HPV Vaccine Concerns

First of all, I’d like to welcome new readers who have come here for information on the Texas HPV vaccine law. I hope you’ll stick around. A few of you have made comments which have caused me to want to clarify my stance on the vaccine, as you have made very good points which I did not yet cover adequately. I have five main points of concern regarding the Merck vaccine and making it mandatory (even with opt out provisions):

1) Long-term effects data is not available
The vaccine in question has only been studied for a few years. This weekend I’ll compile a list of citations for studies on the vaccine, and summarize some of the adverse effect data. However, none of this data will reflect whether girls will have problems with the vaccine further down the road.

2) Consumers do not have a choice
Another HPV vaccine made by another pharmaceutical company is currently being tested. If you’re going to make the vaccine mandatory, why not wait until a second option is available and let patients make the choice?

3) HPV may not be an urgent or public health concern
Most other vaccines are for more readily transmittable infections, things you can catch through close contact or the air. HPV is not so readily transmissable. The “State” may not have as legitimate an interest in requiring this vaccine as it does in vaccines such as the MMR, so perhaps it should stay out of it.

4) Women do not have a choice.
The bodily autonomy argument is a difficult one. On one hand, the vaccine would be most effective if girls got it before they were sexually active, which for most people is going to mean while they are still minors and their parents are making medical decisions on their behalf. On the other hand, I’m not convinced that young girls should be forcefully subjected to something (by either parents or the State) for which long-term effects are not known.

5) The public is not receiving full disclosure of the interests of the legislators proposing these vaccine laws.
Several people have suggested that the Texas governor has financial ties to Merck. This should be something every parent is informed of. I did a search yesterday, and found the Merck political action committee had donated $5,000 to an organization supporting Perry’s election. I don’t want anyone’s health messed around with for the sake of money.

There are aspects of the vaccine I support. I think it’s a great idea when consumers have all available information. My own mother had cervical cancer, and her complaints were ignored by doctors until it was at a point where a hysterectomy was required. Growing up in the shadow of “I hope mom’s cancer doesn’t come back” tends to make you supportive of things that would prevent such cancers. Granted, cervical cancer is not the biggest killer of American women, but we don’t have a vaccine for heart disease or breast cancer yet. I do think this vaccine is an encouraging development for researchers who may want to look for other viral causes of cancer (and some researchers are currently looking at viral causes of breast cancer in mice). I think it’s a positive development, but that we may be jumping the gun when we start to require it. On the other hand, my understanding is that when the vaccines become mandatory, funds have to be allocated to provide the vaccine to people who could otherwise not afford this very expensive regimen, thus making protection available to more women. However, I think perhaps legislation could be passed to require funding without requiring vaccination for school entry.

It’s a complicated issue, and I thank those of you who were civil and thoughtful in your comments and emails.