Texas governor mandates STD vaccine for all school age ...

Candi,

Yes, people do have different perspectives on this. Maybe I would feel differently if I actually did have HPV. However, HPV isn't the only virus or disease that causes cervical cancer. The makers of the vaccine even state this. In addition, most women who die from cervical cancer are Hispanics and other groups that typically don't receive regular screenings due to a lack of access to healthcare and education.

Marina
 
RE: Texas governor mandates STD vaccine for all school ...

>Well, everyone--thanks for the interesting and respectful
>discussion despite our differing opinions.
>
>If this vaccine does not cause undue negative side effects,
>then it will be another good vaccine to add to the list. My
>problem is that it has not been around long enough for us to
>know what the side effects may be and whether or not we think
>that those side effects are worth the risk.

I think it is important to note that Merck has been developing this vaccine for at least 10 years--not a LONG time--but it certainly is not something they just started 6 months ago.
>
>
>I am still troubled by the mandatory aspect. Should the
>government mandate that all girls 11 and over be injected with
>depo prevara to prevent teen-age pregnancy?

I don't think this is an accurate analogy as pregnancy--at least nowadays-- rarely results in death. This vaccine is to prevent the virus that can lead to CANCER.

I pretty much stated my opinions in last week's discussion on this topic but just wanted to add that there is a book out now entitled VACCINE by Arthur Allen. It has been positively reviewed by both the Wall Street Journal and the New York Times(so both right and left:) )It delves into the origins of vaccine and how public suspicion of vaccines in our contemporary lives could be very dangerous for everyone. He also spells out in full detail a point that I, and others, were trying to make last week that pharmaceutical companies absolutely do NOT "get rich" off of vaccines. In fact, more and more companies are not working on developing vaccines because it has become so cost prohibitive.
 
RE: Texas governor mandates STD vaccine for all school ...

Let me preface this by stating that these are my thoughts based on what I've found on genital HPV and the vaccine. I encourage parents and women considering the vaccine to research.

As a parent, I am undeided about this vaccine. If my DD remains chaste (no genital activity) until marriage, what are the chances she will marry a man with the same history? HPV testing is limited to females and specific strains, so this isn't something to test for before beginning an intimate relationship. Condoms reduce transmission of HPV but protection is limited (NEJM).

With that said, I also consider the potential benefits of this vaccine to public health. Mandatory vaccinations for school are established to protect students from diseases transmitted through casual contact (sneezing, touching). Genital HPV is primarily sexually transmitted (through genital contact), although non-sexual transmission is possible. However, genital HPV is a concern in public health with as many as 80 percent of women infected with genital HPV by the age of 50. Thankfully, most genital HPV goes away on its own (~90%). There is also the cost-benefit to consider. The treatment alone for genital "HPV infection in 15-24 y/o females, including follow-up for abnormal screenings, is estimated at ~$3 billion per year". I am eager to see an analysis. But, mandating this vaccine is premature IMO, which even the American Academy of Pediatrics agrees with a go-slow approach.

I support voluntary vaccinations. The vaccine is promising. It may prevent cervical cancer, abnormal paps, genital warts (~1 million new cases/year). "The real benefits of this are going to be cancer reduction globally, but, in the U.S., it's going to be its effects on abnormal Pap smears," Columbia University pathologist Thomas Wright said. Though fewer than 10,000 women in the USA will be diagnosed with cervical cancer this year, at least 600,000 will be found to have cervical pre-cancers, and about 60% of those are caused by the two cancer-causing HPV types targeted by Gardasil, Wright said. Abnormal Pap smears then lead to more tests and procedures.” USA Today.

If parents review the evidence and want their child vaccinated, I support that. It is mandating I oppose for a few reasons. The HPV vaccine is ~5 years old. Perhaps my status as a DES daugther has left me cautious. :) The vaccine has not been proven to prevent cervical cancer, which takes 10-15 years to develop once abnormal cells begin. Even the FDA notes "the study period was not long enough for cervical cancer to develop, the prevention of these cervical precancerous lesions is believed highly likely to result in the prevention of those cancers". It is believed to prevent cancer based on what is "known" about genital HPV and cervical cancer. For what it is worth, HPV is linked to cervical cancer (99.7%) and most experts consider it the cause/necessary for cervical cancer development although no direct link has been shown. “The finding of HPV viral DNA integrated in the majority of cellular genomes of invasive cervical carcinomas supports epidemiologic data linking this agent to cervical cancer; however, direct causation has not been demonstrated.” cancer.gov

There are so many factors to consider that I remain undecided about voluntary vaccination, who is only 6, but mandating this vaccine may be premature IMHO. Let me add, my humble opinion may change as evidence becomes available. :)

Sources:
http://www.fda.gov/bbs/topics/NEWS/2006/NEW01385.html
http://www.cancer.gov/cancertopics/pdq/prevention/cervical/healthprofessional/allpages
http://www.usatoday.com/news/health/2006-06-08-cervical-cancer-vaccine_x.htm
http://www.ashastd.org/learn/learn_hpv.cfm
http://www.cdc.gov/std/HPV/default.htm
http://www.thehpvtest.com/
http://content.nejm.org/cgi/content/full/354/25/2645

Walboomers JM, Jacobs MV, Manos MM, Bosch FX, et al. Human Papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology 1999; 189: 12-19
 
RE: Texas governor mandates STD vaccine for all school ...

Autumn,

Thanks for your educated comments!

My gyno told me that HPV is contracted only through sexual transmission.
 
