Hey Texas girls! Don't want/need vaccinated against STDs? Too bad...

[Kweepa]

esper, it's been approved by the FDA:
http://en.wikipedia.org/wiki/Gardasil

[esper]

Vioxx has been too, but it's been at the helm of quite a few negligent death suits for Merck & Co.

http://www.pbs.org/wgbh/pages/frontline/shows/prescription/

Look further down at the explanation of the drug's testing phase. Nothing is known about it's long term effects yet, and it's not even a completely sure thing that it does any good... or doesn't do any harm, as it were.

[Raggit]

Man, now that the dust is settling I feel like a jerk.  (Note to self: Take breaks in between rapid responses.)

Going over the thread, it looks more of a fight than a debate, which is partly my fault.

I'm sorry if I acted like a prick to any of you.  (Especially Becky)


However, I still don't support this vaccine.   

[Snarky]

I'm assuming that the vaccine is effective and that the decision was not influenced by personal financial gain. But even if it was bought, I would consider the policy a Good Thing.

I like that the only other person besides me who actually has to worry about HPV is the only person I agree with here.

That hurts.  :'(

Let's talk about tetanus vaccinations. Ã, I'm not sure if tetanus vaccines are mandatory or not, but I wouldn't be as opposed to them if they were, simply because you can get infected with tetanus very easily.

Why does that matter? By your logic, shouldn't it be up to me to decide whether I'm at risk for tetanus?

And given that I don't think tetanus is particularly contagious (in 72 hours I won't have much opportunity to infect anyone anyway), it's not like there's a real public health concern, unlike with HPV.

You're going to be making a conscious decision to have sex, and should know the risks. Ã, 

Not if you get raped, you're not. Even if we ignore the other ways you can catch it.

Like Steve said, it's precisely because so many people are hysterical and irrational about anything to do with STDs that a vaccine like this should be made mandatory.

Now, I agree that taking some drug that is still in trials and injecting it into all girls in Texas might be moving a bit fast, but that's a separate issue. If we assume that the vaccine is safe and effective, and the price isn't insanely disproportionate to the good it will do, then this strikes me as an excellent policy.

[Pesty]

I'm assuming that the vaccine is effective and that the decision was not influenced by personal financial gain. But even if it was bought, I would consider the policy a Good Thing.

I like that the only other person besides me who actually has to worry about HPV is the only person I agree with here.

That hurts.Ã,  :'(

Let's talk about tetanus vaccinations. Ã, I'm not sure if tetanus vaccines are mandatory or not, but I wouldn't be as opposed to them if they were, simply because you can get infected with tetanus very easily.

Why does that matter? By your logic, shouldn't it be up to me to decide whether I'm at risk for tetanus?

And given that I don't think tetanus is particularly contagious (in 72 hours I won't have much opportunity to infect anyone anyway), it's not like there's a real public health concern, unlike with HPV.

You're going to be making a conscious decision to have sex, and should know the risks. Ã, 

Not if you get raped, you're not. Even if we ignore the other ways you can catch it.

Like Steve said, it's precisely because so many people are hysterical and irrational about anything to do with STDs that a vaccine like this should be made mandatory.

Now, I agree that taking some drug that is still in trials and injecting it into all girls in Texas might be moving a bit fast, but that's a separate issue. If we assume that the vaccine is safe and effective, and the price isn't insanely disproportionate to the good it will do, then this strikes me as an excellent policy.

Sorry, let me restate.

I like that the only other person besides me who actually has to worry about HPV is one of the only people I agree with here. I also agree with Snarky.

Better?

Also, Raggit, I still don't understand why you support mandatory tetanus vaccines and not mandatory HPV vaccines. If it's because it's untested, then that's a reasonable concern, but if it's just because one has strains that are sexually transmitted and the other isn't is a really bad reason not to support something that could potentially save many lives.

[Raggit]

Again, I don't know which vaccines are mandatory and which ones aren't.

However, one tetanus shot is only good for so long.  After you get poked and scratched enough, you need another one.  You're totally free to choose not to get that shot, and go ahead and take your chances with tetanus.

I guess the reason I'm more comfortable with giving kids mandatory shots for measles, small pox, meninigitis and so fourth is because many of those kinds of diseases are highly contaigious, transmissible through any kind of contact, not just sexual.

