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Sun-Times, Trib both oppose mandatory cancer vaccine

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Illinois

Both the Sun-Times and the Tribune have recently editorialized against a proposed mandatory cervical cancer vaccine for young girls. Two bills have been introduced in Springfield, both with opt-out clauses.Sun-Times:

The march of modern medicine is a great and wondrous thing in preventing diseases that once were thought unpreventable. Among them is the sexually transmitted human papilloma virus, which causes the cervical cancer that kills 3,700 women in the United States each year, and also causes genital warts. There is now a vaccine that can immunize girls against HPV. The question is, should the three-shot series be added to the other immunizations and booster shots legally required by schools?

A bill in the Illinois Senate says yes. It would require the vaccine, Gardasil, to be administered to girls at 11 or 12 by the 2009 school year. We say not so fast. Our objection is not the moral one raised by conservatives: We’re not concerned this treatment would encourage promiscuity.

We think this vaccine is an important medical advance. Still, we believe parents, some of whom may have to pay $120 per shot, should be making this choice. This type of decision is best left to parents after talking to the doctor. State-mandated vaccinations should be limited to preventing diseases caused by casual contact.

Tribune:

If many parents have welcomed the chance to protect their daughters, some have reacted more guardedly. The vaccine, after all, doesn’t prevent a childhood disease, but one that would not strike for many years. Kids are not at risk in the classroom, through casual contact, as with most other diseases calling for mandatory vaccination. HPV is a sexually transmitted virus. […]

Should the shot be mandatory? This would be an easier decision if Gardasil were catching on quickly across America. It wouldn’t be necessary to issue a mandate. But so far, Gardasil is not being used as often as some doctors would like, the Associated Press reported. That’s probably about cost and insurance coverage and undoubtedly some parents’ queasiness over vaccinating a preteen girl against a sexually transmitted disease.

The Gardasil debate forces us to think about a question of principle: Should the state require medical treatments for diseases that aren’t easily communicable in our day-to-day casual contact with one another? That’s a big step from our current public health policies for protecting children in classrooms and on the playground. Examined through that prism, the Gardasil debate may well be the first of many as drug companies develop new vaccines–or even cures.

Gardasil is a terrific breakthrough in the fight against cancer. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths in the United States each year. Still, it’s premature for this vaccine to be added to the mandatory list for Illinois schoolchildren.

Not mentioned is that the manufacturer of the drug, Merck, is pushing legislatures throughout the state (through a legislative group called Women in Government) to make the vaccine mandatory, which could result in billions in profits.

Proponents say the vaccine will save lives. Some opponents, who worked against making the drug available in the first place, claim it will somehow encourage promiscuity. Other opponents point to opposition by the American Academy of Pediatrics to mandating the vaccine right away. The Academy wants more research first.

The state Senate mandate is here, the House bill is here.

Thoughts?

posted by Rich Miller
Tuesday, Feb 6, 07 @ 8:50 am

Comments

Given the long list of medicines which have turned out, after years, even decades of widespread use, to have significant and even life threatening side effects for certain populations, this rush to impose its use on the public as a mandatory measure is quite frightening. This is particularly true as no one can know the effects of mass inoclulation. Almost certainly, some groups, with physical vulnerabilities as yet unidentified, will have negative side effects.

This is an outrageous effort on the part of liberal Democrat elites to impose government policies on the masses. One wonders if these liberal and wealthy elites will find a way around vaccinating their own daughters if they have doubts. Almost certainly. Most of their kids go to private schools anyway, and private schools will not bar entry because of the failure to get an experimental vaccine. A tip to the headmaster will take care of that.

Illinois may find, in this initiative, a reason to be a tad less enthusiastic about living in a blue state ruled by wealthy ultraliberal Democrats. Because this mandatory vaccination program is one of them.

Comment by Anonymous Tuesday, Feb 6, 07 @ 9:21 am
Every so-called “conservative” in the political sphere who raises moral arguments against Gardasil should be asked, point-blank, the following hypothetical:

1. If an immunization were discovered that would be nearly 100% effective at preventing HIV transmission, would you oppose its adoption as a standard immunization for children in the United States?

If cornered on the point, they can’t win: if they say “yes” (ooposing HIV vaccinations), they’re monsters; if they say “no” to the hypothetical, they’re utter hypocrites, because the moral arguments are 100% the same as applied toward the Gardasil vaccination. The only way out of that is to ignore the question, or backpedal on their opposition to Gardasil, in which case humanity wins.

