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Re: Leave it to Texas...
Old 02-03-2007, 01:49 PM   #41
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Re: Leave it to Texas...

Quote:
Originally Posted by Texas Proud
.....And being gay or black and all that 'stuff' is false argument IMO.. rubbish.....
DING, DING, DING,,,,give THAT contestant the home versionof our game!!

Know why people "resent" Asian/Indian immigrants? Because they come here and adhere to old-fashioned ideals that built this country, not the new fangled "I deserve it" crap of the younger generations. They get out there and bust their humps to succeed, and when they do succeed our lazy folks all scream "unfair" and whimper for more government handouts. More power to them, and to all who WORK for what they want or want to achieve.

Sorry for the rant, not trying to kidnap the thread. Really.
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Re: Leave it to Texas...
Old 02-03-2007, 02:06 PM   #42
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Re: Leave it to Texas...

Quote:
Originally Posted by Rich_in_Tampa
.....Cervical cancer in the USA: about 10,000 new cases a year, about 4000 deaths.....
Based upon your figures this vaccine has the potential to "help" a mere .0036% of the population of the US. And yet, Merck's TV commercials make it sound like it's critical for about 20-25% of the population. Maybe it's just me, but if they succeed in this "mandatory vaccine" crap they effectively increase their market, and thereby their profits by 5555.55%.

I say, wonderful, but leave it as an option to be discussed with your family doctor and your family.
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Re: Leave it to Texas...
Old 02-03-2007, 02:22 PM   #43
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Re: Leave it to Texas...

Quote:
Originally Posted by retiredbop
Based upon your figures this vaccine has the potential to "help" a mere .0036% of the population of the US. And yet, Merck's TV commercials make it sound like it's critical for about 20-25% of the population. Maybe it's just me, but if they succeed in this "mandatory vaccine" crap they effectively increase their market, and thereby their profits by 5555.55%.
I'm no cheerleader for big pharmaceutical (esp Merck) business practices, but that is probably not a valid way to look at it, IHMO. You are taking numbers from the at-risk population and applying them to the general population.

Many preventive interventions work in small numbers and proportions, but over a long period of exposure. That's why risk of side effects is so important in this type of decision; even a small risk in a large population becomes huge when you consider that only a small fraction of that population would even benefit from the intervention. That small risk for 95% of the population can easily overwhelm the 5% who might benefit. Targeting the right population is critical. Complicated stuff.

As an example, statins reduce the risk of a first heart attack in the AT RISK population by roughly 0.3% per year. Not an impressive number. But over 10 years, its 1:33 prevented, over 20 its 1:16, etc. Most will not benefit in any case.

So far, from a scientific and public health perspective, this one seems to be passing the test. Time and postmarket surveillance (which includes numbers impossible to achieve during clinical trials) will tell.
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Re: Leave it to Texas...
Old 02-03-2007, 02:37 PM   #44
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Re: Leave it to Texas...

Quote:
Originally Posted by Rich_in_Tampa
I am not in my area of expertise, so did some quick reading. Here is what I found in trusted sources:

o 95%+ effective in preventing HPV infection when used as directed.
o Side effects thus far are extremely rare. Some studies include thousands of patients over nearly 5 years with no detectable adverse effects compared to unvaccinated controls.
o Cervical cancer in the USA: about 10,000 new cases a year, about 4000 deaths.
o It is over 95% effective in preventing early cervical cancer when used as directed, so far (5 years).
o Most scientists and researchers feel it is very, very safe and highly effective.
Thanks Rich, I am sold.

On a personal note, I just spoke to my sister. She had just come from the funeral of a dear friend, a 45 y.o. woman who raised 4 kids on her own, cutting hair and giving perms. She never got far enough ahead to get health insurance, so when she discovered her cancer it wasn't in an early stage. Her long hard struggle ended a few days ago.

Plenty of people can fall through the cracks in our system. I know a 25 year old man with cervical cancer; he is getting a hysterectomy next week. How did this happen? He is FTM, and it seems that these guys are not fully comfortable with going to the local gyn to get their annual Pap smears. The gyn profession is not exactly reaching out to them either.

