For those interested in the facts about cervical cancer and Gardisil

[Horse with no Name]

The inflammatory rhetoric that keeps rearing its head from RW sites is very frustrating.
What has to be kept in perspective...is that ANYTIME we talk about women's reproductive choices...it has to remain exactly that.
A choice. In the case of New Hampshire and South Dakota, they are making it easy. In the case of Texas, not so easy.
Mandatory means nothing except that every women who wants the vaccine can get it. Those that don't can simply opt out.
I don't know why this is hard to understand.
I would not entertain the thought that "I" should tell every woman to get the vaccine or force any parent to vaccinate their child against their will. I doubt anyone who is pro-vaccine will.
I take Rick Perry completely out of the equation. He is a scumbag.

As the data below clearly shows:

HPV-->minority women-->minority women under 18
Poverty-->minority women-->minority women under 18

However, Planned Parenthood (an organization that has protected woman for years) is for this vaccine:

http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/HPV-Immunization.htm
>>>>snip
New York, NY — Planned Parenthood Federation of America (PPFA) today urged the Advisory Committee on Immunization Practices (ACIP) to recommend widespread human papilloma virus (HPV) immunization as the path toward eradicating cervical cancer in future generations. PPFA encouraged ACIP to recommend that girls 11 to 12 years of age be vaccinated and that all young women up to age 26 should also be immunized. To ensure that the HPV vaccine will be widely accessible, PPFA asked that the HPV vaccine be included in the Vaccine for Children program. Following is the PPFA statement presented to ACIP today by Emily Stewart, PPFA Regulatory and Policy Analyst.

Remarks of Emily Stewart, Regulatory and Policy Analyst
Before the Advisory Committee on Immunization Practices (ACIP)
June 29, 2006

It is an honor and a pleasure to represent Planned Parenthood Federation of America, Inc. during this meeting where decisions will be made about who will be able to access the first vaccine to prevent cervical cancer and external genital warts. My remarks incorporate the comments of Dr. Vanessa Cullins, Vice President for Medical Affairs and Dr. Jeffery Waldman, Senior Medical Director for PPFA, both of whom regret that they are unable to attend.

As you are aware, the HPV vaccine-coupled with cervical cancer screening programs, early detection, and treatment-has enormous potential to impact public health. This potential can only be realized if those who need the vaccine are provided access to it. We recognize that enabling easy access to the HPV vaccine is no small feat, but we draw your attention to those immunization strategies that have had the greatest success — that is, those strategies that allow for herd immunity and are executed through a strategy of vaccination of all (such as smallpox), or those that are have been made a prerequisite for school admission. Access to the vaccine should be a public health priority.

Given the high cost of the HPV vaccine-at approximately $360 for the series, it is the most expensive vaccine ever-recommending routine immunization is critical to making the vaccine accessible. By doing so, you ensure coverage by private health insurers and government vaccination programs. In this vein, we strongly encourage you to include the HPV vaccine in the Vaccines for Children (VFC) Program. Under VFC, the HPV vaccine should be made available to all previously unvaccinated youth from 11 through 18 years of age.
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The World Health Organization approves the vaccine and puts forth some pretty grim statistics. Worldwide, they state that HALF A MILLION WOMEN A YEAR DEVELOP CERVICAL CANCER and HALF of those DIE.
That is 250,000 women A YEAR that will die of cervical cancer. That is an incredible number of women who will die from this disease.
http://www.who.int/bulletin/volumes/85/2/07-020207/en/index.html
>>>>>snip
As of the end of 2006, the vaccine had been approved in 49 countries worldwide, with more expected to join the list this year. The quadrivalent vaccine gives 100% protection against infection from HPV types 16 and 18, which are responsible for around 70% of all cervical cancers. It also protects against HPV types 6 and 11 that cause genital warts. GlaxoSmithKline Biologicals applied to the European Agency for the Evaluation of Medicinal Products for international regulatory approval in March 2006 to market its bivalent vaccine Cervarix for HPV types 16 and 18.

"There are challenges for countries in terms of cost and so on, but this vaccine is unique and offers tremendous possibilities."
Dr Teresa Aguado, WHO’s coordinator for the Initiative for Vaccine Research, Product Research and Development team.

