The "cervical cancer" vaccine is NOT about saving lives. It's about scaling back pap smears!

[mhatrw]

I didn't want to get into this before because it is a bit esoteric. However, in medical cost vs. benefit modeling (which strongly informs national medical public policy making and far too strongly informs the medical policies of HMOs), 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. Think HMOs. Now consider why pap smears, blood tests and urine tests aren't recommended every month for everyone. Testing monthly could definitely save more than a few lives, and there is no measurable associated medical risk. But the cost would be astronomical versus the benefit over the entire US population when comparing these monthly tests to other therapies, procedures and medicines.

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 pap smears.

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 five years), and no risk of any medical complications for any subset of the population (Merck's 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 pap smear starting at age 18 to a woman who gets a yearly pap smear starting at age 18 plus the three GARDASIL injections at age 11 to 12. Even if you include all of the potential medical cost savings from the projected reduction in genital wart and HPV dysplasia removal procedures and expensive cervical cancer procedures, medicines and therapies plus all of the indirect medical costs associated with all these ailments and net all of these savings against GARDASIL's costs, the best case numbers for these analyses come out to well over $200,000 per life year gained -- no matter how far the hopeful pro-GARDASIL assumptions that underpin these projections are tweaked in GARDASIL's favor.

Several studies have been done. They have been published in several prestigious medical journals. None even so much as consider a strategy of GARDASIL plus a regimen of annual pap smears starting at age 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 pap smears may -- depending on what hopeful assumptions about GARDASIL's long term efficacy and risks are used -- hopefully result in a modest cost per life year savings compared to annual pap smears starting at age 18.

If you don't believe me about this, just ask any responsible OB-GYN or medical model expert. If anyone wants the references, I can provide them.

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 pap smears starting at age 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 pap smears 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 pap smears 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, especially if we used a small portion of the money we are planning on spending on GARDASIL to promote free annual pap smears for all low income uninsured US women.

5) The studies assume that any constant cervical cancer death rate (rather than the downward trending cervical cancer death rate we have today) that results in a reduced cost per life year gained equates to sound medical public policy.

As I said before, if any of you don't believe me about this, please simply ask your OB-GYN how the $500 cost of GARDASIL can be justified on a cost per life year gained basis if we don't delay the onset of pap smears and back off from annual pap smears to biennial or triennial pap smears.

Finally, if you don't have anything to say that is actually germane to this analysis, your post will receive the response it deserves.

[JVS]

1. interesting

[mhatrw]

71. As requested below, here are the medical journal references.

http://dx.doi.org/10.1001/jama.290.6.781

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=15100338&dopt=Abstract

http://www.nature.com/doifinder/10.1038/sj.bjc.6602049

[Richard Steele]

74. None of which even mention this "vast anti-pap-smear conspiracy" you seem to believe in.

[mhatrw]

78. What are you talking about, dick?

It's not a conspiracy. It's all happening in plain sight. The recommendations are already in:

http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm

The USPSTF strongly recommends screening for cervical cancer in women who have been sexually active and have a cervix.

Rating: A recommendation.

Rationale: The USPSTF found good evidence from multiple observational studies that screening with cervical cytology (Pap smears) reduces incidence of and mortality from cervical cancer. Direct evidence to determine the optimal starting and stopping age and interval for screening is limited. Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years (go to Clinical Considerations). The USPSTF concludes that the benefits of screening substantially outweigh potential harms.

[Eurobabe]

2. Perhaps but this vaccine is NOT a substitute for PAPS

This virus only "guards" against 4 strains most implicated in causing cervical cancer and even at that it is NOT 100%.

An annual exam is imperative for a woman's reproductive health, not to mention keeping current on tests for OTHER STDS.

Good news! My daughter does NOT have cervical cancer we found out late yesterday evening.

I have to ask her now if she is going to get the vaccine, but she's an adult so she can make her own decision based on her experience these past two months.

