Say Anything Blog

Rob,

I don’t have a problem with certain vaccines for communicable diseases being mandatory. It’s common sense that the government has the obligation to protect the general population from contagion.

This particular vaccine doesn’t stop the spread of any disease. It should be the choice of the family or the recipient whether or not to take it. In cases like this the government has absolutely NO RIGHT to mandate the vaccine.

Election ‘08 - We Are So Screwed

When I first heard about this, I didn’t have a problem with it.  A vaccine that protects against a disease is a good thing.  However, after I saw a commercial for he vaccine, I changed my mind.  The commercial talks about how it “might” be a vaccine that stops 70% of what “may” cause cervical cancer.  That’s too many indefinites for me to believe that it is worth the invasion of privacy.

"Although I can accept talking scarecrows, lions and great wizards in emerald cities, I find it hard to believe there is no paperwork involved when your house lands on a witch.”
- Dave James

For me, the argument is the greater good must be significant enough to outweigh the harm done to a few.

In this case, the good is the eventual elimination of HPV in humans, and the near elimination of cervical cancer. The harm?  People get stuck with a needle against their will, and forced to become immune to a rather nasty virus.

Seems to me that mandating HPV vaccines is no more odorous than any of the other mandatory vaccines.  Would you really withhold TB vaccinations from your daughter, for example, to prove your independence from the state?  Why should any responsible person accept such a risk?

Just as with vaccines of other “dread deseases”, I just don’t see how making this vaccination voluntary helps anybody.

As usual, for more facts just Wiki it.

While I agree with you in general Rob, the states do have compelling reasons for requiring certain vaccinations for children attending public schools.  After all, the children will be at a government facility, forced to go there by law and contagion is a serious threat in school settings.  Hence we have mandatory vaccinations for mumps, measles, rubella, et cetera.  All of which are easily communicable in a school setting.

On the other hand, the HPV variants that cause cervical cancer better not be easily communicable in a school setting.  Unless the schools are having teaching “Group Sex 101”, there is no compelling reason for the state to make HPV vaccinations mandatory.

As a father of four daughters in the state of Texas, I can tell you that my objections are three fold: 1) I am not yet thoroughly convinced that the HPV vaccine is safe considering its relative newness on the market and it having been fast-tracked through the FCC approval process.  2) The state has no compelling interest in forcing me to vaccinate my daughters.  3) Our turn-coat of a governor issued this decree through an executive order, by-passing any channels where we citizens could voice our concerns and opinions on the matter.

For me, the argument is the greater good must be significant enough to outweigh the harm done to a few.

Then why don’t we implement a government mandated excise and diet program?  We could even install two-way video screens in everyone’s home and hire fitness instructors who can lead everyone in their morning exercises.  If anyone, say someone named Winston, decides to slack off, the fitness instructor can admonish them for not working for the greater good of society.

Actually, the safety of the vaccine is debateable.  Something like 5% of the 2000 people in the test sample developed some level of adverse side effects.  Increase that sample to a million teens in Texas, and you could be talking about some serious problems that weren’t found in the fast track approval process.  Statistically, Gov. Perry’s order (no relation, BTW) just doesn’t wash.

Moreover, the “herd” we’re talking about here is not all young ladies, but rather sexually promiscuous people of both sexes.  Why not have the doctor candidly ask young people of both sexes whether they think it might be a good idea instead?  (or even better, require it for young people treated for STDs or asking for AIDS tests) Let’s face facts here; one promiscuous boy can infect quite a few promiscuous young ladies, so concentrating on young ladies also misses the point.

And finally, doing this by executive order....sorry folks, but a conservative ought to know better than this.

5% problems times one-million vaccinations equals 50,000 people that are hurt by this.

How many of the population come down with this kind of problem?  How many of those people bare some of the blame for their own risky behavior.

What’s going to happen to US industry when the global warming extremists like John McCain double the price of electricity?  I would think all these factories will close and set up in countries where they aren’t scared of technology.

Not only that, Whistler, but the vaccine regimen comes to $360.  Put gently, this is an annual subsidy for the vaccine maker of about $100 million.  Yes, it could reduce cervical cancer, but the ugly fact about that is that annual pap smears could virtually eliminate those, too.

