STD Vaccines

[ST88]

There is now a viable vaccine for the virus that casues cervical cancer (HPV). In fact, there are two versions of this vaccine, one from Merck, and one from GlaxoSmithKline. Both have been shown to be almost 100% effective against the most common strains of HPV, which are associated with sexual contact, but such contact is not necessary for transmission. However, in the future, we may see vaccines against other viral STDs, such as HIV and chlamydia.

Many in the medical community want these vaccines, as they become available, to be mandatory for children at least before high school, possibly along with other routine vaccinations. Many conservative groups oppose making them mandatory because it would lead to reckless sexual behavior among youngsters. They further believe that immunizing people from STDs would undermine their message of abstinence.

Assuming the efficacy of these vaccines, should they be mandatory?

Do these vaccines undermine the message of abstinence coming from conservative groups?

Resources:
Seattle Times article
New India Press article
San Diego Union-Tribune article

[Jose]

We must also remember the folks who know so little science that they are afraid of vaccination. Look at the fear of being vaccinated against anthrax, and the goofiness of thinking that the preservative in vaccines causes autism. Of course, this sort of goofiness might go away in the face of a serious disease, when people start to think that the likelihood of getting it might be pretty high.

For STDs, there's resistance among not only the scientifically ill-informed, but also among those who consider STDs to be the wages of sin--and no one should sin in the first place, so they deserve it. I do not exclude some overlap in these two groups. Unfortunately, the latter group has done a very good job of preventing a frank public discussion of this--and, according to the data, may have inadvertently created an epidemic of oral infection by STDs as a result of abstinence-only sex "education."

But, looking at the scenario of infection of children who have not yet been vaccinated, I wonder about how well we are defended against some of the diseases we believe we've eradicated. We've stopped giving vaccinations for the good old Nasty Diseases, because they aren't around much any more. The claim is that the risk of complications from the vaccination is greater than the risk of infection. Uhhh...this seems rather like it puts the whole population at risk if the disease sneaks back on an airplane from someplace where it still exists (I won't even mention intentional release). Aren't we better off vaccinating one cohort a year, than in creating an entire population that is at risk, and that is simply too big to be vaccinated when the epidemic arrives? STDs may not fall into this category, since they aren't transmitted simply by sneezing, but they seem to be able to reach epidemic proportions nonetheless.

Shouldn't we vaccinate everyone against everything?

[mrmufin]

What liability is assumed by the mandating agency in the event of complications due to a compulsory vaccination?

That's a good question. Without socialized medicine, compulsory vaccination and its subsequent liability insurance would appear to be an unfunded mandate. I favor single-payer health insurance. I'm a free-market guy, but the most efficient health care system isn't in a free market.

Currently, we don't have socialized medicine. And every once in a while there are complications associated with vaccination. I'm really unsure as to what type of system would best serve the States. I am increasingly frustrated with the state of healthcare services, costs, and quality.

However, what is the liability of the individual who refuses vaccination and then spreads the disease? Just for the sake of argument, lets say the disease gets spread to pre-vaccinated children -- those who would have been vaccinated at the correct time during development, but had not yet been.

That's a good question. Perhaps going unvaccinated should incur liability. Not being vaccinated does not mean the individual will contract a disease, nor does contracting a disease mean that the individual will transmit the disease.

Remember that this thread is about STD vaccines. If the choice was between nothing, MMR, and MMR-STD, what do you think the percentages would be?

I really don't know. I'd guess that greater than 99.9% percent of the population would get MMR. While less may get MMR-STD, STDs are generally not spread through casual contact, and as such one does have the option to protect via abstinence. (Hey, whatever you're into!) I also suspect that the percentage getting MMR-STD vaccinations would likely increase over time, which would diminish the incidence of the STD in the population..

Shouldn't we, as a society, try to eradicate as much disease as we possibly can? Why should we leave it up to the cranks, the paranoid, and the other anti-vaccination yahoos to carry on the tradition of incurable viral disease?

I really don't see the cranks and paranoid getting many customers. Perhaps I'm overly optimistic there. Perhaps I don't suspect that there would be a very significant difference between the number of people who are currently unvaccinated and those who would opt out (in the case of MMR).

Regards,
mrmufin

[mrmufin]

What liability is assumed by the mandating agency in the event of complications due to a compulsory vaccination?

That's a good question. Without socialized medicine, compulsory vaccination and its subsequent liability insurance would appear to be an unfunded mandate. I favor single-payer health insurance. I'm a free-market guy, but the most efficient health care system isn't in a free market.

We don't have socialized medicine at the moment... While I agree that free market forces may have a tendency to undermine the healthcare interests of individuals, I do not know what the solutions are to those problems. Healthcare delivery systems in the US appear to be less than optimal, and I really don't know how it could be fixed. While I have some ideas, perhaps a "Putting Our Heads Together" topic would be a more appropriate place to fix healthcare problems in the USofA.

However, what is the liability of the individual who refuses vaccination and then spreads the disease? Just for the sake of argument, lets say the disease gets spread to pre-vaccinated children -- those who would have been vaccinated at the correct time during development, but had not yet been.

The individual who refuses vaccination and transfers a disease should bear some liability. One of the reasons that children typically are not vaccinated at birth is because they retain much of their mother's resistance to disease, so I'm not sure how significant that threat actually is. .

Remember that this thread is about STD vaccines. If the choice was between nothing, MMR, and MMR-STD, what do you think the percentages would be?

I really don't think that the percentages would be much different than they currently are. One way to guesstimate those numbers might be to look at current rates of voluntary vaccinations, which are pretty high. According to the National Network for Immunization Information, immunization policy site, all fifty States offer medical exemptions, forty-eight states offer religious exemptions, and twenty states offer philosophical exemptions from vaccination.

As has already been pointed out, the transmission method of STDs offers the protection available by not engaging in high-risk activities. This is far different than transmission of diseases such as measles. This being the case, I would suspect that the MMR-STD vaccination wouldn't be as popular as MMR, but I doubt that the real MMR vaccination rate would be too much different than what it currently is.

Shouldn't we, as a society, try to eradicate as much disease as we possibly can? Why should we leave it up to the cranks, the paranoid, and the other anti-vaccination yahoos to carry on the tradition of incurable viral disease?

Yes, we should try to eradicate as much disease as possible. I guess this is why I don't see the cranks and paranoid running the show any more than they're already doing. Perhaps I have a greater measure of confidence in the public to properly disseminate information and make intelligent choices.

As long as the pathogen is in the population, vaccination would be mandated for anyone who didn't want the disease. So the only way to remove the necessity of vaccination is to vaccinate. It would take decades, but it would happen.

While the MMR vaccination is incredibly safe and effective, other common vaccinations have lower effectiveness rates and/or require boosters on fixed intervals to insure protection. Unless you're suggesting mandatory vaccinations for a very wide variety of diseases and an enormous effort spent verifying immunization records, quite a few pathogens will remain in the population. As well, we don't generally have the capacity to legislate or enforce beyond our open borders.

In any population, you will find at least a few people who want Pat Buchanan to be president, who deny that NASA went to the moon, and who believe Iraq and Al-Qaida were jointly responsible for 9/11. Without their cooperation, vaccination programs would never end.

I guess I don't see the actual rates of vaccination changing based on whether or not they're mandatory. As long as there is enough common sense in a population, the wackos shouldn't reach epidemic proportions, which is a worthy--and achievable--objective.

Regards,
mrmufin