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February 06, 2007

Comments

tomjedrz

I think your arithmetic is incorrect, as is your conclusion.

- 170K Texas 6th graders
- 1 in 21K women get the disease
- so ~8 women who are now 6th graders will get the disease
- the vaccine prevents 70% of the cases, the vaccinations will prevent ~6 cases.
- $60 million to prevent 6 cases -- $10/million per case prevented.

AND, this argument ignores the costs of any side effects.

This is a stupid decision by the Texas governor. The disease does not occur often enough for vaccination absent other risk factors. It is political payback plain and simple, and a waste of Texas taxpeyers money. The $60 million could be much better spent.

(Mycroft: I clarified the numbers, above. My original analysis is based on the reported incidences and deaths in TEXAS, not the per-year hazard rate -- which, in any event, seems to be higher than 1 in 21K by any calculation.)

geoff

This analysis isn't quite complete. At least two very important questions have not been answered. First, in order to assess the desirability of the program, we'd need to know what else the money could be spent on. Do you know that there aren't more effective (and perhaps cheaper) vaccines that could be given but aren't? What about programs entirely unrelated to vaccination--are any other welfare programs a better cost-benefit deal? Even more importantly, what would be the benefit of not taking this money for government use at all? Why does this form of redistribution (on average, from parents of healthy daughters to those of girls who would otherwise have gotten cancer) improve upon a world where the money to fund the program is left in the hands of the taxpayers to invest, to use for other forms of preventive medicine, or even to spend on vacations or food or iPods? I'd think one would need to know or estimate the answers to these questions before knowing whether to support the plan.

Second, is there no way to improve upon the proposed plan? Most obviously, is there no way to determine which girls are more likely at risk? Does the vaccine need to be given to every girl, indiscriminately, or could we improve the cost-benefit ratio by targeting girls with a family history of cervical cancer (if that matters), girls who are sexually active, etc? Relatedly, what are the costs of giving every girl the vaccine? Your analysis doesn't address problems arising from giving the vaccine (side effects, e.g.). There are surely some costs other than the price of the vaccine itself--a proper analysis would seek to maximize effectiveness while minimizing these costs (meaning the optimal number of girls to vaccinate is almost certainly not "all"). I believe that a proper analysis of the optimal program need not take the proposed regime at face value, nor should it.

There are other complications, as well, but these will suffice for now.

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