I’ve covered the approval of Merck’s HPV vaccine extensively in the last month or so. It’s great news for women everywhere, both here in the United States, and especially in the third world. The question now is “should it be mandatory?” Of course ACIP recommended the vaccine, as I predicted they would, so it’s certainly something to consider.
An editorial by someone published in the NYT this past week questions whether the vaccine should be mandatory. Of course, there are some vaccines that are required for anyone entering a public school, for instance. Gardasil could be among these required vaccines (MMR, etc.) for girls aged 9-26. (So that means college students as well.)
I don’t see the problem with making the vaccine mandatory. While there are some reasons that this might not be necessary — cancer-causing HPV can only be contracted through sexual contact — there aren’t any reasons listed that are compelling safety issues.
So we have a sexually-transmitted disease, and a vaccine to prevent it. Should the vaccine be mandatory?
I present to you two brief arguments for why I believe it should.
First off, someone who has HPV doesn’t always know they have it. I have a friend, for instance, who contracted it from a partner who didn’t know she was infected it. While he can’t get cervical cancer because he’s, well, a guy — she can. And she didn’t know she had it. From WebMD:
Most people infected with the HPV viruses have no symptoms and may not know they are infected.
Oops. A mandatory HPV vaccine several years ago would mean that she would never have contracted it, and as a result, wouldn’t have passed it to my friend.
Secondly, not all sexual contact is voluntary. Rape happens. It’s an unfortunate fact of life, but there it is. A woman (or man, for that matter) can contract the human papilloma virus through unwanted sexual contact just as easily as a consenting partner can. STDs don’t differentiate between the willing and the unwilling. And there is no cure for HPV once it’s contracted.
So why again shouldn’t this vaccine be mandatory? If there are no unhealthy downsides, where’s the problem? Is it money? I don’t think so. How much does it cost to treat cervical cancer? Quite a bit more than it costs for a vaccine. For that matter, the costs of treating repeated outbreaks will add up to be more than the cost of the vaccine which runs around $360 for 3 shots. An ounce of prevention compared to a pound of cure works when comparing the dollars and sense involved with a compulsory vaccine. The cost of a single tube of Aldara cream, for example, is over $100.
In short, I see smoke in mirrors, and not much substance.
DB has got some commentary on the issue as well.
[tags]Medicine, pharmacy, cancer, oncology, gardasil, vaccines, vaccination, hpv[/tags]