HPV, cancer, and STD vaccines

DISCLAIMER: Lanky has old ties to Merck and the production of the HPV vaccine.

So the good news is there's a Human Papilloma Virus (HPV) vaccine coming out . It's touted as the first ever vaccine for cancer. (Which is a little silly to say because vaccines are for viruses and cancer is a condition....but the HPV virus causes a cancerous condition, so a vaccine that prevents its transmission prevents cancer. All clear now?) This Time article delves into a peculiar pseudoconflict behind it's release: there are concerns that making people safer from cancer might encourage more unprotected sex. The whole article's worth reading, but I wanted to pull out a few tidbits.

Tidbit one, there are a number of strains of HPV and together they infect 70-80% of the population. While it only causes cervical cancer in people with cervixes (ie women), 4000 domestic deaths per year is a lot for a disease, and it would be a good thing to prevent. The Time article has a curious line here:

HPV is the most common sexually transmitted infection; the Centers for Disease Control estimates that 20 million Americans carry it.

I don't know how 75% of the US boils down to 20 million Americans, but I'm guessing that's the number with the virulent cancerous strain. I should really visit the CDC to find out, but regardless of whether it's 20 million or 200 million, that's a lot of folks.

Second tidbit:

Public health experts say that vaccines generally work best when everyone gets them: the laws of "herd immunity" dictate that the more people are protected against a particular virus, the more likely it is to eventually disappear altogether.

Now I'm not going to argue with public health experts, but sometimes it pays to contextualize. There are diseases that can be eradicated, and diseases that cannot be. The most common reason for a disease to be non-eradicable (is that a word?) is that it has an animal reservoir that can re-transmit the disease to humans. And HPV has a pretty big reservoir in the entire male population. Unless the decision is made to vaccinate males (which it won't be), drug companies are going to be selling HPV vaccines as long as they care to make them. Good marketing, I suppose.

Third tidbit: Conservative organizations are now saying they aren't against the drug, they're just against making it mandatory. It hurts me to say this, but I have to agree. The rationale for forced immunization is that exposure to the non-immunized constitutes a threat to the greater public health. Since in this case "exposure" means, (pardon my technical terms) "nookie". I think you can make a case that being surrounded by non-immunized people is only an issue if you get it on with them. I am mindful of the case for making it required, mostly because insurance will be more likely to fund it, and you won't have to decide whether your sweet angel needs a $300-400 dollar shot to keep safe from a STD.

Third and a half tidbit: All of these people running around claiming it will make people "disinhibited" shouldn't be hiding behind the libertarian argument. These people are opposed to the vaccination. And they're stupid to be. Maybe their daughter is going to be pure as the driven snow up to her wedding (yeah, right), but how are they going to know her husband was? Giving your children better health is a no-brainer. I might philosophically oppose legislating mandatory immunization, but you bet your ass I'll have my kids immunized.

And finally, this passage kills me. Time says:

So conservative groups met with representatives from Merck, the vaccine manufacturer, which among other things presented evidence at the CDC hearings that there was no data linking access to the vaccine with increases in sexual behavior. "We did what we ordinarily do when we are prepared to launch a vaccine," says Merck spokesperson Kelley Dougherty. "We met with physicians, consumer groups and in this case faith-based organizations, to talk about what the disease looks like, what the vaccine does; it was part of a broad communications strategy." Merck also launched an ad campaign, "Tell Someone," that aims to teach viewers about the prevalence of HPV and its link to cervical cancer.

Boy do I love that. Two politically conservative powerhouses meeting to resolve their differences. I wish I could have been a fly on the wall there. Merck is incredibly sensitive and responsive. They're scientific innovators AND politically smooth as silk. Getting the opponents all together and addressing the specific "parental concerns" is genius. They dealt with hostile consumers the same way they deal with the government. They identified the issue, studied it, built a scientific argument to support their case, and explained it as clearly as possible. If nothing else, a detailed explanation of the science and the disease and how it kills people gives them a moral high ground. This is the disease, this is what it does to people, this is them dying. We have a product that prevents that. We'd like to sell it so people won't have to die, if that's ok with you. I'm sure it was less passive aggressive, but I'm also sure the point was made.

You try to argue that people should have to die because you're worried that your child might become disinhibited and have sex.

My sources tell me Merck is very pleased with the vaccine and they're continuing work on another version that confers immunity to a wider variety of strains. Preventing people from dying. We could use more of that.