Meanwhile, the World Health Organization (WHO) has been developing information that countries can use to formulate their policies on HPV vaccination.

“Vaccines have been tested in North America, Latin America, Europe, to some extent in Asia, but not in Africa yet,” said Dr Teresa Aguado, WHO’s coordinator for the Initiative for Vaccine Research, Product Research and Development team.
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http://www.aap.org/advocacy/releases/jan07immsch.htm
>>>>snip
CHICAGO - The American Academy of Pediatrics (AAP) has issued the recommended 2007 childhood immunization schedule for the United States. The statement was approved by the AAP, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP).

The 2007 schedule includes the following major changes:

* Oral rotavirus vaccine for universal administration to all infants at 2, 4, and 6 months of age.
* Universal administration of a second dose of varicella vaccine at 4 to 6 years of age.
* The age range for universal annual administration of influenza vaccine has been expanded to children 6 to 59 months of age and those in close contact with children 0 to 59 months of age.
* Human papillomavirus vaccine (HPV) for girls 11 to 12 years of age, including catch-up immunization of girls 13 to 18 years of age. This vaccine prevents most cases of cervical cancer and genital warts, (AAP’s formal recommendation for HPV vaccine to be released soon.)
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Speaking of the incidence of HPV in minority women:
http://www.4woman.gov/minority/hispanicamerican/cc.cfm
>>>snip
Hispanic/Latina women have the highest rates of new cases of cervical cancer and the second highest death rate from cervical cancer (behind African American women). In fact, Hispanic/Latina women are about one and a half times as likely as White women to die from cervical cancer. One reason for this is that Hispanic/Latina women have low rates of Pap testing. It is thought that as many as 80 percent of these deaths could be prevented by regular Pap screening and patient follow-up. There are things you can do to reduce your risk. Limit your sex partners and always use latex condoms.

Almost all cervical cancers are caused by two types of human papillomavirus (HPV), a common virus that is spread through sex. Other types of HPV can cause genital warts. Many types of HPV do not cause problems at all. HPV can’t be cured, but you can talk about treatment options with your doctor if abnormal cells grow.
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Speaking of Texas population and the increasing "minority" population:
http://www.hhsc.state.tx.us/research/dssi/PopStats/ProjectionsTX_GenderRace.html
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Speaking of poverty:
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/002484.html
Overview

* The number of people below the official poverty thresholds numbered 35.9 million in 2003, or 1.3 million more than in 2002, for a 2003 poverty rate of 12.5 percent. Although up from 2002, this rate is below the average of the 1980s and 1990s.
* The poverty rate and number of families in poverty increased from 9.6 percent and 7.2 million in 2002 to 10.0 percent and 7.6 million in 2003. The corresponding numbers for unrelated individuals in poverty in 2003 were 20.4 percent and 9.7 million (not different from 2002).
* As defined by the Office of Management and Budget and updated for inflation using the Consumer Price Index, the average poverty threshold for a family of four in 2003 was $18,810; for a family of three, $14,680; for a family of two, $12,015; and for unrelated individuals, $9,393.

Race and Hispanic Origin

* In 2003, among people who reported a single race, the poverty rate for non-Hispanic whites was 8.2 percent, unchanged from 2002. Although non-Hispanic whites had a lower poverty rate than other racial groups, they accounted for 44 percent of the people in poverty.
* For blacks, neither the poverty rate nor the number in poverty changed between 2002 and 2003. People who reported black as their only race, for example, had a poverty rate of 24.4 percent in 2003.
* Among those who indicated Asian as their only race, 11.8 percent were in poverty in 2003, up from 10.1 percent in 2002. The number in poverty also rose, from 1.2 million to 1.4 million. For the population that reported Asian, regardless of whether they also reported another race, the rate and the number increased to 11.8 percent and 1.5 million.
* Among Hispanics, the poverty rate remained unchanged, at 22.5 percent in 2003, while the number in poverty increased from 8.6 million in 2002 to 9.1 million in 2003.
* The poverty rate of American Indians and Alaska natives did not change when comparing two-year averages for 2001-2002 and 2002-2003.
* The three-year average poverty rate for people who reported American Indian and Alaska native as their only race (23.2 percent) was not different from the rates for blacks or Hispanics. It was higher than the rate for non-Hispanic whites who reported only one race. The three-year average poverty rate for people who reported American Indian and Alaska native, regardless of whether they also reported another race (20.0 percent), was lower than the rates for blacks or Hispanics and higher than the rate for non-Hispanic whites who reported only one race.

