RE: Gardasil question

[Guest guest]

You and I would have a one sided heated discussion on this point. I am in 100% agreement with you! I feel angry with the pharmaceutical companies for their manipulation of patients and physicians.

Your handout is gperfect and hopefully patients will take the time to read it. I felt my blood pressure rising just reading it.

Alla Kirsch, M.D.

[Guest guest]

I’m not an MD, but the doctor who

shares space with us stopped doing them when Merck put out the warnings about

the patients who were having bad side effects. As a mom of an 8-year old girl,

I’m not going to allow her to be vaccinated for this just yet.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Skaggs

Sent: Monday, December 15, 2008

7:56 AM

To: practiceimprovement1

Subject:

Gardasil question

I know on

this list we usually talk in terms of how to get paid for immunizing, where to

buy vaccines, etc...but I have more of a clinical question. Am I the only

one not thrilled with Gardasil ? Sure the CDC recommended it...and surely

they are smarter than I..but I really wonder how smart we are to spend that

much money on something with such limited potential benefit. I mostly

don't see kids, so it doesn't come up for me that much, but see my handout that

I whipped up because there is a family bringing in a young gal today and they

specified that they want Gardasil.

The other vaccine I lie awake worrying about is that for varicella....We

now have a generation of teens, soon to be young adults who do not have natural

immunity...and lucky for the vaccine manufacturer (Merck, I think)

will now need a lifetime of periodic boosters...and they don't dare just blow

it off and take their chances...varicella is much more wicked in adults..

We have seen what the fear of shigles has done for the sales of

Zostavax.... yet another vaccine I have doubts about.

Don't get me wrong, I'm not against immunizations. My kids got all the

recommended ones.... I get a flu shot every year....My horses get a whole pile

of them every January and West Nile boosters

in the warm months, and Flu-rhino 2-4 times per year...but these newer

ones worry me.

What do you guys think?

Annie

--

Annie Skaggs

Lexington, KY

[Guest guest]

I am glad someone has had the courage to post this and I have given GArdasil , but not much LOnna's post makes sense to me.I thought I was the only wierdo questioning .I mean the press is so good we can prevetn cancer but it is not that simple

pap smears are the ultimate low tech preventive medicine.Although you have to be seen pap smears are better for undeveloped countries in some ways becasue they are cheaper than vaccines For vaccine syou need needles and refigerators and gathering people up and doing it three times on schedule Do a pap and any well trained professional can do it plus you'd get to take a bp counsel about contraception etc etc.

I understand that abnl paps from hpv mean m any visits and much care and some procedures I do not discount the usefulness for some folks of this vaccine but I remain skeptical about putting it int he water so to speak for now.

Jean

I like your handout, .I have two primary concerns regarding. Gardasil. First, we only know that it protects against the 4 strains of HPV that are in it for about 5 years. That doesn't seem like long enough to me. If it does give lifelong immunity, it might be cost effective, but that isn't know yet.

Second, it is recommended for girls and women 9-26, and the focus is on giving it to 11-12 year olds. The studies that were done on the vaccine were primarily on girls 16-26. There were very few younger girls in the studies; read the package insert for a start. It is somewhat amazing that we are giving it to an age group that was studied so little.

In this country, where most women get paps and we have a relatively good system set up for cervical cancer screening, the vaccine does not seem

necessary. Perhaps in other countries with less access it makes more sense, or perhaps as our country spirals into chaos, the vaccine will become more needed, but the money is better spent elsewhere, like on improving access to primary care.

Lonna

Subject: Gardasil questionTo: " practiceimprovement1 " < >

Date: Monday, December 15, 2008, 7:56 AM

I know on this list we usually talk in terms of how to get paid for immunizing, where to buy vaccines, etc...but I have more of a clinical question. Am I the only one not thrilled with Gardasil ? Sure the CDC recommended it...and surely they are smarter than I..but I really wonder how smart we are to spend that much money on something with such limited potential benefit. I mostly don't see kids, so it doesn't come up for me that much, but see my handout that I whipped up because there is a family bringing in a young gal today and they specified that they want Gardasil.

The other vaccine I lie awake worrying about is that for varicella... .We now have a generation of teens, soon to be young adults who do not have natural immunity...and lucky for the vaccine manufacturer (Merck, I think) will now need a lifetime of periodic boosters...and they don't dare just blow it off and take their chances...varicella is much more wicked in adults.. We have seen what the fear of shigles has done for the sales of Zostavax.... yet another vaccine I have doubts about.

Don't get me wrong, I'm not against immunizations. My kids got all the recommended ones.... I get a flu shot every year....My horses get a whole pile of them every January and West Nile boosters in the warm months, and Flu-rhino 2-4 times per year...but these newer ones worry me.

What do you guys think?Annie-- Annie SkaggsLexington, KY

-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

I have not been actively recommending or giving Gardasil.That said, I

can imagine that even if it lessens the chance of getting cervical cancer for the

10% of patients who don't have spontaneous hpv resolution, as was mentioned before,

in lesser developed countries it may be cost effective.Paps are only

good if they are repeated. To do that a patient must return for more testing. There

have to be trained providers to do the pap properly, then get it to a center for a

pathologist to look at. Then have follow up for any abnormalities. All of that

takes a ton of time and money really.In less developed countries, each step in

that process can easily break the chain and lead to inadequate care. Getting a population some vaccines that may lessen the chance of cancer for 1% or

