Wednesday, March 7, 2007

Please don't kill the budget...

Yesterday's recommendation by the House of Commons finance committee has raised the stakes of the March 19th budget... and they're much higher than partisan interests.

The committee believes the federal government should provide funding ($300M over 3 years) for a series of new immunization programs -- including a vaccine that prevents human papilloma virus (HPV), a leading cause of cervical cancer.

While currently unapproved for public consumption in Canada, the vaccine is pegged at $400 and is most effective when administered before women become sexually active. Presumably, the federal government will follow the Americans' lead, and make the vaccine available to women aged 9 to 26. Our program sounds like it would involve the vaccination of all female Grade 6 students, with voluntary vaccination available for others.

Let's not play politics with women's lives. Pass the budget so that we can make the vaccine available as soon as possible.


Anonymous said...

Many vaccines have side effects and using this method to protect against obscure disease is crazy.

Anonymous said...

Any girl who becomes sexually active at age nine has serious problems. Way too early for vaccination.

DeepRedTory said...

(1) Few side-effects are worse than cancer or cancer treatment. Ask anyone who's had it.

(2) Obscure? I guess it depends on your definition of how many women have to die for it to be a serious concern. According to the Canadian Cancer Society, 1350 more women were diagnosed with cervical cancer last year, and 390 died. I'll grant you that improvements in screening have reduced both the incidence and mortality rates over the past 30 years. But if you have the opportunity to dramatically reduce the presence of a deadly disease in your country, isn't it worth the effort and money? Ottawa's swimming in surplus dollars -- let's use it for a noble cause. (I'll donate the money I save from my tax cut.)

At the very least, we should be considering a government-subsidized, voluntary vaccination program. (Although, the women most at risk are likely unable to afford the vaccine even with the subsidy.)

(3) Yes, any girl who becomes sexually active at age nine deserves help with her 'serious problems'. (E.g., cervical cancer -- unlike breast cancer -- is correlated with low socio-economic status.) Giving her an increased chance of developing cancer isn't helping.

(4) If we are going to vaccinate, the earlier the better.

(5) Judging from the last comment, I doubt very much that we'd be having this discussion if a vaccine were developed for prostate or testicular cancer. Granted, the former has a 10-fold greater incidence rate than cervical cancer. But the opportunity to save men's reproductive organs somehow grabs the public's attention in ways that HPV doesn't. Witness: Lance Armstrong and Phil Kessel.

(6) It's time to put down the scalpel and shelve the deep tax cuts. We have a real opportunity to save lives. It's worth it.

Anonymous said...

1.Age 9 is an excellent recommendation because they are aiming to vaccinate women BEFORE they become sexually active.
2.Common side effects of vaccines include itching and burning at the site of injection and more rarely fever or nausea. I think I'd take a day or two of these inconveniences rather than chemotherapy.
3.HPV is not obscure. Many people carry it and do not know. Any woman who has sex with any man who is not a virgin is at risk.

ACB said...

Let me say from the outset that I’m one-side with the end goal here. The prevention of cervical caner is indeed a noble and worthwhile goal. I may even go so far as that it should be fully publicly funded. The problem I have is that I’m not sure that I want the state telling me what vaccinations that my daughter should have. I don’t want the state involved in every aspect of my life, and for that matter, I don’t want 6th grade girls dragged (forced?) into the gym and a needle stuck in their arm – thrice! No matter how noble the cause. It appears that the Texas law-suit mentioned in the story is about this matter.

Now before you even start, yes, I’m fully aware that the state already tells us what needles we should have as children (boosters etc). I understand, but that’s the root of the problem here. The boosters, for all intents and purposes are a choice (albeit one that is most often (always?) followed). Parents, for the most part, are intelligent folks. If you can make the logical argument – like you almost did, (without the rhetoric and hyperbole) – regarding the benefits of the shot, I’m convinced that parents would deliver their children to either their family doctor, or a walk-in clinic en masse (a la the flu shot) for the needle. But I, for one, don’t want my children being lined up like sheep and inoculated by a public health nurse in the school gym.

DeepRedTory said...

ACB --

I sympathize. I, too, am not crazy about lining students up for vaccines. Comparisons to the polio vaccination program are a stretch, at best.

On the surface, you have a point. The typical gut-reaction to your proposal is to say that it's not 'your' daughter who is at risk here. Go ahead and opt-out of the program, because she's not likely the permiscuous type who would contract an STD like HPV.

Here's the problem, though: HPV isn't spread through promiscuity -- it's carried by 'average men' and 'nice guys', not just the man-hoes you see at the club. You or I could have it right now and not know it, which puts even the most sexually-selective women at risk. Granted, your chances of contracting any STD increase with the number of partners you have, but this one's a little different than visible diseases. Your daughter may be less at risk, but she's not out-of-the-woods entirely.

As for a voluntary vaccination program, I've suggested that one might work. The problem here is that the people most at risk of contracting the STD are probably the least likely to visit the clinic to get the vaccine. (Worse yet, if it were only partially subsidized, low-income Canadians would likely opt-out.)

The compromise solution may be to offer a 'recommended' vaccination to all girls at age 9 -- through schools, using permission slips -- with an additional clinic-based, subsidized, voluntary innoculation program for women over 9. A public education program should accompany this (in tandem with the American pharmaceutical ads already in circulation).

No matter what the specifics of the program, though, I think we can all agree that this vaccine should be made available to the public at a reduced cost (preferably free), and that this should be done as soon as possible. It shouldn't be left up to cash-strapped families or the provinces, and it should be considered a national health issue. It should be passed as part of the March 19 budget.

DeepRedTory said...

As passed along to me by a learned friend...

Re: The stats I reported earlier on the 'obscurity' of cervical cancer... These indicate the number of NEW DIAGNOSES and deaths. They do not include the number of women who are living with cervical cancer, whether diagnosed or undiagnosed.

ACB said...

Wait. Now you've done it.

"It shouldn't be left up to cash-strapped families or the provinces, and it should be considered a national health issue."

Last time I checked the constitution, which is more often than one may think, health-care was a provincial responsibility. So why, exactly, shouldn't it be up to the provinces to run this? If the feds want to pay for the vaccine, fine. But this should absolutley be a provincial deal. Now as a staucnh defender of prvincial rights, I don't think you get to have it both ways. You're either onside, or you're not.

And I'd further like to note, that at no time, did I say "my daughter wasn't at risk." I understood fully, the pseudo-medical bits that you put forth - unknown carriers etc. I get it.

My point was that the program would be better served if it was delievered by a medical type of my choosing, rather than a state run program.

DeepRedTory said...

Simple: It would be a clear-cut use of federal spending power. The vaccination program would likely fall under the guidelines of SUFA (impotent as the document is), which allows the federal government to spend on individual Canadians provided it has the backing of the provinces.

Besides, if memory serves, the provinces ceded control over national vaccinations and nation-wide health issues (including pandemics, research, emergencies) to federal government. More recently, the Council of the Federation offered to let Ottawa run a national pharmacare program. I could be wrong here, but I doubt any of the provinces would be up in arms over a national HPV vaccine. Certainly, the provinces would demand (quite rightly) that they be consulted on delivery, and that the program be fully funded from Ottawa.

As for me being an advocate for provincial rights... Don't be so sure. Some issues are truly of national concern. Provincial collaboration would be nice in this case, but -- like the issue of the Millennium Scholarship Fund -- this is a straightforward use of the federal spending power.

DeepRedTory said...

And, yes, I did throw the Millennium Scholarship Fund in just to get your goat.