[shaniqua6392]

3. Thank you for mentioning that it only guards against 4 strains.

There are actually over 100 strains of HPV. The pharmaceutical company and any state that is trying to force the vaccine on us have ulterior motives for doing so. They stand to make billions of dollars pushing this vaccine upon the public. It has not gone through extensive testing. They have done this with medications in the past that have had dire consequences for those taking them. They do their best to cover up side effects so that they can continue to make money. I will not be giving this medication to my daughters. I think we should, as parents, promote the use of condoms. This is just another issue, such as pregnancy, AIDS, etc. that we add to the list of sexually transmitted diseases that we discuss with our children. A brand new vaccine which only protects against four strains of the virus which may or may not prevent cervical cancer has too many unknown elements in it for me. What if they find out that our daughters give birth to babies with defects because they had the vaccine? How long do you think they will cover it up before they tell us? It could be anything like this and I don't care for their track record on these issues. I am very happy about your daughter. That is great news.

[mhatrw]

5. Not just condoms should be promoted but also free annual pap smears

for all low income women without annual pap smear health care coverage.

[Katherine Brengle]

32. Planned Parenthood and other clinics...

usually offer a sliding scale for these things - low income = free or very low cost exams.

[and-justice-for-all]

4. Nor should it be thought of as a sub for PAPS...nt

[phylny]

6. How many threads about this are enough for you?

As someone who has had cervical dysplasia, and who had cryosurgery, which was neither painless nor pleasant (not even to discuss the three week AFTERMATH of the cryosurgery) I can't say that anything that will help reduce the risk of cervical cancer is bad.

Lives really can't be measured in money, in my book. I think a combination of the vaccine plus a pap smear according to the schedule set by a woman's gynocologist, is a great combination.

[kickysnana]

8. OP totally agrees with you. HMOs & NIH do not n/t

[PLF]

16. My wife had the exact same thing you had

Do we want Merck to force our daughter to take their chemical injecitons? NO.

This move by Rick Perry is really bad and that "opt out" clause is likely to be erased some time in the future.

[mhatrw]

20. Even if that pap smear schedule is bienniel or trienniel and delayed

in order to offset the cost of the vaccine?

Even if cervical cancer mortality contraction rates stop declining and instead starting increasing because of this new schedule?

[kickysnana]

7. Aside: Congress exempted vaccine makers from any liablity n/t

[madrchsod]

9. please provide references to these statements

"Several studies have been done. They have been published in several prestigious medical journals."


"If anyone wants the references, I can provide them".

[BleedingHeartPatriot]

10. Yes, a link to those studies in prestigious medical journals would be nice, but won't happen.

Personal agenda driven OP, he/she slipped up in a previous OP and said the only women who get cervical cancer have compromised immune systems or "many, many sexual partners" and questioned whether the cost/benefit ratio really justified saving their (promiscuous) lives. MKJ

[BleedingHeartPatriot]

12. A link to OP's concern that too much money is being spent on women with "many, many sexual partners"

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=389&topic_id=145744

OOPS. Real agenda, folks, right there. MKJ

edited to add, as you read the thread you'll see that he/she was called out on it, first he/she protested that it was 100 percent true, then admitted that it wasn't true and so what?

:eyes:

[PLF]

15. that's a red herring

Rick Perry's move is very dangerous and it probably won't be long for that little "opt out" clause is erased. Let's all be slaves of big pharma, yeah, that's the ticket.

[bettyellen]

51. HPV caused by "too many partners" "compromised" their own "immune systems" woulda died "soon anyway"

red herring or total puritanical woman hating bullshit? I'd have to say the latter.


http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=389&topic_id=145744

[Mayberry Machiavelli]

18. B-b-but the OP teaches at a medical school! That's what they said on another thread!

[mhatrw]

24. B-b-but all you have is ad hominem attacks.

Please ask yourself, how is this contributing any discussion in any way?

If you have some facts, some evidence, some logic or even some thoughts in opposition to the original post, I would lover to hear them.