Age

* For all children under 18, the poverty rate increased from 16.7 percent in 2002 to 17.6 percent in 2003. The number in poverty rose, from 12.1 million to 12.9 million.
* Neither people 18 to 64 years old nor those age 65 and over experienced a change in their poverty rate, 10.8 percent and 10.2 percent in 2003, respectively.

States

* The poverty rate for Arkansas (18.5 percent) — although not different from the rates for New Mexico, Mississippi, Louisiana, West Virginia and the District of Columbia — was higher than the rates for the other 45 states when comparing three-year average poverty rates for 2001 to 2003. Conversely, New Hampshire’s rate (6.0 percent) — though not different from the rate for Minnesota — was lower than those of the other 48 states and the District of Columbia.
* Seven states — Illinois, Michigan, Nevada, North Carolina, South Dakota, Texas and Virginia — showed increases in their poverty rates based on two-year moving averages (2001-2002 and 2002-2003), while two states — Mississippi and North Dakota — showed decreases.

[Katherine Brengle]

1. Thank you for taking the time to do that --

hopefully many DUers will take the time to look at it.

[Horse with no Name]

2. I don't hold a lot of hope out there

and Thank you.

[Lisa0825]

3. K&R

Thanks, though I doubt it will get through the noise.

[Lurking Dem]

4. kick

[The Cleaner]

5. Lots of double talk; not much sense-making.

So you're essentially saying it's mandatory but it's not. That's like telling a prisoner you have to stay in your cell, but you really don't. Mixed messages? You bet.

Sure you can opt out. But as a few of us pointed out yesterday, it's NOT EASY. You have to request an AFFADAVIT form be sent to you through the mail. You can do this through the internet. Then you have to fill out the form for every child, make an appointment with a notary public, get it notarized, then send it back for approval. Will they simply approve without further hassle? Will they call you up to clarify and THEN approve after a board reviews it? Most likely.

Stop making opting out sound fun and easy. Furthermore how many poor have access to the internet. How many have a permanent address. How many have access to a notary public, where to find one, or even what the hay a notary public is to begin with. They have NO RECOURSE, and thus are forced into taking this vaccine. The poor become guniea pigs.

Surprising that so many Dems are in favor of a state governor making a dictatorial decision over and above the democratic process - votes, the will of the people, you know - that sort of thing.

[Orangepeel]

8. it is more like telling someone in the path of a storm that they have to evacuate

when there is a mandatory evacuation, it means that the shelters are open, that rescue personnel are available to help you leave, that you don't have to go to work, and that the state won't take any responsibility for your safety if you don't heed the order. It doesn't mean that you'll be arrested if you don't go.

[Nikki Stone1]

18. Good post

...

[Horse with no Name]

16. Big fucking deal.

They are scheduling the immunization around other MANDATORY vaccinations to make it easy.
And...the people screeching the loudest about it will be calling their representatives, marching in the streets, yowling on message boards, etc.
Why not just avoid the drama and sign the fucking form?
Nobody is forcing you or anyone you love to do anything you don't want to do.

[The Cleaner]

26. Nobody is forcing me? Oh yes they are! That's why Rick Perry has made Gardasil MANDATORY!

You seem to not understand the meaning of "mandatory." That means FORCED. It means you have no CHOICE. It means if you want to opt-out, you have to file an AFFIDAVIT which is not easy, particularly for underpriveliged folks.

A choice would not be mandatory now, would it? A choice would be opt-IN, not opt-out. Washington State is doing this. Texas doesn't have to be made mandatory, but Rick Perry has struck a special deal with Merck.