Were I a doctor, I would certainly push this one HARD for young men and women who were sexually active--again, let’s not forget that half the “herd” here is male--but I don’t think that the statistics here indicate the Gov’s move is right here.

I can’t believe the arguements that it should be mandatory. If you don’t get the vaccine and you become infected, well that’s your problem. Aside from that, I don’t think the we can even begin to debate wheter or not it should be mandatory until it has been on the market longer.

Another thing that troubles me is that I wonder how much of this is based on legitamate concern and not just Merck (and the politicians it supports) trying to make millions of dollars from the American public. On the other hand, Merck has one of its largest complexes in my hometown so I’m sure the substantial profit increases will equate to additional tax revenue which may translate into town improvements and tax cuts.

which may translate into town improvements and tax cuts.

Tax Cuts?  Are you kidding me? 

Town improvements, maybe, but only if you all higher salaries for public employees an improvement.

What’s going to happen to US industry when the global warming extremists like John McCain double the price of electricity?  I would think all these factories will close and set up in countries where they aren’t scared of technology.

Carrick said, In this case, the good is the eventual elimination of HPV in humans, and the near elimination of cervical cancer. The harm?  People get stuck with a needle against their will, and forced to become immune to a rather nasty virus.

Seems to me that mandating HPV vaccines is no more odorous than any of the other mandatory vaccines.  Would you really withhold TB vaccinations from your daughter, for example, to prove your independence from the state?  Why should any responsible person accept such a risk?

Oh, good grief. Are you really trying to compare a highly contagious communicable disease to a sexually transmitted disease?

I’ll tell you what: when people start catching HPV by inhaling another person’s sneeze, get back to us. Until then, with all due respect, back off on this one. You have no business here.

It bothers me to think that any decision like that is a State mandatory law. Shouldn’t that decision be up to your doctor and you?  I am not a big fan of making laws that take away basic freedom…

Shouldn’t that decision be up to your doctor and you?

It should be, unless you can walk down the street and pass on the disease, at which point there is a public health threat. That is the only time the “greater good” should trump your own bodily rights. Notice that HPV doesn’t fall into that category. It’s fairly hard to catch the disease. You have to work for it!

HA! hahahhhhhhhhhhhha!

Tax Cuts?  Are you kidding me?

Well I’ve got to have some dreams, don’t I? While the property taxes in the area are more expensive than others, having Merck there has helped with some of the burden.

Town improvements, maybe, but only if you call higher salaries for public employees an improvement.

This is within the realm of possibility. Likely a lot of it will go into the public schools, and therefore increased salaries of teachers. The district is quite massive, in fact the high school (which is only grades 10-12) has 3000+ students and that number continues to grow. The district has always been able to maintain a high level of technology and great facilities due in large part to Merck. But I must say the town also does a great job of maintaining itself (in fact large portions are undergoing cosmetic improvements), and with the ever-growing population, the roads could use some expansion and work.

Likely a lot of it will go into the public schools, and therefore increased salaries of teachers.

They only make more than architects and most other white collar jobs, so what’s a few more bucks?

I love the education system. It’s one of those places were failing is rewarded with higher pay. Besides those types of government jobs, can you think of another industry that routinely rewards failure? I’m sure they exist, but I can’t think of one off-hand.

As a side note, the HPV drug is 4 years old and made Merck. Additionally, the idea was lobbied to Perry by a Merck lobbies who used to work for Perry.
So the plan smells for a number of reasons.

Also consider that mass immuniztion can help drug resistant mutant viruses gain a artificial advantage in natural selection thereby allowing for the spread of drug resistant HPV. Just like the first HIV/Aids drugs of antibiotics, if you over use them they loose their effectiveness.

Rob B., not quite true on super-viruses.  The effect you speak of really is mostly the creation of super-bacteria through the use of antibiotics.  Were we creating super-virii, we could no longer prevent polio, smallpox, measles, mumps, and rubella through vaccination.  The opposite is true.

(I am no foe of vaccines, and might consider getting this one for my daughters in about a decade--when the very real concerns about this vaccine’s efficacy and safety have been answered.  But let’s make it a choice, and direct it at the sexually promiscuous, K?)

Rob B.,

On your first point, Perry has always been a good dog and done whatever his masters command.  Unfortunately for us Texans, he was the best choice out of a wide array of jackasses.  And for you Kinky supporters, the guy is a clown and would have run the state like a three ring circus.