Otherwise, what exactly is your purpose for posting on this thread?

[bettyellen]

54. ad hom? like "too many partners" "compromised" their own "immune systems" woulda died "soon anyway"

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=389&topic_id=145744#145832

[mhatrw]

64. Why are all your posts on this thread about something I didn't say in another thread?

[bettyellen]

66. "1300 lives a year, many of whom would probably die soon of other causes" "many many partners"

:hi:

[bettyellen]

67. almost 3,700 US women died of cervical cancer last year. But that's less than 2.5 US women out of ev

[Name removed]

70. Deleted message

Message removed by moderator. Click here to review the message board rules.

[bettyellen]

72. how many is "many many partners?"

[mhatrw]

73. Here are DU's rules. Please read them.

Do not post personal attacks or engage in name-calling against other individual members of this discussion board. Even very mild personal attacks are forbidden.

Do not hurl insults at other individual members of this message board. Do not tell someone, "shut up," "screw you," "fuck off," "in your face," or some other insult.

Do not call another member of this message board a liar, and do not call another member's post a lie. You are, of course, permitted to point out when a post is untrue or factually incorrect.

http://www.democraticunderground.com/forums/rules_detailed.html

Do not post personal attacks or engage in name-calling against other individual members of this discussion board. Even very mild personal attacks are forbidden. ...

Do not "stalk" another member from one discussion thread to another. Do not follow someone into another thread to try to continue a disagreement you had elsewhere. ... Do not post messages with the purpose of "calling out" another member or picking a fight with another member.

[Richard Steele]

75. It's official: IRONY is dead!

Or were you vaccinated against it at an early age?

:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl:

[mhatrw]

76. Who am I stalking about what they didn't write in another thread, dick?

Or don't you know what irony means?

[mhatrw]

21. Here you go.

http://dx.doi.org/10.1001/jama.290.6.781

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=15100338&dopt=Abstract

http://www.nature.com/doifinder/10.1038/sj.bjc.6602049

[madrchsod]

39. - i have read some of the studies

and i thank you for providing these links. i`m changing my mind on this issue because of some of these studies. i noticed that boys would be benefited more than the girls if i read that correctly. what bothered me the most is the studies of cost benefits which is a cold study of human costs but i know has to be factored into any study. as far as i am concerned the jury is still out on this subject of mandating only girls and not boys and whether there should be a mandate at all. politics and medicine is always a bad mix and as we have seen that mix clouds the truth.
again thank you for the links...

you should have included these links in your original posts

[mhatrw]

65. I didn't know who would have access to them and be able to understand them.

I don't like when someone tries to make a point by getting too scientific for others to follow, so I was trying to avoid that. But in retrospect, you are 100% coreect.

[bleedingheart]

11. Your argument is completely incorrect. and just more anti-vaccine hyperbole

HPV screenings aren't the only reason's for Pap Smears.

So even with the HPV vaccine, you still need a Pap Smear every year.

Just like kids need a yearly pediatric visit in spite of their vaccinations.

Just like all adults should visit their doctor once a year for a check up in spite of taking a vitamin every day.

[mhatrw]

22. But you won't be getting yearly HPV screenings. n/t

[bleedingheart]

30. when you have physical proof and you can bring a class action law suit..

I will believe you.

In the meantime, I would recommend expending effort on convincing women to actually get pap smears.

Many women do not get their annual pap smear because they just "forget" or are embarrassed or because they don't realize that even without insurance groups like Planned Parenthood will do them for them..

My mother in law went for 10 years without a pap smear or a mammogram...and only upon the insistence of the three daughter in laws ...did she actually do it...we had to threaten her...we told her we wouldn't call her mom anymore...

[mhatrw]

33. I also want them to ask for annual HPV screenings to be done at this time.

I should have been more clear that the OP was concerned with one (soon to be less than annual) testing component of the annual pap smear which is HPV screening -- rather than "pap smears" themselves.

