Let’s Use Teenage Girls As Lab Rats

I wouldn’t normally post this here, but with other state legislatures considering this measure, it’s only a matter of time before Georgia does. We might as well start talking about this now.

This has been discussed a bit here, but today the Wall Street Journal is running this article (subscription required) on states requiring girls to get the HPV vaccine. What I didn’t know was that the effort at the state level corresponds to Merck Pharmaceutical’s lobbying efforts. Merck has a monopoly on the vaccine and the vaccine is more expensive than vaccines like the MMR shot.

From the article:

Bills being drafted in some 20 U.S. states that would make a cervical-cancer vaccine mandatory for preteen girls are sparking a backlash among parents and consumer advocates.

The bills coincide with an aggressive lobbying campaign by Merck & Co., the maker of the only such vaccine on the market. Called Gardasil, the three-shot regimen provides protection against the human papillomavirus, a sexually transmitted virus that is responsible for the majority of cases of cervical cancer.

If the state bills become law, they would guarantee the Whitehouse Station, N.J., drug maker billions of dollars in annual revenue from the vaccine.

I’m not one of those unibomber types that lives in the woods and refuses to comply with mandatory vaccination laws for my children. But, let’s be clear here — this vaccine is not needed to stop a readily communicable disease like chicken pox or measles or mumps, etc. The disease in question, HPV, is spread by sexual conduct. It sometimes causes cervical cancer. And the vaccine does not even prevent all strains of HPV Again from the article:

Read on . . .

Merck says cervical cancer is the second-leading cancer among women around the world, but the disease’s prevalence is actually low in the U.S. The American Cancer Society estimates that 11,150 women will be diagnosed with cervical cancer and 3,670 will die from it in the U.S. this year. That’s equivalent to 0.77% of cancers diagnosed in the U.S. and 0.65% of U.S. cancer deaths each year. By comparison, the society estimates that 178,480 American women will get diagnosed with breast cancer in 2007 and 40,460 will die from it.

I think a responsible parent might want to get the vaccine for their daughter. But I don’t think it is sound public policy to be forcing the profit stream of a pharmaceutical company onto an unwilling public when the company has a monopoly on the drug and seems clearly to be behind the efforts to get these laws passed.

Lastly, the drug just came out. Do we really want to forcibly treat school girls as guinea pigs for Merck when the majority of them probably will never even need the vaccine or get the disease the vaccine hopes to prevent? And Merck does not even know if booster shots will be needed later in life. The drug is that new. In fact, it hasn’t even been fully tested on children and doesn’t wipe out all strains of HPV, and the risk of pelvic disease has doubled in those who have had the vaccine. Oh, and boys aren’t getting the vaccine despite the fact that they also can contract the virus.

This gives me the creeps. With the 100th anniversary of eugenics being remembered in the country, it just gives me the creeps that we might be forcing teenagers to serve as guinea pigs for a new drug held monopolistically by Merck that probably is not needed for most of them — but we’re doing it for the children.

Sure, it sounds good. It sounds like an excellent idea. But the lobbying by Merck behind the proposal and the fact that the drug is so new and prevents a virus that is not nearly as communicably infectious as standard mandatory vaccines gives me pause. No doubt we might all decide that this is sound public policy. But why rush into with the lobbyists pushing for it when we can, right now, educate parents and let them decide.

17 comments

  1. memberg says:

    Erick, hate to Wiki-factcheck you, but see http://en.wikipedia.org/wiki/Human_papillomavirus (namely the epidemiology section).

    I raise the point that types of HPV are apparently transmitted to many children cutaneously, i.e. it’s not only, or primarily, transmitted sexually.

    That doesn’t mean I’m up for forced vaccinations…but I think it is worth looking into requiring the vaccine…especially if all types of HPV can lead to cervical cancer.

  2. Erick says:

    Good to know memberg. My point still stands, however. This disease is not as communicable as what MMR prevents, etc.

    And it is very new to the market. And it is being pushed by lobbyists, not public health officials.