Ha

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Re: Leave it to Texas...
Old 02-03-2007, 02:41 PM   #45
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Re: Leave it to Texas...

Quote:
Originally Posted by Rich_in_Tampa
.....even a small risk in a large population becomes huge when you consider that only a small fraction of that population would even benefit from the intervention. That small risk for 95% of the population can easily overwhelm the 5% who might benefit. Targeting the right population is critical.....
Far be it for me to argue with a doc, Rich, but that was sort of my whole point. Even if you applied your 10,000 number to only 20% of the US pop that's still only .0145% realizing benefits. If you accept the presumption of saving a completely different statistical set each year It takes 75 years to benefit a total of 1%.

What Merck did was play upon sensationalistic fears, grease a few palms, and guarantee themselves a HUGE return on a drug with limited applicability and market. Personally I'd much rather see them concentrate more on an AIDS vaccine or cure.
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Re: Leave it to Texas...
Old 02-03-2007, 03:06 PM   #46
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Re: Leave it to Texas...

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Originally Posted by retiredbop
but that was sort of my whole point. Even if you applied your 10,000 number to only 20% of the US pop that's still only .0145% realizing benefits.
We're looking at the numbers from two different perspectives. I concur that the net beneift is small in absolute numbers. The trick is to a) identify the subgroups with much higher incidence of disease who will thus, as a group, get much more benefit, and b) monitor adverse effects, if any, with the same rigor which Merck spends on their marketing .

This no different from the decisions regarding polio, smallpox, measles (which can be a killer), tetanus, etc.

As a digression, I gotta wonder where all the heat is coming from on this issue when, as REW pointed out, the parents may opt out by signing a sheet of paper. No one is being forced to do anything; just the default state is changing -- kinda like everyone participates in the corporate 401K, unless they opt out. Oh, well.

If my daughter were still young, she'd be getting it.
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Re: Leave it to Texas...
Old 02-03-2007, 03:08 PM   #47
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Re: Leave it to Texas...

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If one can argue that HPV vaccine should be given to 11-12 year old girls than its only a very small step to say that Birth control should be mandated for that same group of people. After all, its proven safe, and you just never know....

At long last! Into the light of day! :P
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Re: Leave it to Texas...
Old 02-03-2007, 03:14 PM   #48
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Re: Leave it to Texas...

[ when the reality is that almost all cases of HPV- associated cervical cancer can be prevented with annual pap screening of girls who are sexually active.
".
[

I believe the standards for Pap tests are 21 years of age so I can see how a lot of teens and pre-teens will fall threw the cracks .Plus most young girls who are sexually active are probably not going to a gyn doctor .
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Re: Leave it to Texas...
Old 02-03-2007, 03:15 PM   #49
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Re: Leave it to Texas...

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Originally Posted by Caroline

At long last! Into the light of day! :P
Another well thought out comment I see....
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Re: Leave it to Texas...
Old 02-03-2007, 03:17 PM   #50
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Re: Leave it to Texas...

Oops I meant through !! Sorry !
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Re: Leave it to Texas...
Old 02-03-2007, 03:21 PM   #51
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Re: Leave it to Texas...

Quote:
Originally Posted by Moemg
I believe the standards for Pap tests are 21 years of age so I can see how a lot of teens and pre-teens will fall threw the cracks .Plus most young girls who are sexually active are probably not going to a gyn doctor .
Even under rigorous study conditions, about 30% of cervical cancers slip through these screening programs (Pap smears). In the real world, the young girls and women who would benefit most are, indeed, reluctant to adhere to regular Pap smears for a variety of reasons: cost, embarrassment, ignorance, access, etc.
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Re: Leave it to Texas...
Old 02-03-2007, 03:22 PM   #52
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Re: Leave it to Texas...

If the state of Texas (or any of the others that are now considering this) wanted to reduce cancers, and the cost of treating cancers, they would outlaw cigarettes tommorrow and save more lives and more money than this HPV vaccine will ever save.