Again, it is my understanding that these most harmful kinds of HPVs are SEXUALLY TRANSMITTED, and therefore are only a high risk if you're sexually active with many partners.  That's what I'm basing my opinion off of here.

[Pesty]

Again, I don't know which vaccines are mandatory and which ones aren't.

However, one tetanus shot is only good for so long.Ã,  After you get poked and scratched enough, you need another one.Ã,  You're totally free to choose not to get that shot, and go ahead and take your chances with tetanus.

I guess the reason I'm more comfortable with giving kids mandatory shots for measles, small pox, meninigitis and so fourth is because many of those kinds of diseases are highly contaigious, transmissible through any kind of contact, not just sexual.

Again, it is my understanding that these most harmful kinds of HPVs are SEXUALLY TRANSMITTED, and therefore are only a high risk if you're sexually active with many partners.Ã,  That's what I'm basing my opinion off of here.

I'm sorry, I'm done with this debate then. I can't keep going around and around in circles with you about this. How many more times do I have to say "HPV IS NOT JUST AN STD. IT IS ALSO DANGEROUS TO PEOPLE WHO ARE NOT SEXUALLY ACTIVE." before you actually listen to me? If I were to be diagnosed with cervical cancer tomorrow from HPV, what would your argument be then?

I'll end this with saying that I think your reasoning is weak. It's okay when it's other diseases, but if it's something that can be related to sex, OH NO MANDATORY VACCINATIONS ARE WRONG?

[Snarky]

I guess the reason I'm more comfortable with giving kids mandatory shots for measles, small pox, meninigitis and so fourth is because many of those kinds of diseases are highly contaigious, transmissible through any kind of contact, not just sexual.

Again, it is my understanding that these most harmful kinds of HPVs are SEXUALLY TRANSMITTED, and therefore are only a high risk if you're sexually active with many partners.Ã,  That's what I'm basing my opinion off of here.

Well, you've convinced me. Let's only vaccinate those girls who might potentially have sex at some point in their lives.

[Shane 'ProgZmax' Stevens]

I think that if it works in much the same way as tetanus does, ie, prevents illness and death, then why should it be a problem that people are being given it? 

I agree that the circumstances surrounding the decision need to be investigated by some third party group, and the safety of the drug established.  If/when this is done, though, I see no problem at all with mandatory vaccinations, since parents typically don't even explain (or even understand in many cases) the many possible consequences of sex, and kids tend to be too naive to understand the implications.

Get those shots, womenfolk!

[Raggit]

Yes indeed, get those shots... but don't make them mandatory.

Like Pesty, I simply don't know what else to say. 

Yes, I am fully aware that there more strains of HPV that are not sexually transmitted.  I adressed that earlier.  Perhaps you missed it. 

I've attempted to make my stance as clear as possible, while evidently not doing a very good job. 

So in conclusion:

I think that any female who doesn't want to get these sexually transmitted HPVs should go get that shot as soon as possible.

Whenever the government takes one more step into the private lives of citizens, I oppose it.  Quit telling me that I MUST do this and THAT in order to be "safe."  I'll take responsibility for my own health, thank you very much.

[MillsJROSS]

Truly, I don't understand how there's an argument here. I don't see this as being that negative of a thing. However, I do agree that people should be given a choice. Moreover, people ARE given a choice. You just read an article, and are inflamed by it, but the things it doesn't mention, is that each state has to provide for a way to waive the use of a vaccine. People have the freedom not to take this vaccine if they want, assuming their intelligent enough to find out what paperwork needs to be filled. I have avoided many vaccines I "needed" to take this way. There is no way for them to force you to take anything, because they have to provde for religious and personal beliefs. So stop arguing about not having freedom, you do have freedom, you just have to sign shit for it.


-MillsJROSS

[EagerMind]

Look further down at the explanation of the drug's testing phase. Nothing is known about it's long term effects yet, and it's not even a completely sure thing that it does any good... or doesn't do any harm, as it were.

Ever here of phase 4 testing?

Phase IV trials involve the post-launch safety surveillance and ongoing technical support of a drug ... designed to detect any rare or long-term adverse effects over a much larger patient population and timescale than was possible during the initial clinical trials.