We’re also completely ignoring the role of men as reservoirs of casuing the HPV infection, but then females have historically been on their own dealing with the consequences of sex; but I digress.) We are also not discussing the overall global burden of HPV disease, which is considerable. None of the above analyses apply to women in Africa, where horrible cervical cancer deaths are sickenly common.

What should change the editorial board’s mind?

If Merck were to donate 2 free doses of Gardasil to women in Africa for each dose sold in the US(which would still net them a healthy profit). But I’m wouldn’t hold my breath.

Comment by 105th Blues Tuesday, Feb 6, 07 @ 9:24 am
I’ve got one girl and two boys. The girl will get the vaccine whether it is mandatory or not- that is a no brainer for me. I’d like to see it mandatory though for the boys benefit- so their future wives don’t have their lives cut short by this cancer. So, I come down on the side of making it mandatory. Oh, and I am hard-right conservative.

Comment by Anonymouse Tuesday, Feb 6, 07 @ 9:26 am
Often modern science forces us to face issues and ask questions that either change or reinforce traditional behavior. This is one of those times.

As such, we should not be allowing the pace of this debate to be set by Merck. Neither should we be allowing a state government to set the pace, as is the case currently in Texas.

It is also tough to prove a negative - did the vaccine prevent a lady from contracting a virus that could develop into cancer when she was 12 years old? The fact that she didn’t contract the virus, or develop the cancer doesn’t necessarily mean the vaccine she received a decade earlier prevented it. There is a reason Merck has discovered that this is a tough sell on the market.

But we should allow this product to be accepted or rejected on the market - not mandated by a group of politicians looking for re-election. This is not a political issue that needs to be addressed by governments.

Sorry Merck, but while I would have no problem deciding in favor of having my daughters vaccinated within the age window recommended, I have a problem with you playing politics over it and looking for a finacial score to impress your stockholders at the next quarterly meeting.

The reasons for this vaccine push does not see my family as the priority it is to me. Sorry, no.

Comment by VanillaMan Tuesday, Feb 6, 07 @ 9:27 am
Why isn’t the $120 cost of this vaccination covered under AllKids?

Did Blago drop the ball on this?

Comment by Leroy Tuesday, Feb 6, 07 @ 9:44 am
My wife and I have been discussing getting our daughters vaccinated. Our oldest daughter’s doctor recommended it. Notice the decision-making here is between the parents and the doctor. The government has no business in this decision and I resent any legislator who sticks their nose into my family’s personal business.

Comment by Bluefish Tuesday, Feb 6, 07 @ 9:45 am
I think it should be up to the parents to decide. However I do have one question. Does anyone know if requiring it would make it more likely or mandatory for insurance companies to cover?

Comment by Way Northsider Tuesday, Feb 6, 07 @ 10:12 am
If you receive any funding from the government for health care, the government should be able to mandate certain preventative treatments. I don’t see any problem with that. When I received funding to buy my house, they mandated that I get fire insurance… He who has the gold makes the rules.

Comment by C$ Tuesday, Feb 6, 07 @ 10:58 am
I don’t think that the HPV vaccine should be mandatory, its one think to mandate that children be vaccinated for diseases that are easily communicable. It another thing to require that everyone vaccinate their children for diseases that are far harder to spread and don’t pose the same threat of large scale outbreak that would threaten public health and safety. Personally I hope that every one, men and women, would get this vaccine, and if/when I have children I will most likely get them vaccinated for HPV or encourage them to. It should be up to the individual in this case, not the government. It also seems that this is a case of large company, Merck trying to use government regulation to increase their profit margin.

Comment by RMW Stanford Tuesday, Feb 6, 07 @ 11:52 am
Until the state of Illinois pays for the shots, let my husband, doctor and I decide. It is none of the governments business.

Comment by leigh Tuesday, Feb 6, 07 @ 11:58 am
I too think that this vaccine should be given only after parents consult with their own children’s physician. The government should butt out. They don’t require flu shots and every year flu kills more people worldwide than any std.

