Re: Appeal to Insurance about Gardasil shot--for a man!

December 6, 2011

HPV is implicated in oral cancer and lung cancer. Condoms are not an effective option in reducing those risks. He protects his partners and himself by getting the vaccine. Carla Gibson FNPMissoula, MT To: Sent: Monday, December 5, 2011

9:22 PM Subject: Re: Appeal to Insurance about Gardasil shot--for a man!

Why can't he use a condom to prevent genital warts. Sometimes an ounce of prevention via lifestyle is better than shots and loads of boosters. It seems common sense is outshouted by pharmaceutical companies hype. If he is that concerned he has a few options....celibacy, condoms or cash (his own).

From:

Kennedy, Jim ;

To:

< >;

Subject:

RE: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 12:07:24 AM

The patient can still get the shot. I am not sure the vaccine is even approved for adults.

From: [ ] On Behalf Of [davidbfeig@...]

Sent: Monday, December 05, 2011 11:39 AM

To:

Subject: Appeal to Insurance about Gardasil shot--for a man!

Does anyone have any experience in putting together an appeal to an insurance company. Had a patient, a male patient request Gardasil shot based on his history of little sexual contact and wanting to potentially protect against cancer.

Insurance denied--insurance company makes a BIG deal of covering preventative stuff.

I will include new studies and recommendations from CDC, anything else that should help?

F

December 6, 2011

1 I think supporting our patients is good But if this is an uncovered service your one letter will not change it . It is not like a prior auth You alone cannot make insurance cover something. I think those changes are administrative ones made over careful consideration of many requests over time so a letter supports this but for the practical purpose of NOW, he would have to pay for it I think

2 I just looked in Vaers as an exercise I have reported to them but never looked. It is a very user friendly place. There are lots of reported events for HPV vaccine about 16 as life threatening and 53 as serious. but sorting them out is complex everything from blepharospasm and emotional distress and gait disorder and menstrual irregularity ( I doubt you can pin that on a vaccine ,common as that is in the same age group!!) to circulatory collapse and " mri abnl " - no detail as to the case, as to whether there were coincidental events etc i did not dig far though, nor did I try to compare with say Tdap or Prevnar and would suspect further data would be ffound elsewhere, dunno.Interesting exercise

3 A few weeks ago someone said re the LEAP testing " Those of us in this area already know that most such modalities are treated " guilty until proven innocent, " when pharmaceuticals and other convention dogma is clearly " innocent until proven guilty. " I do not think convention dogma is innocent til proven guilty It is hard work to get good info as Alice says Hard work to get balanced info-sometime years go by but I have to make daily choices.

Thanks for reminding me about Vaers.this is such a tough job... Jean

Alice,Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).Thanks,

SharonSharon McCoy MD

Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

From:

Sharon McCoy ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon in my role as mother of and doctor to various teenage girls

-- MD ph fax

December 6, 2011

Alice,

Do they get vaccinated against Hep B, life style choices should keep

it at bay alos. No sex with a carrier, not sharing needles with

carriers should work almost 100%, as lifestyle choices in the USA to

prevent Hep B infection.

from the Barrio

Alice,

Could you share the sources for your

data on the HPV vaccines?

Also, do you mind sharing your

background a bit (physician, etc.) (sorry if I

missed it before).

Thanks,

Sharon

Sharon McCoy MD

Renaissance Family Medicine

10 McClintock Court; Irvine, CA 92617

PH: (949)387-5504 Fax: (949)281-2197 Toll free

phone/fax:

www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM,

alicerobertson@...

on

wrote:

Sharon....I am the mother of

four daughters and two adult sons. I

feel differently than you do because

newer research is showing the

original glowing reports aren't

completely panning out. My daughters

feel there is important lifestyle

choices that work 100% of the

time....but they do take self

control. They have not had the

shot...one is a nurse. But even

without self control....it grieves

me that California removed parental

rights on little girls for some sort

of greater good. That is an abuse of

the state's power....but then they

were going to ban circumcision. It's

flustering because often you find

doctors quoting pharmaceutical

literature without looking beyond

it.

From:

Sharon McCoy ;

To: < >;

Subject:

Re:

Appeal to Insurance about Gardasil

shot--for a man!

