Posted by: bridget | 25 February 2007

Texans Sue to Stop Vaccinations

Texans are suing to stop the State from implementing the executive order, signed by Gov. Rick Perry, which would require middle school girls to be innoculated with Merck’s STD vaccine. The lawsuit does not raise issues of parental authority and moral objections to the vaccine (Texas has an abstinence-only sex ed policy), but focuses on the ability of the governor to issue such executive orders.

Gov. Perry is a Republican. Many GOPs are upset with the measure and are issuing a legislative bill to block the executive order. This is where the Constitutional fun comes in: which one wins? If Gov. Perry does indeed have the authority to issue an executive order, it could only be trumped by the legislature if his authority is dormant (only allowable when the legislature has not spoken to that particular issue).

Gov. Perry’s office stated that requiring the vaccine will ultimately save money for Texas. First of all, when most parents are paying for the vaccine themselves (this amounts to a tax on parents of middle-school girls), the state will naturally reap the benefits without the burdens. This does not, however, translate into a cost-effective vaccine. As previously blogged, the vaccine will be a lot less expensive when it goes off patent; mandating its use now is not cost-effective.

The vaccine costs approximately $400. According to the Census, there are approximately 3,166,000 girls under the age of 18 in Texas. Over the next nine years (patent term for Gardasil), approximately 1.58 million girls will have to receive the vaccine. The total cost will be $633 million dollars, or $70.3 million per year. The vaccine prevents 70% of the 10,000 annual cervical cancer cases, of which 3,700 result in death. (Cervical cancer can be caused by, inter alia, smoking, the Pill, and genital herpes.) Assuming a perfect distribution of cervical cancer cases in Texas as across America, there will be 539 cases of cervical cancer that are prevented by the vaccine every year. Of those women 200 women would have died.

The average age for women to develop cervical cancer is 50-55. Therefore, it will take roughly 40 years to see a benefit from the vaccine. The vaccine does not reduce the need for Pap smears, so that cost is not canceled out or reduced from having the vaccine. $633 million spent now is not the equivalent of $633 million forty years from now. Assuming an interest rate of 4% (historical average for savings – this results in a lower number than the 7% used for the stock market), today’s $70.3 million, with a benefit seen in forty years, is equivalent to roughly $586 million.

$586 million for 539 cases of cervical cancer: this only balances out if each case of cervical cancer will cost $1 million to fight. While the 200 lives saved are priceless, it is not the best use of resources to spend $2.9 million per woman. Isn’t there a better use of public and private resources?

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