RE: Texas governor mandates STD vaccine for all school ...

Wow.. great info here. Thanks! I had no clue how many women were infected with HPV and how easy it is to get infected. Love my twice yearly paps! Still think women should have the right to chose if they want the vaccine or would like to wait till there is more research done.
 
RE: Texas governor mandates STD vaccine for all school ...

Candi,

<<My gyno told me that HPV is contracted only through sexual transmission.>>

This topic is controversial. Genital HPV is primarily sexaully transmitted. There are unexplained cases.

"There is no evidence that contaminated toilet seats, doorknobs, towels, soaps, swimming pools or hot tubs, can transmit HPV. However, some unexplained cases of HPV lesions do occur and one should never rule out the possibility that an HPV infection may have been caught in a non-sexual event". http://cme.asccp.org/faq/histHPV.cfm#8

There are studies that suggest various routes of transmission, but I don't want to link these and cause anxiety based on suggested routes of transmission. If anyone is interested, pm me.

Autumn
 
>Candi,
>
>Yes, people do have different perspectives on this. Maybe I
>would feel differently if I actually did have HPV. However,
>HPV isn't the only virus or disease that causes cervical
>cancer. The makers of the vaccine even state this. In
>addition, most women who die from cervical cancer are
>Hispanics and other groups that typically don't receive
>regular screenings due to a lack of access to healthcare and
>education.
>
>Marina

Which is why a mandate would reach these people. They could not start school without the vaccine. Schools set up free clinics for giving of mandatory vaccinations, so they would get the vaccine free of charge.
 
RE: Texas governor mandates STD vaccine for all school ...

The HPV vaccine is ~5 years old.


Autumn...I am wondering where you got this information? Doing an, admittedly, simple search I can find the independent researchers who isolated certain components of this drug at Georgetown began their work in 1982 and made huge strides around 1992. As for Merck, I found their involvement in actual studies to begin in 1997.

Please understand that I am in no way trying to be argumentative, I just really want to try to find the correct answer to this question.:)
 
RE: Texas governor mandates STD vaccine for all school ...

<<Autumn...I am wondering where you got this information? Doing an, admittedly, simple search I can find the independent researchers who isolated certain components of this drug at Georgetown began their work in 1982 and made huge strides around 1992. As for Merck, I found their involvement in actual studies to begin in 1997.

Please understand that I am in no way trying to be argumentative, I just really want to try to find the correct answer to this question.:)>>

I do understand and do not see your statement as argumentative.

I should have been more specific in my statement and for that I apologize. I am specifically referring to the Gardasil Vaccine (quadrivalent vaccine) and when it was given to humans to evaluate effectiveness (Phase 2 & 3) and safety. I couldn't remember the exact date clinical trials began
http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4222B3.pdf
http://www.fda.gov/cber/label/hpvmer060806LB.pdf
 
RE: Texas governor mandates STD vaccine for all school ...

I have hpv, probably got it a very long time ago and never knew it. I had precancerous cells on my cervex about 15 yrs ago and had to get numerous painful biopsies, freezings and a lazer coning. Because of this my cervix was thinned out. When I became pregnant I had a miscarriage in my 3rd month, possibly due to my weak cervix. When I became pregnant again I had to get a cerclage around 20 weeks and went into preterm labor at 27 weeks. My daughter was born at 30 weeks, a premee, and had to be hospitalized for 5 weeks. She is fine now and so am I. She won't have any brothers or sisters because I now barely even have a cervix. They say I could get pregnant and get an abdominal cerclage but if I go into preterm labor again, which is likely, they would not be able to stop it and would have to deliver right away or my uterous could explode. Yikes, I don't think so...... Bottom line, when my daughter is old enough I want her to get this vacine.
 
RE: Texas governor mandates STD vaccine for all school ...

I am sorry for your loss and that you have been through this. I know many, many stories similar to your story and hope no woman ever has to share your experience. So much focus is on preventing cervical cancer, but genital HPV can cause health problems long before cervical cancer develops. It is important for people to understand gential HPV beyond cervical cancer. I don't blame you for wanting to vaccinate your DD, and my hope is that this vaccine proves to provide protection from genital HPV and cervical cancer.
 
RE: Texas governor mandates STD vaccine for all school ...

Autumn I always appreciate your comments. I'm emailing you (if that doesn't work I'll PM you - thanks:7 )

Briee
 
Doctors who don't support mandating

It looks like the Texas Medical Assocation doesn't support this for some of the reasons cited by some of us including newness.

http://www.chron.com/disp/story.mpl/front/4532274.html

...Other reasons cited by doctors in Texas and across the country include the vaccine's newness; supply and distribution considerations; the possibility opposition could snowball and lead to a reduction in other immunizations; the possibility it could lull women into not going for still-necessary cervical cancer screenings; gender-equity issues; and the tradition of vaccines starting as voluntary and becoming mandatory after a need is demonstrated.

The article also reports this:
The 60,000-member AAP circulated a statement last week that lays out many concerns about a mandate. The statement, written before Perry's order, notes that 24 states and the District of Columbia have introduced or prefiled legislation requiring adolescent girls to get the vaccine.

Among the statement's points is that mandating a vaccine for a disease not spread by casual or occupational contact — and currently only available to one gender — represents a departure from past practice. Such school immunization requirements came into existence, it says, to protect schoolchildren from outbreaks of contagious disease in that setting, not to compel vaccination. (The quickest a vaccine has gone from approval to mandatory in Texas was the chickenpox vaccine, which took 5 1/2 years.)
 

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