A Gardasil Analogy: Killer Salmonella
Comments on my anti-Gardasil post have continued to trickle in. The general sense is that of disagreement with my position, and I must admit that my economic analysis was somewhat off-the-cuff. But I remain opposed to the vaccine on a pragmatic basis, which I hope to explain a little further here by way of an analogy:
Did you know that you can die from Salmonella? Really. Severe abdominal pain, nausea, vomiting and copious bloody stools can lead to dehydration and vascular collapse, which can be fatal!
Now what if I told you that for about $400 you could buy a special cutting board that could reduce (not eliminate) your chances of getting Salmonella? (And remember, you can DIE from Salmonella.) Wouldn't that be wonderful? [Note: the expensive cutting board piece is fictitious; everything else is real.]
Hopefully, you would say that's ridiculous. Salmonella can usually be avoided by commonsense precautions like avoiding the consumption of raw or undercooked eggs, poultry and shellfish. Even if you do contract Salmonella, it is eminently treatable with antibiotics and supportive measures to prevent dehydration. Although technically one can die from it, as a practical matter the only way to do so is if you don't get any medical care at all. Why spend such a ridiculous amount of money against a disease that isn't all that hard to avoid in the first place, and is essentially never fatal with relatively modest levels of medical care. And yet nothing I said above about Salmonella is wrong -- technically. The only difference is that it doesn't cause "cancer," which is a scary word.
That's my argument against HPV vaccination. I'm not disputing that HPV -- left untreated for many years (10-12) -- can cause cervical cancer. I'm not disputing that Gardasil can reduce (but not eliminate) the chances of contracting high risk strains of HPV. But early stage HPV disease is eminently treatable, and completely avoidable via abstinence (of which I am an advocate in principle, although not a "Just Say No" fanatic.) Finally, it is virtually impossible to die of cervical cancer unless you never see a doctor.
The vaccine costs $120 per dose, with a recommended 3-dose schedule. The jury is still out on booster doses at this time. That's a pretty hefty sum spent to reduce -- not prevent -- a disease that, with usual medical care, will never occur. Yes, it may cut down the number of abnormal paps, but it still seems to me to be too little benefit for too great a cost. The appeals made by advertising are to the emotions provoked by the word "cancer."
That said, in answer to the question about who should get it: anyone with enough money to spare, to whom "peace of mind" is worth it.
Don't even get me started on a certain Governor who signed an executive order -- never mind bothering with the legislature to, yanno, pass a law -- mandating this vaccine for all 11 and 12 year old girls in his state. However much Merck spent to buy him, you know they stand to make it back big time.