Monday, February 19, 2007

A Breakthrough Drug, But Only For Women

The human papillomavirus (HPV) vaccine is a breakthrough drug because it dramatically reduces the odds of women getting deadly cervical cancer.

Some 20 states are considering or have adopted mandatory programs for middle school-aged girls to be vaccinated against HPV, although most are allowing opt-out provisions for parents who do not want their daughters inoculated.

Texas Governor Rick Perry's recent decision to require 11- and 12-year-old girls to be vaccinated has ignited a firestorm of controversy among conservative religious and sexual abstinence advocacy groups who claim the vaccine -- marketed as Gardasil by Merck & Co. -- will encourage young girls to have sex.

Civil liberties and anti-vaccine groups also have spoken out because of concerns that Gardasil is being forced on girls and is being introduced too quickly with little real-world experience beyond clinical trials.

Additionally, there are concerns about the expense of the vaccine – About $360 for a three-shot course -- and whether girls from poor families will be able to avail themselves of the drug.

But lost in the debate is a huge question:

If Gardasil is so good at pushing back against the epidemic of sexually transmitted infections and diseases, why not give it to males as well?

HPV is not even casually contagious, but German measles, measles, mumps and chicken pox are, and both females and males are routinely immunized because inoculating everyone is the only way to suppress and eliminate those diseases.

There is no question that girls and women are at much higher risk for HPV and other sexually transmitted infections, especially when they have been raped or sexually assaulted, which puts the lie to the arguments of conservative religious and abstinence groups that HPV merely is a “lifestyle disease” and it’s your own tough luck if you become infected.

There also is no question that the vaccine is very effective: 89 percent effective in preventing HPV infection and 100 percent effective in preventing cervical cancer and genital warts, according to a study published in the journal Lancet Oncology. Allergic reactions to the vaccine appear to be mild and fairly rare.

And there is no question that Gardasil is a goldmine for Merck and soon will be for GlaxoSmithKline, which will introduce a similar vaccine into what is seen as a $5 billion market.

Merck has aggressively lobbied women’s groups and state legislatures to promote Gardasil, which it claims can only be administered to girls and women ages 9 t0 26, andis airing touchy-feely mother-daughter TV commercials touting Gardasil as a must have.

But why stop at vaccinating only half of the at-risk population?

At least 50 percent of sexually active people – female and male -- get HPV at some time in their lives and when the age group most vulnerable are people of both sexes in their late teens and early 20s.

Yes, 70 percent of females who get cervical cancer have been infected with HPV, but males don’t get a go-free card. Although cancers of the penis and anus are comparatively rare, a large percentage of the victims of those cancers are infected with HPV. The virus also can cause cancers of the brain and neck.

Women usually bear the brunt of making birth-control decisions and too often have been marginalized when it comes to breakthrough drugs, so Gardasil is a welcome exception.

But if the vaccine was only being offered to males, feminists would be in an uproar. As it is, there is much to be concerned about when the marketing prowess of a major pharmaceutical company is driving public-health policy.

(Please see the next post for links to articles and info on the vaccine.)


Anonymous said...

Have patience. I know for a fact that Merck, the maker of Gardasil is conducting trials in both men and women over 26. It should be given FDA approval for both of these groups within the next 18-24 months.

Shaun Mullen said...

That would seem to be good news, but it doesn't change my larger point:

Public-health policy is being determined through aggressive pharmaceutical company lobbying and advertising campaigns and that is wrong.

Melissa said...

Great post. I agree with you entirely. I would just like to add one suggestion, that the vaccine be offered to other than young women. I'm 50, HPV negative and would like to stay that way.

Christine said...

I'm sorry to say, but I simply can't trust such vaccines anymore. I prefer white panther than a vaccine that is supposed to protect women from some type of cancer. I have read many articles about how the FDA got bribed on numerous occasions to approve unsafe drugs and vaccines.