Still Hating America.

[robustpuppy]

Originally posted by Adder
Really? 300 bucks per treatment to prevent X number of future cancer cases (that might cost big bucks to treat)?

Would the legislature pass it?

I think the numbers are such that it might not be so clear. Like, only a few strains out of many are shown to cause cervical cancer, and those strains will only remain in the bodies and potentially cause cancer in a very small number of women who contract that strain. HPV of all strains resolves itself in most people, meaning it just goes away by action of the immune system. So I think RT's point about allocation of resources is quite valid.

Given that my mother died of cervical cancer, I am not opposed to the vaccine, but I don't think it addresses a public health crisis to render it mandatory.

[Mmmm, Burger (C.J.)]

Originally posted by Adder
Really? 300 bucks per treatment to prevent X number of future cancer cases (that might cost big bucks to treat)?

Would the legislature pass it?

ETA: Although I guess one could wonder why it shouldn't be given to boys too, if the goals is to do away with HPV.

There are about 11k cases of cervical cancer per year, not all caused by HPV. So it's not like $300 prevents one cancer, more like .001

[Replaced_Texan]

Originally posted by Adder
Really? 300 bucks per treatment to prevent X number of future cancer cases (that might cost big bucks to treat)?

Would the legislature pass it?

ETA: Although I guess one could wonder why it shouldn't be given to boys too, if the goals is to do away with HPV.

There was a bill in the legislature to do essentially what the governor did, but it hasn't hit the floor yet. The legislative session started last week and will end toward the end of May.

The chances of passing it are dependent on how much the 2006 election shifted the power of the religious right in Texas. Certainly two formerly safe Republican seats shifted to moderate Democrats in Houston and Austin in the last election. Analysis indicates that too much social conservitism tipped the scales in those two districts.

I think the goal is to reduce the incidence of cervical cancer, not eliminate HPV. The various news reports (and it seems that's all the news reporters out of Austin are reporting on lately) seem to indicate that the vaccine hits the four strains that cause 70% of cervical cancers.

Other factors:

The thing is, though, they're supposed to administer the vaccine before woman is sexually active, so there are fewer chances that she's already been exposed to the virus. Hell, sixth grade may not be young enough.

It's a three injection vaccine over a period of time. I dunno what happens if you don't get the full course, but I don't think it'd be a good idea not to follow through.

The last numbers I saw indicated that more than 50% of sexually active people in the country carry some form or another of HPV. (It also causes genital warts and cancer on the anus and penis.)

Other states have filed similar legislation, so Texas is just the canary in the coal mine on this one.

Going back to Sebby's second hand smoke numbers game, cervical cancer has been on the decline lately. About 3,700 people in the US die from it every year.

The last mandatory vaccine was the chicken pox one, and that took five and a half years to get through the legislature.

The AMA and the TMA are unimpressed with the governor's action:

"We support physicians being able to provide the vaccine, but we don't support a state mandate at this time," said Dr. Bill Hinchey, a San Antonio pathologist and president-elect of the TMA, which represents 41,000 physicians. "There are issues, such as liability and cost, that need to be vetted first."

Other reasons cited by doctors in Texas and across the country include the vaccine's newness; supply and distribution considerations; the possibility opposition could snowball and lead to a reduction in other immunizations; the possibility it could lull women into not going for still-necessary cervical cancer screenings; gender-equity issues; and the tradition of vaccines starting as voluntary and becoming mandatory after a need is demonstrated.

The vaccine isn't yet on some drug benefit plans, which means kids whose parents have insurance are going to have to shell out cash to go forward.

[Spanky]

Jack O'Connel, our State Superindendent of Public Instruction, just gave his state of California education speech. He holds a statewide elected position which is supposed to be non partisan, but there is always a Dem and a Repub running for it. He was the Democrat nominee.

Anyway, eventhough he is a Dem he went on and on about how much good the California High School Exist exam has done, how important it was to collect data to know what schools, and teachers were peforming, and to have high standards. He empahsized that you need data "to shine a flashlight into every crevice in the system so you know what is working and what is not, and who is performing and who is not". Seems like he was reading some of the Republican talking points.

What was also interesting was he referred to the California State education system as an "eduction delivery system". I like that term. Reminds people what the sole purpose of the insitution is (not a job corp program or social engineering tool).

In any event, I am sure the CTA is really mad at him. But he was just elected so they won't be able to do anything about it for a while, and what are they going to do, support his Republican opponent next time around?

He is a courageus man. I wish there were more Dems like him (especially in our state legislature). Maybe this is a sign that CTA is losing its iron grip on the Democrat Party here in California.

[Greedy,Greedy,Greedy]

Originally posted by ltl/fb
I'm glad I STP'ed because I was going to say this. The whole thing with vaccination is that it's most effective when almost everyone is vaccinated -- then the disease is wiped out (like smallpox) or nearly so (like polio/mumps/whooping cough). G3, HPV can be transmitted even if condoms are used. I think you would have to have a full genital area barrier to keep it from being transmitted. And it's become really, really prevalent. RT may have statistics on the proportion of young(ish) people who have it. Hell, you may have it -- I'm not sure they test for it in men ever, except on request, and a woman who has been married for years probably wouldn't be tested as a routine matter. The virus wouldn't show up on a pap.

