Sunday, February 18, 2007

The HPV vaccine

Okay, okay, gettin' some emails from people asking what I think of Gardasil, the new vaccine that supposedly guards against some strains of the human papilloma virus (HPV) that can cause cervical cancer.

The shots cost $360 and were recently made mandatory for girls (why only girls when boys also carry the virus?) In Texas where, not coincidentally, the ex-chief-of-staff to the governor is--surprise!--now a lobbyist for Merck. No surprise Merck is lobbying other states to make the vaccine mandatory (# of girls x $360 = big profits). If something's mandatory, why do we allow drug companies to make profits? Serious conflict of interest here.

I don't really know about long-term side effects, partly because they haven't done any long-term studies and I don't know if they plan to. Bottom line, here's are article from the NY Times' BUSINESS section on how desperate they are to sell this vaccine. All I know is I don't want lobbyists, advertisers, and politicians making MY healthcare decisions. Eeeek!

THE toughest girl on television isn’t on a show or in a music video. She’s in a drug advertisement. Dressed in an indie-rocker T-shirt, furrowing her fierce, Kahloesque brows and scowling, she says, “I want to be one less woman who will battle cervical cancer.” Cut to a garage, or maybe a basement, where she’s whacking the drums like Tommy Ramone. Then to a shot of her leaning back, nonchalantly flipping a drumstick: “One less,” she says levelly, as if you’re going to argue with her. She’s the coolest girl in the room, whatever room she’s in.

This vision of do-it-yourself authenticity is flogging Gardasil, a vaccine intended to protect women against some strains of the human papillomavirus, a sexually transmitted disease that has been linked to 70 percent of cervical cancer cases. Manufactured by Merck, Gardasil was approved by the Food and Drug Administration in June. The vaccine is available as a series of three shots, costing a total of $360.

A vaccine against cancer: it sounds like the easiest sell in the world. But Gardasil, which can be administered only to girls and women ages 9 to 26, has an audience problem. It has to sell itself to young women"
...

The mothers appear about halfway through, and they’ve got bad news. In loving tones they break it to their daughters: “Gardasil may not fully protect everyone.” they say. Tenderly they list the side effects.

This is an ingenious ploy: The cool girls want to be “one less”; the moms are the ones putting on the brakes. Having mothers voice the downside of Gardasil reinforces the message that if you get this vaccination, you’re a rebellious, independent thinker:

“Forget the side effects. Forget Mom. I’m gettin’ vaccinated.”


Let my Eeeeeeeeeek cascade down the canyons and to the rivers...

Read more here.

As always, you can use mine:

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7 comments:

CA Momma said...

Was diagnosed with Cervical Cancer this summer. Yep- HPV. Yep, BOYS have it too. Duh!

NOT a fan of vaccines, was torn on this issue at first but... MY daughter is not getting it.......MANDATORY? Thanks for the post.

Green Fertility Marie said...

Thank you for YOUR post. Cervical cancer is horrible and I'm sorry to hear about your diagnosis, but yes, with this whole Merck being so hot to get this vaccine into all these 9 yo girls, I might want to stop and consider exactly whose interests are at stake. I mean, the vaccine's only been out on the market a few months.

Thanks again for sharing.

--marie

Susan said...

hmmmm.. this is a hot topic around our house. We have 12 and 16 yr old girls. They've both seen the ads and are like, "When are we getting that?" We haven't decided yet.

girlsdoc said...

adolescent gynecology is my focus:
i have no financial interest in this vaccine, but please: a vaccine that prevents a cancer that only affects sexually active women is a no-brainer. don't let the government get in our way.

50% of our daughters are sexually active by age 16 (this is a conservative estimate, see cdc.gov or guttmacher.org), and 14%have had >4 partners by this age. condoms decrease transmission somewhat with perfect use (and good luck with that with a 16 yr-old boy), but 80% of us all have been exposed to this cancer-causing virus by 50.(acs,2006)

the vaccine is unanimously endorsed by all the great scientific minds of our time - 7 million doses have been distributed thus far with very low incidence of side effects. while, it would be wonderful if this were invented 10 years ago, and our now preteens would have the benefit of time, it is relatively new, (fda approved in the U.S. in June 2006), but represents an unprecedented opportunity to decrease the incidence of a deadly disease in our lifetime. (500,000 women worldwide are diagnosed with cervical cancer every year, and almost 250,000 women die each year of the disease.) it disproportionately affects poor, developing countries where pap screening is lacking. but even in the U.S. 11,000 women were diagnosed last year, and 4,000 women died of this disease - which is now on the verge of being preventable.

why fight progress for our daughters just for political spite? i agree i don't want it mandated, patients and their doctors should make a personal informed decision about their health. this is also a chance to talk with our daughters about behavioral ways to reduce exposure to the HPV virus. (Most are related to sexual activity: delay first intercourse, limit total # lifetime partners, choose partner carefully, consistent condom use, don't smoke and avoid other STIs (which can act as cofactors, such as herpes and chlamydia.)

perhaps most importantly, even with vaccination (which by now you can tell i support wholeheartedly), get pap screening annually 3 years after onset of intercourse.

forget about merck (drug companies aren't always right), but look at the data. it's compelling, and our daughters are worth the research. best of luck - s.m. md

Green Fertility Marie said...

But there's been no long term testing on this...OB friends of mine are refusing the vax for their daughters--what does THAT say?

sharpinchitown said...

To Girlsdoc, WHERE ARE THE LONG TERM FERTILITY STUDIES?

What an excellent way to narrow down the population in a BIG WAY within one generation huh?

sorry, no relative of mine will be taking this vaccine if I can help it. Encourage it all you want but remember...THERE HAVE BEEN NO LONG TERM FERTILITY STUDIES DONE.

Anonymous said...

i am just outside the age range but if i read what it does (doesn't seem all that much), vs what i'm risking (bad enough despite its low probability, unknown fertility effects, vs not that much gain) and the risk factors to contract the disease (a behaviour/lifestyle that is not mine in the first place), i would probably decline. sure statistically in some countries a large proportion of young girls are sexually active, but if this is the only risk factor even if the statistics are 99%, if i am in the 1% that does not have the risk factor, surely i should be able to refuse it.

statistics generalise and are good for population-wide policy, but a policy may not fit at an individual level. i mean, generally based on statistics, the policy is for everyone to lower their salt intake, but individuals like my husband could have a sodium deficiency issue and should actually ignore this policy since it does not affect him.

personally, it seems to me that a sexually promiscuous lifestyle (by either the males or females or both) necessitates a woman to run many different risks posed by the need to take hormonal birth control, vigilance on STDs, vaccinations such as this one, multiple abortions if the birth control fails, and that's just the biological health risks. whereas these risks can be largely avoided or at least grossly minimised by simply having an ethical lifestyle (dare i use the word 'chaste'?), and then you'd really only have the risks of childbirth, quite manageable in this day and age.

i mean, if i even read the labels in my shampoo and buy BPA-free water bottles to try and avoid unnecessary exposure to carcinogens, why would i go out of character and run the risks of a promiscuous lifestyle? just to be 'rebellious'? better to make rational decisions.

-Kirana