Insurance confusion stops women from HPV vaccine

At Loyola and other Baltimore-area universities, confusion about insurance coverage and cost, as well as a lack of awareness, stands between female students and a new vaccine that may greatly reduce their risk of acquiring a sexually transmitted disease that may cause cervical cancer.

At a table of four Butler and Hammerman residents having dinner together in Boulder last Friday, three had heard of the HPV vaccine, two had spoken about it with their family physician, and one knew of at least one person who had gotten the vaccine. But none were aware of the cost, or had any idea the vaccine was offered at Loyola's clinic.

"My physician said to wait until more research comes out on the long-term side effects," said freshman Morgan Baker, who said she plans on waiting a year before being vaccinated.

The vaccine, which is administered in a series of three shots over six months, wards off four strains of the STD human papillomavirus. Two of these strains cause genital warts, while the other two lead to approximately 70 percent of the instances of cervical cancer in the United States.

Healthcare professionals at schools including Loyola, Johns Hopkins, and the University of Maryland are working to promote the vaccine and educate their students about the prevalence of the virus.

But what they are failing to tell students about the vaccine's widespread insurance coverage is perhaps more significant: the $390 cost, a barrier for many financially strained students, will most likely be reimbursed by students' private insurance providers, according to Merck, makers of Gardasil, the brand name of the vaccine.

This message is especially critical in light of a recent study funded by the Centers for Disease Control and Prevention, which found women aged 20 to 24 to be at the greatest risk for contracting HPV. The study noted that 44.8 percent of women between those ages had the disease, and that women's chances for acquiring the disease rose each year between the ages of 14 and 24.

"Girls are hesitant, I think, because of the cost; it is a factor that weighs on their decision," says Lenore Meyers, a health educator at Towson University. Health insurance companies have been re-viewing the vaccine since its approval by the FDA in June 2006 and slowly incor-porating its coverage into their plans. According to Merck, 94 per-cent of private health insurers are covering Gardasil in over 100 insurance plans.

At Loyola, a bright, colorful 21-page pamphlet is on display in the Health Clinic. Produced by Merck, it presents startling statistics on the link between HPV and cervical cancer.

The pamphlet is part of a campaign meant to spread awareness among women about the prevalence of HPV, which, according to the pamphlet, affected "9.2 million young adults, 15-24" in 2000.

"You'd tell her she has lipstick on her teeth. So why wouldn't you tell her about a virus that can cause cancer?" reads the front cover.

In all 21 pages, though, neither the brochure, nor any of the accompanying information sheets, provide any indication of the cost of the vaccine or how women can get the cost reimbursed by insurance companies. And when these women speak with nurses at the clinic, information on payment and insurance can be murky.

Jeanne Lombardi, director of Loyola's clinic, says she tells students that it depends on their insurance plans but believes "many are not covering it." This she attributes to the fact that the vaccine falls under preventative care.

Loyola began offering the vaccine in October, and as of early February only four women had received a shot. Lombardi is happy to report that now over 100 have started the series of shots.

On larger campuses, like Hopkins and Towson, the vaccine has been better received, but information about insurance coverage is still failing to reach students. Dr. Alain Joffe, director of Johns Hopkins' student clinic, estimates that 10 to 20 students per week are re-ceiving their first vaccine shot.

"They have been flying off the shelves," says Joffe, who explains that his students are paying out of pocket for the shots. The vaccine is not covered on Hopkins' health care plan, though he promises it will be next year.

Meyers has been placing notices in Towson's e-mail bulletin, the Daily Digest, and promoting the vaccine when she speaks in classes and at on-campus seminars about the clinics' reproductive health care. She reports that in the first month the vaccine was offered, 23 women received their first shot at the clinic.

At the University of Maryland, only 63 of approximately 18,000 women began the vaccination process in the first four months Gardasil was offered, according to the Alli Matson, coordinator of sexual health programs.

Information on Gardasil will be available at the Health Fair on Thursday, April 19 from 11 a.m. to 2 p.m. in McGuire Hall.