Thursday, July 20, 2006

Your money or your life

The vaccine for the human papillomavirus was approved for use in New Zealand today on the grounds that it is both effective and safe. Most people probably know by now that HPV is a STD and it causes cervical cancer. Obviously this vaccine is a huge step forward for women's health (and men's too HPV also causes penile cancer).

But there are a couple of big questions around it, the first is cost. The vaccine will be available from September, but it'll cost $400. It can be publicly funded if it is on the National Immunisation Schedule.* But getting a vaccine on the scheduleis a process that takes at least a year. They don't expect that will happen before 2008. I don't know how many women will become infected with HPV between now and then, but it'll be too many. I believe that this vaccination should be offered to women, free of charge, as soon as it is available in New Zealand.

I'm also really unclear about how and whether they'll offer the vaccine to women who are already sexually active (obviously I have a vested interest in this). Ideally they'll offer the test for HPV to all women, and the vaccination to those who don't already have the disease. But I suspect they're too cheap to do that. If they can't do that they should offer the vaccine, for free, for every woman who wants it. Even if there's a 90% chance that I already have the virus it seems worthwhile to get the vaccine.

So far we haven't had any moralistic jumping up and down about how this will encourage children to have sex (thank God). But I do think that it's important that there's a way that girls whose parents refuse them permission for the vaccine can get vaccinated, ideally at the same time at everyone else, but failing that the vaccine cannot just be funded at one age. Because then women whose parents are reactionary fucks will have to fork out $400 for protection that everyone else gets to take for granted.

Edited to add: Hexyhex has let me know that you can't really test for HPV, my position is that the government should then make the vaccine available to anyone who wants it.

*I was looking at the National Immunisation handbook, and it's quite interesting. It convinced me to vaccinate any hypothetical children with all the vaccines included, but it also said a lot about medical research. Like this: "A primary course of Hib-OMP at two and four months of age and a booster dose at 12 months had an efficacy of 100 percent in 2588 Navajo children less than 15 months of age, who had received either one or two doses." - we wouldn't want to use white children as guinea pigs.


  1. Just an FYI: Testing for HPV is notoriously unreliable. There is currently no reasonably realiable "test" that can tell you if you have the virus if you aren't displaying symptoms.

  2. Thanks for that hexyhex. If we can't test for HPV then they should offer the vaccine to any woman who wants it.

  3. I'm amazed that it isn't going to be made free and freely available. It's got to cost a lot less to vaccinate large numbers of women and girls than to pay for cervical cancer treatments. Cervical cancer is a horrible way to die.

    Oh yeah, and add me to the list of people sighing with relief that no fanatical dickhead has started saying the vaccine will encourage girls to have sex. (Because of course it's better to have cancer than to have - gasp - sex!)

  4. My understanding is that women who have been sexually active for an extended period of time are much more likely than not to have already been exposed to the virus; thus it's a poor use of public health dollars to vaccinate us. The money is better spent on pap screening. The thing that I find disappointing is that there isn't more movement to vaccinate boys/men, who are, of course, the primary vector for infecting girls/women. Not to mention that HPV can apparently cause penile cancer, though the incidence is much much lower than cervical cancer. I also wonder whether if they played up the penile cancer, the nutjob opposition to widespread vaccination would drop.



  5. The bottom line is how many lives it will save and how much spare resources we have.

    Some quick maths indicates that you get more "bang for your buck" by improving dangerous corners on roads or more advertising for "five a day" than by making this free for everyone. It is quite possible that no matter what the system a 10% chance of protecting you from some strands of HPV might never be worth total funding even if we diverted all our money into health.

    With any luck our government does these calulations of resource allocation.

  6. But the problem is that it depends on how sexually active a woman has been, and how she has been sexually active. That's the problem it's all guesswork. So it seems to me safer to let women do the guessing, than any medical formula.

    Does anyone know if/how HPV can be transmitted by women having sex with women?

    Genius: If the government made those sorts of calculation a lot more of our houses would be insulated.

  7. From a little research - HPV can be transmitted orally but it is rare

    There is also the potential for sharing vaginal fluids depending on how the hygiene was managed...

    > Genius: If the government made those sorts of calculation a lot more of our houses would be insulated.

    Well yes... But I expect they just do it within certain domains where they feel they have a mandate to act.