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Srdjan Kamenko

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When it comes to vaccine intervention for disease control, should personal liberty go before the benefit to society?

This question is extremely important when one considers current news on the Human Papillomavirus vaccine. The main vaccine, Gardasil, has been widely used on women ages 9-26 since its introduction in 2006. The vaccine first made waves in 2007 when Texas governor Rick Perry issued an executive order to mandate the vaccine for all young women in Texas. Even though it was met with much opposition and ultimately failed, the question still remained: should we have a mandatory HPV vaccine for all women? The two sides of the argument clash, each bringing significant evidence to bear on the issue. Mathematical models indicate that with a vaccine as effective as this one (about 100%), mandating the vaccine will stamp out the virus types targeted by the vaccine. HPV is the most common STI with 45% of college age women currently infected. Freeing society of such a dangerous virus, the number one cause of cervical cancer, is a highlight of the pro-mandate argument. The opposition suggests that personal liberty is at stake, and that parents should have the choice to vaccinate their children if they believe the vaccine is worth it for them. What do you think? Is it reasonable to limit personal liberty for the good of the community in the face of a spreading killer virus?

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    Mar 6 2012: I don't know enough about HPV to know how I feel about a mandate as proposed by Rick Perry. I have read that the only way a child would be at risk is through sexual intercourse. I also am not sure about the claims for Guardasil being 100% effective in protecting sexually active women against contracting HPV, nor do I know the side effect profile of the vaccine. Because it is relatively new, only time will tell, and fortunately for me, my daughter has 14 years or so before this will be a decision in our lives. I say this primarily because by then I will have much more information on its use, and effects to make a sound decision on its benefits.

    If this was a question about vaccinations of children for diseases we have almost eradicated because we've had them in use and have outcomes data, I say yes they are important for the health of our communities against once deadly viruses. This, however, is very new. I also don't have much confidence in Rick Perry, so him being the person who brought this into the Texas legislature leaves me with more doubt than confidence. I can't help but wonder how Rick Perry, a staunch proponent of individual liberty, and of abstinence only sexual education for students because "abstinence is 100% successful in the eradication of teen pregnancies and stds" would advocate for mandatory vaccinations of teens against HPV, a virus that is only a risk for the sexually active? There is a reason, but I don't think it is what he presents solely to the public. What do you think?

    What do you think?
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      Mar 7 2012: The sexually transmitted strains of HPV, including the four covered by the Gardasil vaccine, can be transmitted through oral, anal, and vaginal sex.

      The claims about it's effectiveness are based on the high likelihood of antibodies against HPV in vaccinated women being present (around 99%). In addition, one study "in which vaccinated women were given a challenge dose 5 years after enrollment into the study demonstrated an augmented rise in antibody titer consistent with immune memory." This shows that the immunity against the HPV virus lasts at least for five years.

      Source: http://www.cdc.gov/mmwr/PDF/rr/rr5602.pdf

      Also, you're qualms about Rick Perry's motivation for proposing such a mandate may be well founded. He has received a lot of campaign donations from Merck, the manufacturer of Gardasil.

      Source: http://www.cnn.com/2011/09/15/opinion/krumholz-beckel-perry-pharmaceutical/index.html

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