Give It a Shot
Yale activists convince their school to cover the HPV vaccine.
By Zach Marks, Yale University
Thursday June 21, 2007
Yale student Alizeh Gangji, then a sophomore, was in her “Biology of Gender and Sexuality” lecture last spring when she decided she should get vaccinated against human papillomavirus (HPV). “I heard these disturbing figures about how widespread HPV was and how deadly it could be if it led to cervical cancer,” she said. “Then the professor told us they had just come out with a vaccine and how it was really easy to get it.”
But when Gangji went to University Health Services to get her first dose of the vaccine, Gardasil, which is delivered in three shots, she found out that getting vaccinated wasn’t as easy as 1-2-3.
“They said I’d have to pay for [the vaccine] out of pocket since student insurance didn’t cover it,” Gangji said. The three-course immunization, which prevents infection from the four HPV strains that cause about 70 percent of cervical cancer cases and 90 percent of genital warts cases, costs $360. “I knew the vaccine was important, but I just couldn’t spend that kind of money.”
Gangji’s experience will sound familiar to many young women nationwide who rely on their universities’ student insurance plans to cover healthcare costs. Since obtaining approval from the Food and Drug Administration and coming onto the market in June 2006, Gardasil has remained out of reach for young women without private insurance plans that cover the vaccine. Many university health plans do not cover certain immunizations under the assumption that students have already been vaccinated by the time they arrive on campus.
“When we prioritize, [vaccines are] not usually one of the things that we want to raise the cost of the insurance for,” Dr. Carlo Ciotoli, medical director of the student health center at New York University, told AlterNet in March. “Many students who come in have already had their vaccines, so we focus on other issues.”
But since Gardasil had only arrived on the market a few months before the 2006-2007 school year began, many students had not received the vaccine or did not know it was available. So the Yale chapter of Colleges Against Cancer (CAC) launched a campaign to educate students about the vaccine and cervical cancer, which kills about 3,700 women in the United States each year.
“We scheduled the campaign to coincide with Valentine’s Day,” said senior Molly Clark-Barol, Chair of CAC’s Education and Advocacy Committee, which led the effort. The slogan was, “Wish your cervix a Happy Valentine’s Day. Get vaccinated against HPV.”
When Clark-Barol realized many students could not afford the vaccine, she decided to transform the effort to promote awareness into a campaign to get the university health plan to cover the vaccine. Thanks to a slew of “visually arresting” posters and an editorial in the Yale Daily News, CAC gained student support for the campaign, gathering over 1,300 signatures for a petition to present to university health administrators. CAC also reached out to other public health groups, both undergraduate and in the professional schools. Armed with an endorsement from the Yale College Council (YCC), Yale’s student government, which overwhelmingly passed a resolution urging the university to subsidize Gardasil, Clark-Barol and students from the YCC, CAC, and Public Health at Yale met with administrators from UHS.
“I really didn’t want to be combative in our interactions with them, at least not at first,” Clark-Barol said. “Any students who come in brandishing a lump of signatures and frothing at the mouth with a righteous sense of entitlement are not going to get taken seriously by people who are, in fact, not soulless bureaucrats, but members of the same community that they are. There are certain realities that restrict the actions of even the most well-intentioned administrator.”
Among these obstacles was the fact that Yale determines which medications are covered in the university health plan. Some smaller schools, like Dartmouth and Princeton, use outside insurance providers that decided to cover the vaccine without any pressure from students. Setting the budget for Yale’s health plan, on the other hand, is a long and arduous process, and since the vaccine was approved and released after the budget had been set, the health plan could not be amended to cover the vaccine in time for the start of the 2006-2007 school year.
Acknowledging that immediate action was not possible, the student activists asked administrators to incorporate coverage of the vaccine into the student insurance plan for the 2007-2008 school year.
“We discussed the worries of the administration, which, to their credit were entirely practical, like concerns about compliance with the required three-shot course, rather than political, like what parents will think about having their darling baby girl vaccinated against an STD,” Clark-Barol said.
After several meetings over the course of the spring semester, Dr. Michael Rigsby, medical director of Yale’s UHS, told students that Gardasil will be covered under the “Prescription-Plus” healthcare plan for the upcoming school year. But the vaccine will be subject to the same $100 deductible as other prescriptions, as well a 20 percent co-pay.
“Everyone acknowledges that while this is not the ideal result we were looking for [a complete subsidy of the vaccination], it is a jumping-off point on which a successful student-administration partnership will build in the coming years,” Clark-Barol said.