On your second point, I think you need to do a little more research.  There are no drugs that combat viruses directly and there is certainly no drug that is specifically used against HPV.  Antibiotics do not affect viruses.  The HIV cocktail, AZT, that is now the common treatment for HIV infected patients works with the body to overcome the virus and it doesn’t even come close to curing the patient.  The best defense against viruses is a healthy immune system that has already encountered the virus and recognizes it as a threat.  That is why we vaccinate for viral infections like mumps, measles, rubella, chicken pox, flu, small pox, hepatitis, et cetera.

And for you Kinky supporters, the guy is a clown and would have run the state like a three ring circus.

Would anyone have noticed any difference?

I was refering to the drug resistence that we already know about with viruses like HIV. For example,

Successful HIV treatment usually consists of at least three drugs from two different “classes,” or types, of medications. Each class of HIV medication works differently, so that an HIV mutation that makes the virus resistant to one class won’t make it resistant to another class.

There are now four classes of HIV medications: NNRTIs, NRTIs, protease inhibitors and fusion inhibitors, each of which works somewhat differently at stopping HIV from multiplying. What makes today’s HIV treatment so effective is that it is more powerful than ever before, with fewer side effects. Today’s treatment combinations can just about stop HIV’s ability to reproduce.

They have more on it here.

But I did confuse that a little, with the way I worded it, with antibiotic treatments and bacteria. My bad.

Either way, my point was just that mass innoculations aren’t a guarenteed fix because you can remove viral componets that would starve out a viral mutations that are drug resistant via natural selection. So instead of killing off the virus, you just get a new strain.

However, cccording to the CDC’s site they’re for vaccination so I guess I’ll just tell my microbiology prof that he’s cracked but at a gut level I still don’t like it being mandated by the state.

As a disclaimer: I voted for Perry. Kinky was a tool and at least Perry did well with the hurricane response.

Rob B., I’d suggest the difference is some virii mutate more quickly than others.  Smallpox and polio are remarkably stable, but HIV, the common cold, and the flu seem to readily mutate.  Hence, we have good vaccines for the former, but not the latter.

I voted for Perry. Kinky was a tool and at least Perry did well with the hurricane response.

Even better than Blanco?

What’s going to happen to US industry when the global warming extremists like John McCain double the price of electricity?  I would think all these factories will close and set up in countries where they aren’t scared of technology.

Either way, my point was just that mass innoculations aren’t a guarenteed fix because you can remove viral componets that would starve out a viral mutations that are drug resistant via natural selection. So instead of killing off the virus, you just get a new strain.

I still think you are a little confused on the issue, Rob B.  Firstly, none of the HIV treatments attack the virus directly.  Each work within the cells that host HIV to stop the production of new HIV viruses.  Guess what happens if the patient stops taking the drug(s).

Secondly, as Robert Perry points out, viruses either mutate readily or are stable.  Flu, cold and HIV readily mutate in general.  No amount of drug research is going to stop them.  Vaccines, on the hand, inform our immune systems, preparing the only known effective defense against viruses.  Some vaccines work for the rest of your life and mass immunizations can eliminate the virus because the virus remains stable.  Other vaccines will only work for a short amount of time, like the flu vaccine, because the virus continually mutates.  It doesn’t really matter whether the vaccine only knocks out certain strains in that case because the virus mutates regardless of the environment.  My guess is that HPV is a relatively stable virus since the variants that cause cervical cancer are a small and known group.  Contrast that with flu where the number of strains is unknown because there are so many and many new strains are discovered every year.

Some vaccines work for the rest of your life...

We’re finding out that that may not be true. For example, those polio vaccines that those of you 40 and above may have gotten on your arm may no longer inoculate against the disease. It seems that cellular memory isn’t as long as once thought.

If polio breaks out of the lab today, we’re all in trouble. In today’s world, virii are now forever.

I’d like to know where Robert Perry got his 5% number.  I looked up the side effects of the HPV vaccine and the most common side effect was temporary soreness in the region of the injection.  Beyond that, of the 11,000 women in the study, there were no serious side effects reported. If 5% got temporary soreness, but it prevented cervical cancer (the second most common cancer in women after breast cancer) in 0.1%, that wouldn’t be much of an argument against the vaccine.