Sent:

Tue, Dec 6, 2011 4:33:53 AM

I

like that the guy is

willing to get a

vaccine to protect

his future female

partners from

cervical cancer and

I also like that

Dave is wiling to

help get insurance

to cover.

Sharon

in my role as mother of

and doctor to various

teenage girls

December 6, 2011

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with

sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side

effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

From:

Batlle, MD ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 6:43:27 PM

Alice,

Do they get vaccinated against Hep B, life style choices should keep

it at bay alos. No sex with a carrier, not sharing needles with

carriers should work almost 100%, as lifestyle choices in the USA to

prevent Hep B infection.

from the Barrio

Alice,

Could you share the sources for your

data on the HPV vaccines?

Also, do you mind sharing your

background a bit (physician, etc.) (sorry if I

missed it before).

Thanks,

Sharon

Sharon McCoy MD

Renaissance Family Medicine

10 McClintock Court; Irvine, CA 92617

PH: (949)387-5504 Fax: (949)281-2197 Toll free

phone/fax:

www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM,

alicerobertson@...

on

wrote:

Sharon....I am the mother of

four daughters and two adult sons. I

feel differently than you do because

newer research is showing the

original glowing reports aren't

completely panning out. My daughters

feel there is important lifestyle

choices that work 100% of the

time....but they do take self

control. They have not had the

shot...one is a nurse. But even

without self control....it grieves

me that California removed parental

rights on little girls for some sort

of greater good. That is an abuse of

the state's power....but then they

were going to ban circumcision. It's

flustering because often you find

doctors quoting pharmaceutical

literature without looking beyond

it.

From:

Sharon McCoy ;

To: < >;

Subject:

Re:

Appeal to Insurance about Gardasil

shot--for a man!

Sent:

Tue, Dec 6, 2011 4:33:53 AM

I

like that the guy is

willing to get a

vaccine to protect

his future female

partners from

cervical cancer and

I also like that

Dave is wiling to

help get insurance

to cover.

Sharon

in my role as mother of

and doctor to various

teenage girls

December 6, 2011

Alice,I would like you to consider that most of the doctors and other providers on this list do seriously look into side effects of what we offer and of what we don't offer, and do our best to educate.

I'm not sure you've been part of the list long enough to realize it, but this group tends to be a special breed. (Not to say that non-IMP's aren't also trying their best.)

Do you work in healthcare?

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

www.SharonMD.com

On Tue, Dec 6, 2011 at 12:06 PM, alicerobertson@... on wrote:

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).

My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with

sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.

Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side

effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

From:

Batlle, MD ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 6:43:27 PM

Alice,

Do they get vaccinated against Hep B, life style choices should keep

it at bay alos. No sex with a carrier, not sharing needles with

carriers should work almost 100%, as lifestyle choices in the USA to

prevent Hep B infection.

from the Barrio

Alice,

Could you share the sources for your

data on the HPV vaccines?

Also, do you mind sharing your

background a bit (physician, etc.) (sorry if I

missed it before).

Thanks,

Sharon

Sharon McCoy MD

Renaissance Family Medicine

10 McClintock Court; Irvine, CA 92617

PH: (949)387-5504 Fax: (949)281-2197 Toll free

phone/fax:

www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM,

alicerobertson@...

on

wrote:

Sharon....I am the mother of

four daughters and two adult sons. I

feel differently than you do because

newer research is showing the

original glowing reports aren't

completely panning out. My daughters

feel there is important lifestyle

choices that work 100% of the

time....but they do take self

control. They have not had the

shot...one is a nurse. But even

without self control....it grieves

me that California removed parental

rights on little girls for some sort

of greater good. That is an abuse of

the state's power....but then they

were going to ban circumcision. It's

flustering because often you find

doctors quoting pharmaceutical

literature without looking beyond

it.

From:

Sharon McCoy ;

To: < >;

Subject:

Re:

Appeal to Insurance about Gardasil

shot--for a man!

Sent:

Tue, Dec 6, 2011 4:33:53 AM

I

like that the guy is

willing to get a

vaccine to protect

his future female

partners from

cervical cancer and

I also like that

Dave is wiling to

help get insurance

to cover.

