Vaccines
Last week, the federal Advisory Committee on Immunization Practices recommended adding a new vaccine, Gardasil, to the standard immunization schedule for 11 and 12 year old girls. Gardasil immunizes against several strands of the Human Papilloma Virus (HPV), which causes genital warts and cervical cancer.
As Rivka at Respectful of Otters explained, the conservative groups that had initially responded to the prospect of such a vaccine in a hysterical snit ("How are we going to stop people from having sex if we can’t threaten them with deadly disease?" — no that’s not a literal quote, but the real ones aren’t far off), have moderated their message, and are now saying that they’re glad the vaccine is available, but it shouldn’t be mandatory. This change is rhetoric seems to have been effective: the NYTimes says that "a few religious groups have expressed mild reservations about the vaccine." But Rivka argues that there will always be exceptions available for religious objectors, and if the vaccine isn’t made mandatory, states may not pay for it.
If I understand the issue correctly, assuming that HHS accepts the ACIP recommendations, the new vaccine will be covered under Medicaid and the federal Vaccines for Children program. So really poor kids should get it (as long as they have access to the documents to prove their citizenship, but that’s a topic for another day). And most private insurance will cover it as well. The problem is the state programs that provide vaccines for kids who aren’t poor enough to qualify for Medicaid, but don’t have insurance. Gardasil is expensive — $120 per shot, with a series of three shots required — and covering it would nearly double the cost of some states’ immunization programs.
However, on the parenting lists that I’m on, most of the discussion has been from parents who aren’t sure that they want to give their daughters a new vaccine, especially if they’re not sexually active. I’m not going to quote anyone without permission, but what I’ve been hearing is pretty similar to the parents quoted in this article about the vaccine. My kids are way too young, and the wrong gender (although eventually Gardasil or another similar vaccine is likely to be available for boys and men as well), so it’s not a decision I’m personally facing. But I tend to be pretty pro-vaccine in general.
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I saw a poster on the metro over the weekend, seeking healthy volunteers to participate in clinical trials for a malaria vaccine. I don’t remember the URL and google has failed me in digging it up, but I’m going to look for the poster again. Obviously, I want to learn more about both the vaccine and the study protocol, but I’m seriously considering doing it.
July 4th, 2006 at 7:25 pm
As someone with a strong family history of cervical cancer and a young daughter-I jumped for joy when this was announced. But then again she is only 3 so the vaccine will not be so new when its her turn.
July 4th, 2006 at 8:47 pm
I absolutely will have my daughter vaccinated for this, as soon as possible (and my son, when that day comes).
The thing I can’t personally understand about the right-wing arguments against this vaccine is that, even the ‘goodest’ of good girls can get raped. Or get exposed to it by their husband, who brought it into the marriage. Or whatever.
I mean, it’s not like our floor is carpeted with rusty nails, yet she still had the tetanus vaccine. Because sometimes bad things happen to people. As parents, we should try to protect our children from those bad things.
July 5th, 2006 at 12:08 am
My oldest son was almost three when the rotavirus vaccine was implicated in intussusceptions. As a result I am very cautious about new vaccines. Vaccines with an established track record — those my kids will get on time and without complaints from me about the ensuing crankiness. But I object to efforts to make new vaccines mandatory. The exemption requirements in my state don’t allow me to object to the varicella vaccine because I’m dissatisfied with the long-term efficacy data. This bugs me. (It doesn’t have a lot to do with the HPV controversy, though.)
July 5th, 2006 at 10:10 am
interesting post. a thought – if the disease is passed by males and females, why not recs for males to get too?
July 5th, 2006 at 11:19 am
Because men don’t die from HPV, lyssa. So the benefit to males from receiving a vaccine is quite limited — though there would be a benefit to their female sexual partners.
July 5th, 2006 at 11:26 am
Is the vaccine a pooled blood product? I find those creepy as they may spread a virus we haven’t don’t screen for because we haven’t identified it. Otherwise, vaccination seems like a slam dunk.
July 5th, 2006 at 2:34 pm
The HPV vaccine is a biotech product consisting of two viral proteins that “self-assemble” into virus-like (but not infectious) particles. There are no human blood products used in its manufacture.
Clinical trials for vaccines are among the most ethically difficult experiments imaginable. They are on the edge of violating one of the basic principals of the Declaration of Helsinki that states that “Medical research is only justified if there is a reasonable likelihood that the populations in which the research is carried out stand to benefit from the results of the research” (Ethical principles for medical research involving human subjects; http://www.wma.net/e/policy/b3.htm). For a fuller discussion of the ethical problems you might want to look at http://www.nature.com/ni/journal/v5/n5/full/ni0504-465.html. Also the University of Pennsylvannia has a website and blog on the “Ethics of Vaccines” (http://www.vaccineethics.org/2006/02/welcome.html) that brings together many views.
July 6th, 2006 at 8:46 am
I am also generally pro-vaccine–BUT I can see the other side too. Vaccines are not altogether safe. That fact was always sort of theoretical for me until I started dating; my sister-in-law lost a good portion of her early memories, and has lasting cognitive damage, from a bad reaction to a childhood vaccine. I know, overall, it’s a benefit–but I can certainly see the argument that “my child is in a very low-risk group and I don’t think the cost-benefit works out” as a reasonable reason to refuse vaccines.