Journal of Infectious Disease in October 2012 found the prevalence of vaccine preventable HPV types (6, 11, 16 and 18) in Papanicolaou test results of women aged 18–24 years has significantly decreased from 28.7% to 6.7% four years after the introduction of the National HPV Vaccination Program.[93] A 2011 report published found the diagnosis of genital warts (caused by HPV types 6 and 11) had also decreased in young women and men.[96]
In October 2010, the Australian regulatory agency, the Therapeutic Goods Administration, extended the registration of the quadrivalent vaccine (Gardasil) to include use in males aged 9 through 26 years of age, for the prevention of external genital lesions and infection with HPV types 6, 11, 16 and 18.
In November 2011, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended the extension of the National HPV Vaccination Program to include males. The PBAC made its recommendation on the preventative health benefits that can be achieved, such as a reduction in the incidence of anal and penile cancers and other HPV-related disease. In addition to the direct benefit to males, it was estimated that routine HPV vaccination of adolescent males would contribute to the reduction of vaccine HPV-type infection and associated disease in women through herd immunity.[97]
On 12 July 2012, the Australian Government announced funding to extend the National HPV Vaccination Program to include males, with implementation commencing in all states and territories in February 2013.[98]
From February 2013, free HPV vaccine is being provided through school-based programs for:
Further information is available on the HPV Vaccination Program website at www.australia.gov.au/hpv
Canada has approved use of Gardasil.[99] Initiating and funding free vaccination programs has been left to individual Province/Territory Governments. In the provinces of Ontario, Prince Edward Island, Newfoundland and Nova Scotia,[100] free vaccinations to protect women against HPV were slated to begin in September 2007 and will be offered to girls ages 11–14. Similar vaccination programs are being planned in British Columbia and Quebec.[101][102][103] The cost for the 3 required shots is reported to be $510.00 .[citation needed]
Country | Date of introduction | Gender(s) | Target age group | Financed by | Policy |
Austria | 2006 | M/F | 9–15 | Fully financed by patient | |
Belgium | 2007 | 10–13 | Financed 75% by national health authorities | ||
Canada | 2007 | M/F | 9–26 (M)/9–45 (F) | Financed by the provincial health authorities. | Currently free for girls born 1987 or later.[104] |
Denmark[105] | 1 January 2009 | F | 12 | Fully financed by national health authorities | Part of the Danish Childhood Vaccination program |
France[106] | 11 July 2007 | F | 14–23 | Financed 65% by national health authorities | Voluntary immunization for women not yet sexually active |
Germany[107] | 26 March 2007 | ||||
Greece[108][109] | 12 February 2007 | F | 12–26 | Fully financed by national health authorities | Mandatory for all girls entering 7th grade |
Hungary[110] | 2014 | F | 12 | Fully financed by national health authorities. In addition subsidised by local councils for 13-14 year olds. | |
Iceland | 2011 | 12 | Fully financed by national health authorities | ||
Ireland | 2008 | 12–13 | Fully financed by national health authorities | ||
Italy[107] | 26 March 2007 | F | 12 | ||
Latvia | 2009 | 12 | Fully financed by national health authorities | ||
Luxembourg | 2008 | 12 | Fully financed by national health authorities | ||
Macedonia | 2009 | F | 12 | Fully financed by national health authorities | Mandatory; part of the national immunization schedule |
Netherlands | 2009 | F | 12–13 | Fully financed by national health authorities | |
Norway | 2009 | F | 12–13 | Part of the national immunization program | |
Portugal | 2007 | 13 | Fully financed by national health authorities | ||
Romania | November 2008 | F | 10–11 | ||
Slovenia | 2009 | 11–12 | Fully financed by national health authorities | ||
Spain | 2007 | 11–14 | Fully financed by national health authorities | ||
Sweden[111] | 1 January 2010 | F | 10–12 | ||
Switzerland | 2008 | 11–14 | Fully financed by national health authorities | ||
UK | September 2008 | M/F | M:9–15 F:9–26 | Fully financed by national health authorities for girls only |
In the UK the vaccine is licensed for girls aged 9 to 15, for women aged 16 to 26, and for boys aged 9–15.[112]
HPV vaccination with Cervarix was introduced into the national immunisation programme in September 2008, for girls aged 12–13 across the UK. A two-year catch up campaign started in Autumn 2009 to vaccinate all girls up to 18 years of age. Catch up vaccination will be offered to:
By the end of the catch up campaign, all girls under 18 will have been offered the HPV vaccine.
In September 2012, Gardasil replaced Cervarix as the HPV vaccination of choice due to its added protection against genital warts.
It will be many years before the vaccination programme has an effect upon cervical cancer incidence so women are advised to continue accepting their invitations for cervical screening.[113]
Introduced in 2012. Target age group 13–14. Fully financed by national health authorities only for this age group. For the year 2013–2014, girls in the eighth grade may get the vaccine free of charge only in school, and not in Ministry of Health offices or clinics. Girls in the ninth grade may receive the vaccine free of charge only at Ministry of Health offices, and not in schools or clinics.[114] Religious and conservative groups are expected to refuse the vaccination.[115]
Introduced in 2010, widely available only since April 2013. Fully financed by national health authorities. In June 2013, however, Japan's Vaccine Adverse Reactions Review Committee (VARRC) suspended recommendation of the vaccine due to fears of adverse events. This directive has been criticized by researchers at the University of Tokyo as a failure of governance since the decision was taken without presentation of adequate scientific evidence.[116]
Both Cervarix and Gardasil are approved for use within Kenya by the Pharmacy and Poisons Board. However, at a cost of 20,000 Kenyan shillings, which is more than the average annual income for a family, the director of health promotion in the Ministry of Health, Nicholas Muraguri, states that many Kenyans are unable to afford the vaccine.[69]
In 2013 Laos began implementation of the HPV vaccine, with the assistance of the Gavi Alliance.[92]
The vaccine was introduce in 2008 to 5% of the population. This percentage of the population had the lowest development index which leads to the highest incidence of cervical cancer.[117] The HPV vaccine is deliver to girls 12 – 16 years old following the 0-2-6 dosing schedule. By 2009 Mexico had expanded the vaccine use to girls, 9–12 years of aged, the dose schedule in this group was different, the time elapse between the first and second dose was six months and the third dose 60 months later.[118] In 2011 Mexico approved a nationwide use of HPV vaccination program to include vaccination of all 9-year-old girls.[118]
The publicly funded New Zealand HPV Immunisation Programme began on 1 September 2008. Gardasil is available free for New Zealand girls and young women born on or after 1 January 1990 through general practices, some family planning clinics and participating schools. HPV immunization is part of the regular immunization schedule for girls in year 8 at school (or age 12 if not delivered through a school-based programme). There is also a catch-up programme for older girls. Girls born in 1990 and 1991 have until 31 December 2011 to start the programme for free. Girls born from 1992 onwards have until their 20th birthday to start the programme for free. Over 82,000 New Zealand girls and young women have chosen to get the HPV immunisation in the programme's first year.[119]
The vaccine was added to the national immunization program in 2008, to target girls in the population aged 10.[117] The vaccine is being administer by clinics and schools.[118]
Cervical cancer represents the most common cause of cancer-related deaths—more than 3,000 deaths per year—among women in South Africa because of high HIV prevalence, making introduction of the vaccine highly desirable.[120] A Papanicolaou test program was established in 2000 to help screen for cervical cancer, but since this program has not been implemented widely, vaccination would offer more efficient form of prevention.[121] In May 2013 the Minister of Health of South Africa, Aaron Motsoaledi, announced the government would provide free HPV vaccines for girls aged 9 and 10 in the poorest 80% of schools starting in February 2014 and the fifth quintile later on.[122] South Africa will be the first African country with an immunisation schedule that includes vaccines to protect people from HPV infection, but because the effectiveness of the vaccines in women who later become infected with HIV is not yet fully understood, it is difficult to assess how cost-effective the vaccine will be. Negotiations are currently underway for more affordable HPV vaccines since they are up to 10 times more expensive than others already included in the immunisation schedule.[120][122]
On July 27, 2007, South Korean government approved Gardasil for use in girls and women aged 9 to 26 and boys aged 9 to 15.[123] Approval for use in boys was based on safety and immunogenicity but not efficacy.
