Health policy and human papillomavirus vaccine implementation

¶ … Human Papilloma Virus (HPV) in the United States of America. It also discusses its association with different diseases. It highlights the role played by federal and state government to control this disease from preventing. In addition to that this paper also discusses whether the Human Papilloma Virus (HPV) vaccination should be made mandatory for girls entering sixth grade or not.

Human Papilloma Virus (HPV) can be defined as a group of viruses that have almost hundred types. About forty of these types are very dangerous for the genital area. They infect the areas such as skin of penis, vulva or anus. They also harm the vaginal lining, rectum and cervix. High risk is associated with some of these types and they can lead towards high abnormalities in pap tests and they may cause various cancers, including cervical cancer. Whereas, some of these types have low risk and they cause low level abnormalities in Pap test or Pap smear. Generally the low risk types are the cause of genital warts. ("Human papillomavirus (hpv),")

Human Papilloma Virus (HPV) is the most common disease which is being transmitted through sexual contact in the United States of America. At the present time about twenty million citizens of the United States of America are infected with this dangerous disease. According to an analysis minimum fifty percent of men and women who are active sexually do get infected with Human Papilloma Virus (HPV) once in their lifetimes. It is also being determined that by the age of fifty about eighty percent of the women in the United States of America would be infected with this virus. The estimated amount of cases that are reported in the United States of America each year related to cancer associated Human Papilloma Virus (HPV) type 16 and 18 is 22000 out of which about 7000 cases of Human Papilloma Virus (HPV) associated cancer are found in the male gender. About 6.2 million citizens of the United States of America get infected with this virus annually. ("Human papillomavirus (hpv),")

Human Papilloma Virus (HPV) usually passes from one person to the other through sexual contact. As this is a silent disease and most patients do not have any idea that they are infected with Human Papilloma Virus (HPV) because of the non-occurrence of any prominent symptoms therefore they can easily transfer the disease to their sex partner. However, there is very probability of a mother passing the disease to a baby during a non-surgical delivery. ("Human papillomavirus (hpv),")

The most dangerous complication caused by the Human Papilloma Virus (HPV) is cervical cancer in women. Continuous presence of high risk Human Papilloma Virus (HPV) types that is HPV 16 and HPV 18 can lead towards the infection of the cervix which may result in cervical cancer. The American society of cancer has estimated that about 12,170 fresh cases of Cervical cancer will be reported in the United States of America and there is also a probability that about 4210 women will die in the United States of America due to cervical cancer associated with HPV 16 and HPV 18. Cervical cancer is prevalent among women only in the United States of America but throughout the world. It is estimated that about 470000 fresh cases of cervical cancer associated with HPV 16 and 18 will be reported globally and about 233000 women will die throughout the world due to this disease. ("Human papillomavirus (hpv),")

Apart from cervical cancer HPV can also be responsible for anal cancer as the lining of the anus is similar to that of the cervix. It has been observed that a prominent number of cases of anal cancers were associated with HPV 16 and 18. According to the studies conducted in the United States of America about 35 men out of a set of 100000 men, who are not suffering from HIV, are patients of anal cancer. Whereas, among the men who are suffering from HIV the rate of anal cancer increases from 35 to 70. It has also been observed that about sixty percent of men who are not infected with HIV and have sex with men and about ninety percent of those who are infected with HIV and have sex with men are suffering from Human Papilloma Virus (HPV) in relation to their anal canals. It has also been indicated by studies that the rate of anal cancer among gay and bisexual men is five to ten times greater than that of cervical cancer among women. (Matterson)

Low risk Human Papilloma Virus (HPV) types including HPV 6 and HPV 11 are most commonly associated with diseases like genital warts. It has been indicated by different studies that the rate of increase in genital warts is two times greater than the rate of increase in genital herpes. Genital warts are caused by a limited number of Human Papilloma Virus (HPV) types. Other types usually cause warts on the palms and soles of feet. Genital warts are very contagious in nature can easily transmit from one sexual partner to another. It has been indicated by several studies that every two out of three people having sex with partners who have genital warts get infected with them too. Genital warts are not visible all the time therefore an infected person easily transmit it to the other person. It has also been estimated by studies that each year about one million fresh cases of genital warts will be reported in the United States of America. (Matterson)

According to a survey conducted by American Social Health Association (ASHA) the people who have suffered from Human Papilloma Virus (HPV) have adverse effects on their personality. It was observed that these people had signs of depression, anger and shame. In addition to that the people infected with Human Papilloma Virus (HPV) also hesitate indulging in sexual activity. (Matterson)