10% might be very, very helpful.Therefore, though I have questions about

Gardasil, especially in our country, I still remain hopeful that the method could be

helpful for millions of women in the world.Finally, I would support

regular Gyn care for all women throughout the world as such care is much, much more

than just getting a pap or preventing cervical cancer. So, that would be my primary

focus. My thoughts on Gardasil only relate to trying to help with that one issue

until resources could support full gyn services. It's just the reality of the

world that millions (billions?) of women simply do not have access to optimal, or

even near-optimal, gyn care.Tim

I am glad someone has had the courage to

post this and I have given GArdasil , but not much LOnna's post

makes sense to me.I thought I was the only wierdo questioning .I mean the press is so good we can prevetn cancer but it is not that simplepap

smears are the ultimate low tech preventive medicine.Although you have to be seen pap smears are better for undeveloped countries in some ways becasue they are

cheaper than vaccines For vaccine syou need needles and refigerators and gathering

people up and doing it three times on schedule Do a pap and any well trained

professional can do it plus you'd get to take a bp counsel about contraception etc etc. I understand that abnl paps from hpv mean m any visits and

much care and some procedures I do not discount the usefulness for some folks of

this vaccine but I remain skeptical about putting it int he water so to speak for

now.Jean

I like your handout, .I have two primary

concerns regarding. Gardasil. First, we only know that it

protects against the 4 strains of HPV that are in it for about 5 years. That doesn't seem like long enough to me. If it does give lifelong

immunity, it might be cost effective, but that isn't know yet.Second, it is recommended for girls and women 9-26, and the focus is

on giving it to 11-12 year olds. The studies that were done on the

vaccine were primarily on girls 16-26. There were very few younger

girls in the studies; read the package insert for a start. It is

somewhat amazing that we are giving it to an age group that was studied

so little.In this country, where most women get paps and we

have a relatively good system set up for cervical cancer screening, the

vaccine does not seem necessary. Perhaps in other countries with

less access it makes more sense, or perhaps as our country spirals into

chaos, the vaccine will become more needed, but the money is better

spent elsewhere, like on improving access to primary care.Lonna

Subject:

Gardasil questionTo:

" practiceimprovement1 "

>Date: Monday, December 15,

2008, 7:56 AM

I know on this list we usually talk in terms of how to get paid for

immunizing, where to buy vaccines, etc...but I have more of a clinical

question. Am I the only one not thrilled with Gardasil ? Sure the CDC

recommended it...and surely they are smarter than I..but I really wonder

how smart we are to spend that much money on something with such limited

potential benefit. I mostly don't see kids, so it doesn't come up for

me that much, but see my handout that I whipped up because there is a

family bringing in a young gal today and they specified that they want

Gardasil.The other vaccine I lie

awake worrying about is that for varicella... .We now have a generation

of teens, soon to be young adults who do not have natural immunity...and

lucky for the vaccine manufacturer (Merck, I think) will now need a

lifetime of periodic boosters...and they don't dare just blow it off and

take their chances...varicella is much more wicked in adults.. We have

seen what the fear of shigles has done for the sales of Zostavax.... yet another vaccine I have doubts about.Don't get me

wrong, I'm not against immunizations. My kids got all the recommended

ones.... I get a flu shot every year....My horses get a whole pile of

them every January and West Nile boosters in the warm months, and Flu-rhino 2-4 times per year...but these newer ones worry me.What do you guys think?Annie-- Annie SkaggsLexington, KY

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[Guest guest]

Not to put too rabid a slant on things: http://www.lifesitenews.com/ldn/printerfriendly.html?articleid=07092004

I like your handout, .I have two primary concerns regarding Gardasil. First, we only know that it protects against the 4 strains of HPV that are in it for about 5 years. That doesn't seem like long enough to me. If it does give lifelong immunity, it might be cost effective, but that isn't know yet.

Second, it is recommended for girls and women 9-26, and the focus is on giving it to 11-12 year olds. The studies that were done on the vaccine were primarily on girls 16-26. There were very few younger girls in the studies; read the package insert for a start. It is somewhat amazing that we are giving it to an age group that was studied so little.

In this country, where most women get paps and we have a relatively good system set up for cervical cancer screening, the vaccine does not seem necessary. Perhaps in other countries with less access it makes more sense, or perhaps as our country spirals into chaos, the vaccine will become more needed, but the money is better spent elsewhere, like on improving access to primary care.

Lonna

Subject: Gardasil questionTo: " practiceimprovement1 " < >

Date: Monday, December 15, 2008, 7:56 AM

I know on this list we usually talk in terms of how to get paid for immunizing, where to buy vaccines, etc...but I have more of a clinical question. Am I the only one not thrilled with Gardasil ? Sure the CDC recommended it...and surely they are smarter than I..but I really wonder how smart we are to spend that much money on something with such limited potential benefit. I mostly don't see kids, so it doesn't come up for me that much, but see my handout that I whipped up because there is a family bringing in a young gal today and they specified that they want Gardasil.

The other vaccine I lie awake worrying about is that for varicella... .We now have a generation of teens, soon to be young adults who do not have natural immunity...and lucky for the vaccine manufacturer (Merck, I think) will now need a lifetime of periodic boosters...and they don't dare just blow it off and take their chances...varicella is much more wicked in adults.. We have seen what the fear of shigles has done for the sales of Zostavax.... yet another vaccine I have doubts about.

Don't get me wrong, I'm not against immunizations. My kids got all the recommended ones.... I get a flu shot every year....My horses get a whole pile of them every January and West Nile boosters in the warm months, and Flu-rhino 2-4 times per year...but these newer ones worry me.

What do you guys think?Annie-- Annie SkaggsLexington, KY -- Annie SkaggsLexington, KY