Introduced in 2013. Target Group 9–26. Fully financed by national health authorities. Administration in schools currently suspended owing to objections and concerns raised by the Catholic Board, but fully available in local health centers.
As of late 2007[update], about one quarter of US females age 13–17 years had received at least one of the three HPV shots.[124] By 2014[update], the proportion of such females receiving a vaccination had risen to 38%.[125] The government began recommending vaccination for boys in 2011; by 2014[update], the vaccination rate among boys (at least one dose) had reached 35%.[125]
According to the US Centers for Disease Control and Prevention (CDC), getting as many girls vaccinated as early and as quickly as possible will reduce the cases of cervical cancer among middle-aged women in 30 to 40 years and reduce the transmission of this highly communicable infection. Barriers include the limited understanding by many people that HPV causes cervical cancer, the difficulty of getting pre-teens and teens into the doctor's office to get a shot, and the high cost of the vaccine ($120/dose, $360 total for the three required doses, plus the cost of doctor visits).[1][126]
A survey was conducted in 2009 to gather information about knowledge and adoption of the HPV vaccine. Thirty percent of 13- to 17-year-olds and 9% of 18- to 26-year-olds out of the total 1,011 young women surveyed reported receipt of at least one HPV injection. Knowledge about HPV varied; however, 5% or fewer subjects believed that the HPV vaccine precluded the need for regular cervical cancer screening or safe-sex practices. Few girls and young women overestimate the protection provided by the vaccine. Despite moderate uptake, many females at risk of acquiring HPV have not yet received the vaccine.[127]
Since the approval of Gardasil in 2006 and despite low vaccine uptake, prevalence of HPV among teenagers aged 14–19 has been cut in half with an 88% reduction among vaccinated women. No decline in prevalence was observed in other age groups, indicating the vaccine to have been responsible for the sharp decline in cases. The drop in number of infections is expected to in turn lead to a decline in cervical and other HPV-related cancers in the future.[128][129]
Shortly after the first HPV vaccine was approved, bills to include the vaccine among those that are mandatory for school attendance were introduced in many states.[130] Only two such bills passed (in Virginia and Washington DC) during the first four years after vaccine introduction.[130] Mandates have been effective at increasing uptake of other vaccines, such as mumps, measles, rubella, and hepatitis B (which is also sexually transmitted).[126] However most such efforts developed for five or more years after vaccine release, while financing and supply were arranged, further safety data was gathered, and education efforts increased understanding, before mandates were considered.[130]
Other measures that have been considered include requiring insurers to cover HPV vaccination, and funding HPV vaccines for those without insurance. The cost of the HPV vaccines for females under 18 who are uninsured is covered under the federal Vaccines for Children Program.[131] As of 23 September 2010, vaccines are required to be covered by insurers under the Patient Protection and Affordable Care Act. HPV vaccines specifically are to be covered at no charge for women, including those who are pregnant or nursing.[132]
Almost all pieces of legislation currently pending in the states that would make the vaccine mandatory for school entrance have an "opt-out" policy.[133]
The National Conference of State Legislatures periodically issues summaries of HPV vaccine related legislation.[133]
Other states are also preparing bills to handle issuing the HPV Vaccine.[133]
State | Proposal | Status |
Alabama | HB 42 would allow parents the option of immunizing female students entering the sixth grade, and requires the Department of Health and Senior Services to directly mail age appropriate information to parents or guardians to those students regarding the connection between HPV and cervical cancer and the availability of the immunization. | Passed |
Alaska | Voluntary vaccination program | Passed |
Florida | SB 1116 Would require the Department of Health to adopt a rule adding HPV/cervical cancer to the list of communicable diseases for which immunizations are recommended; requires that schools provide the parents or guardians of certain public school students information regarding the disease and the availability of a vaccine; requires the department to prescribe the required information. | Not passed |
Georgia | HB 736 Would require public Schools to provide parents or guardians of sixth grade female students information concerning the infection and the immunization against the human papillomavirus. | |
Hawaii | HCR 71 Would request the Department of Health to make human papillomavirus immunization available to indigent patients and through the teen VAX program, and urging insurers to offer coverage for human papillomavirus immunization to female policyholders eleven to twenty-six years of age. | Not Passed |
Iowa | SSB 3097 Would create a study bill for a HPV public awareness program and make appropriations for the public awareness program, provision of vaccinations, and cervical cancer screenings. | In committee |
Kansas | HR 6019 Resolution would urge the U.S. Food and Drug Administration to use caution in approving new vaccines such as Gardasil which has had a number of health problems including some deaths associated with the use of this vaccine. | In committee |
Kentucky | HR 80 Would urge females ages 9 to 26 and males ages 11 to 26 to obtain the Human papillomavirus (HPV) vaccination and all citizens to become more knowledgeable about the benefits of HPV vaccination. | Passed |
Maryland | HB 411 Would require the Statewide Advisory Commission on Immunizations to study the safety of the human papillomavirus (HPV) vaccine; requires the Commission to include specified components in the study, make recommendations, and report the results of its study. | Passed |
Minnesota | HF 1758 Would require the commissioner of health to prepare informational materials on vaccines including the HPV vaccines and encourages public and private schools with students in grades 6-12 to provide this information to parents in a cost-effective and programmatically effective manner. (Introduced 3/16/09) | |
Michigan | SB 1062 and SB 1063 Each would require health insurers to provide coverage for humpan papillomavirus screenings for cervical cancer. | In committee |
Mississippi | HB 1512 Would require health benefit plans to cover HPV screenings. | Not Passed |
Missouri | HB 1935 Would require health insurers to provide coverage for human papillomavirus screenings for cervical cancer. | In committee |