Thank you for bringing that to my attention. Do you have any other constructive criticism or any facts, evidence or logic in opposition to the OP?

[frustrated_lefty]

13. Utter horse crap.

The vaccine targets the 4 strains of HPV most commonly associated with cervical cancer, but it is NOT a cure all. It does NOT negate the need for annual pap-smears.

1) When you say nobody is coming clean, you simply mean nobody who works in the field agrees with you.
2) The vaccine does not negate the need for pap-smears.
3) Nonsense. Any research professional looks at potential inadvertant costs. That is one of the things addressed in the patenting process, and nobody wants to be responsible for Thalidomide v.2
4) Wtf? No, they don't take into account yada-yada-yada about pap-smears, because that isn't what they're studying. That's like saying aspirin sucks because accupressure works.
5) Ummm....you confuse me. I thought fewer dead people = good.

On a personal note, try saving a life before bitching about how others go about doing it.

[mhatrw]

25. Read the papers. Then get back to me.

HPV screening will not be done annually in the vaccinated population because the cost per life year gained is simply too high:

http://dx.doi.org/10.1001/jama.290.6.781

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=15100338&dopt=Abstract

[Eurobabe]

14. And while we're at it, let's vaccinate young MEN

if we are pushing this on women, girls, why no responsibility for the men-folk, since they can be carriers? I am sick to DEATH of the pharma industry pushing BCPs, etc. only on the women-folk.

:mad: :mad: :mad:

[PLF]

17. heck, let's just set up a minimal big pharma consumption quota

If you haven't taken your quota of crap from Merck et. al. then you will be arrested.

:grr:

[mhatrw]

29. I agree. But at $500 per vaccine, the cost per life year saved would be

even harder to justify among the male population, and there is no money to be recouped by backing off on HPV screening. That's why we will never see this vaccine made mandatory for males.

[Katherine Brengle]

31. What do you not understand about HPV NOT being the only reason for Pap smears???

You are just looking for ANY justification to be against the vaccine.

:eyes:

[mhatrw]

68. I understand perfectly and I appreciate the constructive criticism.

What I meant to say in the original post was that the HPV screening component of pap smears rather than pap smears themselves will be changing from annual to biennial or triennal in order to save money on HPV screening tests to offset the incredibly high cost of the vaccine.

The recommendations are already in:

http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm

Rationale: The USPSTF found good evidence from multiple observational studies that screening with cervical cytology (Pap smears) reduces incidence of and mortality from cervical cancer. Direct evidence to determine the optimal starting and stopping age and interval for screening is limited. Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years (go to Clinical Considerations). The USPSTF concludes that the benefits of screening substantially outweigh potential harms.

[Name removed]

19. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[Name removed]

23. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Tektonik]

26. seconded, n/t

[Katherine Brengle]

28. rofl

[Katherine Brengle]

27. The only Paps this will prevent are the ones being done every 3 months for women

with abnormal cells due to the HPV they won't have bc they got the vaccine.

There are a lot of other reasons to get Paps done - not the least of which is - you can't get a hormonal birth control prescription in this country without getting one done, and the longest anyone is getting that for is 12 months.

:eyes:

[mhatrw]

34. So you are assuring all of us that HPV screening with remain

annual and start at age 18 among the vaccinated population?

[Katherine Brengle]

36. A pap does NOT screen only for HPV -- and considering that

other strains of HPV will still be out there, I don't think screening will stop at all, for those who currently bother that is.

This vaccine could be a great thing for preventing a ton of cervical cancer, but it doesn't prevent pregnancy, or other STDs.

Women will still need an annual for birth control pills, other hormonal bc, and screening for other potential problems.

Less cancer = good. It doesn't mean an end to paps.

[Katherine Brengle]

48. No argument?

:eyes:

[mhatrw]

52. What I am saying is that annual screening for HPV strains will

stop for the vaccinated population based on hopeful and unproven projections about the vaccine's efficacy.