Sharon

in my role as mother of

and doctor to various

teenage girls

December 6, 2011

This has been a very interesting discussion so far!I know some members of the list have strong opinions about , uh, various areas of healthcare. I would like to comment on a few things about my post and myself.

1) Just because I suggested the shot does not mean I would tell the patient not to use condoms, practice unsafe sex, sex with multiple partners, various exotic forms of sex with multiple people and orifices that only the very daring would think of, or encourage him that " now you are covered for HPV you are BULLETPROOF! "

2) In my current and former practice, and in discussion with my female colleagues, I've NEVER heard of teenage or college age women saying, " man, if it weren't for this HPV thing, I'd be out sleeping with as many guys as possible all the time! If only there was some shot or something that would absolve me of all responsibility for my actions...What there is Gardasil? "

I educate my patients on the value of exercise, diet, stress reduction, sleep, and safe/potentially unsafe behaviors. That being said, I would only consider the shot to be complementary to , for women at least, routine pap/health care and other recommended preventative services. For men its obviously much more complicated, but the last studies I looked at noted that cervical cancer and certain kinds of anal cancer do appear to be on the rise, and perhaps head and neck cancer as well in non-smokers--all suspected to be linked to hpv. Since there is now a shot which might reduce some of that risk, and my patient asked, I recommended it.

And yes, never having sex, never using IV drugs, or never doing anything might reduce your risk of disease. For a population I'm not sure if an appropriate mitigation strategy for reduction in cervical cancer would be to ban all sex for unmarried women. Abstinence only Sex education is a very interesting topic which I can't stand to hear about anymore. Is Abstinence only cervical cancer prevention next?

3) I think Gardasil is a safe shot. I am trying to think about the potential risks of vaccines, and I would be firmly in the camp that vaccines and development of modern sanitation systems probably has helped public health than most other interventions. Mind you, I just had a very long and fruitless conversation with a friend also about HPV shot. Most of her information came from the Mercola web site and articles. And a friend of a friend of hers who did " her own research " and decided that her newborn did not need any vaccines. Mind you, she found in her own research that pertusis/whooping cough is " easily treated with 2 weeks worth of antibiotics, so why subject my child to the dangerous and toxic DTAP shot. " Or that she apparently sells her own homeopathic cure for whooping cough.

I gave up then, as I do now.

December 6, 2011

One last "Plus" for those who are considering advising or getting for themselves even the vaccine or any others that can lower risk in STD like transmissions. It bothers me as much as I do firmly believe in personal freedom, choice and responsibility too and that WE in the medical field should NOT be turned into being Mommy and Daddy for grown people and those grown people's children. I do sort of shudder and get a bit of a knee jerk reaction from too much of all problems would go away if everyone were to just STOP doing everything. If human behavior was that simple we'd all be programs and machines instead of highly specialised mutli-system and celled animals with a few billions neurons in our skulls.....

As many of you know, I have a love for Psychology especially clinical and the like. Well, From purely a pyscho-social science perspective, For the last few decades research in the field of infidelity has consistantly shown that at least 40% of all women and 50% of all men admit to have been at least at one point during their marriage or presently being in, an affair or some other forms of extra maritial relations which includes paid for sexual activites such as hookers and the like. And remember in cases such as these folks tend to "Under Self Report" as opposed to over reporting. If we were to then extrapolate a step further based on these repeatedly proven fairly valid numbers from these various studies, and the researchers in these cases many of them have made this point, they then lead us to consider this next step and conclussion:

If only about half of those 40% of the women are not perfectly lined up with one of the men who are likewise being unfaithful in their own marriages, in an attempt to keep things at a one to one ratio between the men and the women, then we might be very well looking at rates of as high as 70-80% of ALL marriages will experience at least one of the partners being involved in at least one act or more of some sort of an extra marital situation, affair relationship be it short lived or long and on going, sometime during the lifespan of their marriages.

