Everything about testing and distributing this vaccine is ridiculous and completely based on outdated assumptions about female sexuality. I agree 100% with this article. It's females who are responsible for birth control, it's females who are responsible enough to get a check up every year, and now it's females who are responsible getting vaccinated for STIs. I bet that if new vaccines are developed for other STIs, females will be responsible for getting all of them.

On top of all of this, women over 26 can't get vaccinated (or rather, insurance won't cover it, and it costs a good $500). This is absolutely ridiculous. It is approved in other countries for women in their 40s and 50s and has been found to be safer in older women. Suspicious of the motives for this, I wrote the FDA and asked for an explanation. They sent me back the legal documentation from the Merck (is it Merck?) clinical trials. Apparently, the FDA only approved it for women under 26 because Merck only tested it on women under 26. There is one small paragraph explaining something like they used genital warts as a proxy and the largest sample they could get of genital warts was of women under 26.

I buy the explanation *two* doctors gave me instead: the FDA (under the Bush Administration) assumed that all women over 26 are either a) married forever b) a slut anyway, so they've probably already got all the strains of HPV or c) an old maid- if they haven't had sex yet, they're not going to. Therefore, vaccination for women over 26 did not provide enough benefits to justify the costs. I was 28 when this vaccine came out, and I fell into none of these catagories. Sure, I may have been exposed to the strains in the vaccine already, but there's a good chance I haven't been. Because the FDA thinks I should be married by now, I've got to fork over cash I don't have to prevent cervical cancer, while slews of women two years younger than me got it for free.

Does anyone really think it's a coincidence that the cut-off age for the vaccine is the same age that was the average age of marriage for women at the time?

I am an economist and I'm all about cost-benefit analysis. But with any analysis, your assumptions have to correct. Merck/FDA assumed that girls would be the ones responsible to get the vaccine and assumed that an arbitrary age validates sexual activity. They created the analysis around the results they wanted.

Yes, this yet another example of the infinite conspiracy to repress women.

The real reason is probably that if the vaccine was not as effective in older women, American women would file an expensive class action suit. Money talks. Merck probably found the sweet spot of uninfected women and verified their vaccine on them. Any cost-conscious tester would do that for the first run.

The answer is simple: vaccines work if received prior to exposure. HPV is ubiquitous in older people due to sexual exposure. for example, giving you the polio vaccine after you have polio is worthless. Same with the flu vaccine. Its not about discriminating against women who should be married, its about targeting the population most likely to benefit and least likely to have been exposed to the virus.

FeTuS:

The answer is simple: vaccines work if received prior to exposure. HPV is ubiquitous in older people due to sexual exposure. for example, giving you the polio vaccine after you have polio is worthless. Same with the flu vaccine. Its not about discriminating against women who should be married, its about targeting the population most likely to benefit and least likely to have been exposed to the virus.

But that population is not targeted correctly.Yes, HPV is *almost* ubiqituous, however, there are a lot of different strains of it. All of my doctors have suggested that I get the vaccine as there's a high likelihood that I haven't been exposed to certain dangerous strains. The 26 cut off is completely arbitrary- I had only had one sexual partner by age 27, so there was a very high likelihood that I would benefit from the vaccine, but I was too old to get it. Imagine a woman who has had NO sexual partners but plans to in the future. On her 27th birthday, she suddenly won't benefit from the vaccine? That's completely ridiculous. What about a woman who had married early, only had sex with man, and then gets divorced at 40 (or hell her husband dies) and starts dating again. She suddenly wouldn't benefit? What about a woman who's husband ends up cheating on her? What about a woman who ends up cheating on her husband?

As I said, I understand the concept of cost-benefit analysis. The problem is the parameters are all messed up and based on incorrect cultural assumptions. On top of that, they didn't measure the possible benefits of giving the vaccine to other groups. The fact is, they have nothing to compare the results to. They don't know the level of benefits wouldn't outway the costs. They're only basing that claim on these loose and arbitrary cultural assumptions. I know they didn't test other groups because I read the documentation.

My current gynecologist is invloved in a campaign of doctors who are trying to get the FDA to extend the age limit. These doctors feel that all sexual active women could benefit from the vaccine. I'm 31 now and both my primary doctor and my gynecologist have strongly recommended that I get it before I have any additional sex partners. The problem is I just don't have the money. I pay for health insurance for stuff like that.

Yes I do think it's discrimination. A woman is perfectly eligible for this health care measure one day, when she's 26 and 364 days old. She wakes up on her birthday and she's not eligible. Yes, clearly that stroke of midnight means that she wouldn't benefit from preventative measures against cervical cancer.

Aren't there tests to see if you have HPV? It's a virus, if you had it, you'll always have it, and if you DON'T have it yet, than the vaccine would be covered? Wouldn't that be way more effective than setting a random age, in covering the "correct target population," and besides, wouldn't it be useful just in itself to know whether or not you have it? And yeah, men and boys should be getting (or at least have access) to this vaccine as well.

Cant argue with your logic Buggie. Nothing magical happens at the age of 27. Guidelines are initially established and hopefully moved as more data comes out. Also, you hope for some physician discretion where possible in cases like yours.

jemand:

Aren't there tests to see if you have HPV? It's a virus, if you had it, you'll always have it, and if you DON'T have it yet, than the vaccine would be covered? Wouldn't that be way more effective than setting a random age, in covering the "correct target population," and besides, wouldn't it be useful just in itself to know whether or not you have it? And yeah, men and boys should be getting (or at least have access) to this vaccine as well.

No, I'm not really clear on how it all works, but it's apparently not as simple as just testing to see if you have HPV, mostly I think because there are just all these different strains. I've heard different information on this, but basically, you get a pap test, but it either comes back "normal" or "abnormal" NOT positive or negative. And an abnormal result can stem from a lot of other stuff like you just had your period or you're about to get your period or you had sex a couple days before or even just lab error. I had an abnormal pap test once (followed by a normal biopsy and all normal pap tests), but I'm pretty sure the information I got was that it didn't mean I actually had HPV...in terms of which kind you have...again, I'm unclear. I've heard that they can't (or don't) test for which strains you have (but then I've heard stuff to the contrary so I don't know). But my doctor basically said that no one really knows if they've been exposed to the strains included in the vaccine.

Also, I don't think you always have the virus, you have exposure to it. It's like the flu, you don't always live with the disease and can't always spread it, but if you are exposed to one strain of flu, you build immunity to that strain. Just because it's a virus it's not necessarily like herpes where you always have the actual disease and can spread it. I think this is correct.