Ladies' Choice

Today, while reading my aforementioned issue of Elle Magazine, I saw this ad for Gardasil, Merck's vaccine against cervical cancer.

Turns out, I have less than two more years to receive the Gardasil vaccine-- it's officially recommended only for women and girls aged 9 to 26. Once you hit 27, it's next to impossible to get insurance to cover the three shots, which aren't cheap: Gardasil has a list price of $360, plus you have to pay the price your doctor charges for administering it.  In fact, it's the most expensive vaccine ever to receive the FDA's recommendation.

Since my time is kind of starting to run out, I decided to do some homework today about cervical cancer and what Gardasil does. You guys: I was pretty surprised by what I found. 

The first thing I looked for was the actual figures about cervical cancer itself. According to the most recent estimates from the National Cancer Institute, there were 11,070 women diagnosed with cervical cancer in the US in 2008, and 3,870 deaths attributed to the disease. Some perspective: 182,460 US women were diagnosed with breast cancer in 2008, with 40,480 deaths. In fact, cases of cervical cancer make up just 1.5% of all cancer diagnoses in American women every year, and 0.7% of cancer diagnoses in the US overall.

I was shocked that the incidence of cervical cancer is so relatively low, especially given the number of ads for Gardasil I've seen over the past two years and the number of friends I know who have gotten the vaccine. That said, I do realize that 11,070 cases is 11,070 cases too many, especially if it can be prevented. It's still a no-brainer to take a vaccine that could completely eliminate that risk, no matter how small, right?

But then I realized that many of us already take proven precautions against cervical cancer with yearly Pap tests. And, it seems if more women did the same, that already-small 11,070 figure could drop dramatically: According to the American Cancer Society,
between 60% and 80% of American women with newly diagnosed cervical cancer hadn't had a Pap test in the past 5 years-- and many of them had never had a Pap test.

In light of all this, Gardasil's adoption in its short time on the market seems almost irrational. The CDC reported in October that a whopping 25% of all teenage girls in the US have received the Gardasil vaccine. Virginia now requires by law that girls complete a three-shot vaccination against HPV before they enter the sixth grade, and nearly every other state has had similar bills under discussion since Gardasil's debut.

It seems to me that Gardasil has had a disproportionately large adoption rate for a vaccine that seems poised to benefit such a relatively small potential audience. For me, the jury is still out on whether or not I'm going to take the vaccine-- but after the research I did today I feel more confused than ever.

Seriously-- am I missing something here?  What's up with Gardasil?

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