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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 have read through the comments and I do agree with many of the conversations. I just wanted to reiterate that the vaccine requires three shots over a six month period and can cost upwards to $400 (which is not always covered by insurance.) This is a lot of money for the average American (especially during these rough economic times). It is understandable that people are concerned.
    In a recent NPR article called HPV Vaccine: The Science Behind The Controversy, the writer Richard Knox gives an overview of both sides of the controversy. Knox talks about how recent studies show that by the time girls reach 15 years old, nearly 10% of American girls are infected with HPV. Not to mention that by age 17, that number doubles to nearly 20%.
    Knox also interviewed Dr. Diane Harper, a professor at the University of Missouri-Kansas City School of Medicine. Harper is skeptical of the necessity for the vaccine. By Harper's calculations, the tried-and-true method of regular Pap smears is a more effective way to prevent cervical cancer. In the article, Harper says "Pap smear screening is far and away the biggest thing a woman can do to protect herself, to prevent cervical cancer."
    I believe both sides have their truths. I do think that this vaccine is expensive and maybe administered at too young of an age. But I also believe the researchers have a point. If we administer this vaccine at a younger age, quite possibly the antibodies in the younger individual may gain better immunity as compared to a older individual.
    Overall, this is a choice. A choice that should either be decided by the parents or by the individual themselves.
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      Mar 8 2012: As far as the cost goes, Srdjan wrote above that "girls ages 18 and under may qualify for the federal Vaccines for Children (VFC) program, which will cover the $120 for each injection." In addition, private insurers may also cover the vaccine as they do most vaccines recommended for routine immunization by the CDC.

      On the topic of pap smear screening vs. vaccination, one study shows that "the difference in screening coverage rates among countries affects the effectiveness of the vaccination program." The study also says that "the HPV vaccination program is cost-effective in only 46 countries where per capita GDP is high." I believe the USA would fall into the category.

      Source: http://www.ncbi.nlm.nih.gov/pubmed/18835313

      I believe the main motivation behind vaccinating the girls young is to protect them before they become sexually active, not because of age-related immune system decline (not to say that doesn't help!) Giving a girl a vaccine if she's already infected with that HPV strain has no upside.
    • Mar 8 2012: In regards to the cost of the vaccine: I think the primary cost that is associated with the vaccine is not the cost that the average American would have to pay. There are plenty of vaccination programs (Vaccines for Children program, Merck Vaccine Patience Assistance Program, Planned Parenthood, and many universities) that provide the vaccination for no, or a reduced cost. I think the main issue, and thing that would stop girls from getting the vaccination (if given the choice) is the stigmatism that is associated with young sexually active people. Although I feel that the shot should not be mandated, I do find it hard to believe that our government that would even potentially mandate this vaccination that prevents a STI that most public schools aren't even authorized to teach about. I feel strongly that the decision to have this shot, or not, should be left up to the individual because I feel that if they did receive the knowledge about the potential risks associated with various sexual diseases the individual would chose to have the shot, the real problem lies in that we are taught abstinence. If more of the focus of our sexual education programs was on prevention of STIs, and WHY we should care about preventing these, then maybe more people would understand why we want to protect ourselves from HPV and act accordingly. Maybe some of these people would chose abstinence, but those who do not would understand why it is important they receive this vaccination.

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