Monday, January 26, 2009

Gardasil: Why? גארדאסיל: למה כן

I’m not running to give my daughters the Gardasil vaccine, even though it’s been offered to my oldest two. I discussed it with each of them, and we decided not to go for it. Why not?

I intuitively felt that it was just three more injections that aren’t really going to be of any benefit, so why get them? Just to satisfy myself that I’m not outside the ballpark in my thinking, I consulted here, wherein is stated multiple times that 1) The vaccine does not replace regular pap smears and 2) It does not protect against other venereal diseases / STDs. Further, there’s fortunately no history of cancer in my family, so we’re not in a risk group.

Therefore I conclude that it won’t have any substantial effect on either my daughters’ health or their behavior, i.e., their partners will still have to use condoms, and they’ll still have to get regular pap smears. I just don’t feel like spending ₪550.00 for what seems like no marginal gain.

Yes, I know that “money” is a dirty word when spoken in the same breath as “health care”; we’re supposed to spare nothing when it comes to our kids’ health. But let’s be honest: Everyone has their ceiling, and every commodity has its market limit. What if Gardasil cost ₪5,500.00? Would it still be recommended? How accessible would it be? I admit that if it cost ₪55.00, I might think differently. Should I be sent to parent detention for such an awful admission?

This decision is consistent with my view that medical advances are not a substitute for healthful living and taking reasonable precautions. This philosophy colored my decisions not to give my kids chewable vitamins and not to run for the medicine chest or to the doctor to beg for antibiotics every time they have a fever. I told them that our bodies need nutrients from actual (nutritious) food, not pills; and that fevers happen for a reason and (up to a point) our immediate reaction need not be to suppress them and their symptoms. Finally, apparently I’m not alone: See here, here, and here.

?חיסון נגד סרטן צוואר הרחם: מועיל

לפני שמתחילים להתרוצץ למרפאה הקרובה, כדאי
לברר כמה עובדות:
· "החיסון אינו מחליף מעקב שגרתי אחר למניעת סרטן צוואר הרחם. על נשים המקבלות גרדסיל להמשיך לעבור בדיקות לגילוי סרטן צוואר הרחם כנהוג."
· החיסון פעיל לגבי 70% מהסוגים של סרטן צוואר הרחם. ז"א שעדיין ל30% מהסוגים, לא קיימת הגנה.
מה זה אומר ברמה המעשית?
· עדיין קיים הצורך לבדיקות שגרתיות, כולל משטח pap שנתי.
· סרטן צוואר הרחם מתפתח מנגיף הפאפילומה האנושית, המועבר דרך מגע מיני. ז"א שזוג אינו פתור משימוש באמצעים (קרו: קונדומים).

"תכלס": החיסון הוא אינו תרופה-המרפאת-הכל.


  1. (Mir)Yam,
    Like you, I opted, at least for now, to not give my teenage daughter the human papiloma virus vaccin. We should not use vaccins just because they exist. Use of them has to be carefully weighted, as with most things there are pro's and cons. I fear that the use of the vaccin might impose false feeling of protection to girls and woman. But, it is especially those who are at higher risk for not protecting themselves who should get Gardasil.
    To add just an egoistic note to this, the vaccin is too new to be given to my daugther. We'll hang in there for a while and keep following it up

  2. I would geve them the shot. I'm waiting for the shot to be open to boys too, so they don't spread those particular nasty strains of HPV to their spouses. Yes, we should use condoms, yes we should be careful but I know of a few women who got precancerous HPV from -their husbands! Most people don't use condoms every time with a spouse. These women went through considerable pain, expense, and annoyance with extra pap smears, biopsies, and cervical freezings.

    However, of all the vaccines to skip, this one is one that doesn't pose as much of a significant public health problem the way skipping other vaccines does. Unless of course, your kid picks up a cancer causing strain and passes it down the road to the next person.

  3. M, you make interesting points, esp. the giving it to boys!