How’s your cervix?

I have been following the the Gardasil vaccine story for a couple of years now. It was developed several of years ago, and the original batch of trials included studies in Pittsburgh. Here is a little background according to wikipedia:

“Gardasil is a vaccine against certain types of the human papillomavirus (HPV), technology created by workers at University of Rochester. Key elements of the technology originated from HPV research in the Schiller and Lowy labs at the National Cancer Institute. The vaccine, marketed by Merck & Co. in America, whilst paying royalties to CSL, is designed to prevent infection with HPV types 16, 18, 6, and 11. HPV types 16 and 18 cause about 70% of HPV-related cervical cancer cases. In addition, some types of HPV, particularly type 16, have been found to be associated with oropharyngeal squamous-cell carcinoma, a form of throat cancer. [1] HPV types 6 and 11 cause about 90% of genital wart cases. Human papillomavirus (HPV) infection causes virtually all cases of cervical cancer, the 7th most common cause of death from cancer among women worldwide. ”

I think that the Gardasil story is a prime example of the best and worst of our society. Scientific ingenuity led researchers to basically create an incredibly effective vaccine that can prevent cancer. Capitalism led Merck (and GSK) to educate the world about HPV and cervical cancer. The result is increased sales for the company as more people sign up for the immunization and increased knowledge for society. A win-win situation, right? So where is the interesting part? Stories that have perfect endings aren’t really all that interesting. Well the problem arises when fundamentalist morals and conservatism get into medicine’s domain. While I think an overlap between politics and medicine can be a good thing, there is potential for abuse. Gardasil is an example of that abuse. Politicians are politicizing the vaccine which has the potential of saving women’s lives because HPV is generally sexually transmitted. The hope is the fear of HPV or cervical cancer might be deterring girls from having sex.

Many states are currently considering mandating the vaccine for school aged girls. I believe every single proposal includes an opt out option for parents who don’t want their children to receive it (for medical, religious, or moral reasons). But there is a lot of groups protesting the programs proposed. The main points of contention are that mandating the vaccine violates parental rights, there is not enough study of the adverse reactions, and that it encourages sexual activity.

I believe Dr. Christine Peterson, director of the University of Virginia’s Gynecology Clinic, explains it best: “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.”

You might be wondering why I am bringing this topic up today, since it has been in the news off and on for the last several years. It is because it was just approve/revealed that starting next week all 8th grade girls in Toronto will be able to receive the vaccine for free. I think Canada is setting the perfect example and I would be interested in seeing how it will pan out. The program is highly suggested, but only voluntary for now. It also saves families who may not have been able to avoid the near 500 dollar prices tag on the medicine.

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