New Jersey | S 1163 Would require health insurers and State Health Benefits Program and SEHBP to provide coverage for screening for cervical cancer, including testing for HPV. (Sent to Committee 1/23/12) A 2185 Would require insurers and State health care coverage programs to cover cost of HPV vaccine. | In committee |
New York | SB 98 (same as AB 2360) Would encourage voluntary, informed vaccination against human papillomavirus (HPV). (Amended in Senate Committee on Health 1/5/12) AB 699 Would require immunization against HPV for children born after Jan. 1, 1996. (Sent to Assembly Committee on Health 1/5/11) AB 1946 Would require insurance companies to provide coverage for the vaccine against human papilloma virus. (Sent to committee 1/12/11) AB 2360 Would encourage voluntary, informed vaccination against human papillomavirus (HPV) for school-aged children and their parents or guardians. (Sent to committee 1/18/11) SB 4708 Would require insurance companies to cover HPV vaccine. | In committee |
Oregon | HB 2794 Would require health benefit plans to provide coverage of human papillomavirus vaccine for female beneficiaries who are 11 years of age or older. | Passed |
Pennsylvania | HB 524 Would require health insurance policies to provide coverage for vaccinations for human papilloma virus. | In committee |
South Carolina | HB 4497 Would enact the Cervical Cancer Prevention Act and allow the Department of Health and Environmental Control to offer the option of an HPV vaccine series to female students entering the seventh grade at the request of their parent or guardian pending state and federal funding. | In committee |
Texas | HB 2220 Would allow the Executive Commissioner of the Health and Human Services Commission to require immunization against human papillomavirus or other immunizations for a person's admission to elementary or secondary school. | In committee |
Virginia | HB 1419 Would repeal the HPV vaccination requirement for female children. (Passed House 1/21/11, Indefinitely passed by the Senate Committee 2/17/11) HB 65 Would repeal the requirement for children to receive the HPV vaccination for school attendance. (Left in committee 2/14/12) HB 824 Would require that the Commonwealth shall assume liability for any injury resulting from administration of the human papillomavirus vaccine. HB 1112 Would eliminate the requirement for vaccination against human papillomavirus for female children. | Passed House and sent to Senate |
Source: National Conference of State Legislatures
Between July 2008 and December 2009, proof of the first of three doses of HPV Gardasil vaccine was required for women ages 11–26 intending to legally enter the United States. This requirement stirred controversy because of the cost of the vaccine, and because all the other vaccines so required prevent diseases which are spread by respiratory route and considered highly contagious.[134] The Centers for Disease Control and Prevention repealed all HPV vaccination directives for immigrants effective December 14, 2009.[135]
There has been significant opposition from health insurance companies to covering the cost of the vaccine ($360).[136][137][138]
However, Medicaid covers HPV vaccination in accordance with the ACIP recommendations, and immunizations are a mandatory service under Medicaid for eligible individuals under age 21. [1][citation needed] In addition, Medicaid includes the Vaccines for Children Program. [1][citation needed] This program provides immunization services for children 18 and under who are Medicaid eligible, uninsured, underinsured, receiving immunizations through a Federally Qualified Health Center or Rural Health Clinic, or are Native American or Alaska Native.[1][citation needed]
The vaccine manufacturers also offer help for people who cannot afford HPV vaccination. GSK has the Vaccines Access Program, which provides Cervarix free of charge to women who do not have insurance and who have a low income, and who are ages 19 to 25 and therefore too old for the Medicaid Vaccines for Children Program.[citation needed] For example, Merck offers the Merck Vaccine Patient Assistance Program, which provides Gardasil for free to people over the age of 19 who do not have health insurance or cannot afford to pay for the vaccine.[citation needed]
Several conservative[139][who?][quantify] groups in the U.S. have publicly opposed the concept of making HPV vaccination mandatory for pre-adolescent girls, asserting that making the vaccine mandatory is a violation of parental rights. They also say that it will lead to early sexual activity, giving a false sense of immunity to sexually transmitted disease. (See Peltzman effect) Both the Family Research Council and the group Focus on the Family support widespread (universal) availability of HPV vaccines but oppose mandatory HPV vaccinations for entry to public school.[140][141][142][143]
Many organizations such as the American Academy of Pediatrics disagree with the argument that the vaccine increases sexual activity among teens.[144] Dr. Christine Peterson, director of the University of Virginia's Gynecology Clinic, said "The presence of seat belts in cars doesn't cause people to drive less safely. The presence of a vaccine in a person's body doesn't cause them to engage in risk-taking behavior they would not otherwise engage in."[145][146]
An investigational nonavalent (types 6, 11, 16, 18, 31, 33, 45, 52, and 58) vaccine produced by Merck called V503 is awaiting approval from the FDA. In a phase 3 clinical trial, V503 provided comparable protection to the four types that Gardasil protects against as well as a 97% reduction in cases of high-grade cervical, vulvar and vaginal diseases of five additional HPV types that are considered high-risk for developing cancer. Reported adverse effects of receiving V503 were mild to moderate and generally comparable with Gardasil, with injection site adverse effects (swelling, pain, erythema) being slightly more frequent.[147]
Merck & Co., Inc has a V503 (nonavalent HPV vaccine) candidate in review by the FDA which will extend protection to HPV types 16, 18, 31, 33, 45, 52 and 58.[148]


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Duane Reade Inc. on Friday said it's set to uncork its first new advertising campaign in years, with the drug chain's messages blanketing spaces throughout New York City.
Retail News Breaks Archives
NEW YORK – Duane Reade Inc. on Friday said it's set to uncork its first new advertising campaign in years, with the drug chain's messages blanketing spaces throughout New York City.
Plans call for the New York-themed campaign — which sports the tagline, "Your city. Your drugstore. Duane Reade" — to start appearing next week in thousands of subway cars and buses, as well as on phone kiosks, billboards and urban panels near rail stations, according to the company.
The ads will be seen in one of every three subway cars, one of every 10 city buses and inside one of every two Manhattan buses, said Duane Reade, which currently bills itself as "uniquely New York" in its in-store and outside marketing.
