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HPV Vaccine Subsidy To End July 31

End of 2-year program promoting vaccination against genital warts, cervical cancer draws little attention

By Arianna Markel, Crimson Staff Writer

A sunset provision will quietly terminate University subsidies for a vaccine preventing genital warts and cervical cancer at the end of the month, ending a program created two years ago only after months of ardent student campaigning.

Urged on by a coalition of over 15 Harvard student organizations, University Health Services approved a two-year subsidy for the then-newly available vaccine Gardasil in the summer of 2007, reducing the cost of the three-shot treatment from $154 to $25 per shot.

The vaccine, which was approved by the Food and Drug Administration a year earlier, protects against four types of the human papillomavirus—or HPV—two of which cause 70 percent of cervical cancer cases, according to drugmaker Merck’s Web site. There are over 40 strains of HPV that can infect the human genital area, according to the Center for Disease Control's Web site, although most people who become infected do not show symptoms.

At the time of the subsidy's adoption, student leaders said they wanted the two-year initiative extended. Rachel M. Berkey '08, then-President of the Harvard Cancer Society, said in 2007 that the HPV vaccine was "certainly not an issue that ends with the current system" and that she hoped more funding could be identified to continue the program.

But the subsidy has become less imperative as the vaccine's use has become widespread and more women have been vaccinated prior to entering college, according to Susan B. Marine, director of the Harvard College Women's Center, which lobbied for the subsidy in 2006.

“Very few students have mentioned the vaccine to me,” Marine said. “I think a lot of people know about it and have it, or are choosing to get it at their family doctor.” She added that “for some people, the cost might be a deterrent, but most people are getting the vaccine in their teenage years.”

According to Soheyla Gharib, chief of medicine at UHS, and Maria Francesconi, chief of nursing at UHS, the University's vaccine subsidy was never intended to last for more than two years. The temporary program was approved because students who came to Harvard before 2007 did not have the chance to get the vaccine under their full insurance before arriving. The University's Student Health Plan, which can cost $1,420 per term, does not normally cover immunizations.

The University's program has bolstered the number of students who completed the immunization series. Before Harvard began subsidizing the cost of the vaccine, UHS had administered the full immunization series to 141 students and at least one shot to 403 other students; as of May 31, 1,126 students had been administered all three shots, with another 1,237 students having received at least one shot. Francesconi said that roughly 85 percent of the students immunized at UHS were covered under the University's Blue Cross Blue Shield insurance plan.

Today, Francesconi said, a large number of the students who want immunization may be arriving on campus having already received the vaccine from pediatricians. The Centers for Disease Control and Prevention has recommended the vaccine for girls from ages 9 to 26, before they are likely to become sexually active or exposed to HPV. Some states are considering legislation that would require school-aged girls to get the vaccine.

Francesconi said that she did not know if the number of vaccinated students would decrease after the subsidy's removal, but added that if Harvard were to subsidize any immunization permanently, the premium for the Student Health Plan would have to increase substantially. The subsidy for the HPV vaccine was estimated to have cost around $470,000, Francesconi said.

As of February, over 40 million doses of Gardasil have been distributed worldwide since its launch in 2006 without showing evidence of major health concerns, according to Reuters.

Despite the less visible activism on campus today around the vaccination, some student organizations have continued discussions about increasing the vaccine's accessibility for students.

The Seneca, an all-female student organization whose mission, according to its Web site, includes “promot[ing] discourse and awareness of issues that affect women," met with a UHS liaison in the fall to discuss a possible continuation of the subsidy.

“We knew about the subsidy change and had meetings with UHS to see if we could get it to last longer,” said Lei’La’ R. Bryant '11, who serves as the Seneca's Women's Outreach Committee Chair. “We really wanted to have a one-day vaccine day so people could get the vaccine all day long, but we couldn’t work it out.”

According to Bryant, the Seneca is continuing to look into other ways of increasing awareness and accessibility for the vaccine.

“I’m afraid that [fewer students] will get the vaccine now—especially those who are on the fence about it, or are trying to save money,” she said.

—Staff writer Arianna Markel can be reached at amarkel@fas.harvard.edu.

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