[Katherine Brengle]

57. Perhaps for the 4 it protects against, not for the rest.

And I am willing to bet those will still be checked for until the longevity of the vaccine is fully known.

[mhatrw]

69. Come on, HPV screens test for 36 strains. How would screening for 32 instead be cost

effective, especially when 2 of those 4 are currently the most deadly?

Anyway, the recommendations are already in.

http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm

Rationale: The USPSTF found good evidence from multiple observational studies that screening with cervical cytology (Pap smears) reduces incidence of and mortality from cervical cancer. Direct evidence to determine the optimal starting and stopping age and interval for screening is limited. Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years (go to Clinical Considerations). The USPSTF concludes that the benefits of screening substantially outweigh potential harms.

[Name removed]

35. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

37. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[Dastard Stepchild]

38. Anecdotally...

I wear many hats and have many roles, one of which is work with a large urban health system. From what I have gathered from providers and administrators in our organization, this vaccine is to be viewed as compliment to current standards of care, not as a replacement. In other words, one piece of the holistic cookbook for working with women on issues of reproductive health.
In fact, another organization that I am no longer affiliated with but still have friendly ties to has no intention of changing their protocol either.

So, I am not sure that things will evolve in the manner that you suggest, in part because I know of few gyne docs (or docs in general) that see any one form of treatment as the end-all, be-all response for every woman. I think, more likely, the vaccine will be added to the standard of care that also includes other elements (paps, STI testing, breast exams, etc.).

[mhatrw]

40. And what are current "standards" for HPV screening?

Annually, biennially or triennially? Whose standards are we talking about? If you look into this a little, I think you will come to agree with my original post.

[Dastard Stepchild]

43. Our system protocols....

And I can look into the actual wording of our standards, but it goes something like this:

1 12 month pap recommended for individuals with no hx of HPV
2 biannual paps recommended for individuals with confirmed low-risk strain HPV in the first 2 years of confirmation, annually thereafter if no evidence of changes in cervical cells.

Then it gets more tricky, because of the presence of high-strain HPV.

If high strain HPV confirmed, triannual Pap for first year, biannual next 2 years additional year, annual thereafter if no suspicion of changes in cervical cells. If cervical cells change and tx is required, patient reverts back to triannual paps for 1 year following procedure.

This is my best remembrance of the protocol. Though they vary by health system, so I can really only speak to our protocols, and can't assume that other systems act, or will act, in similar fashion. The vaccine would not really affect our pap protocols as they are designed, but it may reduce the number of women falling under the high-strain pap protocol. That is how I see it affecting our providers' work.

[Recursion]

41. I think the risk over the whole population is a red herring, personally

Consider an individual instead. Every woman has a "base" risk of devloping cervical cancer over the course of her life of about 1%. If she carries any strain of HPV, it's something like 1.7%, and if she carries strain 16 or 18, it's 2.5% or so.

So, there's clearly an association. What's unknown is the type of association -- it's presumed to be causal because that's all we have to go on, but we do know there are some risk factors that increase the chance of both HPV and cervical cancer, so that eats into that association a bit (like emphysema and yellow fingernails; they are strongly associated but neither causes the other, and a pill that prevents keratinous jaundice will not prevent emphysema, though God knows Eli Lily would try to sell it as that).

Look at diseases vaccines have been effective against:
mumps
rubella
whooping cough
smallpox

ie, contagious diseases with high morbidity and (except for polio) rapid onset of symptoms from the infection. These are also "single cause" diseases: nobody gets smallpox or whooping cough without exposure to the pathogens. Also, these were all conditions where campaigns of sanitation, education, public health and hygiene went hand-in-hand with vaccination campaigns -- one doesn't work without the other, and sub-saharan Africa today is an example of that (they have the vaccines but people are still dying because the vaccinated person still needs good sanitation and nutrition).