Then add to those facts that many people never do learn of the partner's infidelities or that there was an affair at the heart of a divorce they went thru, and that many people who engage in such acts of infidelity seem to forget about proper protection at the time they are lost in their extra marital activities, and we have an all too real public health problem on our hands even for those on the faithful side of these marriages who honestly do believe that they are in a commited relationship and behaving faithfully and are taking responsibility for such personal actions and behaviors. Therefore, these are some pretty concerning numbers for those of us in healthcare, mental healthcare, family and marital counseling and therapies, as well as in general public health side of things attempting to properly advise, counsel and care for our patients.

Lastly, although the numbers are almost identical there is actual statistically significant proof in valid research on the subject that there is a small lead in who does or does not cheat by those that are actually more religous and more conservative verses those that are more liberal and less religously involved. Again the actual amount "more" is fairly small, just a few percentage points. But the findings did reach a firm level of statistical significance and was conducted by those who like us; know how to properly set up and run a study...

So one could honestly believe that they are married to a great man or women and even be very regular attendees at their house of worship of their belief and faith and still, even though they personally have chosen to do the right thing, they are all too likely, almost certainly at risk for being exposed through no direct fault in behavior of their own. This is all way too common and widespread and these numbers tend to stand up even in the face of various cultures, SES, even different cultures and nations around the globe.

So when thinking about whether or not to advise your patients about taking some relatively easy and low risk measures to protect themselves from deadly or life changing health effects brought about by sexual behaviors, try to remember those stats while doing so. I know the first time I learned and read about them, I too was sort of, Naaahh, This can't be correct when in fact it really is..... as many as 3/4's of all marriages no less others who live together and otherwise date believing that they too are in some form of a commited and exclusive relationships.....

So after that great and upliftiing news, have a great night and be well.....

To: Sent: Tuesday, December 6, 2011 4:49 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

This has been a very interesting discussion so far!

I know some members of the list have strong opinions about , uh, various areas of healthcare. I would like to comment on a few things about my post and myself.

1) Just because I suggested the shot does not mean I would tell the patient not to use condoms, practice unsafe sex, sex with multiple partners, various exotic forms of sex with multiple people and orifices that only the very daring would think of, or encourage him that "now you are covered for HPV you are BULLETPROOF!"

2) In my current and former practice, and in discussion with my female colleagues, I've NEVER heard of teenage or college age women saying, "man, if it weren't for this HPV thing, I'd be out sleeping with as many guys as possible all the time! If only there was some shot or something that would absolve me of all responsibility for my actions...What there is Gardasil?"

I educate my patients on the value of exercise, diet, stress reduction, sleep, and safe/potentially unsafe behaviors. That being said, I would only consider the shot to be complementary to , for women at least, routine pap/health care and other recommended preventative services. For men its obviously much more complicated, but the last studies I looked at noted that cervical cancer and certain kinds of anal cancer do appear to be on the rise, and perhaps head and neck cancer as well in non-smokers--all suspected to be linked to hpv. Since there is now a shot which might reduce some of that risk, and my patient asked, I recommended it.

And yes, never having sex, never using IV drugs, or never doing anything might reduce your risk of disease. For a population I'm not sure if an appropriate mitigation strategy for reduction in cervical cancer would be to ban all sex for unmarried women. Abstinence only Sex education is a very interesting topic which I can't stand to hear about anymore. Is Abstinence only cervical cancer prevention next?

3) I think Gardasil is a safe shot. I am trying to think about the potential risks of vaccines, and I would be firmly in the camp that vaccines and development of modern sanitation systems probably has helped public health than most other interventions. Mind you, I just had a very long and fruitless conversation with a friend also about HPV shot. Most of her information came from the Mercola web site and articles. And a friend of a friend of hers who did "her own research" and decided that her newborn did not need any vaccines. Mind you, she found in her own research that pertusis/whooping cough is "easily treated with 2 weeks worth of antibiotics, so why subject my child to the dangerous and toxic DTAP shot." Or that she apparently sells her own homeopathic cure for whooping cough.

I gave up then, as I do now.

December 6, 2011

I agree with you, Alice. When parents ask me if I think their children need this vaccine, I tell them, "Everyone needs this vaccine who is not going to remain celibate until marriage and faithful thereafter to someone else who has made that same decision. If you think that's not realistic for your child and the way you're raising them, then absolutely yes, the vaccine is vitally important. This is a sexually-transmitted disease that leads to cancer -- but sex is an optional activity."