Slated to run throughout the year, the campaign was created by advertising agency DeVito/Verdi and marks the 253-store, metropolitan New York drug chain's first new branding campaign in nearly a decade.
"We're strengthening the connection between New Yorkers and a uniquely New York drug store chain," Joe Jackman, chief marketing officer at Duane Reade, said in a statement. "This campaign will help keep us top-of-mind with New Yorkers and provide a quintessentially New York voice for our brand."
The ads take various New York symbols, events and local references to convey the chain's understanding of what New Yorkers need and when they need it, Duane Reade said.
For example, one ad shows the Statue of Liberty unwilling to completely raise her lit torch, with the copy reading, "Everything a New Yorker needs, like deodorant." Another ad depicts a bottle of Pepto-Bismol next to copy that states, "Feast of San Gennaro. September 10-20."
Other ads capture the hectic nature of New York living, the company said. One ad shows the inside of a subway car and says, "The pole you're holding has a gazillion germs on it," while another ad instructs shoppers to "Get everything you need in 15 minutes. Or as New Yorkers call it, lunch hour."
"This campaign works particularly well on, and under, the streets of New York," Jackman commented.
Duane Reade added that in 2010 it would consider expanding the campaign to include other media.


text:
Reader comments are listed below. Comments are currently closed and new comments are no longer being accepted.
The Google allege is one of the most ridiculous things I heard recently. The so-call hacker source in Jinan is a crappy vacation school with 80386 computers. How can you...
Oh wait. Maybe we can ... How about a trip to "the world's most owesome hacker den"? You yankee can play James Bond and discover the dark secrets in the most evil communist country! Merely for $50000! Guarantee 5-star hotel (with breakfast) and free souvenir (Mao's quotation). What are you waiting for!? Pick up your phone NOW! 400-100-34234
I am more concerned about the safety and security of my gmail content than anything else. It might be the handiwork of Chinese government backed hackers, but google have failed to ward them off. I want to look at this as a breach of cyber security and am less interested about the political outcome.
Does this mean, gmail is not so safe as it is made out to be ? Is it also a pointer to it's other products ? Google should spend more effort in beefing up the security of it's product rather than shouting 'Wolf'. The hackers ( government backed or not ) are going to be there.
Wow. I've heard a lot of sanctimonious nonsense, but yours probably takes the cake. Let me throw an analogy at you. What you have said is tantamount to saying that if a city doesn't have walls around it or a military base directly on it, any nation is perfectly within its rights to storm in and raid the citizens of that city. After all, what were they doing having no defenses to begin with?
Yeah, Gmail needs cybersecurity work, there's no question. However, it's ridiculous to assume that justifies theft of information by the Chinese government, assuming they are the culprits.
Its very unfair to hack by the chinese millitary force.Google has done a great job by finding the culprit.
Its good for the world if the google increases its sequrity services
and the google is doing it
@I thought you were impartial
Back in the old days, many Germans think hating Jews is quite normal, as you might think about China. We don't need to go further, just read wikipedia:
The Chinese community try to defend China when they think it's unfair. Like I won't defend China when people saying stop Ai Weiwei is wrong, because I hold the same point of view, but Economist assuming that Chinese military is involved in this only because google tracked messages from Jinan city, which is huge with 6 million plus population, I tend to not believe it.
The debate between those who don't like China (and most don't know China) and those who defend China (not all necessarily Chinese, never mention all work for the Communist Party) is part of a thing called communication. This is actually the magical thing and the only thing that could stop real confrontation. By the way, I work for a French laboratory, I have never been or will ever be working for any Communist party, but I still think that when some people hate you for no reason, the better way to fight back is to try to prove them wrong. That's exactly what many Chinese young are doing: trying to tell the West that Chinese are just as human as the Westerners.
One quick question - how many of these posts are written by people working for the Communist party? I am just asking. Of course you have every right to defend your country. But we in the west have a tradition of freedom of the press that goes back nearly 1000 years. We enjoy a right to privacy that goes back even further. Fraud is fraud whomever commits it. Crime is crime whomever commits it. An invasion of privacy is intolerable. The more of a fuss China makes the less likely the international community is to believe China's protestations. To quote one of our great poets "methinks he doth protest too much."
re "The ability of the US (not to mention Google) to do deliberate damage to China is very large. A single" from pungent.
No one should doubt google's technical ability to retaliate. They have an astounding concentration of computing talent. If it is true that the Chinese govt was involved, its interesting to note the contrast of a government behaving badly with a corporation showing restraint. It's only natural for a corporation to behave this way. The corporation's duty is to act in the interests of shareholders. Retaliation would not be in shareholders interest, not to mention probably illegal.
"China does this to many multinationals and to many foreign governments, most people just don't have the guts to report it. "
Could you give any links? Name of the books? Agencies? Or just something you have read in fictions... since they are even not reported?
nschomer wrote:
Jun 2nd 2011 4:27 GMT
It doesn't work that way. Physical labor is 15% of the cost of a product. How do you use labor on a plastic good anyways? These are molded. It is impossible to mold plastic by hand in any sort of efficient fashion.
In a recent Economist article, they even said that Chinese manufacturing is not labor intensive at all. Except for things like electronics assembly, the "cheap plastic crap" is actually highly automated and relatively high-tech. Its the iPhones and iPads that are actually "low tech" for the part that goes into them in China. But those have little to do with China's core competency.
How will you "move" these plants, even "low tech" assembly ones? First, none of these plants don't belong to US companies. They belong to Taiwanese and HK companies mostly, with mainland, Taiwan and Japanese suppliers. The US doesn't get to decide to "move" them.
Second, rising wages actually have little impact on the real cost of production. It's just 15% of the final cost. The real reason is the increase in oil prices driving up transportation costs and rising coal prices driving up electricity.
Thirdly, these export plants have nothing to do with China's core technologies and high tech companies such as Huawei, ZTE, SMIC, ICBC, Baidu, Sinopec, China Railway, Baosteel, AVIC, etc.
A fairly frivolous last line. Quite irresponsible.
"Hundreds of senior officials" in the US government are using gmail for their official business?
There have been lots of stories about Chinese cyberattacks on American networks, private and government alike. It is not surprising that China is hungry for American government secrets since every country probably is. But it is significant that China appears to able at cyber-warfare. Particularly because it suggests that China is catching up in modern computer technology which may displace more jobs requiring advanced skills in modern computers and many assumed that Americans would be making their living developing products that could then be physically manufactured in Asia. This may not turn quite so.
Also, one may ask how many Chinese cyber-spies were educated in computer science in the United States and whether the US would not have been better off giving them a greencard stapled to their degrees.
I seem to be missing the assumed humor in your closing "Shooting careless officials would be a start."