But of course, there is no money to be made in outlawing tobacco products, and no corporation is greasing the wheels in state legislatures to make it happen so instead, in the name of preventing cancers, they are essentially *giving* Merck BILLIONS of dollars in government and private handouts..by forcing this upon the public with backroom deals.



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Re: Leave it to Texas...
Old 02-03-2007, 03:27 PM   #53
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Re: Leave it to Texas...

Hmmm...we're stuck in a rut it seems. No matter how many times the benefits are pointed out or the ability to opt out, its still only being done so someone can make a profit and its being forced on the public.

I imagine its fully feasible to keep yelling opinions past each other for another 5-7 pages before we degrade to bad words. Although thats quite possibly going to happen even sooner.
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Re: Leave it to Texas...
Old 02-03-2007, 04:38 PM   #54
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Re: Leave it to Texas...

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You seem to be saying that males should never care about any women's issues and vice versa. Is that what you really mean?
No, Rich, that is not what I really mean, and thank you very much for asking. In fact, men are vitally involved in this issue -- it is their grandmothers, mothers, wives, sisters and daughters who die of cervical cancer. The emotional and financial costs to men are enormous and they have a vital role to play.

What I'd like to see is exactly what I have seen on this thread, for the most part -- a reasoned discussion of the issue, based upon research and medical standards. I'm impressed by the information from both sides -- information on the risk factors, the benefits and their distribution, the medical alternatives, etc.

That said, a discussion limited to the United States is incomplete. Cervical cancer is apparently the second most common cancer in women worldwide, and the third most common killer. Yes, pap smears in developed countries save many sufferers, but these tests are not readily available elsewhere. In addition, the pap smear doesn't cure cancer (in so far as I know) -- it only finds it so that a woman can undergo the trauma of chemo, radiation, and / or surgery to escape death. (If we are talking about drug company profits here, how much do you think a lifetime of annual pap smears and/or subsequent cancer treatments cost per year?)

None of this takes into account the psychological pain of a cancer diagnosis, however optimistic it might be.

I also think that a discussion of parents' rights is necessary, as it's not absolute. Certain parents, for example, have refused life-saving treatment to their children on religious grounds. The courts have found many of them culpable in their childrens' deaths. Where does this instance lie on the spectrum of childrens' rights vs parental decisionmaking? Further, it's not just about one's own child. What if that child DOES contract the virus and then passes it to someone else? Does not the idea of vaccination include the community, as well as the individual?

Finally, I'd like to see a discussion of the viability of innoculating BOYS against this disease. They carry the disease from one woman to another, they get genital warts if not cancer themselves, and they have an equal responsibility in all of this. The medical community is apparently discussing such a step already.

I have watched people die of cancer, and I think we need to do all we can to save our loved ones from this appalling fate. The idea that one more mother, wife, or daughter should be sentenced to disease, pain, or death on the basis of a political agenda, rather than a reasoned, medical risk assessment, is more than I will ever understand.
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Re: Leave it to Texas...
Old 02-03-2007, 07:55 PM   #55
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Re: Leave it to Texas...

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Originally Posted by retiredbop
Far be it for me to argue with a doc, Rich, but that was sort of my whole point. Even if you applied your 10,000 number to only 20% of the US pop that's still only .0145% realizing benefits. If you accept the presumption of saving a completely different statistical set each year It takes 75 years to benefit a total of 1%.
Let's go with the data from before... and let's say it prevents 75% of the deaths... that is 3,000 DEATHS saved per year... that is the number of people who died on 9/11 which was a horrible number of people... multiply by 10 years and it is 30,000 women...

We do many things that cost a lot more money that save a LOT fewer people...

And again for the hundredth time.... YOU CAN OPT OUT....
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Re: Leave it to Texas...
Old 02-03-2007, 08:29 PM   #56
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Re: Leave it to Texas...

