liveonearth (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
liveonearth) wrote2011-09-24 03:23 pm
liveonearth) wrote2011-09-24 03:23 pm
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A Public Health Perspective on HPV Vaccination
As you may know I lean libertarian. I am skeptical whenever government authority is imposed. There has to be a good reason for government to exist, or to do anything at all. So it could come as a surprise to you that I think universal HPV vaccination is worth considering. I am sensitive to the argument by Andrew McCarthy that the state should not be "encouraging sexual promiscuity by socializing its cost." HPV is easy to avoid. All you have to do is keep your mucus membranes away from everyone else's sexual equipment. Easy? To ask humans to abstain from sex, at any age, is a losing battle. Teens especially. You may get your kid convinced that saving her virginity is important, but another kid might change her mind. Those who are abstinent may be vocal, but they are a small minority.
I am averse to government mandates and intervention in personal lives, except when it is necessary for the long term health and well being of the society. There is a role for government, folks! Government is our tool to collectively attain peace and productivity. Hence we have borders and militaries, education and social programs, public works of all kinds which theoretically make our society more peaceful and productive, and keep us from strife down the road. We also treasure our individual freedoms and rights. These things are in balance, because in our freedom we recognize the need to sometimes work together for our collective good. At least American democracy used to work that way.
Vaccines are suspect, too. The very material in them may be allergenic or toxic. The corporations producing them are motivated by profit. The vaccine production process is in some other country, in some factory that I don't get to inspect. It is reasonable to want to know what is being injected into your body. We have reasons not to trust pharma, even if individual vaccine accusers have been debunked. The last thing I want is a medicine prescribed for me by a government I don't trust, and made by a corporation for whom I am $. And I hate the thought of my government in bed with bigPharma. Ick.
But back away from the bedroom. This bug, HPV, is prevalent. There are many types, but there are two types that cause cancer, and two more types that cause genital warts but not cancer. If you lump all the types together, over half of all Americans are carriers. The carcinogenic types are found in 3-4% of the population. More in men than in women, including the oral type. Dentists are testing for HPV now. You swish a liquid and spit into a tube for virus detection.
HPV is a causative factor in many cancers: cervical, anal, pharyngeal--any mucous membrane is vulnerable. HPV changes the genes in the host so that cells don't know to stop dividing. Cervical cancer is the #3 cancer and 4th leading cause of cancer death worldwide. If we could vaccinate the world, just for one generation, we could shrink this death toll significantly. Or we could just do it here in the states. We could have fewer people with their faces half gone, hiding in dens, because they were promiscuous with one wrong person.
So imagine that for just one generation we decide that we're going to vaccinate everybody for the carcinogenic forms of HPV. Everybody we can get. Vaccinate the world. Eliminate the bug. Supervise bigPharma to make sure the product is pure and safe and reasonably priced. Like polio, carcinogenic HPV could be a thing of the past. If we could all work together with the long view, we could eliminate each epidemic in its turn, and then retire that vaccine until the bug is sufficiently reintroduced as to require another round. Rather than forcing all of us to take many vaccines, simply prioritize and promote (require?) important immunizations aggressively, while more judiciously recommending the others.
Think about polio. This bug is carried in the GI and easily shared by unhygienic food handling. Once contracted it can ruin motor nerves, causing lifelong paralysis and wasting. Horrible. The polio epidemic peaked in 1952, the same year that the first polio vaccine was developed. We all were vaccinated for a while, and now we don't have polio anymore. It's gone. There are a few elders with post polio syndrome still hanging around to tell us about it. You're unlikely to be exposed to polio, so there's less need for the vaccine. HPV could be like that. Old news.
Notes:
http://liveonearth.livejournal.com/1057557.html
I am averse to government mandates and intervention in personal lives, except when it is necessary for the long term health and well being of the society. There is a role for government, folks! Government is our tool to collectively attain peace and productivity. Hence we have borders and militaries, education and social programs, public works of all kinds which theoretically make our society more peaceful and productive, and keep us from strife down the road. We also treasure our individual freedoms and rights. These things are in balance, because in our freedom we recognize the need to sometimes work together for our collective good. At least American democracy used to work that way.
Vaccines are suspect, too. The very material in them may be allergenic or toxic. The corporations producing them are motivated by profit. The vaccine production process is in some other country, in some factory that I don't get to inspect. It is reasonable to want to know what is being injected into your body. We have reasons not to trust pharma, even if individual vaccine accusers have been debunked. The last thing I want is a medicine prescribed for me by a government I don't trust, and made by a corporation for whom I am $. And I hate the thought of my government in bed with bigPharma. Ick.