Comment by i d Tuesday, Feb 6, 07 @ 1:02 pm
To everyone who has posted some variant of “this decision should be between the parent and doctor,” if you would take two minutes to look at the bill summaries that Rich helpfully posted the links to, you would see that, in fact, the decision is left to the parent. There may be other decent reasons to oppose these bills, but to say that it’s a government mandate and that you and your child have no choice but to comply is plainly wrong.

Comment by A Non Tuesday, Feb 6, 07 @ 1:08 pm
Excuse me for failing to make myself plain. Mandate, schmandate. Government input, studies, tracking mechanisms and general involvement regarding this new vaccine should not be allowed under these circumstances. As far as I am concerned this is a money making mechanism for a major medical machine (Merck) making monstrous monies for their megagluttonous mentors (politicians). Let us see: 30 bucks for 1 flu injection and then 360 bucks for a series of 3 HPV injections.

Comment by i d Tuesday, Feb 6, 07 @ 1:36 pm
“First, do no harm.” Another ‘well-meaning’ intrusion by gov. into our lives. Let the market take care of this.

Comment by Mr. Wizard Tuesday, Feb 6, 07 @ 4:32 pm
this is a goofy, stupid bill…and I’m a Liberal from Chicago!!

Comment by Mike Williams Tuesday, Feb 6, 07 @ 5:43 pm
A Non - From what I read, yes a parent or guardian can refuse the shot. However, like so many other mandatory things that have an “out”, the “out” gets overlooked by well meaning do gooders.

What will always catch the eye is “… a female student who is 11 or 12 years of age may not enter any grade of a public, private, or parochial school unless the child presents to the school proof of having received a human papillomavirus (HPV) vaccination …”

The “out” which says “… after having received HPV information required to be provided by the Department of Public Health, the student’s parent or legal guardian presents to the school a signed statement that the parent or legal guardian has elected for the student not to receive the vaccination. …”

People by nature stop reading when they have found what supports their narrow point of view. I am guiltly of doing the same thing.

I have daughters, I will have to think long and hard about compelling them to get the shot. So far there does not seem to be a public health policy or concern about young ladies getting cervical cancer.

What also turns me away from this shot is that Merck is pushing the legislation. The individual public health agencies are not. Neither is the CDC. A drug company is attempting to use mass political mass hysteria to line its pockets with the public’s money.

Comment by Huh? Tuesday, Feb 6, 07 @ 6:22 pm
P.S. Leroy - the cost is not $120 but $360 for the three shot regimen. Who is going to pay for it? My insurance? Out of my pocket? The state thru “All Kids”? Oh wait, that’s out of my pocket too.

Comment by Huh? Tuesday, Feb 6, 07 @ 6:24 pm
The government should stay out of my blood stream.

Comment by anon Tuesday, Feb 6, 07 @ 6:31 pm
Also not mentioned is that smoking is banned in public places, even though the effects of second-hand smoke may not be felt for decades. Or that we force everybody to drink chlorinated water, even though the benefits may not be felt for decades, or that we force kids to wear safety belts every day, even though the benefits won’t be felt by all and may not come for decades, yada-yada-yada.

We do it not because the benefits are immediate or because the problem is communicable, we do it because the cost is very high.

Given that more and more teenagers are getting sexually active at the age of 12, even though they may not bear the cost of it for another decade or two, it makes sense to spend a little to prevent cancer.

Comment by Yellow Dog Democrat Tuesday, Feb 6, 07 @ 11:48 pm
Well, let’s run them all down…

Anyone who thinks this will lead to promiscuity is not reading the label. Protects against HPV does not equal ‘protects against pregnancy, HIV/AIDS, chlamydia, clap, etc..’. Anyone who thinks Gardasil is a ticket to reckless sexual abandon has deeper issues to address than ‘potential’ cancer.

If we wanted to, a one time runthru of giving all IL girls age 10-15 (~450K girls) would only cost $150-175 million retail ($360/per), with an ongoing annual hit of $30-38 million; ideally we could get a volume discount too. Or only pay for the poorest 20% and do it for under $8 million/year. That’s a rounding error in the medicaid budget…

Comment by OAD Wednesday, Feb 7, 07 @ 1:32 am
I’m with Yellow Dog.

If the government is to be expected to pay for your health care, do not be surprised when they start mandating preventative treatment.

i.e. Your blood stream is not necessarily yours, if other taxpayers are paying to keep it healthy.

Comment by Haha Wednesday, Feb 7, 07 @ 7:05 am