If we want to look at it coldly, add up the cost of the vaccine for all girls age 11 and add up the cost of 9,500 people undergoing cancer treatment per year. I believe the Docs on this board can tell you how many vaccines a round of chemo could buy.

As a person of faith, I empathize with the emotions (hairball) that some have to possibly giving a subtle endorsement of teen sex, but I tell you my two daughters will recieve the shot. And my older daughter has Down Syndrome, so is much less likely to engage in behavior that will put her at risk. Problem is, the ugly truth is those who walk this earth and are scum see children like my daughter as an easy target.

The fact that parents can opt out should completely put this debate to rest, no one is passing laws on your children's bodies. Your kids already get half a dozen vaccinations, if this virus passed through any other method than STD, there would be no debate.
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Re: Leave it to Texas...
Old 02-03-2007, 09:26 PM   #57
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Re: Leave it to Texas...

Quote:
Originally Posted by retiredbop
Based upon your figures this vaccine has the potential to "help" a mere .0036% of the population of the US. And yet, Merck's TV commercials make it sound like it's critical for about 20-25% of the population. Maybe it's just me, but if they succeed in this "mandatory vaccine" crap they effectively increase their market, and thereby their profits by 5555.55%.
Better up those numbers a tad. Our kid just joined the vaccine club today.

It's interesting to note that the pediatrician was far more concerned about meningococcal infections than the HPV vaccine. Apparently the fomer is much more a growth industry among teens.

Quote:
Originally Posted by Caroline
Yes, pap smears in developed countries save many sufferers, but these tests are not readily available elsewhere. In addition, the pap smear doesn't cure cancer (in so far as I know) -- it only finds it so that a woman can undergo the trauma of chemo, radiation, and / or surgery to escape death. (If we are talking about drug company profits here, how much do you think a lifetime of annual pap smears and/or subsequent cancer treatments cost per year?)
Finally, I'd like to see a discussion of the viability of innoculating BOYS against this disease. They carry the disease from one woman to another, they get genital warts if not cancer themselves, and they have an equal responsibility in all of this. The medical community is apparently discussing such a step already.
Here, Caroline, you're too polite to say what needs to be said. I'm a guy so I'll say it.

If prostate digital rectal exams involved a speculum, a flashlight, an excision, and a laboratory procedure, then guys would be high-fiving each other about the arrival of the vaccine for prostate cancer. It would've been developed years ago.

As far as HPV vs HIV, I think a treatment/vaccine for the latter will be far more profitable. But I wonder how much of the R&D effort for HPV is being recycled to help make headway on an HIV treatment or vaccine. And let's not forget malaria or a host of other tropical diseases which are equally as challenging. Developing one vaccine over another isn't a zero-sum game-- every little advance pays off on the other efforts.

Rich, what's more cost effective for the medical community (not the pharma companies): the current OB/GYN exam & Pap smear, or the HPV vaccine?
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Re: Leave it to Texas...
Old 02-03-2007, 11:31 PM   #58
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Re: Leave it to Texas...

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Originally Posted by Caroline
No, Rich, that is not what I really mean, and thank you very much for asking.
That's what I figured .
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Re: Leave it to Texas...
Old 02-03-2007, 11:33 PM   #59
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Re: Leave it to Texas...

Quote:
Originally Posted by Nords
Rich, what's more cost effective for the medical community (not the pharma companies): the current OB/GYN exam & Pap smear, or the HPV vaccine?
If you mean for the doctors, no big deal one way or the other. I just get paid for doing the pelvic exam and pap smear like an office visit (even though done with respect it takes a bit longer).
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Re: Leave it to Texas...
Old 02-04-2007, 03:45 PM   #60
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Re: Leave it to Texas...

Quote:
Originally Posted by Rich_in_Tampa
.....pap smear.....done with respect it takes a bit longer).
<shudder> You know, if I were a chick I would probably opt FOR this vaccine just based on that alone. Ever since I learned what a pap smear was I've been both relieved I was born an "mcp" and sympathetic to whatever partner I had at the time. I feel for you, ladies.
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