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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 7 2012: I think an overlying risk associated with the spread of HPV is the concept of contact rate. When determining the threshold of how much of the population must be infected to stamp out HPV we have to determine the rate of spread. When comparing this virus with others such as Polio and Measels, we have very high contact rates due to the ease of spread. The spreading of HPV is limited to sexual encounters. So shouldn't a primary concern of ours be not to vaccinate this "infections disease" based on the assumption that everyone is sharing multiple partners, but to educate the masses into not engaging in dangerous promiscuous activities, but to use protection and reduce the overall amount of sexual partners?

    This seems like an easier and cheaper option than vaccinating the masses with a relatively expensive vaccine that we don't know all the facts about. Who knows how long Gardasil is effective or all of the potential side effects? It's just too early to mandate such a vaccine, we can educate people, advertise the potential benefits and let people decide. Forcing insurance companies to pay for the vaccine we don't fully understand and also placing the burden of our children dealing with unknown consequences of this vaccine are just unnecessary. Also, HPV rarely leads to an acute onset of cervical cancer, these cancers can be easily prevented during annual check ups.

    Another huge aspect to mandated vaccines is we can express our freedom of choice. Although many colleges require a meningitis vaccine, there are multiple cases in which an individual can claim religious views or other factors to a public health official and attend college without the vaccination.

    Until we discovered there are no potential biological side effects of the vaccine and that it lasts forever, we cannot mandate such a vaccine, and in the mean time, we are at a struggle with the social concerns surrounding the mandate on a sexually transmitted disease vaccination. If we have choice, we can refuse.
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      Mar 7 2012: While reducing the contact rate among people by telling them to abstain from sexual activity would be the most straightforward solution to the answer, I think we all know that people will keep having the same amount of sex regardless.

      We've seen how abstinence-only education is ineffective at changing the sexual behaviors of the youth, and I believe any education program we provide advocating for less sex amongst the youth will similarly be a failure.

      "The research group found that 'participants [in the abstinence-only program] had just as many sexual partners as nonparticipants and had sex at the same median age as nonparticipants.' In other words, abstinence education programs did nothing favorable – the result was the same as if there were no program being offered at all."

      Source: http://www.openeducation.net/2009/01/05/abstinence-only-sex-education-statistics-final-nail-in-the-coffin/
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        Mar 7 2012: I guess I should clarify: Our efforts should be into deterring the behaviors of unsafe sex, not sex entirely. Sex has become such a taboo in our society, and I believe this is (at least in some part) due to our abstinence education programs. Instead of urging our youth to abstain from sex entirely, we should educate them to make informed decisions toward engaging in sexual activities. We should urge them to get Pap smears before engaging in sexual activities if changing partners, and praise them for practicing safe sex, not punishing them for having sex in general.

        Last I checked a Pap smear can cost anything from 11 to 300 dollars. Lets find a way to lower this cost, make these tests more accessible, and teach our youth to utilize them. Instead of eradicating a single virus right now, lets also use this opportunity to teach our youth about safe sex so this lesson can extend to other STD's.
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          Mar 7 2012: When it comes to HPV, it's not so easy for someone to protect themselves if they still wish to have sex. Several months to years can elapse before the virus can be detected clinically (through paps). Source:
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477576/?tool=pmcentrez

          This, combined with the fact that men can't be tested means that if anyone wishes to engage in sexual intercourse at all, they will still have the risk of getting the virus. Wearing condoms also reduces the risk of contraction, however it can be spread from contact by other genital areas uncovered. Abstinence is the only way to decrease the risk to 0%. Unfortunately for HPV there is no such thing as safe sex.

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