History, Background and Availability of Human Papilloma Virus (HPV) Vaccine

The first vaccine that was being designed to prevent the prevalence of Human Papilloma Virus (HPV) in the people was Gardasil. It was manufactured by Merck. The Food and Drug Association (FDA) of the United States of America approved and licensed Gardasil to be used by females on June 2006. Gardasil is also known as quadrivalent HPV vaccine or HPV4. In 2009 this vaccine was also licensed to be used by the male population that is infected with the Human Papilloma Virus (HPV). Another vaccine known as Cervarix or bivalent HPV vaccine (HPV2) was approved to be used by the infected female population in October 2009. Cervarix was manufactured by Glaxo Smith Kline. The HPV 4 vaccine that is Gardasil has been available in the market since last seven years whereas, the HPV2 vaccine that is Cervarix's time on market is three years. ("Recommendations on the," 2011)

Gardasil, the quadrivalent HPV4 vaccine provides guard against four types of Human Papilloma Virus (HPV) that is type 6, type 11, type 16 and type 18. Whereas, Cervarix, the bivalent HPV2 vaccine provides guard against two types of Human Papilloma Virus (HPV) that is type 16 and type 18. ("Recommendations on the," 2011)

In the month of April 2011, Gardasil was licensed and approved by one hundred and twenty three countries and by the same Cervarix was approved to be used in one hundred and fourteen countries. Even though these vaccines are licensed in a number of countries but they have not been marketed in each and every country till now. ("Hpv vaccines," 2012)

The Human Papilloma Virus (HPV) vaccines are injected in three doses and the cost per dose is dollar 120, which accumulates to dollar 360 per course. This is a very costly medication and cannot be afforded by everyone ("Hpv vaccine: Implementation," 2008). Therefore, the GAVI Alliance, which is an alliance of the top most health agencies of the world, has entered into an agreement with Merck and Co. regarding the price of Gardasil in June 2011. According to this agreement GAVI Alliance will provide the HPV4 vaccine at dollar 5 per dose and the countries that are interested to get GAVI's support in relation to the vaccination will be entitled to pay dollar 0.20 to dollar 0.40 per dose. ("Hpv vaccines," 2012)

Role Played by Federal Government in Human Papilloma Virus (HPV) Policy Making

In the United States of America in the 21st century is considered as the era of vaccinations. In the United States of America vaccinations have been very beneficial for the citizens as due to different kind of vaccinations the life period of the citizens has increased up to thirty years. In addition to that when a child is born in the United States of America he can be provided guard against more than seventeen diseases through vaccinations. Moreover, the appropriate use of vaccination can save the lives of two to three million people each year throughout the globe. ("2010 national vaccine," 2010)

Human Papilloma Virus (HPV) is one of the most commonly spread and the most dangerous disease in the United States of America. Eradicating this disease from the society can turn out to be a painstaking job for the government of America. It may require mass and robust campaigns to educate the society about this disease and to get a large amount of citizens vaccinated. In order to eliminate this disease from the country and to secure the lives of citizens different programs have been introduced by the federal government an example of such programs include National Vaccine Program (NVP). ("2010 national vaccine," 2010)

This program has a number of specific goals. The objectives of this program include; development of advanced and efficient vaccines, establishment better and secure vaccination program, educate people about vaccination programs so that they can make better decisions about whether to get vaccinated or not, facilitate the supply and availability of recommended vaccines in the United States of America and to eradicate hazardous diseases throughout the globe by the use of effective and efficient vaccines. ("2010 national vaccine," 2010)

The federal agencies involved in the campaign to eliminate this hazardous disease from the United States of America include, Centers for Disease Control and Prevention (CDC), Administration for Children and Families (ACF), Food and Drug Administration (FDA), Global Alliance for Vaccines and Immunizations (GAVI), the National Cancer Institute (NCI), National Institute of Health (NIH), Department of Human and Health Services (DHHS), The Advisory Committee on Immunization Practices (ACIP) etcetera. ("2010 national vaccine," 2010)

The Advisory Committee on Immunization Practices (ACIP) can be defined as a group of people who have professional expertise in the field of medicine and public health. Their basic responsibility is to make recommendations regarding the use of different vaccines in order to eliminate hazardous diseases from the United States of America. ("The advisory committee," 2012) The Advisory Committee on Immunization Practices (ACIP)

