Sunday, September 16, 2007

To prick or not to prick

The Globe and Mail carries an interesting article on the Gardasil vaccination program in Ontario. What makes it really noteworthy on my radar is how it de-emphasizes the major reasons I have yet to put my daughter under the needle.
On this day, nearly all of the 72 Grade 8 girls at Westheights will receive the HPV vaccine – a drug that studies show will give them immunity to a sexually transmitted virus that could some day grow into cancer. The school is one of the first in the country to begin administering the vaccine. Over the next few weeks, however, girls in specific grades will be offered the drug for free – with parental consent – in the rest of Ontario, Nova Scotia, PEI and Newfoundland. The rest of the provinces and territories have either delayed their programs until next year, or announced no decision.

For many Canadian parents, the vaccine program is controversial. It was rolled out in lightning speed after Ottawa announced a $300-million funding package for participating provinces. If it lives up to its potential, the vaccine will significantly reduce the incidence of a cancer that on average kills more than one Canadian woman every day, and often leaves those who survive infertile. According to trials, the vaccine, marketed by Merck Frosst Canada Ltd. under the name Gardasil, provides nearly full immunity to four types of the human papillomavirus, which causes 70 per cent of all cervical cancer and 90 per cent of genital warts.

For many parents, it's a no-brainer: Anything that will protect their daughters from cancer, even one of the more uncommon types, is worth the risks. But at the same time, mothers and fathers are grappling with a fear of side effects, questioning the motives of a drug company that stands to make big profits and politicians who may be pandering for votes, and feeling a certain queasiness about dosing girls as young as 10 years old with protection for an STD. At the very least, the needle is making for some interesting – and awkward – family conversations.

They don't have long to mull it over: Once those consent forms come home this month in the four provinces with a program, families will have days to send them back. Adding stress to their decision is money. Parents who decline the school-based program and then change their minds, or choose to wait until their daughter is older, will have to pay for the vaccine themselves, if they don't have private insurance plans that cover it. That's roughly $400 for three doses over six months.

I have the cadillac of private medical insurance with one of the largest insurers in this country. This vaccine is not covered, and if you know of insurer in Canada who does cover the cost of this vaccine - let me know, I just might change.

But why hasn’t my daughter gone under the needle? It has nothing to do with sexual morality or lack thereof. Nor has it had anything to do with the actual cost of the vaccine. It has all to do with the potential risk of this vaccine. No long-term studies have been carried out on this vaccine. Even the human trials on this vaccine were speed-dated through the process due to the alleged “success” of this vaccine. Forgive me, but I really have a problem in general with the idea of trusting the integrity and research methods of the manufacturer of VIOXX.

The vaccine will not prevent any inoculated female from developing cervical cancer. The vaccine does offer some promise of protection against a few strains of the HPV (but not all strains of HPV), which may cause some cervical cancers. Condoms, when used properly, offer protection against all strains of HPV. As far as cervical cancer killing one woman a day in Canada - let’s put it in perspective. More women will die from heart attacks and strokes in any given year than will die from cervical cancer…a very treatable cancer I might add. I’d rather teach my daughter how to ensure condoms are used properly. My daughter is many things, but a human guinea pig for Merck - she is not.

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