You might also find this interesting (quoted from this article):

The drug is also approved for use in Australia, New Zealand, Canada, and countries of the European Union ....

... A panel of experts, the Advisory Committee on Immunization Practices, gave their approval for the vaccination of Gardasil on children as young as 9 years old. The ACIP recommended that Gardasil be placed on the childhood immunization schedule at the 11 to 12 year old visit. They also recommended that the vaccine be included in the federal Vaccines for Children Program, which would provide the vaccines free of charge to children under the age of 18 who are uninsured.

Legislation has been introduced in the state of Michigan to require Gardasil. If passed, this would make them the first state to require that its school children be vaccinated.

Australia's government announced on 29 Nov 2006 that they will provide this vaccination to all 12-26 year-old girls in 2007. After two years, the program will be scaled down to 12-13 year old girls only. Australia also approved Gardasil for boys 9-15 years old, but Australia is not providing government funding for vaccinating boys.

To suggest that schoolgirls are being turned into guinea pigs for an untested and unapproved drug is just uninformed.

How about this (from this article)?

Of the more than 120 known HPV types, 37 are known to be transmitted through sexual contact. Infection with sexually transmitted HPVs is very common in adult populations worldwide.

Or this (from this article)?

Genital HPV infection is very common, with estimates suggesting that up to 75% of women will become infected with one or more of the sexually transmitted HPV types at some point during adulthood.

I think the case can be made that this is a rather widespread health issue. And I don't see why the fact that this disease is transmitted through sexual contact (as well as other ways) should have anything to do with whether vacciniation should be mandatory or not.

Perhaps you're upset that the Texas governor bypassed the state legislature through an executive order, or that it appears he's in Big Pharma's pockets? OK, that's valid. Then I encourage you to do something about it: contribute to foundations working for campaign finance reform, write letters to your local government representatives and encourage others to do so. There's one thing that influences politicians more than money: the fear of not being re-elected. "By the people, for the people" sounds all well and good, but it does require "the people" getting off their asses and making their will known.

[esper]

I used to bother with that crap. Then I experienced this firsthand:

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/01/11/INGHT44JFQ1.DTL

And I still don't care if they say it's ready or not, or if they say it's safe or not. The simple fact is that it is not fully tested. I return your interest to the link I posted earlier: http://www.pbs.org/wgbh/pages/frontline/shows/prescription/

What's the purpose of linking to the Phase IV article, that plainly says this:

Such adverse effects detected by Phase IV trials may result in the withdrawal or restriction of a drug - recent examples include cerivastatin (brand names Baycol and Lipobay), troglitazone (Rezulin) and rofecoxib (Vioxx).

Note that Vioxx was pulled AFTER several negligent death lawsuits!!!!

I bring your attention to this interview question with Paul Seligman, Director of the office of Drug Safety in the FDA:

What don't we know about a drug at the time it's approved?

There are a lot of things that we don't know about a drug at the time that it's approved. First of all, because of the limited number of people who were studied during the clinical trial phase, rare adverse events are often difficult to pick up during that phase.

For example, for a serious side effect that occurs once in every 10,000 prescriptions, if you have a clinical trial that only studies 350 individuals in three separate arms, it may be very difficult to understand or to pick out that piece of critical information.

Once a drug is marketed and used in tens [of thousands], hundreds of thousands, or even millions of individuals, it's more likely for that rare adverse event to occur.

There are also lots of other things that we don't know at the time a drug is approved. For example, it's hard to fully characterize the entire range of use of a particular medication, once it is on the market.

The general population is a complex one. People have many underlying illnesses. They use many different kinds of drugs. They have many different kinds of diets. They use different kinds of dietary supplements or herbal medicines. All of the potential interactions, underlying illnesses -- co-morbidities, as they are called -- can contribute to the underlying risk profile of the drug, and can result in an unintended or unpredicted adverse event. ...

[Snarky]

If adverse side effects are so rare that they don't show up in the trial phase, chances are that they're negligible compared to the number of lives the vaccine is going to save because they don't get cancer.