It's really interesting to watch the parent and child honestly look at each other, perhaps for the first time ever, and then turn back to me to give me their answer.

Deanna Tolman, DNP, FNP-BC

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon

in my role as mother of and doctor to various teenage girls

December 6, 2011

I am not under the impression that HPV rates are going down, the last national study I saw just before the shot came out was 40% all age groups. And I'm glad that your daughter waited, and found a responsible young man who also hopefully waited. But people lie to each other about sex, men and women say they haven't had another partner, only to find out later they did. THis happens all the time in pregnancy care. The woman WAS celibate, the male wasn't before marriage, but told her he was. The virus is there forever, but in a time of immune suppression such as pregnancy it blossoms. I have had to bring too many couples in during pregnancy only to find out that one had a past they didn't tell the other about. At a rate of 40%, you really only have to have one partner, by the time you've had 2 you have been exposed. I think this whole discussion is naive and inflammatory. I certainly don't force anyone to have the vaccine, but I'm glad insurance pays for it for young women, I believe it is safe, and if they want to take a change on their partner, okay your life, not mine. At least they are informed.

Cote'

To: Sent: Tuesday, December 6, 2011 12:06:39 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon

in my role as mother of and doctor to various teenage girls

December 7, 2011

I read yours after I posted mine, but I completely agree.

To: Sent: Tuesday, December 6, 2011 4:05:29 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

My point exactly .... Read my response in the same vein..... It's life and reality. If some care to live in denial of the facts of true human behavior as brought to light by clinical experience and properly conducted research, then at some point we here have done our best..... And BTW, as you can see in the facts I posted, the rate of infidelity is almost but not quite equal between men and women too. This is a universal human behavior for about half of our population even when is a supposedly commited relationship that should have no outside partners involved.

To: Sent: Tuesday, December 6, 2011 6:55 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

I am not under the impression that HPV rates are going down, the last national study I saw just before the shot came out was 40% all age groups. And I'm glad that your daughter waited, and found a responsible young man who also hopefully waited. But people lie to each other about sex, men and women say they haven't had another partner, only to find out later they did. THis happens all the time in pregnancy care. The woman WAS celibate, the male wasn't before marriage, but told her he was. The virus is there forever, but in a time of immune suppression such as pregnancy it blossoms. I have had to bring too many couples in during pregnancy only to find out that one had a past they didn't tell the other about. At a rate of 40%, you really only have to have one partner, by the time you've had 2 you have been exposed. I think this whole discussion is naive and inflammatory. I certainly don't force anyone to have the vaccine, but I'm glad insurance pays for it for young women, I believe it is safe, and if they want to take a change on their partner, okay your life, not mine. At least they are informed.

Cote'

To: Sent: Tuesday, December 6, 2011 12:06:39 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon

in my role as mother of and doctor to various teenage girls

December 7, 2011

Hmmm.....so am I right to assume you are able to tell your patients the ingredients in the shot you are giving them, the type of preservative....how it will react in their system...how many boosters.....the number of reported reactions and even deaths that could possibly result if they get the shot (going beyond the CDC's blatant problems with full disclosure)? It seems fair ...to me....as a potential patient that the administrator of that shot should understand completely the risks and rewards of their action. And the list of side effects you tell your patients to watch out for when they go home? That would be bare bones basics. Did you see the recent lab findings on the DNA found in the shots that was reported to the government? I assume from your letter you know this information verbatim? We have better (and more understandable) food

labeling for a box of cereal than we do drugs, and sadly, the information can be complicated and controversial....but a duty of any doctor providing the shot.Would it matter if I provide you with a PhD, or researcher qualifications when there is already so much difference of opinion among intellectuals on everything from evolution, immunology, preservatives in shots (again...I assume by your letter you are studied on the conference from last month where experts disagreed over the use of mercury as a preservative....in truth...I doubt most doctors truly understand the debate on thimerosal, etc. They rely far too heavily on clinical trials paid for by BigPharma. I am currently reading Overdosed America....what a travesty we are dealing with).There is room for disagreement, but not ignorance.....let us seek clarity and understanding and learn from the harm medicine has did ...with sometimes good intentions.....defensiveness will

build barriers to the truth.....and that hurts doctors and patients.

