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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: One of the things that concerns me about a mandatory vaccination is the expense. While I know that children can now stay on their parents' insurance until the age of 25, what about women (like myself) whose parents didn't have insurance? When I finished high school and moved away to college, I had to obtain my health insurance through my college, and while that was alright at the time, I know that people have had issues with that not covering some traditionally more basic needs, such as contacts and glasses for those with vision impairments. While I recognize the benefits of the vaccination, such as its high ability to protect and that it has been shown to be cost effective in the long run, I feel that mandatory vaccinations are a slippery slope. Additionally, cost effectiveness over a long period of time is certainly something for all individuals to consider with any vaccination, but that also requires someone to have the ability to pay the initial expense, which I don't believe is possible for everyone. Does anyone know if it's possible to get the price covered by an organization, or reduced rate through something like Planned Parenthood?

    I know that it have been mentioned here a few times already, but I agree that education is something that should be expanded upon. Many students have sex education courses and I don't remember hearing much in there about HPV. Also, if people are more educated on a subject, they may be more apt to talk about it and thus, we might be able to reduce some of the stigmas that exist in talking about sex and STIs.

    One last thing I'm curious about...the primary vaccine is established as being for women up until the age of 26. What is the reasoning for that upper age limit? As many women are dating over this age, and there is the unfortunately high rate of divorce, what possibilities other than safe sex practices and abstinence are there for this population?

    Thanks!
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      Mar 8 2012: I agree! I think if we are to consider vaccinating the masses we need to have the vaccine at an affordable cost for all. Here are the payment options I found: Girls ages 18 and under may qualify for the federal Vaccines for Children (VFC) program, which will cover the $120 for each injection.

      • Merck, the manufacturer of Gardasil vaccine offers a patient assistance program for young women, ages 19-26, based on financial eligibility.

      • Some private health insurance policies may provide coverage (private insurance clients will need to pay for the vaccine at the time of service and then submit a receipt for reimbursement from their insurance company).
      Source: http://www.plannedparenthood.org/ppsworegon/hpv-cervical-cancer-vaccine-29204.htm

      As for your question regarding the upper age limit for the vaccine, here is a direct quote from the CDC: "Both vaccines were studied in thousands of people from 9 through 26 years old and found to be safe and effective for these ages. The vaccine is not licensed in the United States for persons over age 26 years, as GARDASIL has not been demonstrated to prevent HPV-related outcomes in a general population of women and men older than 26 years of age".
      Source: http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm

      It is interesting, Canada offers the same vaccine but their upper age limit for women is 45 as of April of last year. The difference comes from doing more studies with the vaccine up to that age limit.
      Source:
      http://www.newswire.ca/en/story/796529/health-canada-approves-gardasil-for-women-up-to-age-45
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        Mar 8 2012: It sounds to me like because they tested Gardasil on women ages 9-26, that's the ages where they were willing to ensure its safety. I'm sure that it's set up this way because of legal considerations, but I feel like it's a really random age to cut off the ability to obtain the vaccination. I don't have a lot of knowledge about human physiology, but I don't feel like there is much difference between 26 and 27. Give me another week or so and I'll tell you if 28 feels any different.

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