Wednesday, February 7, 2007

scared of needles?

This week, Gov. Rick Perry of Texas announced that by executive order, he would be requiring the young girls of Texas to receive the vaccine Gardasil. A similar measure is being considered in Maryland. This has stirred up all kinds of excitement. Conservative bloggers are all aflutter. (full disclosure here: my wife does research on vaccines).

Gardasil is a vaccine that prevents infection with several subtypes of the Human Papillomavirus (HPV). In some cases, infection with HPV causes cancer. So, by blocking the infection with this virus, HPV prevents cancer. End of story? Well, not really. The thing is that HPV is transmitted sexually. So we're talking about a cancer that is sexually-transmitted. Granted, not everyone who gets the virus, gets the cancer (most people never know they had it - which is why it is transmitted so readily. You're much more likely to notice your partner has gonorrhea.) You'll never in a million years notice that your partner has HPV. The other complication is that for this vaccine to work, you have to have it before you ever contract HPV. Meaning, you have to have it before you have sex. Or, rather, girls need to have it before they have sex. The recommended age for administering this vaccine is 12.

And there's the rub. Vaccinating girls against a sexually transmitted disease before they should be having sex. Most parents hope their children aren't even *thinking* about sex at that age. Quite frankly, when I was that age, I could hardly think of anything else, but I'm male, and such is the stereotype. So the arguments I've heard against making this vaccine mandatory have included:

1) This vaccine shouldn't be mandatory because it only works against some strains of the virus. As it happens, it doesn't prevent mad cow disease either, but I think that's not a valid argument for not having a mandatory vaccination program.

2) This vaccine shouldn't be mandatory because all the profits are going to one company. Though I'm very interested in intellectual property rights, I'm not going to discuss it here. But let's just run with the assumption that in modern capitalistic democracies, intellectual property rights should be respected, and really are not sufficient reason to not want to use a drug.

3) This vaccine shouldn't be mandatory, because it prevents a cancer that is spread by sexual contact. Do people who have sex deserve to get cancer?

and finally 4) Vaccines are dangerous, they cause autism/ADD/insert your favourite disease here. Hogwash. There are side effects to *some* vaccines. These side-effects are rare, and are always less dangerous than the disease they prevent (when this is not the case, for example the rotavirus vaccine that caused intussussception) the vaccine is quickly withdrawn. Vaccines *don't* cause autism or ADD. I will discuss this later, as this is a pet-peeve of mine.

Safety is a real issue. While I'm sure that Gardasil has been tested on thousands of people, that is not sufficient to find side-effects that occur on the one in one hundred thousand level. So it is possible that there will be side-effects that we don't know about yet, but they should be exceedingly rare.

The real issue that no one is talking about is that there are people out there who don't want their daughters to have this vaccine. That is, there are people out there who don't want to protect their daughters from cervical cancer. Whether this is through some puritanical aversion to sex, or whatever, it's sad that any government has to talk about making Gardasil mandatory. People *should* be lining up around the block to get this vaccine for their kids.


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