OP-EDS

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February 27, 2007

Getting HPV vaccine may be costly, but not getting it is even more so

Gardasil became the first, and so far only, preventative cancer vaccine when it was released by Merck this past June. The vaccine’s release was accompanied by an ad campaign encouraging women to become “one less”: one less statistic, one less family turned upside down, one less cervical cancer patient. While women who are not yet sexually active are particularly advised to receive the vaccine, women who do have sex or even already have or have had human papillomavirus (HPV) are encouraged to receive it as well. This is because Gardasil targets four different strains of HPV, and women who have had one may not have had all of them. The vaccine is available to women between the ages of 9 and 26 because the vaccine was not tested on women outside this range, so its effectiveness and side effects for other women or for men are not known.

There are myriad reasons to abstain from the HPV vaccine. Gardasil is not—as early announcements claimed—100 percent effective. Dozens of strains of HPV exist that are not covered by the vaccine, though it does target the two strains responsible for a combined 70 percent of all cervical cancers. The longevity of the protection offered has not been proven, and there may still be more side effects to its use that have not been discovered—as was the case with the pain-reliever Vioxx, a Merck drug that was recalled in 2004.

The HPV vaccine has also generated some concerns among social conservatives, who fear the vaccine will encourage promiscuity in young people by reducing the perception of risk that accompanies pre-marital sex. I’m sure there are those who will abuse the vaccine in this way. All the same, a woman may remain abstinent and still marry a man who is an HPV carrier—and he may not even know it. Carriers don’t exhibit symptoms of HPV, and it is one of the most commonly transmitted STIs. The Centers for Disease Control and Prevention estimate that over 20 million Americans have it.

Then there are the economic concerns. At $120 per dose for three doses—plus the $15 tacked on by the U of C Hospitals should you choose to get it here—Gardasil is currently one of the most expensive vaccines on the market. Merck is working with federal health officials to offer the vaccine to the underprivileged at a reduced price, but right now the company has a monopoly.

Waiting is an option. At least one other cervical cancer vaccine is currently undergoing clinical trials. If that vaccine is approved and released, natural market competition will likely bring down the cost of both. Additionally, not all health carriers are on board with Gardasil yet. However, many already are, and I trust that many more will follow suit. It’s not just humanitarian; it’s financially smart for insurance companies to cover this vaccine. Cancer treatment is expensive, both for the insurance company and the cancer patient. If I were an insurance company, I’d be more inclined to finance a $360 preventative vaccine now than to shell out thousands in treatment expenses down the road.

Despite all these grounds for waiting or abstaining from taking Gardasil, I would like to make the case for getting the vaccine as soon as possible.

Far too many young people have a tendency to blow off longterm considerations for their futures—particuarly with regard to their health.

Yes, at $405, it’s expensive, but I consider $405 now an investment against the financial burden and psychological devastation I may face in the future if I develop cervical cancer. Cervical cancer attacks more than just a woman’s body. It has the potential to destroy marriages, families, friendships, and careers through often unconsidered but related side effects like the loss of a woman’s ability to have children or engage in sexual intercourse and increased susceptibility to alcoholism and depression. Health researchers have also suggested that contracting HPV doubles the risk of getting HIV.

It’s easy to get inoculated for HPV at the Student Care Center. Physical examination is not required. All you need to do is have a brief conversation with a physician right before your appointment in order to have your questions answered. The three vaccines are administered at two- and four-month intervals; so ladies, get the first dose in April, the second in June before heading off for the summer, and when you come back to campus in September, you’ll be just in time for dose three. (It’s better to be late than early for a dose, doctors say.)

Each year in the U.S., 3,700 women die from cervical cancer, and that number swells to more than 230,000 worldwide. If it takes targeting an STI to reduce those numbers, then so be it. Risks are involved with any kind of vaccination, and while I don’t support mandatory inoculation, I believe it’s worth it to weigh the unknown against the hope that I may be one less sufferer of cervical cancer by getting vaccinated for HPV.

My mother is a four-time cancer survivor. One of those cancers originated as cervical cancer. Believe me: You want to be one less.