And Likwid, I understand what you’re saying, but HPV is easily transmitted sexually, the consequences can be devastating, and you are just fantasizing if you think that all teenagers think it all the way through before doing something they probably shouldn’t.

Finally, $360 sounds like a lot, but it’s far cheaper than having your kid in a hospital getting treated for cancer.

Carrick, the rate probably depends on what you define as serious.  On the pro-vaccine side, you’ve got people claiming “no serious side effects.” On the anti-vaccine side, VAERS is getting reports of “loss of consciousness, seizures, joint pain and Guillain-Barre Syndrome.”

http://www.freerepublic.com/focus/f-news/1780480/posts

And the fact remains that with fast track approval, Gardasil has NOT been adequately tested for long term side effects.  As such, it’s premature to vaccinate any but those known to be part of the “herd”.

That is, clearly promiscuous young men and women, not all.  Bad move on Gov. Perry’s sake here to ignore the principles of separation of powers and good science/statistics and do this by executive edict, IMO.

It really is pretty simple. For maximum effectiveness, everyone should be immunized, including boys. This is an epidemiological issue. Sometimes things shouldn’t be left voluntary. I dutifully get out of a fire-truck’s way, when its sirens are blaring. Do you? Or are you going to stick it to the man and stand your ground? Just saying is all...

As for whether the vaccine has been adequately tested. That I do not know. Still, considering how folks here view climate science, I wonder why anyone here would bother wanting it…

Carrick said, And Likwid, I understand what you’re saying, but HPV is easily transmitted sexually, the consequences can be devastating, and you are just fantasizing if you think that all teenagers think it all the way through before doing something they probably shouldn’t.

So what? It’s still not your place to force a vaccine on people to protect them against what is essentially a behavioral disease.

supergreen said, It really is pretty simple. For maximum effectiveness, everyone should be immunized, including boys. This is an epidemiological issue. Sometimes things shouldn’t be left voluntary.

HPV is hard to get. You have to work for it. The vaccine should be voluntary at that point.

I dutifully get out of a fire-truck’s way, when its sirens are blaring. Do you? Or are you going to stick it to the man and stand your ground? Just saying is all...

They don’t compare. One would be putting other people’s lives at risk by not getting out of the fire truck’s way. If one doesn’t get this vaccine, one’s behavior could possibly put other people’s lives at risk.

As for whether the vaccine has been adequately tested. That I do not know. Still, considering how folks here view climate science, I wonder why anyone here would bother wanting it…

That makes no sense.

Robert Perry, I agree with you on the need to adequately test new drugs, and I think you have a point on mandatory inoculations at this point with respect to HPV vaccine.

The problem is, I don’t think our system can really do so anymore.  Part of the problem is they no longer allow adequate testing on animals, and the only way to get an adequate gene pool is to release it on the public.  Still 11,000 subjects is a pretty good size population…

In any case, I had never heard of the NVIC before.  They look a bit over the top to me.  For example, 9800 cases of cervical cancer and 3800 related deaths a year (those numbers are out of date, the real numbers are higher) appears to be dismissed as unworthy of interest compared to other forms of cancer.  That seems more than a little twisted to me. 

I’ve known two women who were diagnosed with cervical cancer associated with HPV.  One of them lost her ovaries and almost died.  And it may be 14th over all among women, as they point out, but among young women, it’s still the second most common form of cancer.

On another issue, I happen to be pretty skeptical of ad hoc reporting of symptoms, which is what the NVIC is eliciting.  It tends to have a very high false alarm rate.  For example, you don’t know how many of the symptoms are related to the vaccine, as opposed to symptoms from other causes improperly ascribed to the vaccine.

In terms of the issues with promiscuity, I’ll point out that the problem is bigger than impulsive behavior of youths and unprotected sex.  While the CDC recommends the us of a condom, condom use reduces but does not appear to eliminate the risk of HPV infection.

In the long run, we really want to eliminate this virus from humans, and the only way to do that, as supergreen says, is 100% immunization.  So the long-term goals, I think are worthy.

Likwid:

So what? It’s still not your place to force a vaccine on people to protect them against what is essentially a behavioral disease.

Um, what are you on about?  I’m not forcing a vaccine on anybody.

