Monday, October 22, 2012

Things They Should Invent: everyone who has ever been entitled to free cervical cancer vaccine is entitled to free cervical cancer vaccine

Fact: The cervical cancer vaccine is offered for free through school clinics in early adolescence.  (In Ontario, for example, it's offered for free to girls in Grade 8.)

Fact: Because of the students' age and the fact that it's offered through the school, parents can veto it, and many do.

Fact: The cervical cancer vaccine is expensive.  It cost me about $400 to get it 5 years ago.  And, in Ontario at least, it isn't covered by OHIP except for the school clinics for Grade 8 students.

Fact: The cervical cancer vaccine is not useful if you already have HPV.  People are generally considered to have been exposed to HPV if they are sexually active and are not certain are that every single one of their partners was HPV-free.

Fact: Many people become sexually active long before they're able to scrape together $400 to spend on a vaccine.

Problem: This means that people whose parents don't allow them to get the vaccine as adolescents may never be able to get the vaccine, because currently your only chance at a free vaccine is when you're in Grade 8.

Proposed solution: Anyone who was eligible for the free vaccine in Grade 8 (or whenever it's done in their jurisdiction) but doesn't get the vaccine at that point can get the vaccine for free from any health care provider (doctor, walk-in clinic, Student Health, Planned Parenthood) at any point in the future as long as it is not medically contraindicated.  You go in to get your first birth control pills, they also offer you Gardasil.

This won't cost any more to OHIP than they've already stated they're willing to pay (one vaccine per girl who has been in Grade 8 since the program started), and it will achieve the public health objectives far more effectively than leaving people whose parents were overprotective when they were 13 with the choice of delaying their entire sex life until they can scrape together more than a week's take-home pay at minimum wage or foregoing the chance to ever be immunized against the cancer-causing strains of HPV.  Eligibility would be easy enough to verify - it's a function of the patient's age and gender.  And normal medical channels could administer the vaccinations when the patients are willing but their parents are not, because medical professionals don't require parental consent to attend to minor patients' sexual health concerns.

This isn't intended to contradict my usual position that OHIP should pay for all health care that everyone needs at all ever.  However, it would serve as an effective interim measure that would better achieve the stated public health objectives without costing any more than OHIP has already stated they're willing to pay. Multi-win, no-lose situation.


laura k said...

It's perfect. Logical, equitable, and cost-neutral.

impudent strumpet said...

Update for googlers: Toronto Public Health does this.

impudent strumpet said...

And you can sign your own consent form and otherwise get the vaccine without parental involvement if you're 14 or older.