Man, I wish more people could see this. Why can't they?
:shrug:

[mondo joe]

29. Opt out is a choice.

And you have NO IDEA how hard or easy it is.

[Richard Steele]

31. Thank you for keeping this thread kicked.

:hi:

[Horse with no Name]

32. Because we are not stupid?

Mandatory means nothing other than it will be paid for.
Why do you want to make it something that it is not?
Nobody is going to hold you down to force an injection you do not want.
The rest is just hyperbole.

[Morgana LaFey]

41. Hey, relax. It's ONLY females, and their bodies -- nothing important

you understand.

Who cares if it's "discovered" several years or decades down the road that it is harmful after all, in the LONG run? Who cares that there was once thalidimide, and DES, and "perfectly safe, no scientific evidence of harm" silicon breast implants. Not all that important.

What's IMPORTANT is profits NOW, dammit.

I find this total blindness and callous indifference to the implications of MANDATORY vaccines for girl children being promoted by the pharmacy company producing it absolutely, positively disgusting and nauseating. And very, very frightening.

DO NOT TURN OUR BODIES OVER TO YOUR FASCIST OVERLORDS, DAMMIT.

[Horse with no Name]

46. I GUARANTEE that I do more for women's health than you do

I fucking guarantee it.
My job works with AND I have volunteered with Planned Parenthood for years.
So STFU with your ignorant-ass rantings that I don't give a shit about women.
After all...the ones who don't want women to get something that could benefit them greatly are actually the stealth women-haters.
So fuck your ignorant statement.

[Morgana LaFey]

49. And to you as well

I don't give a shit HOW much you think you do for women's health, if you're irresponsibly -- YES, IRRESPONSIBLY -- promoting inadequately tested vaccines on anybody but esp. very, very young females, then you need to learn a thing or two about woman-hating AND a LOT about the pharmaceutical industry.

Nice potty mouth, too. Makes you sound quite the humanitarian. Oh yes, it does.

I guarantee you there WILL be harm for some of these young girls IF this mandate goes forward. I guarantee it. I'll remember some of the DUers' names who were on it as virtual co-sponsor, too.

[Horse with no Name]

50. I'll take that responsibility

If you take responsibility for ALL of the young women that contract HPV and cervical cancer.

[Morgana LaFey]

58. Of course not -- don't be ridiculous

For a bunch of reasons:

* The vaccine isn't a CURE,
* Even Merck doesn't know when its efficacy runs out,
* It still doesn't preclude the absolute necessity of yearly pap smears since
* The vaccine doesn't kill all HPV virus strains that can cause cervical cancer, and
* The vaccine doesn't prevent all other forms of cervical cancer.

(Hmm, given the FACTS, it doesen't sound like such a great deal, does it?)

Get real.

[Richard Steele]

6. Kicked and recommended.

[antigop]

7. McCown: Governor's HPV order is unconstitutional

http://www.statesman.com/search/content/region/legislature/stories/02/07/7mccown_edit_rs.html

>>
>>
Under the state constitution, the governor administers the law; the governor doesn't make the law. This principle is textbook civics. Making law is for the Legislature.

With this principle so clear, how can the governor possibly claim the authority to require vaccinations? Well, when the Legislature passes a law, it cannot think of every detail, particularly in our increasingly complex world. To deal with the details, the Legislature often authorizes a state agency to adopt rules. So, in his executive order, the governor hasn't actually required vaccinations; rather, he has ordered a state agency to write a rule requiring vaccinations.

Rules, however, must be consistent with state law and must implement, not expand, the law. To ensure that rules comply with the law, the Legislature requires a state agency to go through a careful process of evaluating its legal authority before adopting a rule. In addition, to ensure that a rule is wise, the Legislature requires a state agency to give the public notice of any proposed rule, give the public a chance to comment, consider the public's comments and provide a written justification for the final rule.
>>

Now are we going to stand up for democratic principles or not?