Compare this with HPV and cervical cancer. Most people who get HPV never get cervical cancer. Many people who never contract HPV still develop cervical cancer. We simply don't know whether HPV is the sole factor distinguishing the population with the higher risk of cervical cancer, or is a marker for an underlying factor. We simply don't know if these vaccinations will actually lower the cancer rate as much as we hope they will. We'll start to know in about 20 years, and we'll only have real lifetime cohort data in 60 years.

Epidemiologists don't yet have models for how this vaccine will affect the diseases in question. We haven't had much success vaccinating against delayed-onset diseases with multiple associated risk factors (the one "success" story, polio, is as full of caveats about the effectiveness of vaccination as it is of hope -- sanitation and public health played a much larger role in defeating that than Salk or Sabin). I write software for biotech and medicine. But I do the public health side of the data, not the virology side. But there's no money to be made in public health, and the reason these threads get so flameful (I think) is that a lot of us see billions of dollars being thrown at pharma when we haven't even been able to show that a pharmaceutical solution is possible. If the association between HPV and cervical cancer simply reflects underlying common risk factors, we'll be throwing all that money at nothing when we have techniques we know do work already.

[cynatnite]

42. Pap smears will not be scaled back...

women will continue to need yearly pap smears. Ask any doctor's office.

[GeorgeGist]

44. Since your post lacks any supporting evidence

for your claims or expertise, I assume you're an amateur scientist.

[nashville_brook]

45. $360 for Gardisil = 4 yearly exams. i think that's quite economical.

$360 according to Wikipedia, btw. http://en.wikipedia.org/wiki/Gardasil

my insurance pays about $100 for a well-woman visit. over the lifetime of a woman you will have 30 or 40 well woman exams if you go every year like you should (that's a big "if"). that's about $4,000.

the money is going to be spent on healthcare. the money is going to be spent on disease prevention. some of us would like the option of not winding up in cancer treatment, which costs a whole lot more than $360.

if you don't like the vaccine don't get one -- but let us make up our damn minds.

[AikidoSoul]

50. I agree with you. But let's not mandate it and have our tax dollars pay for it

Especially for such young girls whos immune and detoxification systems are underdeveloped.

This vaccine was not tested sufficiently on the population for whom it was targeted for the mandate -- very young girls.

[trotsky]

79. Say what?

young girls whos (sic) immune and detoxification systems are underdeveloped

Do you have any scientific data whatsoever to back this up? Is this somehow related to the "vaccines overwhelm babies' underdeveloped immune systems" falsehood?

[HuffleClaw]

46. so...

...you suspect HMOs will deny women pap smears based on whether they've had the vaccine? that would be typical of soulless corporate 'medical' care alright but i'd like to think they wouldn't ultimately be able to get away with such a thing.

[Richard Steele]

55. Yes. He thinks we should deny medical care to women on the grounds...

...that he's afraid someone, somewhere, someday MIGHT
deny medical care to women.

At least that's what he says TODAY.

YESTERDAY he was saying that it was gonna cost MILLION$$$
for every life it saves, and only SLUTS get cervical cancer anyway.

Can't wait to see what his "reason" is tomorrow.

[bettyellen]

56. fucking over the vaccine maker is all that matters to the OP, the "sluts" can die as

long as big pharma doesn't make a dime, i guess.

fuck that.

[AikidoSoul]

47. It's very difficult to opt-out of vaccines-- don't make it sound easy

I know families both here in Florida and in Georgia who did not want their children vaccinated, but to avoid it they had to tell officials that it was against their religion. They also had to fill out forms stating this. In some cases they were intimidated and asked inappropriate questions.

I just called one of the ladies who told me years ago about an official attempting to intimidate her with questions. She refreshed my memory. She said that one official became overbearing and demanded to know "what religion tells you you can't vaccinate your kids?"... and then, "we will need a letter from your pastor saying that this is so". These were bogus, illegal questions, and this lady can't be pushed around. She said she told the official that if he persisted that he could go with her before a judge to settle it.