If this vaccine is effective enough on HPV, and not just effective against some strains of HPV but there are lots more out there (a la the flu virus) then it makes sense to me to require vaccination because the disease, a cause of a cancer that is (I think) pretty deadly, will be wiped out. If it's more like a flu vaccine, then it makes more sense to me for people to choose whether or not to get it, since it only decreases somewhat the chances of getting a form of HPV that causes cervical cancer.

ETA Requirements for this vaccine should be put in place however requirements for other vaccines are put into place. Executive order or law or regulation -- whatever applies.

OK, OK, I saw cancer and thought, not likely to be contagious, and missed the virus.

I see vaccinating against contagious diseases as entirely within the sphere of what government ought to be doing, but I still worry about the "new drug" issues - can someone tell me whether this thing passes all tests with flying colors or did the squeak by the FDA with tests from community hospitals thing? What are the side effects? I get nervous about new drugs.

(And, I am interested, as it sounds like a vaccine we'll need to be considering for our own kids).

[Spanky]

Originally posted by Mmmm, Burger (C.J.)
There are about 11k cases of cervical cancer per year, not all caused by HPV. So it's not like $300 prevents one cancer, more like .001

People freak out over a 1000 deaths a year in Iraq. Think how much money we have spent since a few thousand dies in the twin towers. I think this is a good place to spend tax payer dollars. Its an easy to way to save lives without any downside. And since we are moving towards a universal health care system (sorry Penske - I think you are just going to have to bite the bullet on this one), it will be cheaper than treating the cancer victims on the other end. I hope we do it here in California.

[robustpuppy]

Originally posted by Greedy,Greedy,Greedy
OK, OK, I saw cancer and thought, not likely to be contagious, and missed the virus.

I see vaccinating against contagious diseases as entirely within the sphere of what government ought to be doing, but I still worry about the "new drug" issues - can someone tell me whether this thing passes all tests with flying colors or did the squeak by the FDA with tests from community hospitals thing? What are the side effects? I get nervous about new drugs.

(And, I am interested, as it sounds like a vaccine we'll need to be considering for our own kids).

I'm with you. I'm glad I don't have a 6th-grader right now. 10 years from now we'll know more about safety and efficacy. On the other hand, I think the benefit to the idea of mandatory vaccination for school admission (which they've proposed here in DC and MD) is that it seems like an effort to quash the misguided puritanical objections that RT alluded to.

You can tell by the way a lot of people react to the idea is that they just can't handle the notion of their little girl needing protection from a sexually transmitted disease (even if those people are otherwise open-minded about sex education). That's why I think it's essential to frame the vaccine and a push toward mandatory vaccination as a cancer prevention tool, as something that will protect a girl's lifelong health.

Adder, I don't know that the vaccine would work for boys.

[Spanky]

Originally posted by Greedy,Greedy,Greedy
I see vaccinating against contagious diseases as entirely within the sphere of what government ought to be doing,

2. Exactlly

[Secret_Agent_Man]

Originally posted by SlaveNoMore
Speaking of disconnect - and raping clients for that matter - any of yours have any idea how many hours you guys have billed over the years while posting tripe on these Boards?

Pretty Close to zero.

I track the time I work pretty closely and scribble my notes each day as I go along. While there may be a few bathroom breaks in there -- or when I go to and from the vending machines -- I don't bill Internet time.

S_A_M

[Sidd Finch]

Originally posted by Spanky
Jack O'Connel, our State Superindendent of Public Instruction, just gave his state of California education speech. He holds a statewide elected position which is supposed to be non partisan, but there is always a Dem and a Repub running for it. He was the Democrat nominee.

Anyway, eventhough he is a Dem he went on and on about how much good the California High School Exist exam has done, how important it was to collect data to know what schools, and teachers were peforming, and to have high standards. He empahsized that you need data "to shine a flashlight into every crevice in the system so you know what is working and what is not, and who is performing and who is not". Seems like he was reading some of the Republican talking points.

What was also interesting was he referred to the California State education system as an "eduction delivery system". I like that term. Reminds people what the sole purpose of the insitution is (not a job corp program or social engineering tool).

In any event, I am sure the CTA is really mad at him. But he was just elected so they won't be able to do anything about it for a while, and what are they going to do, support his Republican opponent next time around?

He is a courageus man. I wish there were more Dems like him (especially in our state legislature). Maybe this is a sign that CTA is losing its iron grip on the Democrat Party here in California.

Since O'Connell wrote the bill requiring this exam, it's hardly surprising that he'd speak positively about it.