Supergreen:

Still, considering how folks here view climate science, I wonder why anyone here would bother wanting it…

What’s ironic about that comment, is that Supergreen is just as prone as anybody else to ignore the science, when it doesn’t conform to his agenda.

This includes what climatology tells us about the long-term effects of global warming.  The “sky is falling/oceans are rising” meme of the left is mostly a fiction.  What he either doesn’t know, or simply chooses to ignore, is that global warming has competing effects associated with mean ocean levels. 

The first of these is the melt-off of continental ice fields for North America and Eurasia, which of course does have effect of raising ocean levels.  The second is that the interior Antarctic and Greenland ice fields/sheets actually are expected to grow due to global warming.  This second effect of course tends to reduce ocean levels over time.

This second effect is expected (and indeed observed) because, as the shelf-ice on the coasts of these two land bodies melts off, the water near the shores will raise in temperature, and you’ll get more precipitation over land.  At the same time, it’s damn cold in the interior of the Antarctic and Greenland, even in the summer.  So raising the mean temperature by even 10 degrees F won’t result in a catastrophic melt-off of these ice fields, or necessarily even compensate for the additional snow fall.

What we could end up having (and some climatologists lean this way) is a short-term rise in ocean levels (for the next couple of hundreds of years) followed by a gradual drop in sea levels to below their current levels.

Um, what are you on about?  I’m not forcing a vaccine on anybody.

Maybe not you personally, but you advocated it a couple of days ago. You said this:

In this case, the good is the eventual elimination of HPV in humans, and the near elimination of cervical cancer. The harm?  People get stuck with a needle against their will, and forced to become immune to a rather nasty virus.

Likwid, I’ll grant I said that, but that is a far cry from forcing a vaccine on anybody.

While I’ll accept your point about this being a behaviorally induced disease, it’s my (1 vote) opinion that society benefits more than the individuals are harmed by the inoculation.  Part of the problem, as I pointed out, is that teenagers are typically much more impulsive in their behavior, and that even protected sex with a causal sex partner, while it helps, is not guaranteed to protect against transmission of the virus.

My concern, as I stated in the post, is the slippery slope.  I just don’t like the government making these sort of health decisions.  I especially don’t like hearing them justified because they’re good for society at large.

I think people should be trusted to make these vaccination decisions on their own.  I’m all for informing the public about them and would favor spending tax dollars to spread the word, but mandating the vaccines?

It’s a slippery slope to somewhere we don’t want to go.

When the people fear their government, there is tyranny; when the government fears the people, there is liberty.

-- Thomas Jefferson

Rob’s recently listened-to songs:

Rob:

I especially don’t like hearing them justified because they’re good for society at large

Are you really saying that society as an entity should not be allowed to protect itself from the actions of individuals?  That seems to be the content of this remark.

If you don’t allow society to intervene when the common good is at stake, when would you allow them to intervene?  It seem to me that the alternative to this is pure anarchy:  There must be times that society must intervene for the benefit of the group, even if it harms a few.\

I think people should be trusted to make these vaccination decisions on their own.

As I pointed out, that logic works with normal adults.  It doesn’t work so well with teenagers.

But this vaccination wouldn’t be up to the teenagers themselves.  It would be up to parents.

Are you really saying that society as an entity should not be allowed to protect itself from the actions of individuals?

I’m saying that society should be allowed to protect individuals from themselves, which is what this is.

I don’t know, maybe I’m off in left field on this, but to me the thought of the government telling me to take a certain type of medication is repugnant, and is the sort of abdication of individual responsibility that will soon have the government mandating other sort of things for our own good.

When the people fear their government, there is tyranny; when the government fears the people, there is liberty.

-- Thomas Jefferson

Rob’s recently listened-to songs:

Rob, I think you meant “I’m saying that society shouldn’t be allowed to protect individuals from themselves, which is what this is.”

The problem with the HPV virus is it is one that is not controllable simply by using protection, so that you can get it even if you are trying to be safe.  While I have a single sex partner (my wife, who would kill me if that weren’t true), there are many Americans, rightly or wrongly, who are not monogamous.

If HPV could only be contracted by careless behavior, I would tend to agree with you.  The fact that this appears not to be the case is what raises it from protecting individuals from their negligence to the threshold of protecting people who are trying to be careful in their sexual practices (but choose to have multiple partners through the course of their life).

