May 22, 2006

An Unacceptable Mandate

Let’s be clear about this – I support the marketing of Merck’s new vaccine, Gardasil. If I had a daughter, I would have her vaccinated as a precaution against cervical cancer. But I draw the line at the notion of making a vaccination against a disease that is 100% sexually transmitted mandatory for admission to public schools.

The drugmaker's efforts to educate Christian groups while touting the vaccine's top selling point -- prevention of cervical cancer -- helped win them over.

But Merck may ultimately find itself at loggerheads with those same groups as it seeks to make the vaccine mandatory for school admission, a step considered key for widespread acceptance and one that many of the groups oppose.

The vaccine, known as Gardasil, with an estimated $2 billion U.S. market potential, targets four types of sexually transmitted human papilloma virus, or HPV, which is believed to cause more than 70 percent of cervical cancer cases and 90 percent of genital warts.

"We don't think it should be made mandatory for school attendance," said Peter Sprigg, vice president of policy at the Family Research Council, who attended the Food and Drug Administration (FDA) advisory panel meeting on Thursday.

That view is shared by evangelical Christian group Focus on the Family.
"We support the widespread availability of the vaccine, but we do oppose the mandatory vaccination for entry to public school," said Linda Klepacki, an analyst for sexual health for the group.

For Gardasil to be widely adopted, Merck must first win FDA approval. Then, it must garner widespread backing from the Advisory Committee on Immunization Practices -- a group that advises the U.S. Centers for Disease Control and Prevention on immunization standards. Both Merck and analysts deem widespread backing likely.

States would then consider whether it should be included in the list of vaccinations required for school admission.

And I do draw the line there. Cervical cancer and genital warts are not transmitted via casual contact. No child is going to catch the human papilloma virus just by sitting in the same classroom with and breathing the same air as a child who has the virus – or even either of the resulting conditions. There is simply no way to make the sort of public health argument that exists for requiring other childhood vaccines as a condition for being allowed into school – unless you want to argue that there is rampant sex taking place in the hallways and classrooms of America, and that this vaccination is the means of preventing the uncontrolled spread of the conditions in question. But if that argument is to be made, then there is a much bigger issue surrounding public education that needs be addressed much more quickly.

Frankly, requiring Gardasil would be no different than requiring Norplant of all female students. After all, the means of transmission for the condition to be prevented is identical, and the “exposure” to the risk of transmission is identically likely to happen outside of school as the means of transmission of genital warts and cervical cancer. Pregnancy, like the human papilloma virus, isn’t being transmitted through the air, in the drinking water, or via toilet seats. The very concept of state-mandated birth control shocks the conscience – why doesn’t state-mandated STD-preventatives cause the same outrage?

I teach high school. I know there are many health needs that go unaddressed among my students. We try to take care of some of them through school breakfast and lunch programs, through school-based health clinics (which are not, contrary to some claims, all about birth control and abortion), and through various health screenings. But we donÂ’t mandate a good breakfast, force-feed kids a healthy lunch, or require anything but the most minimal medical care or diagnostic testing. We donÂ’t even require a flu shot, despite the fact that a classroom is a swirling, seething culture of viruses and bacteria during certain times of the yearThat isnÂ’t our mission. Neither is this, and the advocates of mandatory Gardasil are just setting up one more big-government nanny-state intrusion into family decision-making on child-rearing issues.

And by the way, don’t forget that making the vaccine mandatory will also give Merck $2 billion in mandatory profits every year for the foreseeable future. So is this really about public health – or private profits?

Posted by: Greg at 04:20 PM | Comments (5) | Add Comment
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