Perhaps this is a typo? Maybe your page was hacked? In any case, it doesn't seem to fit with The Economist's style - encouraging violence as a solution?
And, perhaps worse for you, esteemed Economist, is that the article doesn't discuss or raise an issue regarding careless officials. The only officials implicated are the seemingly purposeful ones looking for, in their opinion, enemies of the State. So, esteemed Economist, where does this weird comment come from?
I was among the first Gmail users, because my law firm had advertised with Google, and I was given advance access to the new e-mail system in approximately October of 2004, about a year before it became available to the public. It is terrific, and more and more of my friends and colleagues have joined; and I recommend it highly.
HOWEVER, "phishing" and other fraudulent schemes are rampant on the Web. On average, I encounter at least 30-40 phishing messages a day in my "Spam" folder; and I label the messages as such, to warn other Gmail users. Indeed, the following note appears when they open the messages, after I have tagged them:
"Warning: This message may not be from whom it claims to be. Beware of following any links in it or of providing the sender with any personal information."
There are Google and Gmail "impersonators" too, and I report them to Google as well. Also, as a lawyer, I was approached as part of a scheme that thus far has bilked American members of my profession out of more than $50 million, which is a pittance in terms of the fraud that is occurring globally on the Web today. Some of the scammers are Nigerians working out of Toronto, and others are worldwide. Law enforcement is at a loss, for the most part, in terms of stopping them.
See http://naegeleblog.wordpress.com/2010/01/31/lawyers-and-internet-scams/ (see also the footnotes and comments beneath the article)
Lastly, many people who are victims of such fraudulent schemes are elderly, uneducated, or simply too embarrassed to admit that they got scammed, which includes members of the legal profession who should know better.
All you have to do is read the Chinese posters here, both paid (hi nirvana-bound) and unpaid.
When you have an attempt to target govt officials, domestic Chinese dissidents, and other person's of interest, it's pretty clear there was a scheme above just 'some kids playing around'.
And this has been a perpetual theme, but it is part of China's plan. China sees itself as the empire that lost its way and must reclaim its dominance. It is looking forward to Lording over the world just as it lords over most of its own citizens. Its cyberwarfare is a key part of this strategy- to steal more secrets, steal more info, steal more technology, and to do so in a way that does not provoke physical agression.
China does this to many multinationals and to many foreign governments, most people just don't have the guts to report it.
But I love the sanctimonious Chinese. If it was an American hacker there would be 1000 comments from the PLA and others about how evil and world domineering America is. Mean while you openly hack the rest of the world and are quietly raping Africa for land.
What a country.
Google Says Gmail Hacking Linked to China
Google says hackers, probably based in China, tried to break into hundreds of Google mail accounts. These include those of senior US government officials, Chinese activists, and journalists. http://www.newslook.com/videos/319284-google-says-gmail-hacking-linked-t...
Until once we actually find aliens and all people on earth need to fight together (or finger pointing together at the aliens), this kind of paranoid things would always exist. For the time being...
Chinese---replace this one by "Russians" in the past, and "Aliens" in the future---- live for:
Stealing jobs from America and Europe;
Attacking Websites in the West;
Crashing the essential values defended by the West;
Making life harder in other countries;
Stepping on their toes each time rich countries need to do something;
They don't live for:
Finding love, raising children, having a happy family, like people do in the West;
Working hard to find/keep their jobs, like people do in the West;
Trying their best to find answers for social problems, like people do in the West;
Two things are infinite: the universe and human stupidity; and I'm not sure about the universe. said Einstein.
Make a list of the countries where economy goes well:
Germany, Australia...
Actually those are the countries who have had built a great trade relations with China. With Europe, for example, in a mess, if China stops import German products, and French wine, luxury, things would be worse for the whole Europe.
Globalization doesn't mean that only China (or other emerging countries) needs the rich countries, but also they need China.
Talking about boycotting... in 2008, when things have been tough between France and China, it was China which has had stopped some trade contracts, and France couldn't bear losing China as a trade partner...
Nobody would wish for a trade war, but just, maybe you would need to change a little the mentality: we live now in a world no one is dominating. Even not the United-States can say it can get out unhurt starting a trade war. Just don't talk about "So why don't we in the West just boycott everything Chinese until they get the message?" this is not the position where the West is for the moment.
Ok, Chinese Military did attack Gmail- Is Google not responsible if attack is successful? Is there no lack of security at google.
Gmail does not have good security features. Google blames Chinese for their failure.
Didn't Wiki-Leaks come under cyber attacked when it leaked cables for the first time?
Cyber attack is new tool at military's disposal, if you come under fire- you can run or fire back.
You can not cry like a kids(mom, see, he did it!!)
In the scifi enovel, The Price of Freedom by J.L. Leclerc. They talk about this. In the future the military and government official will go back to sending messages to each other on paper hand delivered by couriers. What's old will be new again.
Will IP guided cruise missiles be on next year's defense budget?
Think about it...
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Considering a buyout? Think before you act
Bill Bransford is a partner at the law firm, Shaw, Bransford & Roth. He joins the Federal Drive with information on the legal rights of employees who may feel targeted to accept buyouts.
USPS set to release Specific RIFs
The Postal Service's redesign continues, and employees may receive Specific RIF notices tomorrow.
USPS warns of default on retiree benefits
Without action from Congress, the U.S. Postal Service will default on its obligations to future retirees' health care accounts. Next up are payments to employees and vendors, the postmaster general told Congress Tuesday.
Postal workers ratify contract with 3.5 percent raise
Members of the U.S. Postal Service's largest union voted Thursday to accept a new contract that includes a 3.5 percent raise and cost-of-living adjustments over four years.
USPS offered digital modernization ideas from overseas
The Government Accountability Office spoke with foreign countries about how they've modernized their mail systems and offered ideas to the U.S. Postal Service based on its findings. Phil Herr, director of physical infrastructure issues at GAO, talks about the report.
How to consolidate data centers effectively
The administration plans on cutting 100 data centers this year and 700 more by 2015. Bob Otto of Agilex Technologies says this is an attainable goal and offers tips for agencies in the process.
USPS makes a case for debt relief
The Postal Service asked Congress Tuesday to change laws requiring them to pre-pay health benefits and overfund the Federal Employees' Retirement System. Republicans say USPS needed to do much more to "right-size" its costs and operations.
USPS makes a case for debt relief
The Postal Service asked Congress Tuesday to change laws requiring them to pre-pay health benefits and overfund the Federal Employees' Retirement System. Republicans say USPS needed to do much more to "right-size" its costs and operations.
Postal Service to relocate Frederick Co. carriers
The U.S. Postal Service is relocating letter carriers in two post offices serving Frederick County to save money.