Robert Nelb, a public health advocate who will be a senior at Yale this fall and worked on the HPV vaccine campaign, echoed Clark-Barol’s upbeat tone.
“The most important thing is that students follow up and get the vaccine,” Nelb said. “It comes in three shots, so maybe the fact that there’s a co-pay will remind students to get all three doses.”
Gangji was excited to learn the student health plan would cover the vaccine.
“HPV affects so many people, especially young people who are just beginning to be sexually active in college, so it makes sense for universities to provide it,” Gangji said. When asked if she would get vaccinated now that the student health insurance plan covers the most of the cost, she replied: “I’ll be the first in line.”
Zach Marks, a rising junior at Yale, was secretary of the Yale College Council for the 2006-2007 academic year, and worked on the resolution in favor of covering the HPV vaccine.
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Comments
It’s great this group of college students acted proactively for their own health coverage. Unfortunately, the information cited in this article and the PSA about the benefits of HPV vaccine are inaccurate and incorrect. Gardasil protects against 4 substrains of HPV, two which cause genital warts and two associated with cervical cancer. There are a total of 18 subtypes of HPV associated with cervical cancer. Gardasil does not afford young women the protection it claims to afford, and adverse effects of the vaccine have not been studied to date. Furthermore, combined monthly testing of the pap test and testing for HPV for women has been shown largely effective in decreasing the incidence of cervical cancer to a much greater extent than Gardasil and Merck will ever achieve. Perhaps our university health clinics and insurance companies alike should be encouraged to provide that key service.
— Kit - Jun 22, 01:14 PM - #Actually, Gardasil protects against the 2 strains of HPV that cause the MOST cases of cervical cancer, and the 2 strains that cause the MOST cases of genital warts. Statistically speaking, if you get this vaccine before you become sexually active, you have an extremely low chance of developing cervical cancer or genital warts later in life. Furthermore, most gynecologists do not test young women (meaning under age 30) for HPV because chances are if you’re sexually active, you have it—and if it’s a low-risk strain will naturally run its course without you ever knowing it. For older women, or for any women with abnormal Pap smears, HPV testing becomes more vital. Of course, regular gynecological exams should be provided to all women, and indeed university health plans should ensure coverage of physicals. Gardasil is still most effective for girls who are not yet sexually active, but it can provide important protection even into one’s 20s.
— Ashwini - Jun 22, 01:50 PM - #This vacine is dangerous and a big money maker for the big pharmas. Adverse reactions including death are not mentioned here. For more info go to www.drerika.com. She is an expert women’s Doctor and has all the facts on her site. Get the info and not the shot!
— Diana Smith - Jun 22, 02:16 PM - #I’m thrilled to hear about college students agitating for their health and rights, although I have to echo the concerns listed by the other folks who commented on this article.
Additional thoughts I have about the vaccine include:
— Tanya D. - Jun 22, 02:56 PM - #a) It hasn’t undergone enough testing yet — early birth control pills were too strong but nonetheless ended up being released to the market and made many women infertile. I don’t feel confident that the manufacturer can guarantee that there won’t be unintended side effects.
b) What about the boys? Protecting women from 2-4 strains of the virus won’t stop men from spreading it. HPV is a highly common and transmittable STI-why stop at inoculating against only a handful of the strains?
“We scheduled the campaign to coincide with Valentine’s Day,” said senior Molly Clark-Barol, Chair of CAC’s Education and Advocacy Committee, which led the effort. The slogan was, “Wish your cervix a Happy Valentine’s Day. Get vaccinated against HPV.”
— Genital Warts Treatment - Nov 27, 09:05 PM - #Treatments for genital warts, cold sores (canker sores), genital herpes and HPV from Walden Research labs. FDA approved.
this article is a lie. ask zach marks.
— yale student - Jan 27, 12:18 PM - #hpv is a lie
— yale student - Jan 27, 12:20 PM - #i hope people would open their eyes to important health issues such as this. now that there is a way to eradicate this highly preventable disease- cervical cancer… why not take vaccination into serious consideration, and save lives. now is the time.
— vyjae - Mar 1, 10:08 AM - #I want to believe the lie part — how can they claim that there is a virus that causes cancer — when they can not find it in the male body or the female body — they can only assume you have the viruse that “causes” it when you have the result of the “cause” — this scares me — i have red that the supposed virus has not even been cultured yet — but with what i have red with the HPV Lie bit — they said that the vaccine can be dangerous — I don’t understand how the vaccine can be dangurous when HPV is not even the cause of the Cancer — there is great info on the HPV lie at —— technorati.com/video… ——
— justin howard - Jun 12, 03:46 AM - #