[EagerMind]

I used to bother with that crap. Then I experienced this firsthand:

So what did you do after that? Encourage others to do the same to show that the issue mattered to more people than just yourself? Organize a grass-roots campaign to get people to vote against him the next time he was up for election? Contribute to organizations and campaigns that supported the opposing viewpoint? Or just give up? In order to cause change, you need to make him care - by showing him that you can throw him out of office if he doesn't listen. No one claimed that this is easy.

And I still don't care if they say it's ready or not, or if they say it's safe or not.

So, if experts in the field aren't competent to decide this, then who is?

What's the purpose of linking to the Phase IV article, that plainly says this:

What Snarky said. Every new drug comes to market with the long-term side affects not clearly known, and Gardasil is no different. I don't see what your issue is with this particular drug being "untested."

Note that Vioxx was pulled AFTER several negligent death lawsuits!!!!

Yes, and there's more to the Vioxx case than "the drug got approved and then killed people." Merck may have misrepresented their test results in order to gain approval in the first place. This doesn't necessarily mean a fault in the system, only that Merck lied to get their drug approved.

[esper]

A) I don't mess with governmental affairs anymore. Before I left New England, I attended events for people who want to make a change starting in their community without bothering with writing to their uncaring congressperson. My brother tells me he's seen a community that's taken this so far they print and use their own paper money. Forget the government. They won't help. They don't care. Change needs to start in the people themselves, in the community.

as for B) check your own D). You've answered your own question.

C) My problem is that it's mandatory. But, since you can get out of it, simply by signing a waiver, that's not even really that big a deal. The main problem is all the people that will go along with it because it's mandatory, not thinking about being able to waive it, and having to spend... how much did you say? Up in the 300's? It's all a moneymaking scheme. And it doesn't affect me in any way, so I don't have anything more to say about it. I put up a bit of a fight, but in the long run I heartily agree with Becky and Snarky.

It's not a big issue, definitely not worth the argument, especially since it doesn't affect me. Nothing affects me, because I don't let it. I'm bothered that this is just a whole way for rich people to get even richer, but again: it has nothing to do with me. And if it did, alas: there are ways to get out of it. So...

Let it be...

And @ Snarky: I'm only joking now, so don't take offense, please...

The good of the many outweighs the good of the few.

[Tiki]

Let it be...

That would be Paul McCartney

[EagerMind]

Forget the government.

OK, fine, you're entitled to feel this way. I would only comment that if you choose not to play a part in the way you're governed or understand all the issues at play, then you really shouldn't complain when things don't go your way.

as for B) check your own D). You've answered your own question.

I don't really see how one refutes the other. Most systems fail when deliberate attempts are made to deceive it. If anything, I'd this this means you should avoid being an early-adopter until all the loose ends fall out - but I'd say this goes for anything. In the end, Vioxx still probably helped more people than it harmed. What's unfortunate is that, since Merck may have withheld information, it wasn't possible to avoid using the drug on people that may have reacted adversely to it. Certainly they should be held accountable for this and see if the system can be improved to prevent something like this in the future. But I'm not gonna throw out the baby with the bath water.

Let it be...

Fair enough (whoever may have said it!).

[LimpingFish]

I don't think people object to young women being vaccinated against the underlying cause of cervical cancer, nor to proactive action against any disease/STD/miscellaneous.

Things about this story that interest me:

1. The mandatory nature of the procedure.
2. The supposed links between Rick Perry and Merck, and Merck's history in general.
3. The seemingly arbritrary age bracket decided upon.
4. The nature of the pharmaceutical industry as a whole.

I don't quite agree with the "If it prevents this or that, I don't care about the motives" argument, anymore than I agree with the "Free will! Free Will!" argument.

Tap water in Ireland has flouride added to it at source, the result of a sixty year old government decision to proactively battle tooth decay among the lower classes. The only choice you have is whether you take it upon yourself to filter your tap water or not.

Flouride is a poison in large doses, with its detracters citing it as a possible link to increased chances of developing various bone disorders and even cancer.

I don't dispute the benefits of such treatments, but I can't ignore the flipside either.

And I have no choice in the matter, because my government has decided for me.

[Helm]

If adverse side effects are so rare that they don't show up in the trial phase, chances are that they're negligible compared to the number of lives the vaccine is going to save because they don't get cancer.

You keep making these utilitarian ethics statements in this thread... I don't know how seriously I should take them. Please tell me.