USPS to defend union contract
The Postal Service will save more than $3 billion over the next several years under a labor agreement it negotiated with one of its largest unions, Postmaster General Patrick Donahoe will tell Congress Tuesday. House lawmakers have called a hearing to examine the deal with the American Postal Workers Union and other USPS workforce issues.
Buyout Predictor Guidelines
When it comes to predicting agency buyout plans, it is as simple as winning a bundle in Las Vegas or getting rich by buying low and selling high. And Senior Correspondent Mike Causey says, the winners are older feds who want out and younger people who want to keep their job, and maybe get a promotion too.
Could USPS make money off of truck sensors?
A radical new plan would outfit postal service trucks "with sensors to collect and transmit information about weather or air pollutants," including radioactivity! We talk about it with the originator, the Postal Regulatory Commission's own Chief Counsel to the chairman, Michael Ravnitzky!
USPS cuts 7,500 jobs, offers $20,000 buyouts
The Postal Service will offer $20,000 early retirement incentives to administrative employees, who must make a decision on whether to leave USPS by late April. RIF notices will be issued on May 25 to any affected employees who do not voluntarily retire or move to a lower grade.
COLA For Retirees/Pay Raise for Postals!
Just when it looked like federal workers have hit rock bottom, it turns out that two big chunks of the government family may be in for some good news. Senior Correspondent Mike Causey says there may be pay raises for some postal workers and the return of the COLA for retirees.
How feds help feds survive the worst
The Federal Employees Education and Assistance fund survives on the kindness of federal employees to help federal employees survive disasters from furloughs to floods. We talk with Executive Director Steve Bauer. We also get an update on the latest furlough developments from Federal Times editor, Steve Watkins.
USPS to reduce workforce by up to 30,000 in 2011
The U.S. Postal Service could reduce its workforce by up to 30,000 employees this year. Up to 7,500 of those positions would be eliminated as part of a redesign that USPS will announce March 25, an agency spokeswoman said.
USPS financial rescue may not stop 'death spiral'
Postmaster General Pat Donahoe said he's ready to announce more RIFs and without legislative help USPS will face insolvency this year. Sen. Susan Collins introduced a bill to help solve some of the challenges the Postal Services faces.
There's light at end of the USPS budget tunnel
The Postal Service is encouraged by the President's recognition of the Postal Service's financial situation. For why, and what's next, we talk with USPS CFO, Joseph Corbett.
USPS, DHS, DoD contribute to 'dire' finances
Last week the International Monetary Fund cautioned the government on spending. So how bad are federal finances? We ask GAO's Jeanette Franzel
'More intense' high-risk oversight planned
GAO's biannual list includes 30 programs that are in trouble. House and Senate members promise to focus more of their attention on the initiatives most at risk. Members plan to use the model that worked for DoD and personnel security clearances in other problematic areas.


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NATIONWIDE--MAY 03, 2013-- With Memorial Day weekend just a few weeks away, travel and entertainment companies have cut prices by as much as 70% to spur last-minute bookings.Deals are available over the holiday weekend, May 24-27, and surrounding dates. Our team of deal experts found, researched and compiled a list of the best offers.
For a full list of deals, click below.
Travelzoo Tip: To save on airfare, we recommend to avoid flying on Friday and/or extending your trip over Monday night. Rates at many hotels are lower on the holiday, and airfare is often cheaper on Saturdays and Tuesdays.


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Plan Specification: HHF-3930
Total Square Footage: 1,550Main Level: 1,550Bedrooms: 3Baths: 2Garages: 2Width: 50 ft Depth: 55 ftFoundation: Basement Option, Crawl Space Option, Slab
© copyright by designer |
Plan: HHF-3930Foyer explodes into huge gathering space with fireplace/media wall as the focal point. Secluded formal dining room encourages quiet dining. Master boasts huge walk in closet, with a private toilet room, and grand shower. Bedroom 3 can easily turn into home office or den/study through fench doors.
Similar plans: none
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© copyright by designer First Floor Plan: Top Plan Details


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Shreveport, La (KMSS) — Shreveport Police investigators are asking the public for help in identifying a gunman who robbed a business on Thursday.
At about 12:55 p.m., the bandit entered Easy Money Loans, located at 7013 Pines Road, and robbed the store.
The thief is described as a black male, standing 5'7" with a medium build, in his early 20's, wearing a blue hooded jacket and armed with a semi-automatic gun. Police say he took an undisclosed amount of money from the business, then left the scen in an unknown direction.
Crime Stoppers is offering a $500 reward for any information as to the identity of this suspect. Contact Crime Stoppers at 673-7373 or www.lockemup.org


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Students should plan to arrive at Smart Christian Schools on Wednesday, Sept. 8, BEFORE 9 a.m. When you arrive on campus, you should report to the main office, where you will receive a schedule for the orientation program.
PLEASE NOTIFY THE OFFICE. If, because of airline schedules, it is necessary for you to arrive Sept. 7, you can, but only by previous arrangement.
Parents: If you accompany your child to Smart, please note we will have a special meeting just for families where you will have a chance to meet your child's advisor. Details about these meetings and other opportunities are in the letter to the parents.
Students: Your first academic appointment will be with your academic advisor. Please be certain you complete your placement tests and send them and your final transcript to Smart Academy/Christian School; in addition, it would be helpful to bring copies of your high school academic report cards.
Finally, students who are not permanent residents or U.S. citizens need the I-20 form to obtain an F-1 student visa. We suggest you do this soon.
Please note: You must always have your I-20 form with you when you enter the United States. (Never leave it at home after receiving your F-1 visa.) Please fill out the REGISTRATION FORM by June 15. Information you cannot provide at this time can be forwarded to the office later.


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CAIRO - Leading anti-religion rhetoric for years, world leaders of atheism have swung their attitude towards a populist and crude hatred of Islam, using an already deeply misunderstood and much maligned faith.
Conversations about the practical impossibility of God's existence and the science-based irrationality of an afterlife slid seamlessly into xenophobia over Muslim immigration or the practice of veiling, read a recent article by Nathan Lean on the Salon website was cited by The Independent newspaper.
The New Atheists became the new Islamophobes, their invectives against Muslims resembling the rowdy, uneducated ramblings of backwoods racists rather than appraisals based on intellect, rationality and reason, he added.
The article wrote by Lean, a Washington DC native and Middle East specialist who has recently written a book about the Islamophobia industry, was one of a series of columns that have been written recently about the New Atheism.
The articles followed a series of tweets last month by Professor Richard Dawkins attacking Islam.Haven't read Qur'an so couldn't quote chapter & verse like I can for Bible. But often say Islam [is the] greatest force for evil today, the Cambridge evolutionary biologist wrote.