From:

Sharon McCoy ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 8:36:34 PM

Alice,I would like you to consider that most of the doctors and other providers on this list do seriously look into side effects of what we offer and of what we don't offer, and do our best to educate.

I'm not sure you've been part of the list long enough to realize it, but this group tends to be a special breed. (Not to say that non-IMP's aren't also trying their best.)

Do you work in healthcare?

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

www.SharonMD.com

On Tue, Dec 6, 2011 at 12:06 PM, alicerobertson@... on wrote:

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).

My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with

sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.

Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side

effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

From:

Batlle, MD ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 6:43:27 PM

Alice,

Do they get vaccinated against Hep B, life style choices should keep

it at bay alos. No sex with a carrier, not sharing needles with

carriers should work almost 100%, as lifestyle choices in the USA to

prevent Hep B infection.

from the Barrio

Alice,

Could you share the sources for your

data on the HPV vaccines?

Also, do you mind sharing your

background a bit (physician, etc.) (sorry if I

missed it before).

Thanks,

Sharon

Sharon McCoy MD

Renaissance Family Medicine

10 McClintock Court; Irvine, CA 92617

PH: (949)387-5504 Fax: (949)281-2197 Toll free

phone/fax:

www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM,

alicerobertson@...

on

wrote:

Sharon....I am the mother of

four daughters and two adult sons. I

feel differently than you do because

newer research is showing the

original glowing reports aren't

completely panning out. My daughters

feel there is important lifestyle

choices that work 100% of the

time....but they do take self

control. They have not had the

shot...one is a nurse. But even

without self control....it grieves

me that California removed parental

rights on little girls for some sort

of greater good. That is an abuse of

the state's power....but then they

were going to ban circumcision. It's

flustering because often you find

doctors quoting pharmaceutical

literature without looking beyond

it.

From:

Sharon McCoy ;

To: < >;

Subject:

Re:

Appeal to Insurance about Gardasil

shot--for a man!

Sent:

Tue, Dec 6, 2011 4:33:53 AM

I

like that the guy is

willing to get a

vaccine to protect

his future female

partners from

cervical cancer and

I also like that

Dave is wiling to

help get insurance

to cover.

Sharon

in my role as mother of

and doctor to various

teenage girls

December 7, 2011

This is understandable...but to clarify...the HPV rates were going down before the shot...I believe that was from the CDC site. I know some women who were irresponsible in their youth, but responsible as adults with pap tests. Stats are in their favor.And you are right that my daughter is a rarity...my point was that I am tired of taking my daughter to the doctor and the Gardisil shot is pushed...even when she says she is not sexually active...she has cancer....and the response is...well it's best to be prepared. We love our doctors....but gosh....if you question them it almost seems routine because they clearly are not as well studied as I feel their job demands. They resemble BigPharma brochures. And we are in a top five hospital where residents are the nation's top scorers. In fairness the research doctors are

fascinating....they order special shots without mercury...keep them to a minimum and can talk in great detail about the shots. Our doctor won the top research award two times now.....he was simply a joy to discuss with because he understood the topic from all angles.

From:

magnetdoctor@... ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 11:55:50 PM

I am not under the impression that HPV rates are going down, the last national study I saw just before the shot came out was 40% all age groups. And I'm glad that your daughter waited, and found a responsible young man who also hopefully waited. But people lie to each other about sex, men and women say they haven't had another partner, only to find out later they did. THis happens all the time in pregnancy care. The woman WAS celibate, the male wasn't before marriage, but told her he was. The virus is there forever, but in a time of immune suppression such as pregnancy it blossoms. I have had to bring too many couples in during pregnancy only to find out that one had a past they didn't tell the other about. At a rate of 40%, you really only have to have one partner, by the time you've had 2 you have been exposed. I think

this whole discussion is naive and inflammatory. I certainly don't force anyone to have the vaccine, but I'm glad insurance pays for it for young women, I believe it is safe, and if they want to take a change on their partner, okay your life, not mine. At least they are informed.

