Jane J Kim, PhD, an assistant professor of health decision science in the department of health policy and management at the Harvard School of Public Health in Boston, constructed models to assess the cost-effectiveness of the HPV shot across a range of potential scenarios involving men who have sex with men. The scenarios were based on age, previous exposure to the types of warts that are targeted by the vaccine, and HIV status. Men who test positive for HIV, the virus that causes AIDS, are at higher risk for HPV and anal cancer.
Researchers used measurements called “QALY.” QALY -- which stands for “quality adjusted life year” -- is a measurement of both quality and length of life. In the study, a cost-effectiveness ratio of less than $50,000 per QALY gained is considered a "good value for money."
Vaccinating men who have sex with other men against HPV between the ages of 12 to 26 is a cost-effective strategy, Kim concludes. If further study shows that this vaccine is also effective against HPV-related cancers it may be an even more cost-effective intervention.
This is pretty awesome news. There are still issues to be worked out, of course, particularly in terms of how we get the vaccine to the people most likely to benefit from it. The issue of how people identify sexually versus how they behave sexually, particularly at the ages at which the vaccine will be most effective, will require some decisions to be made about how broadly to cast the vaccination net.
Still, we have an opportunity to help a population that already suffers a disproportionate burden of disease. We can even offer them passive protection up front, when it is most likely to be effective.
Of course, that's not how the Anti-Vaccination Nitwits (yes, I know it's Australian Vaccination Network) sees the issue. From their Facebook page:
Yes, they really did say that young male homosexuals (they left out bisexuals entirely)--and by young, I mean teenagers and very young adults--have a bunch of disposable income. Not only did they indulge in rank stereotyping of gay men, but they completely ignored the truly ugly situation faced by young homosexuals. Or maybe I'm wrong. Maybe Australia is completely civilized in how gay and lesbian teens are treated.
Is it any wonder that the first response to their post was the comment below (removed after six hours on a thoroughly moderated page, according to Reasonable Hank, but captured by StopAVN and brought to my attention by Bob Apthorpe)?
I'm not sure why they bothered to take it down, actually, since it says the same thing the AVN itself said.
Sadly, this stance is entirely in line with what the AVN has previously had to say in an article on HPV vaccines.
This vaccine aims to protect people from a virus that is basically only transmitted when a person engages in what amounts to optional behaviour. HPV is not a public health threat in the same way, say, polio or measles are.
Did I get HPV through having sex? Yes. But it seems a bit odd to refer to something that half of all Australian teenagers have done before leaving high school as "optional behaviour." It's the most pointless of technicalities. Still, that usually how the AVN gets their victim blaming in, if this article is any indication.
Most women who develop invasive cervical cancers have not had regular Pap smears. So to say that because 1,000 women in the U.K. die of cervical cancer every year, and there is thus an urgent public-health need to vaccinate every adolescent girl--without mentioning that many if not most of these women did not have regular screenings--is somewhat disingenuous.
Because heart disease, lung cancer, diabetes, emphysema, and everything else that has a partial cause in human choices is not actually any kind of public health issue. Again, right.
I guess the only thing to do now is to wait for actual vaccination recommendations to be made. In the meantime, we can all "amuse" ourselves laying bets on how the AVN will react to the news. Will it be clueless stereotyping, ignorance of human behavior, or a combination of the three?