The Advisory Committee on Immunization Practices (ACIP) works in association of about thirty organizations. These are professional organizations that are regarded with high esteem in the field of medicine and public health. These organizations are very professional in their working style and they work with the Advisory Committee on Immunization Practices (ACIP) to prepare different schedules to prevent children and families from dangerous diseases. The agencies that are responsible for the operations Advisory Committee on Immunization Practices (ACIP) include the Center for disease Control and Prevention (CDC), Department of Human and Health Services (DHSS), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). ("The advisory committee," 2012)

The Advisory Committee on Immunization Practices (ACIP) consists of fifteen members. All these members have a high degree of experience in the field of medicine and public health. These members are learned and scholarly people who are experts of their respected fields. All these members are selected by the secretary of the Department of Human and Health Services (DHSS) of the United States of America. These members are selected by a scheduled process which includes the members to submit an application, and then they are called for an interview and the last step of the selection process through nomination. ("The advisory committee," 2012)

Fourteen members of The Advisory Committee on Immunization Practices (ACIP) are experts in different scientific fields including the areas of immunology, Vaccinology, pediatrics, public health, family medicine and virology etcetera. The remaining one member of the Advisory Committee on Immunization Practices (ACIP) is the representative of the common men or the consumers. The responsibility of this member is to inform The Advisory Committee on Immunization Practices (ACIP) regarding the perspective of people in relation to their recommendations. ("The advisory committee," 2012)

The operations and working schedule of the Advisory Committee on Immunization Practices (ACIP) includes three meetings that the Advisory Committee on Immunization Practices (ACIP) holds with the Center for Disease Control and Prevention (CDC) at Georgia in Atlanta. In these meetings the members the Advisory Committee on Immunization Practices (ACIP) represent their findings regarding the characteristics, efficiency and effectiveness of different medicines. In addition to that these members also present the report on the availability of these vaccines in the market and the statistical analysis regarding the demand and supply of these vaccines. ("The advisory committee," 2012)

The members also recommend the ages at which people should be vaccinated, the number of doses that make up the complete course of vaccination and the length of break that should be taken between two doses. In addition to that the members of the Advisory Committee on Immunization Practices (ACIP) also comment on the precautions that people should take while they are getting vaccinated and they also put light on the drawbacks of these vaccinations. The data related to these meetings are easily available on the website of the Advisory Committee on Immunization Practices (ACIP). ("The advisory committee," 2012)

Apart from these meetings, the Advisory Committee on Immunization Practices (ACIP) also works in the form of workshops. These workshops stay active throughout the year as they have to inform the Advisory Committee on Immunization Practices (ACIP) regarding the efficiency of different vaccines. Even before a vaccine is being given a license by the Food and Drug Association (FDA) of the United States of America the workshops of the Advisory Committee on Immunization Practices (ACIP) start analyzing these vaccines. Thousands of lab tests and experiments are conducted on a number of volunteers in order to ensure that the vaccine is really beneficial for the general public. After examining the vaccine for a number of times the workshops then represent their data in front of the Advisory Committee on Immunization Practices (ACIP). The workshops, however, do not make the final recommendation about the use of medicine. Due to the lengthy procedure used for the examination and analysis of the vaccines the license procedure may take a number of years. ("The advisory committee," 2012)

The Advisory Committee on Immunization Practices (ACIP) does not have the authority to make laws. The primary fifteen members of the Advisory Committee on Immunization Practices (ACIP) make recommendations regarding the use of vaccines. These recommendations are then approved by the Center of Disease Control and Prevention (CDC). Once the recommendations are being approved by the Center of Disease Control and Prevention (CDC) they are then published in the Morbidity and Mortality Weekly Report (MMWR) of the Center of Disease and they then are then considered as the official recommendations made by the Center of Disease Control and Prevention (CDC) for immunization. ("The advisory committee," 2012)

Role of State Government

Apart from the federal government the state government is also required to play an active role in order to eliminate the deadly Human Papilloma Virus (HPV) from the United States of America. The role played by states includes the legislation that was being proposed by the District of Columbia and 41 other states to eradicate Human Papilloma Virus (HPV) from the United States of America. The first state to make the HPV vaccination a mandatory requirement for the girls entering the sixth grade was Michigan. This bill was passed in the Senate but it was a failure. After the Michigan law was rejected Texas became the first state to implement the legislation that makes it mandatory for the girls entering sixth grade to be vaccinated. (Kabage, 2012)