But back away from the bedroom. This bug, HPV, is prevalent. There are many types, but there are two types that cause cancer, and two more types that cause genital warts but not cancer. If you lump all the types together, over half of all Americans are carriers. The carcinogenic types are found in 3-4% of the population. More in men than in women, including the oral type. Dentists are testing for HPV now. You swish a liquid and spit into a tube for virus detection.
HPV is a causative factor in many cancers: cervical, anal, pharyngeal--any mucous membrane is vulnerable. HPV changes the genes in the host so that cells don't know to stop dividing. Cervical cancer is the #3 cancer and 4th leading cause of cancer death worldwide. If we could vaccinate the world, just for one generation, we could shrink this death toll significantly. Or we could just do it here in the states. We could have fewer people with their faces half gone, hiding in dens, because they were promiscuous with one wrong person.
So imagine that for just one generation we decide that we're going to vaccinate everybody for the carcinogenic forms of HPV. Everybody we can get. Vaccinate the world. Eliminate the bug. Supervise bigPharma to make sure the product is pure and safe and reasonably priced. Like polio, carcinogenic HPV could be a thing of the past. If we could all work together with the long view, we could eliminate each epidemic in its turn, and then retire that vaccine until the bug is sufficiently reintroduced as to require another round. Rather than forcing all of us to take many vaccines, simply prioritize and promote (require?) important immunizations aggressively, while more judiciously recommending the others.
Think about polio. This bug is carried in the GI and easily shared by unhygienic food handling. Once contracted it can ruin motor nerves, causing lifelong paralysis and wasting. Horrible. The polio epidemic peaked in 1952, the same year that the first polio vaccine was developed. We all were vaccinated for a while, and now we don't have polio anymore. It's gone. There are a few elders with post polio syndrome still hanging around to tell us about it. You're unlikely to be exposed to polio, so there's less need for the vaccine. HPV could be like that. Old news.
Notes:
http://liveonearth.livejournal.com/1057557.html
no subject
But I *do* have a few questions before we jump straight to a "big government" solution.
First: Can we do what you want with voluntary charity? Obviously that'll take a little longer because we'll have to fund-raise, but to me the moral differential between forcible extraction and voluntary donation is worth a little bit of lattitude.
Second, Are you intending to make it "mandatory", and if so, on what moral authority? I understand that unless *everyone* takes it, it won't accomplish the erradication you're talking about, but how do you intend to enforce it? What about when the hindu (or whoever) world refuses?
Now, to grind a tangentially related axe :) Big pharma is a *creation* of the government. It is pointless to worry about "my government in bed with bigPharma", because they are now and always were different arms of the same beast. The "oversight" and all the other government controls do not harm bigPharma, they enforce the monopoly of it. Look at the FDA crusades against "supplements" and the claims made of healthy eating, such as the C+D issued to bloody *cheerios* and you'll soon see what I mean. LOok at the draconian politicized, hugely expensive process of drug approval from the perspective of economics, and those things change in your mind from "protecting the public" to "enforcing barriers to entry", and you realize that the FDA is not "restraining" bigpharma, but is in fact breaking the legs of "littlepharma", at vast cost in lives and treasure.
So as far as that goes, just accept that Pfizer (or whoever) is going to make a few billion taxpayor dollars from your plan and decide whether that's worth the price to you.
no subject
If we had a different society we could do it through charity. That transition will take approximately 100 years, provided that the tea party manages to get a lot of true conservatives elected. I have a vision of that society, but the transition is not going to be easy.
The only way to get *everyone* to do anything is through education. This is an increasingly difficult task as people (esp here in the US) are increasingly ignorant, and are *learning* all manner of falsehoods from the ever-increasing stream of garbage that comes at us through the internet and other media. But public health concerns raise the question: how can we get good info out that will be trusted by people on all sides, so that they can then make the best decisions? It may be impossible, but education is the only way that I see. Government mandates don't work for everyone, but they do work for the majority. Simply institutionalizing a requirement can make huge dents because the vast majority of people will simply go along.
You can say that big government created big pharma, but really it is a co-creation. The grew together and in cooperation. The FDA attempts to put small supplement manufacturers out of business because it is an agency of the co-created federally-supported bigPharma.
I would be OK with a pharmaceutical corp making $$$ if they delivered a product that was safe and effective (as advertised) at a reasonable cost. This new requirement would require getting out of bed and doing some tough negotiating.