By the way, Rob, would you please stomp on that adolescent twit that’s been posting pornographic links?  I’d suggest banning him an reporting him to his IP provider. That should work well enough.

By the way, Rob, would you please stomp on that adolescent twit that’s been posting pornographic links?  I’d suggest banning him an reporting him to his IP provider. That should work well enough.

Already in the process of doing that.  I’m editing his comments to reflect that they’ve been deleted (to avoid confusion about disappearing comments).  I’ve also band the IP and am now getting in touch with the internet service provider.

When the people fear their government, there is tyranny; when the government fears the people, there is liberty.

-- Thomas Jefferson

Rob’s recently listened-to songs:

In medical cost vs. benefit modeling (which strongly informs national medical public policy making), the most critical component is a value called “cost per life year gained.” If the cost per life year gained is under $50,000, that is generally considered a decent investment by US medical policy makers. If “cost per life year” gained is over $100,000, that is generally considered a wasteful medical policy because that money could surely be put to much better use elsewhere.

Yes, this is cruel and heartless to some degree, but wide scale medical cost allocations do need to be made and, more relevantly, are continually made using these cost plus risk vs. benefit analyses.

Now on to GARDASIL. By the time you pay doctors a small fee to inventory and deliver GARDASIL in three doses, you are talking about paying about $500 for this vaccine. And because even in the best case scenario GARDASIL can confer protection against only 70% of cervical cancer cases, GARDASIL cannot ever obsolete the HPV screening test that today is a major component of most US women’s annually recommended pap smears. These tests screen for 36 nasty strains of HPV, while GARDASIL confers protection against just four strains of HPV.

Now let’s consider GARDASIL’s best case scenario at the moment—about $500 per vaccine, 100% lifetime protection against all four HPV strains (we currently have no evidence for any protection over 5 years), and no risk of any medical complications for any subset of the population (GARADSIL studies were too small and short to make this determination for adults, these studies used potentially dangerous alum injections as their “placebo control” and GARDASIL was hardly even tested on little kids). Now, using these best case scenario assumptions for GARDASIL, let’s compare the projected situation of a woman who gets a yearly HPV screening test starting at age 18 to a woman who gets a yearly HPV screening test starting at age 18 plus three GARDASIL injections at age 11 or 12. Even if you include all of the potential direct & indirect medical cost savings from the projected reduction in genital wart and HPV dysplasia removal procedures and expensive cervical cancer procedures and net these savings against GARDASIL’s costs, the best case numbers come out to well over $200,000 per life year gained—no matter how far hopeful assumptions are tweaked in GARDASIL’s favor.

Several studies have been done, and they have been published in several prestigious medical journals: Study 1, Study 2, and Study 3.

None of these studies even so much as consider a strategy of GARDASIL plus a regimen of annual HPV screenings starting at 18 to be worth mentioning (except to note how ridiculously expensive this would be compared to other currently recommended life extending procedures, medicines and therapies) because the cost per life year gained is simply far too high. What these studies instead show is that a regimen of GARDASIL plus delayed (to age 22, 25 or 28) biennial or triennial HPV screening tests may—depending on what hopeful assumptions about GARDASIL’s long term efficacy and risks are used— result in a modest cost per life year savings compared to annual HPV screening tests starting at 18.

If you don’t believe me about this, just ask any responsible OB-GYN or medical model expert. Now, why do I think all of this is problematic?

1) Nobody is coming clean (except to the small segment of the US population that understands medical modeling) that the push for widespread mandatory HPV vaccination is based on assuming that we can use the partial protection against cervical cancer that these vaccines hopefully confer for hopefully a long, long time period to back off from recommending annual HPV screening tests starting at 18—in order to save money, not lives.

2) Even in the best case scenario, the net effect is to give billions in tax dollars to Merck so HMOs and PPOs can save billions on HPV screening tests in the future.

3) These studies don’t consider any potential costs associated with any potential GARDASIL risks. Even the slightest direct or indirect medical costs associated with any potential GARDASIL risks increase the cost per life year gained TREMENDOUSLY and can even easily change the entire analysis to cost per life year lost. Remember that unlike most medicines and therapies, vaccines are administered to a huge number of otherwise healthy people—and, at least in this case, 99.99% of whom would never contract cervical cancer even without its protection.