Not everybody's as tough as my friend Linda.

There are many people in authority who would abuse their power to intimidate families.

For Linda --the refusal was not settled in that first year either. Over the years the officials bothered her and she was required to go the the FL Dept of Health, where she waited around for over an hour before they were given forms to fill out.

I've also heard from other families that one of the reasons they home school is so they won't have to have their kids vaccinated.

[AngryAmish]

77. Why don't they want to have their kids vaccinated?

[Nikki Stone1]

49. Having read your last thread and debunked both the mathematics and the "logic" of it

I see you have come back with a new angle. If I have the time, I'll smash your argument into pieces again.

[Junkdrawer]

53. Thanks. I said earlier that, for me, the PUBLIC POLICY decision...

of whether Gov. Perry's decision was justified or not would come down to a cost benefit analysis.

Perhaps this is why Gov. Perry short-circuited the usual legislative review process. :shrug:

PS: If GARDASIL came in at $200 per regimen, perhaps the numbers would be better. But then, Merck's profits would take a hit, and we can't have that..

[foo_bar]

59. so where's the cost benefit analysis?

I see the conclusion, but the "references" explaining any of the steps along the way are dismissed with "I can provide them", like a résumé. There's some mysterious figures rounded to the nearest hundred thousand, like the ones the Reagan white house provided to weaken OSHA regs (I remember the cutoff being $6M per human being in those days, but maybe that's proactive interference from The Six Million Dollar Man), then the OP dismisses the lack of external reference with a rhetorical fallacy:

If you don't believe me about this, just ask any responsible OB-GYN or medical model expert.

The key word being "responsible", as any responsible provider would surely agree with the OP, unless they work for Planned Parenthood or something.

[tammywammy]

58. I'm sorry you don't make sense

There are more than 4 strains of HPV. So, regardless of if you get the vaccine, you'll still need to be tested annually (or more) for it.

Also, the pap smear tests for more than just HPV, so just because you're vaccinated you'll still need to have one annually (or more).

[Lurking Dem]

60. The American College of Obstetrics and Gynecologists

added the vaccine to its Recommendations of Women's Health Screenings and Care in which they stated:

HPV Vaccine
An HPV vaccine was made available for the first time in 2006. ACOG recommends that HPV vaccination be offered to all girls and women 9 to 26 who have not previously been vaccinated. The vaccine protects against four HPV strains that cause most cervical cancers and genital warts and is most effective when administered before the onset of sexual activity.


2001 marked the 50th Anniversary of The American College of Obstetricians and Gynecologists (ACOG). Founded in 1951 in Chicago, Illinois, ACOG today has over 49,000 members and is the nation's leading group of professionals providing health care for women. Now based in Washington, DC, it is a private, voluntary, nonprofit membership organization.

ACOG works primarily in four areas:

o Serving as a strong advocate for quality health care for women.

o Maintaining the highest standards of clinical practice and continuing education for its members.

o Promoting patient education and stimulating patient understanding of and involvement in medical care.

o Increasing awareness among its members and the public of the changing issues facing women's health care.

[Mayberry Machiavelli]

61. Haven't you heard? All OB/GYN docs are in the pocket of big pharma, so disregard this.

:sarcasm:

[Lurking Dem]

63. Silly me.

I forgot myself there for a minute. *sigh*

[AngryOldDem]

62. This post will get the response it "deserves"...

...but I will say it anyway.

Horseshit. Nowhere has ANYONE said that the vaccine will replace annual exams and Pap smears. Sure, some people will construe it as doing just that, but at their own risk.

But I congratulate you though, on putting a new spin on this topic. Haven't heard the "no more Pap smears" line before.

EDIT: Spelling error

[pinto]

80. Locking.

Sorry, but this discussion has generated a number of personal attacks, accusations and personal sniping.

Maybe a revisit at another time, a little more civilly?

Thanks for your consideration.