Cote'

To: Sent: Tuesday, December 6, 2011 12:06:39 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first

objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the

answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved fr!

om lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon

in my role as mother of and doctor to various teenage girls

December 7, 2011

Egads..........sincerely....kindly....I beg of you....could you please start reading in context and intent....or at least asking posters questions before placing unwarranted thoughts in their mouth? If by chance you are summing up anything I said...whew....Houston we gotta a problem:)

From:

Bleiweiss ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Wed, Dec 7, 2011 12:05:29 AM

My point exactly .... Read my response in the same vein..... It's life and reality. If some care to live in denial of the facts of true human behavior as brought to light by clinical experience and properly conducted research, then at some point we here have done our best..... And BTW, as you can see in the facts I posted, the rate of infidelity is almost but not quite equal between men and women too. This is a universal human behavior for about half of our population even when is a supposedly commited relationship that should have no outside partners involved.

To: Sent: Tuesday, December 6, 2011 6:55 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

I am not under the impression that HPV rates are going down, the last national study I saw just before the shot came out was 40% all age groups. And I'm glad that your daughter waited, and found a responsible young man who also hopefully waited. But people lie to each other about sex, men and women say they haven't had another partner, only to find out later they did. THis happens all the time in pregnancy care. The woman WAS celibate, the male wasn't before marriage, but told her he was. The virus is there forever, but in a time of immune suppression such as pregnancy it blossoms. I have had to bring too many couples in during pregnancy only to find out that one had a past they didn't tell the other about. At a rate of 40%, you really only have to have one partner, by the time you've had 2 you have been exposed. I think this whole discussion is naive and inflammatory. I certainly

don't force anyone to

have the vaccine, but I'm glad insurance pays for it for young women, I believe it is safe, and if they want to take a change on their partner, okay your life, not mine. At least they are informed.

Cote'

To: Sent: Tuesday, December 6, 2011 12:06:39 PMSubject: Re: Appeal to Insurance about Gardasil shot--for a man!

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)). My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective

should be encouragement of lifestyle choices and responsibility....then other options. And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly. Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should

you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MD Renaissance Family Medicine 10 McClintock Court; Irvine, CA 92617 PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon in my role as mother of and doctor to various teenage girls

December 7, 2011

Thank you for sharing this! You remind of my award winning pediatrician....oh how I love her! Your patients are very fortunate to have a doctor who thinks outside the box.

From:

tolpeople@... ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Tue, Dec 6, 2011 11:18:32 PM

I agree with you, Alice. When parents ask me if I think their children need this vaccine, I tell them, " Everyone needs this vaccine who is not going to remain celibate until marriage and faithful thereafter to someone else who has made that same decision. If you think that's not realistic for your child and the way you're raising them, then absolutely yes, the vaccine is vitally important. This is a sexually-transmitted disease that leads to cancer -- but sex is an optional activity. "

It's really interesting to watch the parent and child honestly look at each other, perhaps for the first time ever, and then turn back to me to give me their answer.

Deanna Tolman, DNP, FNP-BC

But that is the key. A doctor should look at risk factors before offering panaceas via vaccinations that do carry risk. My daughter was married in June and is now pregnant.....she waited til marriage (didn't do drugs or engage in risky behaviors). She didn't need the Hep B or HPV. My other daughters are 15, 17 and 19....the 19 year old has cancer and doesn't even drive, but she works in physical therapy. I have home schooled for 23 years, and none of my daughters are sexually active (and no I am not naive...I volunteer in the inner city and at Judeo Christian think tank)).My goal is education, evaluation as an individual, and at the very least encouragement to act responsible. I use the example of cigarettes. We mean it when parents or doctors warn against it....but there seems to be a throwing of all caution to the wind with sex. It is just considered a norm that kids will do it....and, of course, many will....but the first objective should be encouragement of lifestyle choices and responsibility....then other options.And if a patient decides to take risks then pay for the vaccine. It isn't that bad...what is a couple hundred dollars per shot if you make the choice to have sex in different styles that may eventually harm you? Although, HPV rates were going down on their own before the shot...and it is clearly not the miracle drug doctors promote. I think lung cancer was mentioned here.....hmmm....the vaccine isn't guarding against that and doesn't protect against many forms of HPV. It is a false sense of protection that leaves many college girls thinking the shot and birth control means they can whoop it up. Some will pay dearly.Why don't doctors educate more? In truth, many simple know so little about the ingredients, the side effects, because med school rarely prepares them to educate patients beyond a blind trust that the shot is the answer....and why should you? The patient signs a waiver.....you are absolved from legal responsibility....but you should not be absolved from lack of research to truly disclose all options to a patient.