4) These studies don’t take in account the fact that better and more regular HPV screening tests have reduced the US cervical cancer rate by about 25% a decade over the last three decades and that there is no reason to believe that this trend would not continue in the future.

mhatrw:

In medical cost vs. benefit modeling (which strongly informs national medical public policy making), the most critical component is a value called “cost per life year gained.” If the cost per life year gained is under $50,000, that is generally considered a decent investment by US medical policy makers. If “cost per life year” gained is over $100,000, that is generally considered a wasteful medical policy because that money could surely be put to much better use elsewhere.

It’s not just the number of years you live, it’s the quality of life that counts.  After all, somebody could develop cancer, lose most of their organs, and be confined to a life-assist machine for 30 years… and your statistic would say “yep… A-OK”.  I make a similar comment to my kids about smoking.  It doesn’t just reduce your life expectancy, it reduces your expected quality of life at the same time.

4) These studies don’t take in account the fact that better and more regular HPV screening tests have reduced the US cervical cancer rate by about 25% a decade over the last three decades and that there is no reason to believe that this trend would not continue in the future.

No matter how you try and dice the statistics, it still amounts to about 10,000 new cases of cervical cancer per year, many associated with HPV, and about 4,000 deaths per year.

Sure sounds clinically relevant to me.

Carrick said:

If you don’t allow society to intervene when the common good is at stake, when would you allow them to intervene?

I guess you could argue whether or not this was for the common good.

What’s going to happen to US industry when the global warming extremists like John McCain double the price of electricity?  I would think all these factories will close and set up in countries where they aren’t scared of technology.

No matter how you try and dice the statistics, it still amounts to about 10,000 new cases of cervical cancer per year, many associated with HPV, and about 4,000 deaths per year.
Out of how many million of people? Also, you are forgetting that the vast majority (if not all) of these cases are among women who haven’t had pap smears within 3 years of diagnosis (check out USPSTF). Given that the amount of public money is finite, wouldn’t spending it on free pap smears/abnormal results evaluation/treatment for poor women result in more lives saved? Gardasil will not prevent all cases of cervical cancer so women would still need regular paps. For the record - a friend of mine had cervical cancer, so she is part of this statistics (it was stage 1, treated, and she’s been cancer-free for a couple years now). Prior to her diagnosis she had been uninsured and she had never had a pap smear. After she started bleedig, she bought herself a health insurance and went to the doctor for the first time in years. Given that she was in her 50s, Gardasil wouldn’t have prevented her cervical cancer. But free/cheap pap smears would have.

There already is a way to prevent cervical cancer. Now, I agree that the evaluation of abnormal results is no fun; and possible overtreatment may affect fertility, so to me the main benefit of the vaccine is reducing the number of these abnormal results. This would convince me to have the vaccine (if I had been young), but it is not the reason for making it mandatory. At least not yet.

I believe that the govenment has a responsibility to protect public health from easily communicable and potentially fatal deseases. But HPV is not a major health threat - most women get over it without any ill effects. As far as herd immunity goes - there are boys, there are older people who may be carriers and may have sex with younger women, .... Given the cost, it is not practical to vaccinate everyone in the world (although donating the vaccine to poor countries where women have no access to pap smears would save a lot more lives). So, it is not practical to believe you are going to completely eliminate it. And we don’t even know how long the immunity to HPV will last, the vaccine is just too new.

One other thing that bothers me is that the governor of Texas made this decision without any recommendation to do so from those qualified to make medical decisions. While CDC recommends the vaccine it doesn’t yet recommend making it mandatory. The vaccine experts are not pushing yet for making it mandatory, many of the doctors are surprised at the speed the governor of Texas made this decision. I don’t believe the governor of Texas has any right to practice medicine, do you?

Kitty...I agree completely! I am from Texas and I have a real problem with the Gov. playing doctor. Thank you, well said…

Carrick said, If HPV could only be contracted by careless behavior, I would tend to agree with you.  The fact that this appears not to be the case is what raises it from protecting individuals from their negligence to the threshold of protecting people who are trying to be careful in their sexual practices (but choose to have multiple partners through the course of their life).

Having multiple sex partner is not anywhere near trying to be careful in sexual practices and it is careless behavior.

You’re essentially arguing for forced vaccinations to protect sluts.