Sometimes, new technology is released that is utterly superfluous. Sometimes it’s entertaining. And occasionally, it’s really damned useful!
A reader of Zelda Lily sent us an email yesterday wanting to share with you all that he has been involved with the thus-far quite successful development of a non-invasive cervical cancer scanner. It is being tested under the name “LightTouch,” and thus far has done …
You are probably all aware of the new-ish vaccine Gardasil. If not, here’s a brief summary: the vaccine was designed to combat some prevalent strains of HPV, some of which are known to lead to a variety of cancers in the reproductive system as well as genital warts, namely in women. The FDA heartily recommends the vaccine, citing the CDC’s Advisory Committee on Immunization Practices, which recommends vaccination before girls reach adolescence. The vaccine hasn’t been without controversy, though. Aside of the debate regarding the large expense and its arguably limited scope, many have questioned whether it’s absolutely necessary to expose young girls to the risk of any side effects from the vaccine.
Now the miracle drug that can literally prevent cancer seems to be in a bit of financial trouble. CNNMoney.com gives a summary of the current financial letdown:
Yeah!? Thanks to William Saletan over at Slate for asking the “experts” if dudes should play their part as well:
No, say the authors [of a British Medical Journal study]. “Our results suggest that if vaccine coverage and efficacy are high among preadolescent girls (12 years), then including boys in an HPV vaccination programme is unlikely to provide good value for resources compared with vaccinating girls only. … [O]ur analysis favours HPV vaccination of preadolescent girls (with continued screening in adulthood) as a valuable intervention for its cost. … Including boys in the vaccination programme, however, generally exceeded conventional thresholds of good value for money.”
Why vaccinate girls but not boys? The authors cite several factors. First, HPV is more likely to harm girls. Second, the vaccine is more effective in girls. Third, the rate of viral transmission depends on the virus’s prevalence “in the opposite sex at any given time.” If girls are routinely vaccinated, there’s nothing for boys to catch or transmit.
Translation: “[B]oys don’t have to get vaccinated for the same reason they don’t have to wash dishes, do laundry, buy birth control, or think about other people in general: Girls will do it for them.”
Preach it, Saletan! Slate goes on the say that the reasons HPV vaccines work better for girls is exactly because they are made for and tested on girls. HPV might affect more girls than boys, says Saletan, but you can make the same case for pregnancy. Guys get to enjoy sex as much as their lady counterparts, why not take a share of the responsibility, too? Especially because HPV can affect the children they father.
Of course, this short-sighted study assumes that all relationships are heterosexual ones. Indeed, the BMJ did not think the include data from gay male participants, who can also suffer the consequences of HPV transmission, and of course, don’t really benefit from female vaccination:
If you want to see a world where men wash dishes and do laundry, it isn’t hard to find. It’s a world where men live, have sex, and share household responsibilities with other men. They don’t have wives or girlfriends to think about and take care of everything for them. They have to do it themselves.
The same is true of protection from sexually transmitted viruses. The authors of the BMJ paper concede that they “only represented heterosexual partnerships and therefore did not reflect HPV transmission among men who have sex with men, who face a high risk of anal cancer and may realise a greater benefit from HPV vaccination.” But the argument for vaccinating gay men isn’t just that they might benefit. It’s that vaccinating women won’t help them. They can’t count on somebody else to take care of the problem.
Saletan says the authors of the study concede that if “coverage in girls ends up being low, then vaccinating boys became much more attractive.” That attitude doesn’t help our homosexual comrades. Plus, seriously, Saletan closes, why should the same sect that takes responsibility for birth control also have to shoulder the HPV vaccination?
The New York Times published an article in which some health experts questioned whether we should inoculate otherwise healthy young girls with the HPV vaccine, given that it carries some risk and cervical cancer can be prevented with proper screening.
“There are not a huge number of side effects here, that’s fairly certain,” said the editorial writer, Dr. Charlotte Haug, an infectious disease expert from Norway, about the vaccine. “But you are giving this to perfectly healthy young girls, so even a rare thing may be too much of a risk.
“I wouldn’t accept much risk of side effects at all in an 11-year-old girl, because if she gets screened when she’s older, she’ll never get cervical cancer,” Dr. Haug said in an interview. “You don’t have to die from cervical cancer if you have access to health care.”
Okay, her argument makes sense. But can any of us truly count on always having access to health care? Let’s say some wealthy parents decline the vaccine. These parents assume their children will always have access to health care that includes an annual exam and screening for cervical cancer. Is that a safe assumption? I don’t think so.
These critics of the vaccine also seem to overlook the fact that the vaccine protects against some strains of HPV that cause genital warts. That alone seems a worthwhile reason to get the vaccine.
Any of the parents whose children have suffered side effects after the vaccine may well be asking whether it was necessary or even helpful given that their children could have been protected from cervical cancer in other ways.
Years ago I read a story about national research looking for a vaccine for chlamydia. Chlamydia, in addition to being a common sexually transmitted infection, is also the world’s leading cause of preventable blindness. If you have access to health care, you don’t have to go blind from chlamydia. People without access can and do go blind from it. For those who do have health care, if there was a vaccine for chlamydia, wouldn’t you get it just to avoid ever having chlamydia?
Maybe the information we should take from the NYT and the experts cited there is that the vaccine has been directed to the wrong audience. Merck has invested a lot of money into its “one less” commercials encouraging women to avoid becoming a woman with cervical cancer. Perhaps this money would have been better spent in handing out free vaccines to those members of our society who have the least access to health care.
Merck has in fact made some efforts to do just that; however, I do wonder how these uninsured patients will ever access the private doctor’s offices where the free vaccine is administered:
Merck has also initiated a new patient assistance program for vaccines. Through this new program, currently available in private physicians’ offices and private clinics, Merck is making available, free of charge, GARDASIL and other Merck vaccines indicated for use in individuals aged 19 and older who are uninsured and who are unable to afford vaccines.
I would think this program would be more effective if they gave away the vaccine at places like Rite-Aid, where the pharmacist can give them and you wouldn’t have to have a doctor visit. But their efforts nonetheless are noteworthy.
I don’t purport to know what is best for 11-year-old girls around our country; but I do think we have been bombarded with information about the vaccine and now have a bit more information to counterbalance Merck’s advertising. Ultimately there are numerous risks to be weighed.
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