*Everybody* Should Be Allowed to Choose the HPV Vaccine
Choosing medicine should be recognized as an individual civil liberty
I originally posted this brief essay on Medium back in March. Today, I’m cross-posting an update with tears in my eyes.
Awhile back, I casually mentioned my contribution to the development of HPV vaccines to a local bartender. The bartender then pointed to a long scar on his neck where he had just had an HPV-induced throat cancer removed. He looked to be about my age (50ish) and he wondered aloud why he and I had effectively been forbidden to choose the HPV vaccine back when it first became widely available (2007). I felt my face flush. I confessed that in 2008 I convinced my employer to offer me the vaccine because of my occupational risk from handling live HPV in the lab. The truth is that I mainly wanted the vaccine because I’m a gay man, and my demographic correlates with dramatically increased risk of developing HPV-induced cancers. I found a lifeboat for myself while quietly watching people like my bartender swim in shark-infested waters. Mea culpa. Mea maxima culpa. OK, maybe not maxima culpa — I don’t legislate federal healthcare policy. But I certainly feel at least a little culpable. In penance, I’m choosing to speak out publicly. Everybody should have been allowed to choose the HPV vaccine in 2007. The paternalistic regulations that deny my bartender the freedom to choose which safe, potentially life-saving, non-addictive medicines he puts in his own body are a moral outrage. This is America. The land of the free. We have to do better.
HPV-induced cancer is a long slow process, but there’s a realistic chance that vaccination in 2007 would have prevented the HPV infection that caused my bartender’s throat cancer in 2021. On the other side of the risk/benefit ledger, the HPV vaccine is safe as houses. In the U.S., the vaccine isn’t cheap — the current out of pocket price would be about $250 without insurance. Like many other lifesaving medicines in our disastrously oligopolized healthcare “marketplace,” the price has been jacked up much faster than the rate of inflation. It’s estimated that the cost of producing the vaccine is about $5.
It would be great if America could use fair market competition to get its healthcare costs under control, but even with the current monopoly extortion pricing the HPV vaccine could still be considered relatively cheap insurance. I’ve known people who had anal cancer and, while it’s not one of the most lethal cancers out there, the morbidity is truly brutal. I really do not want anything like that to happen to me. Moreover, we’re still in the process of finding out what other cancers HPVs might be causing. I contributed to a recent study strongly suggesting that HPVs are causing at least some small fraction of bladder cancers. Better safe than sorry, as far as my bartender and I are concerned.