The fact that the author of the God Delusion hadn not studied Islam's holy book surprised many and led to a flurry of responses from both fans and critics alike.
Muslims are a group that have come to occupy a special place in his line of fire and in the minds of a growing club of no-God naysayers who have fast rebranded atheism into a popular, cerebral and more bellicose version of its former self, Lean wrote of Dawkins.
Though few atheists in the western world historically paid much attention to Islam, the new attacks by atheists were employing a past-9/11 hatred, flirting with Islamophobes and using an already deeply misunderstood and much maligned faith.
Sam Harris, a neuroscientist by trade whose atheist tracts The End of Faith and Letter to a Christian Nation have made him one of the leading anti-religious polemicists of his age, has also involved in new atheism anti-Islam trend.
The idea that Islam is a peaceful religion hijacked by extremists' is a fantasy, and is now a particularly dangerous fantasy for Muslims to indulge, is just one he wrote in Letter to a Christian Nation.
Harris also wrote in favor of torture, pre-emptive nuclear strikes and the profiling not just of Muslims but anyone who looks like he or she could conceivably be a Muslim.
The atheists' attacks on islam drew harsh criticism from many analysts.
[Harris'] sweeping generalizations about a constructed civilization encompassing over a billion people are coupled with fevered warnings - parallel with the most noxious race propaganda of the past - about the purported demographic threat posed by immigrant Muslim birthrates to Western civilization, Murtaza Hussain, a Toronto based Middle East analyst, wrote in a scathing critique on Al Jazeera website recently.
Citing Muslims as a solid monolith of violent evil - whilst neglecting to include the countless Muslims who have lost their lives peacefully protesting the occupation and ongoing ethnic cleansing of their homeland - Harris engages in a nuanced version of the same racism which his predecessors in scientific racism practiced in their discussion of the blanket characteristics of Negroes, he added.
Being a vocal critic of New Atheism himself, left-wing US columnist Glenn Greenwald retweeted Hussain's article, blaming writers like Harris for using their particularly anti-Islamic brand of rational non-belief to justify American foreign policies over the last decade.
When criticism of religion morphs into an undue focus on Islam - particularly at the same time the western world has been engaged in a decade-long splurge of violence, aggression and human rights abuses against Muslims, justified by a sustained demonization campaign - then I find these objections to the New Atheists completely warranted, Greenwald concludes.
In sum, [New Atheism] sprinkles intellectual atheism on top of the standard neocon, right-wing worldview of Muslims.
Reproduced with permission from OnIslam.net


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This recipe is so perfect for Valentine's Day. Simple and so delicious!
I did a whole lot of cooking this weekend. I'm all cooked out. I spent the whole day saturday and sunday in the kitchen prepping for a big week. I've got a few dinner parties, a boat load of meetings, Valentine's Day, and some other fun things to tend to. And I don't know about you, but when I have a busy week coming up, it helps when I cook up a storm before the madness begins. That way, I know that no matter what happens, there is something to eat in the fridge that we can whip out and heat up for dinner.
I roasted some potatoes, created my new favorite kind of carrots (recipe to come soon), threw some BBQ chicken in the slow cooker and then I made these Cheesecake Cookie Bars. And while everything else I made got 2 thumbs up from Thomas, it was these Cheesecake Cookie Bars that really stole the show. I can't even deal. I seriously am considering sending them to work with him tomorrow because knowing me, they will all be gone within 24 hours. I just can't help myself. I combined a WAY easy cheesecake recipe with my favorite Valentine's Day themed m&m cookies and voila… Cheesecake Cookie Bars that are dotted with colorful milk chocolate m&m's. They are delish. And a really fun V-Day themed treat to bring into the office or bake up for your sweetie if you're planning anything like that this year. I'll probably devour all of these, and then make some more for Valentine's Day. And then I'll do a juice cleanse next week. Everything in moderation right? (my mom is probably shaking her head at me right now)
So make these and indulge a bit. Because it's Valentine's Day week… the biggest Hallmark Holiday of them all… and then go buy yourself some flowers because you deserve it!
This recipe is so perfect for Valentine's Day. Simple and so delicious!
This recipe looks delicious! What size bag of M & Ms did you use?
These are perfect for Valentine's Day! So cute and festive…not to mention fabulous!
these look awesome Gaby! so cute!
Perfect treats for Valentines day.
Such a cute treat! My little girl would be all over these.
These look delish & perfect for any Valentine
these are so festive and cute!! busy week, lady! glad you were able to get into the kitchen and cook away this weekend these are perfect for Thursday! xo
These are adorable. Who doesn't want cookie bars on Valentine's Day?
Valentine's perfect,Gaby!
I was so hoping you wouldn't share the recipe but they are calling my name so I must oblige:)
I want these so much! I will make them, I may not share!
My Valentine would go crazy for these!
I want the whole pan!
Yum I have to try these! You could switch in other color M&Ms for other holidays too!
The perfect treat for Valentines Day, or indeed any other day, as far as I am concerned!! Yum!
Two of my favorites… Cheesecake & cookies! These sound and look amazing! Off to pin
I want one of these RIGHT. NOW.
Hi Gaby! I have an 8×8 pan- any suggestions on cooking time or modifications to the recipe?!
Mine are in the oven right now! Cannot wait to share with my 3 boys tomorrow for Valentine's Day. They look delicious.
Thanks Gaby!
I used the 9×9 pan but mine are a lot thicker than yours look in the picture…did you change it when you made them?
These bars look gorgeous and the recipe sounds easy. Happy V-Day, Gaby!
I've just pulled mine out of the oven, so haven't tasted yet. They smell and look delicious! I followed the recipe exactly, but put them in a 9×13 pan, and let my daughter have enough dough to make 2 large sugar cookies to decorate, and it STILL almost overflowed the 9X13 pan. I can't imagine cooking this in a 9X9. It's okay with me… more cookies to enjoy!
Yum! These bars look great. I too try to cook a lot when I know I have a busy week ahead of me.
Loved the flavors but lots of challenges in the baking. I felt there was way too much batter for a 9×9 pan but followed the instructions exactly. The bake time was way off and they were not done at 40 minutes, I went 50 and they were "jiggly" as stated so removed them, but found lots of under cooked (pretty much raw) areas when cutting the bars. The edges puffed way up and the center completely fell in after removing from the oven so I ended up with very few bars that were edible and presentable. A bigger pan could have made all the difference in the overall success of these. I really regret not using a 9×13. But going back to flavor, unbelievable good. My son and I really enjoyed these and would attempt again in the bigger pan.
