The Journal of Law, Medicine & Ethics weighs in on mandatory Gardasil shots
A trio of academics have joined the ‘Pro/Con’ debate over the policy of requiring girls to be vaccinated with Merck’s Gardasil. In a recent issue of the Journal of Law, Medicine & Ethics, Gail Javitt of Johns Hopkins’s Berman Institute of Bioethics, Deena Berkowitz of George Washington University School of Medicine and Lawrence Gostin of Georgetown University Law Center offer five points against the practice of
- The long-term safety and effectiveness is unknown;
- historical justifications for mandated vaccination have not been met;
- in the absence of historical justification, the government risks public backlash by mandating vaccination;
- mandatory vaccination for girls – and not boys – may violate constitutional principles of equality and due process;
- and there are unresolved economic concerns over Gardasil’s cost and insurance coverage.
They go on to write…
- “While the emergence of an HPV vaccine reflects a potentially significant public health advance, the vaccine raises several concerns.
- Long-term safety and effectiveness of the vaccine are unclear, and serious adverse events reported shortly after the vaccine’s approval raise questions about its short-term safety as well.
- In light of unanswered safety questions, the vaccine should be rolled out slowly, with risks carefully balanced against benefits in individual cases.
- The legal and ethical justifications that have historically supported state-mandated vaccination do not support mandating HPV vaccine.
- Specifically, HPV does not threaten an imminent and significant risk to the health of others. Mandating HPV would therefore constitute an expansion of the state’s authority to interfere with individual and parental autonomy.
- Engaging in such expansion in the absence of robust public discussion runs the risk of creating a public backlash that may undermine the goal of widespread HPV vaccine coverage and lead to public distrust of established childhood vaccine programs for other diseases.
- The current sex-based HPV vaccination mandates present constitutional concerns because they require only girls to be vaccinated. Such concerns could lead to costly and protracted legal challenges.
“Finally, vaccination mandates will place economic burdens on federal and state governments and individual practitioners that may have a negative impact on the provision of other health services. In light of these potentially adverse public health, economic, and societal consequences, we believe that it is premature for states to add HPV to the list of state-mandated vaccines.” The Centers for Disease Control and Prevention last month declared that Gardasil is not likely the cause of numerous adverse events. The CDC review of the Adverse Effects of Gardasil followed disclosures twice last year by Judicial Watch, a conservative group, who is using the Freedom of Information Act to get internal FDA reports about Gardasil side-effects. Additionally Judicial Watch is compiling and analysing VAERS reports that include thousands of adverse reactions and several deaths.
Separately, a recent study in the New England Journal of Medicine found the vaccine, which is approved for girls and young women ages 9 to 26, isn’t cost effectiveness for those older than 18. The benefit depends on how long Gardasil’s protection will last, although Merck contends the vaccine is cost effective for women through age 24. Gardasil costs about $360 for a three-dose regimen.
Source:WSJ Health , the Journal of Law, Medicine & Ethics, Judicial Watch, The Centers for Disease Control and Prevention