I'm not suggesting that he's wrong -- just wondering why you are so amazed that a Dem could actually support this program, when it was a Dem's idea -- in fact, that Dem's idea -- in the first place. Or why you would suggest that this Dem, in praising the effect of his own idea, is really using "Republican talking points".

Do you know how the vote for it broke down? I tried to find out but couldn't. It's hard to believe that it would've passed without significant support from the Democratic party, but stranger things have happened.

[SEC_Chick]

Originally posted by Mmmm, Burger (C.J.)
There are about 11k cases of cervical cancer per year, not all caused by HPV. So it's not like $300 prevents one cancer, more like .001

The stats, per the WSJ are as follows:

"Merck says cervical cancer is the second-leading cancer among women around the world, but the disease's prevalence is actually low in the U.S. The American Cancer Society estimates that 11,150 women will be diagnosed with cervical cancer and 3,670 will die from it in the U.S. this year. That's equivalent to 0.77% of cancers diagnosed in the U.S. and 0.65% of U.S. cancer deaths each year. By comparison, the society estimates that 178,480 American women will get diagnosed with breast cancer in 2007 and 40,460 will die from it."

"The vaccine protects against four strains of HPV that cause 70% of cervical cancer cases."

As the mother of a daughter, who thankfully wouldn't have to have this for 10+ years, part of my problem is that of the 25,000 who participated in the study, only 1,184 were preteen girls. That's a pretty small sample and I think that it's a little soon to be making it mandatory. There are things you just don't know until after something has been widely used for a while, like in the case of the prior rotovirus vaccine that got pulled because it caused bowel obstructions in infants. Oh, and they have only verified that it appears to be good for 5 years, but it is not yet known if future boosters would be required. Sorry to put the pour water on the idea of picking up on the hotties in 6 years.

[Spanky]

Originally posted by robustpuppy
You can tell by the way a lot of people react to the idea is that they just can't handle the notion of their little girl needing protection from a sexually transmitted disease (even if those people are otherwise open-minded about sex education).

That attitude was the exact problem we had with Prop 85 in California (the law that would have required a minor to get parental consent to have an abortion). Everyone personalized it thinking of their own daughters. But once we explained to people that this law would not adversely effect children from good households (like theirs) but would negatively effect girls from abusive households, people changed their minds.

Once this argument was floated out Californa went from being 65% for the proposition, to actually defeating it by five points in the election. Gotsa to luv the focus groups.

You could make a similar argument here. Your daugther may not need it, but what about girls that have no choice whether they have sex (abused girls, or girls that get raped or molested by a neighbors or something).

[sebastian_dangerfield]

Originally posted by SlaveNoMore
I'm sure we all have some skeletons in the closet, Dr. Leary.

There's nothing tending the light at the end of my closet.

[Replaced_Texan]

Originally posted by Greedy,Greedy,Greedy
OK, OK, I saw cancer and thought, not likely to be contagious, and missed the virus.

I see vaccinating against contagious diseases as entirely within the sphere of what government ought to be doing, but I still worry about the "new drug" issues - can someone tell me whether this thing passes all tests with flying colors or did the squeak by the FDA with tests from community hospitals thing? What are the side effects? I get nervous about new drugs.

(And, I am interested, as it sounds like a vaccine we'll need to be considering for our own kids).

It seemed to do fine. The only concern that it had in the FDA process was the "promotes pomescuity" factor that held up the Plan B over-the-counter approval. Fortunately, Merck's drug was approved during the gay marriage amendment debate last summer, so the religious right's attention was diverted at the time. Glaxo has a drug in clinical trials that will apparently do the same thing.

Summary of the drug and related proposed legislation. I imagine that the brouhaha in Texas is a factor in the bills in other states being withdrawn.

[Spanky]

Originally posted by Sidd Finch
Since O'Connell wrote the bill requiring this exam, it's hardly surprising that he'd speak positively about it.

I'm not suggesting that he's wrong -- just wondering why you are so amazed that a Dem could actually support this program, when it was a Dem's idea -- in fact, that Dem's idea -- in the first place. Or why you would suggest that this Dem, in praising the effect of his own idea, is really using "Republican talking points".

Do you know how the vote for it broke down? I tried to find out but couldn't. It's hard to believe that it would've passed without significant support from the Democratic party, but stranger things have happened.

Because when I argued for the exit exam yesterday, I was accused of not moving beyond the Republican talking points. ergo, if I was solely using Republican talking points, and he made the same argument as me, he must be using Republican talking points.

In addition, Democrats are under a lot of pressure from the CTA and the CTA hates the exit exam. I have heard representatives from the CTA testify a lot, and almost everything in his speech ran contrary to what they want.

The exit exam, and many of the reforms on education that have passed, all have to have Democrat support in California. That is the problem. Every time a Democrat legislater steps out of line the CTA tries to make them pay and they have big bucks and can turn out armies of precinct walkers.

Like I said, some of the fixes to the education problem in California are obvious to most people (like the Exit exam) but you have the CTA throwing their entire weight against them.