Friday, March 23, 2007

The Gardasil Debate

When it comes to decisions about kids, I believe parents have the ultimate right to decide how things are going to go as long as they're not putting the kids in harm's way (beating them, pumping them full of cocaine, etc.). That's part of the reason the way Merck was lobbying to have Gardasil be mandatory for young girls to attend public school made me uneasy.

If God blessed me with a daughter, despite genetic predisposition to sons, I know I'd get the shot for her. As a vaccine it is 100% effective against certain strains of HPV that are known to cause cervical cancer, and over 70% effective against other strains which may also lead to cancer. The vaccine seems to be a no brainer to me.

As uncomfortable with with the government mandate as I am, it's come to my attention how some folks don't quite understand what's at stake here. You'll see comments like this from fathers:
When you are talking about 8, 9, 10, 11-year-old girls who are not sexually active and most likely will not be sexually active until their maturity, there is no medical necessity for that.
or this:

Parents are going to know the difference between that child, who, as you described before, may be 11 years old and in many circumstances no way, shape or form is going to be sexually active; and parents know other children, 15, 16 years old have been, are starting to be sexually active, in which case this treatment, the shot or what have you, would be appropriate.
There are several issues with this logic. First, it shows a complete lack of understanding of what a vaccine is. With Gardasil, as with any vaccine, a woman has to have it before contact with the HPV virus. Vaccines are for inoculations, and this particular one takes shots spread over a few months to be effective. It's not like picking up antibiotics at the pharmacy and all of a sudden you're inoculated. If the daughter has become sexually active, and she comes in contact with a "dirty dog" who either hasn't been truthful or hasn't been tested, it's game over. Since guys don't usually show any signs of the cancerous strains, they won't know they've got it and the vaccine is the only way to be sure a woman won't contract those strains.

The second issue is that both of these quotes were said by our very own Representative Scott Garrett the other night on the House floor. Obviously, I would hope my Representative would understand what a vaccine is. In addition, it is hypocritical that Garrett votes against a bill protecting parents from being forced to administer overprescribed drugs like Ritalin, but then say they can't be forced to prevent their daughters from getting cancer. Also, I would have hoped after the Terri Shiavo disaster we would have seen the last of members of Congress dispensing medical advice on the floor.

I still don't support the mandate, but with potentially fatal ignorance being entered into the Congressional Record I'm starting to have second thoughts. If you've never read a testimonial of those going through cervical cancer you can go to the National Cervical Cancer Coalition and read lots of them. No matter what level it is, it sounds terrifying. Granted, not everyone gets it like this, but ignorance is no excuse for not preventing this now that we have a vaccine:
I was diagnosed in April 2006, and underwent a radical hysterectomy in May 2006,
removing my uterus, cervix, upper part of my vagina, and some lymph nodes and additional tissue. Unfortunately, the lymph nodes and the upper part of my vagina came back positive for cancer, and I underwent 5 doses of Cisplatin chemotherapy and 28-30 doses of external radiation and 3 internal doses. That finished in July of 2006, and I thought all was well. In January of 2007, my pap came back abnormal. Then the DR. took more biopsies, and those and my CAT scan showed that my cancer had returned. I am now scheduled in early March to undergo a procedure called Pelvic Exenteration - where the Dr.'s remove my bladder, vagina, and rectum, leaving me with a urostomy to replace my bladder, and a colostomy to replace my rectum.


Jill said...

As you know, I am a pro-choice absolutist and I strongly believe that much of the anti-abortion movement is less about babies and human life than it is about punishing the evil sluts who refuse to keep their legs closed and retain their Purity for Daddy.

That said, I oppose, at least at the present time, state mandates on Gardasil. This is not because of any parental rights nonsense, it's because Gardasil is a brand new vaccine. I work in clinical trials, and I work with people who have many years of experience in clinical research. And every last one of them says you do not take a drug until it's been out for at least five years and the required safety studies have been done. A recent article in the AARP newsletter stated that many pharma companies have NOT done these studies in a timely manner.

It's useful to note that Texas Gov. Rick Perry, who was the first governor to mandate Gardasil, has large financial interest in Merck.

From KTBX:

"One of the drug company's three lobbyists in Texas is Mike Toomey, his former chief of staff. His current chief of staff's mother-in-law, Texas Republican state Rep. Dianne White Delisi, is a state director for Women in Government.

Toomey was expected to be able to woo conservative legislators concerned about the requirement stepping on parent's rights and about signaling tacit approval of sexual activity to young girls. Delisi, as head of the House public health committee, which likely would have considered legislation filed by a Democratic member, also would have helped ease conservative opposition.

Perry also received $6,000 from Merck's political action committee during his re-election campaign."

It is interesting that this vaccine has been developed and tested on GIRLS, while boys are able to remain carriers of the HPV virus so that those girls who do not receive the vaccine are at risk. More double standard.

In most cases, where a child's health and well-being is concerned, I would say that public health trumps a fundamentalist Christian's parent's right to make sure that the wages of his daughter's sin is death or extreme disfigurement and pain and humiliation, as in the cervical cancer description you posted. However, until Gardasil has been out for a while and has been proven both effective AND safe over the long term, I think state mandates for drug company experimentation on children is out of line.

rmfretz said...

Thanks for taking the time to write. I think that's part of the reason Merck's pushing for it had me concerned (Vioxx?). This is one of those issues where the smart thing to do is wait a bit, but not for the reasons being spun by Garrett. I hope most parents will make the right choice once its proven safe.

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