[Richard Steele]

19. Thank you for keeping this thread kicked.

[antigop]

9. Sen. Robert Duncan (R-Lubbock) questions governor's authority to issue exec order that changes law

http://www.gosanangelo.com/news/2007/feb/11/perry-move-draws-outrage

>>
“There’s some question about the governor’s authority to issue an executive order that changes law and appropriates funds,” Duncan said last week. “That is constitutionally a legislative function.”
>>

WoW! We have to depend upon Republicans to stick up for our democratic principles.

[Horse with no Name]

14. You can depend on them

I sure as hell won't.

[Richard Steele]

51. Hey, you kicked this thread and I missed it!

I must be slippin in my old age.

Thank you for keeping this thread kicked! :patriot:

[antigop]

10. Lawyers say Perry had no authority to order vaccinations

http://www.statesman.com/search/content/shared/partners/Special_Edition/stories/2007/02/TEXAS_ORDERS_0208_COX.html

>>
>>
Buck Wood, a lawyer whose career included time in Gov. John Connally's office in the 1960s, disagreed, saying: "This isn't even arguable. The governor doesn't have any power to dictate to any agency about what rules it makes."

Scott McCown, who served 14 years as a Democratic state district judge in Travis County, aired similar concerns. While state law permits governors to issue orders in emergencies, he said, Perry's desire to protect young women doesn't clear that hurdle.

"It's a judgment call," said McCown, who initially commented in a column in Wednesday's Austin American-Statesman. "But there is no way this is even close. There is no way this even qualifies" as an emergency.
>>

Either we have (and stand for) democratic principles or we don't.

[Richard Steele]

22. Thank you for keeping this thread kicked.

[antigop]

11. Sen. Jane Nelson asks Perry to rescind vaccine order [issue needs debate]

http://www.news8austin.com/content/legislature_2007/stories/?SecID=561&ArID=178751


>
“This is not an emergency. It needs to be discussed and debated,'' Nelson said.
>

WOW!...Go, Jane! How pathetic is this that we have to depend upon a Republican to defend democratic principles?

[Richard Steele]

23. Thank you for keeping this thread kicked.

[antigop]

12. Twenty-six senators from both parties signed letter asking Perry to withdraw

http://www.news8austin.com/content/headlines/?ArID=178886&SecID=2

>
Twenty-six senators from both parties even signed a letter asking
Perry to withdraw the order.
>

WoW! It's a sad day when I have to root for the Texas lege to come through for us.

Subversion of democratic principles needs to be contested.

[Richard Steele]

33. Thank you for keeping this thread kicked.

[antigop]

13. For those interested in democratic principles....

Texans should scream over what Perry has done.

Since when should a governor, without input/debate/vote from the state legislature be allowed to dictate health policy in a state? Since when?

How hypocritical that people who post on Democratic Underground (that's Democratic) are OK with subverting democratic principles.

Oh, the hypocrisy!

[Horse with no Name]

15. Yeah whatever.

It's not "hypocrisy" I am seeing...and I won't say what it is.
But your "concern" has been duly noted.:eyes:

[antigop]

21. People should be screaming about this -- not "duly noting" it n/t

[The Cleaner]

27. It is a very valid concern. Why do you keep avoiding it?

Because maybe it confuses you that you are supporting a position that is inherently anti-democratic?

[antigop]

36. Because they can't address it n/t

[mondo joe]

28. There's only one question: is it within his authority to do so or not?

If it is within his authority, that has been democratically determined.

If not, his decision can't stand.

[Richard Steele]

34. Thank you for keeping this thread kicked.

[Morgana LaFey]

43. Not just dicatate health policy, but do it at the behest of MERCK!

It's corporate welfare at best,fascism at worst.

The people making these decisions -- or at the very least pushing for this if it's such a damn good idea -- is the totally nonpartisan public health officials. No damn governor ought to make this decision on his own, thanks to the pharmaceutical who produced it and the lobbying by his own former chief of staff who is now their lobbyist.

That alone makes it something that needs much greater scrutiny, people. What is the MATTER with DUers on this??

[Nikki Stone1]

17. THANKS AND RECOMMEND

The hysterical propagandist is at it again this morning. He doesn't care that his math is all wrong and that his logic is flawed.

[antigop]

20. Either we have democratic principles that we stand for or we don't. This is DU.

The DEMOCRATIC Underground.