Oh yum! My daughter would love these—she's an M&M freak! I'll have to whip up a batch for her!
Wow! These look just lovely. I also did a lot of baking and cooking this week…and I'm ready for some take-out. Then again, I might just have to make a batch of these! I'm glad I found your blog! So many great treats here. Thank you for sharing!
These are adorable! It looks like the perfect dessert to give to someone as a gift. I love it!
These look so yummy! I'm from UK and so M&Ms aren't so easily sourced (apart from M&M World) so does anyone know if I can just substitute the M&Ms for Smarties? They are just milk chocolate balls covered in a coloured sugar shell? THANKYOU!


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Reality television has received a crushing blow with the announcement that Vienna and Jake have broken up. By broken up of course I mean the mud slinging he said – she said battle has begun. Listening to them talk smack about each other is more entertaining than their season of... read on
Jake, Vienna, Alli and JDate: Which One Is Not Full of Crap?
July 6, 2010 | 1:44 am
I am fascinated by the phenomenon that is The Bachelor/Bachelorette television franchise. I watch it, I love it, I blog about it, and I still think, after ten years, that it can work. Not... read on


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Did you take time off from your career to have and raise your kids? Then you're a gap mom - a mom who has a gap on her resume between your last job and now. What do you do about it? From the employers interviewed in this article honest description of your choice to stay home with your kids appears to be the way to go. And don't forget to include the skills you've gained during this time - multi-tasking, organization, raising money for school fundraisers, and being able to function with little sleep.
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A new report reveals Emily is engaged and happier than ever! Read on for more details on the proposal, the ring and more!
Turns out Bachelorette Emily Maynard doesn't stay a single lady after all!
The 26-year-old mom is "happy and engaged," a source confirms to Life & Style magazine.
Emily reportedly got engaged to her fiancee on May 11 in the tropical island of Curacao. The final contestant proposed with $90,000 Neil Lane 4-carat ring.
"The proposal took place in the middle of the night, which gave it a more intimate feel," a source tells the mag.
And Emily and her six-year-old daughter Ricki are ecstatic about the happy outcome.
"I am really happy," Emily told Life & Style. "Just having gone through it and learning so much about myself and really feeling like I've grown as a person in the past couple of months — I really couldn't be happier."
But the big mystery is WHO proposed?
Life & Style doesn't reveal the final contestant, but reports that "one of the top guys" was spotted in the airport on his way to Charlotte, North Carolina — Emily's hometown — on May 31.
"He seemed like a very cool guy, very laid-back," an onlooker told Life & Style. "He wasn't flirting with us at all but was low-key and funny."
Only one name comes to mind: Jef Holm.
He's definitely the most laid-back guy of the bunch.
We're so happy to hear that Emily found love.
What do you think, HollywoodLifers? Do YOU think Emily is engaged to Jef? Weigh in below.
More 'Bachelorette' News:
- New 'Bachelorette' Emily Maynard With Daughter Ricki — She's Grown Up Fast
- Emily Maynard: What I'm NOT Looking For On 'The Bachelorette'
- 'Bachelorette' Season Premiere: Emily Maynard Gives First Rose
View Comment
Posted at 1:42 PM on July 11, 2012
Marcia Guess
Posted at 1:54 PM on July 7, 2012
I also watch the show for the travel scenes and just love all the beautiful places that they send the contestants to. Lucky them!!!!
I also feel like an "arm chair" traveler watching the show.
Yes, it is very very hurtful to those who are left behind, all the time thinking they had a chance with the Bachlorette. But that is the chance you take for being on this kind of show. Only one person is going to be selected.
If I were Emily I would choose Arie. He is by far the most suave, sophisticated and adorable of all the guys competing for her affections. The fact that his family spoke Dutch for five seconds is absolutely no big deal as far as I am concerned. In fact, it is nice to hear the native language of the contestant's family. But I have read that she chooses "skater-board boy" JEF who I am sure is a nice guy, but seems quite childish to me, but probably brings out the fun side in Emily. They talk about Arie being away so much, Jef is always traveling the world and will also be "away" a lot. But to each his own!!! Hope it all works out!!!!
Janet Flynn
Posted at 10:51 AM on July 3, 2012
I have watched this show and the bachelor. My thoughts about both shows.
This is not the way to find true love and it is very hurtful to those who have been led to believe they have a chance and then bam off the show. I do believe some are on the show to do all the fun stuff free and not really to find love.
Emily says she doesn't want to hurt anybody and all the time she knows she will since she has been in that position.
Regardless of who is picked I have enjoyed the places they have been and therefore I feel like I have traveled the world.
Nikki Ross
Posted at 1:42 PM on July 10, 2012
jef is the only choice that makes sense to me. He is funny and makes her laugh which is always a sign of a lasting love. Plus, they have a friendship in addition to chemistry which is also a neccisary piece of a relationship puzzle. Ari is way too mushy and they never do anything but make out. That will get old quick, plus he seems to have that whole playboy image. Sean had to go for sure…he is a meathead and his conversation is terribly boring to watch and listen to. GO JEF HOLM!!! He will DEFINATELY win! Mark my words.


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An aneurysm is a scary proposition. All of a sudden finding out you have an important blood vessel that can burst and cause potential harm would be frightening.
There are a lot of places an aneurysm can happen in the human body, and none of these scenarios is very good.


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GSD 2012: Come Skate and Celebrate
This article was posted on May 22 2012
It's that time of year again—Go Skate Day, a.k.a. Thursday June 21, a.k.a. the first day of summer—and Commonwealth's celebrating in style. At 5 p.m. sharp we're firing up the grill and opening up the park to everyone to skate for free. Other attractions include Tribute's Wicked Wallrides Best Trick Contest with special guest judge Brent Atchley, an artshow by Jack Graydon, and live music from Moon By You. Good times, my friends, good times!


text: Cannibal Catfish Waiting for the Catch Lee McFarlin and Misty Garcia with their heads slightly above water looking to beat out Scooter this week with a big catch. Shoe In Catch Lee catches a fish hungry for his shoe. Lee with Fish Lee Shows off his catch and ties him so he doesn't lose him. To the Next Hot Spot Misty and Lee on the boat driving to their next location. Lee is determined to take Scooter of his winning streak. Fish Tail Slap Lee nearly gets hit by a fish tail. Nothing will stop Lee from taking over Scooter's winning streak. Misty with a Catch Misty shows off her big catch. Big Catch for McFarlin Lee McFarlin with a catfish in the water. Will this be big enough to beat out the others? Lee vs Catfish Lee McFarlin with a fish in the water. He is making his mark on the hand-fishin' world. 0 comments   Get Livefyre FAQ Sign in + Follow Post comment Link Newest | Oldest