Unbiased Analysis of Today's Healthcare Issues

Mandatory Vaccines in Michigan

Written By: Jason Shafrin - Sep• 14•06

Seven hundred twenty million dollars.  This would the the annual cost to immunize all girls against the human papilloma virus (HPV).  According to the Detroit Free Press (“Law…“), the state of Michigan is considering requiring all girls entering the sixth grade to receive the HPV vaccine.  Is this good policy?

Cervical cancer affects 9,700 women per year in the U.S.; 3,700 women die from the disease each year.  According to WebMD, “Abnormal cervical cell changes are often the result of high-risk sexual behaviors years earlier.”  CNN wisely notes “Although the vaccine could prevent up to 70 percent of cervical cancer cases, it can’t prevent infection with every virus that causes cervical cancer.” 

What is the cost per life saved?  Using a quick back of the envelope calculations, we see that there are approximately 2 million twelve year old girls in the U.S.  Thus, the total cost to immunize the population (in the long term) is $720m.  If there are 3900 lives saved each year, then the cost per life saved is approximately $195,000.  This does not take into account any side effects from the vaccine on the one hand, and on the other does not calculate any benefits from lower morbidity.  This analysis seems to justify, prima facie, paying the high cost for the vaccine. 

A question remains: if the benefits to this immunization are so large, why require it?  Libertarians would say that parents likely have their child’s best interest at heart and would give the child the treatment if it was beneficial for them.  Why mandate something people should do on their own.  There are a few justifications for this legislation:

  1. Externalities: Parents will only take into account the benefit the HPV vaccine will have on their children and won’t take into account the fact that the vaccine will lower the probability that another child will contract the disease.   
  2. Excessive optimism: Parents may feel that their daughter is not of the promiscuous type.  Thus, they may incorrectly estimate the probability that their offspring will be infected and undervalue the infection. 

If unprotected teenage sexual activity becomes more safe, some may argue that the vaccine will increase the amount of underage sex in America.  I find this unlikely given the fact that we still face the enormous problem of AIDS and other STDs.  Thus, requiring the immunizations does seem to me to be sound policy.

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