  3. CTM says:

    I’ve really had to think about this issue for several reasons. First, I run a doctor’s office and we’ve had several requests for the vaccine from patients. Second, I have two daughters, one of whom is 11 and she is potentially a candidate for this vaccine. Finally, I have an employee who is a cervical cancer survivor because she failed to get genital warts removed when she was younger.

    What bothers me now is that our shipment of Garasil arrived today with the invoice enclosed. For one ten dose vial (about the pill bottle), I am being charged $1,265.40 or $126.54 per dose. Then I read the article in the WSJ about Merck’s lobbying and I thought, “This is going to benefit only one company.”

    Genital warts are fairly easy to cure. You burn them off. However, I am told by females, it is painful. That’s why many women don’t finish the treatment. However, it’s cheap and it works.

    So while Gardasil will prevent the virus, there are treatments that are cheaper and don’t benefit only one company.

  4. Amber says:

    Actually HPV is highly communicable, and MOST adults have it. You probably have it. You just might not know it. Because most peoople who have it don’t show any symptoms, and it can’t be tested for without symptoms.

  5. Amber says:

    Finally, I have an employee who is a cervical cancer survivor because she failed to get genital warts removed when she was younger.

    CTM, that’s not quite accurate. The two are not related causatively. The strains of HPV that cause genital warts do not cause cervical cancer, and vice versa. Failing to have genital warts “removed” (note they can always reappear, because the virus never completely leaves one’s system, it just slows or ceases replicating) would not lead to one having cervical cancer.

  6. CTM says:

    Actually, that is quite accurate. HPV strains 16, 18, 31, 33, and 35 are strongly associated with precancerous and cancerous changes to the cervix. In fact, nearly all biopsies of cancerous cells removed from the cervix have at least one of those types. However, a woman can be infected with one of those HPV strains and not develop cervical cancer. So the link is indisputably causative.

  7. Rusty says:

    At some point I’ll learn to type. That was addressed to CTM, and the first “Type” in the comment at 5:30 should be “Typo.”

  8. Nicki says:

    Amber and Rusty, I love you.

    Also, while I appreciate that the official Peach Pundit stance is more original than usual (the usual being “but vaccinating girls against HPV encourages them to be promiscuous. And god knows my baby will never, ever have sex until she’s married.”), I disgree with pretty much the entire post.

  9. mercergirl says:

    Let me just say that I barely escaped having cervical cancer, and while I’m not sure if it was from HPV more than likely it was. I had to have a colposcopy to remove whatever it was I had (I’m not sure if it was a tumor) and it was one of the scariest things I have had to go through. And if this is in any way preventable I am all for it, even if one company profits from it- thats just good entreprenurialship

  10. grabbingsand says:

    I’ll admit it. I’m stunned that nobody is waving the righteous flag of increased promiscuity over this issue. At least, not blatantly …

    If you want to take a stand against Gardasil because you’re not ready to believe the hype, or because you’re not yet convinced of its safety … fine.

    If you oppose it because Merck is going to make a mint (and they will), then I’m sure there is a long-ass list of other drugs that are just as expensive and just as worthy of their own post.

    But come on … if there is a way to help your daughter (or son, as studies on Gardasil’s effectiveness have included male participants1) avoid HPV, and the state is willing to foot the bill for it, then you have to go with it.

    Chicken pox is a readily communicable disease in school age children because of their close proximity and the high likelihood that one child is going to come in direct contact with other children, thus spreading the disease via direct contact, droplet contact or airborne contact.

    That same kid will be just as much at risk for HPV through their teenage years. Just give a moment’s thought to how you spent or mispent your own adolescence, then consider the fact that penetrative sexual contact is not necessary for HPV transmission. No lie. According to a recent Canadian study, “abstaining from penetrative sex did not protect women from HPV transmission, and they proposed that skin-to-skin contact during nonpenetrative sexual contact may be a primary mode of genital HPV transmission.”2

    I may be proven wrong, but HPV vaccination looks like as much of a win for the future as jabs against MMR, polio and anything else you might never wish for your child.

    1. http://www.timesonline.co.uk/tol/life_and_style/health/article1295381.ece
    2. http://www.cmaj.ca/cgi/content/full/168/11/1391#R2-9

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