It's that simple.

[mondo joe]

30. Does the democratically determined state constitution give the executive

the authority to do this or not?

[antigop]

37. Go read the articles posted n/t

[mondo joe]

38. Simplle question - does the state constitution give the executive

this authority or not?

[antigop]

40. The answer is in the articles posted --- READ THEM!

If you don't see the danger of having a governor unilaterally dictate health policy in a state, then I'm sorry you don't understand.

[mondo joe]

45. I'm responding to the charge that it is undemocratic.

Whether it is wose or not is a different question.

So one at a time please.

Has the democratically determined state constitution granted this authority to the executive, yes or no?

[antigop]

56. Please GO READ THE ARTICLES n/t

[Morgana LaFey]

42. It doesn't matter. Just because you have the AUTHORITY to do

something doesn't always mean you SHOULD do it. Surely most DUers would understand THAT, given 6 years of executive authority excess in the White House.

But, of course, when it's ONLY women's bodies at risk, perhaps not.

[mondo joe]

44. Whether it should be done or not is a second question.

I'm responding to the charge that it's not democratic.

As to the matter of women's bodies at risk, I am siding with Planned Parenthood which has been the leading advocate for women's health in the US.

[Morgana LaFey]

48. but they didn't call for MANDATORY vaccinations, just

widespread use. And they didn't call for it for 9 year olds either.

[Richard Steele]

47. Thank you for keeping this thread kicked.

[Richard Steele]

35. Thank you for keeping this thread kicked.

[ceile]

24. Thanks for posting!

K&R!

[Pithlet]

25. K&R

Thank you for posting this.

[Gelliebeans]

39. Thank you

for posting this information. You have taken the time to research this very important matter on women's health.

:thumbsup:

[KittyWampus]

52. Inflammatory rhetoric? How Can YOU possibly talk about inflammatory rhetoric

go into any freaking thread on this topic and YOUR posts are deleted.

You constantly misrepresent the facts about this vaccine and its not having been tested in the general population, on its not having been adequately tested on pre-teens..

[Horse with no Name]

54. I haven't misrepresented anything

you...on the other hand...

And on edit:
The posts of mine that are deleted are responses to personal attacks--much like this one.
The scientific information I have put forth has been impeccable and from reputable sources. None of those have been deleted.
How about a little honesty?
Nahh..I won't expect too much.

[Avalux]

53. Nice stats.

One of these days, maybe there will be a scientific discussion about the vaccine, the virus it prevents and the ramifications of mass inoculation on this board. Maybe.

[REP]

55. Don't Try To Drag Reason Into This

I see primarily two anti-Gardisil camps: the no-vaccines-for-anyone-ever hand-wringers, and the pro-lie group, who hates anything that suggests that women might have sex without 'paying some price' whether it be an unwanted pregnancy or a hideous disease. These people won't listen; Mercola and Nathanson could preach the benefit of this vaccine and that would do is knock Mercola and Nathanson off their pedestals.

[mhatrw]

57. My calm and dispassionate take on this issue.

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 the HPV screening test that today is a major component of most US women's annually recommended pap smears. These tests screen for 36 nasty strains of HPV, while GARDASIL confers protection against just four strains of HPV.

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 HPV screening test starting at age 18 to a woman who gets a yearly HPV screening test 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, and they have been published in several prestigious medical journals:

http://dx.doi.org/10.1001/jama.290.6.781
http://tinyurl.com/2ovy95
http://tinyurl.com/2tbuma

None of these studies even so much as consider a strategy of GARDASIL plus a regimen of annual HPV screenings 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 21, 22, 23, 25 or 27) biennial or triennial HPV screening tests 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 HPV screening tests starting at age 18.

If you don't believe me about this, just ask any responsible OB-GYN or medical model expert. 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 HPV screening tests 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 HPV screening tests 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 HPV screening tests 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 HPV screening tests 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 HPV screening tests and back off from annual HPV screening tests to biennial or triennial HPV screening tests.

The recommendations are already in: http://tinyurl.com/33p9q6

The USPSTF strongly recommends ... beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years ...