January 28, 2008

Cost Remains High for New HPV Vaccine

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Ever since Gardasil was approved by the FDA in June 2006, it has been widely advertised by the manufacturers as “the only cervical cancer vaccine.” However, it comes with a steep price tag that might deter some women from getting the vaccine.
Full vaccination requires three shots that are 132 dollars apiece if not covered by health insurance.
Gardasil is designed for women aged nine to 26 and it protects against human papillomavirus strains six, 11, 16 and 18. Strains 6 and 11 cause 90 percent of genital warts, and strains 16 and 18 cause 70 percent of cervical cancers. The series of three shots is given over the course of six months, with the first two shots being two months apart and the last shot coming four months later.
According to Dr. Alexandra Hall, a Gannett Health Services physician, strains 16 and 18 cause the majority of cervical cancers and also seem to be the more aggressive of the strains. There are dozens of other strains of HPV, but the effort it would have taken to incorporate all of the other subtypes in the vaccine would have made it impractically expensive.
Some women on campus are not aware of the link between HPV and cervical cancer, or even what Gardasil is.
Elizabeth Onyango ’11 said, “I don’t know anything about the vaccine, I’ve never heard of it.”
To help Cornell women gain a better understanding of HPV, Theresa Schwanke ’09 co-founded the Society for HPV Education and Prevention last spring. SHEP is planning a daytime spa event where there will be arts and crafts, manicures, hand massages, and other activities that girls can participate in while learning facts about HPV.
“The main purpose of SHEP is to help raise awareness around campus and make sure women on campus know what HPV is and how it is transmitted,” said Schwanke.
HPV is transmitted by skin to skin contact, and according to Dr. Hall estimates suggest that about 80 percent of women will get infected with HPV at some point in their lives. Many women, especially young healthy ones, are not even aware that they have the virus because their immune systems clear it up quickly. However, 15 percent of women will have a persistent infection that will show up on a Pap smear.
Though 80 percent of women is a significant portion of the female population, many women opt not to get the vaccine because of the high cost associated with it.
“The American Council on Immunization Practices added it into the routine childhood immunization schedule,” said Dr. Hall. “Once they do that and once the government adds it to the Vaccine for Children program, most insurance companies then follow suit and cover the vaccine.”
Gannett participates in the Vaccines for Children program, so it can offer Gardasil to eligible students for just 10 dollars, according to a release from Gannett. To be eligible for the program, students have to be under 19 years old and be enrolled in Medicaid, an American Indian or Alaskan Native, or not have Gardasil covered by their insurance. The students who are most eligible to obtain the vaccine at Cornell are already on the cusp of turning 19, so there is only a small window of opportunity for them to participate in the program. However, the program can save money for students who fall into one of those categories as the Student Health Insurance Plan does not cover Gardasil.
According to Schwanke, one of SHEP’s concerns is that Gardasil is not available to lower income families. The Vaccine for Children program is beneficial to theses families as they can obtain the vaccines for free at participating practices, or can go to the local county hospital if their regular practice does not participate in it.
There have been reports of girls fainting from the vaccine, which has worried many about its potential side effects. But according to Dr. Hall, the fainting is not a side effect of the drug itself; it is just a reaction to anxiety over the shot.
“There is a 12 percent instance of side affects, most common are pain at the injection site, fever, nausea and vomiting” said Dr. Hall. “The makeup of the vaccine makes it very effective and safe. You can’t get HPV from the HPV vaccine, there’s just no way.”
Since July 2007 Gannett has given a total of 957 shots of Gardasil, 180 of which have been given under the Vaccine for Children program.
To promote better access to the vaccine, Gannett will be setting up clinics to distribute Gardasil from 5:30 p.m. to 7 p.m. Tuesday Jan. 29 and again on Wednesday Jan. 30 at Gannett Health Services in Ho Place. It is best to call in ahead of time for an appointment but walk-ins will most likely be taken.