how many is “a couple”?

Andy and I have been having this argument as to how many is “a couple.” For example, if I say, “I would like a couple of pancakes,” I mean that I want two. But Andy believes that “a couple” can be two or three. What do you think?

Filed under: The more you know

public health and the HPV vaccine

A few months ago, I was following the developments regarding the new HPV vaccines being released by Merck and Glaxosmithkline. The news of the vaccine itself didn’t concern me, but the companies’ attempts to lobby federal and state lawmakers to require school-aged girls to receive the vaccine did.

At the time, Texas Governor Rick Perry had ordered all school-aged girls to receive the vaccination. Since then, this order was overturned by the state legislature when it was revealed that “Merck hired Gov. Rick Perry’s former chief of staff as a lobbyist, and contributed $6,000 to the governor and $38,000 to other legislators.”

Virginia is currently the only state to have a mandate for Merck’s Gardasil, but financial connections run deep there as well. According to the NYT article,

Merck has a growing economic interest in Virginia. In December 2006, Merck announced it would invest $57 million to expand its Elkton, Va., plant to make Gardasil, helped by a $700,000 grant from a state economic development agency that is part of the executive branch. Two months later, Gov. Tim Kaine, who has been mentioned as a possible Democratic vice presidential candidate, signed legislation requiring Gardasil for schoolgirls. Four months after that, Merck pledged to invest $193 million more in the plant to make drugs and vaccines, helped by a state grant of $1.5 million.

Merck said it will not longer actively lobby for state mandates.

To be clear, I believe there are legitimate reasons for choosing to vaccinate yourself or your child and legitimate reasons not to. My concern is state and federal governments using large amounts of public health dollars going towards vaccination. There are finite public health dollars. Therefore, if a state uses money to pursue universal HPV vaccination, it then has to stop funding something else.

Ninety percent of cervical cancer cases (which is caused by HPV) are found in the developing world, where the $360 price tag for the vaccine is prohibitive. In the United States, approximately 3,500 women die of cervical cancer each year. This is less than lung cancer (70,000), breast cancer (40,000), colon cancer (26,000), pancreatic cancer (16,500) , ovarian cancer (15,000), and many others.

The NYT article also stated that of the 3,500 women who died, most had not received regular Pap smears, which is the primary way of detecting cervical cancer. Those who have received the HPV vaccine must also continue to receive pap smears as the vaccine only protects against 70% of HPV strains.

I can’t speak to the science perspective, but questions are being raised about side effects and long-term protection (a booster shot may be needed every 3-5 years making the vaccine even more expensive).

The obvious question to me is: it worth the trade off? Is the benefit of mandatory vaccination of HPV worth the cost of losing other public health services? Merck would like you to think so. But to me, it’s not.

Most of the information stated above came from Researchers Question Wide Use of HPV Vaccines, Drug Makers’ Push Leads to Cancer Vaccines’ Rise, and the American Cancer Society.

Filed under: The more you know

gauging cell phone users

Ever wonder why your cell phone bill always includes 4-5 lines of “fees and taxes” that inevitably add at least $10 to your bill? OpenCongress, the “Congress Gossip Blog,” has an interesting write up on how the taxes started and McCain’s bill to put a moratorium on new ones. While most blanket taxes are regressive, I do think the poor are particularly disadvantaged with cell phones taxes, as this is often their sole form of communication. For land lines you first need a permanent residnce and a deposit, which can be hard to come by for low-income families. Plus, if you’ve failed to pay your land line bill in the past, they’re not going to give you another one unless you pay the back debt and pay an additional hefty deposit. On the other hand, cell phones, and pre-paid cellphones in particular, don’t require a deposit or a permanent residence. They’re cheaper and easier to acquire.

Filed under: The more you know