; To: < >; Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 6:43:27 PM

Alice,Do they get vaccinated against Hep B, life style choices should keep it at bay alos. No sex with a carrier, not sharing needles with carriers should work almost 100%, as lifestyle choices in the USA to prevent Hep B infection. from the Barrio

Alice,

Could you share the sources for your data on the HPV vaccines?

Also, do you mind sharing your background a bit (physician, etc.) (sorry if I missed it before).

Thanks,

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

On Mon, Dec 5, 2011 at 11:03 PM, alicerobertson@... on wrote:

Sharon....I am the mother of four daughters and two adult sons. I feel differently than you do because newer research is showing the original glowing reports aren't completely panning out. My daughters feel there is important lifestyle choices that work 100% of the time....but they do take self control. They have not had the shot...one is a nurse. But even without self control....it grieves me that California removed parental rights on little girls for some sort of greater good. That is an abuse of the state's power....but then they were going to ban circumcision. It's flustering because often you find doctors quoting pharmaceutical literature without looking beyond it.

; To: < >;

Subject: Re: Appeal to Insurance about Gardasil shot--for a man! Sent: Tue, Dec 6, 2011 4:33:53 AM

I like that the guy is willing to get a vaccine to protect his future female partners from cervical cancer and I also like that Dave is wiling to help get insurance to cover.

Sharon

in my role as mother of and doctor to various teenage girls

December 7, 2011

Yes, the post was good....these discussions are uncomfortable, but vital. Now about that "Like" button...hmmm.....I wonder if a better selection would be if patients like it, or not....sadly....the vast majority of doctors do not think as well as two physicians here have shown in their respectful posts and attitude toward a topic......but patients take note....they are the good doctors who do not rah rah just because they feel entitled. Some very foolish doctors are bullying patients out of their practice if they dare question a shot. I watch videos of them sternly declaring they are serving society! Haha! My doctors friends and I scratch our heads in bewilderment about the guise....is it not true that HMO's pay bonuses to doctors with high rates of vaccination? Hmmm.....could it possibly be that they are bumping patients like the airlines do? In an effort to gain a bonus.....oh my....now we know a doctor would not such a thing....it's all for mankind......yes....I am certain that bonus gets donated...grrr....:)Okay....sorry...it's that British sardonic humor thing goin' on......can't they develop a vaccine against that malady? Ha!

From:

Carla Gibson ;

To:

< >;

Subject:

Re: Appeal to Insurance about Gardasil shot--for a man!

Sent:

Wed, Dec 7, 2011 1:23:34 AM

We need a " Like " button. Nicely said. Carla GIbson FNPMissoula, MT To: Sent: Tuesday, December 6, 2011 2:49 PM

Subject: Re: Appeal to Insurance about Gardasil shot--for a man!

This has been a very interesting discussion so far!I know some members of the list have strong opinions about , uh, various areas of healthcare. I would like to comment on a few things about my post and myself.

1) Just because I suggested the shot does not mean I would tell the patient not to use condoms, practice unsafe sex, sex with multiple partners, various exotic forms of sex with multiple people and orifices that only the very daring would think of, or encourage him that " now you are covered for HPV you are BULLETPROOF! "

2) In my current and former practice, and in discussion with my female colleagues, I've NEVER heard of teenage or college age women saying, " man, if it weren't for this HPV thing, I'd be out sleeping with as many guys as possible all the time! If only there was some shot or something that would absolve me of all responsibility for my actions...What there is Gardasil? "

I educate my patients on the value of exercise, diet, stress reduction, sleep, and safe/potentially unsafe behaviors. That being said, I would only consider the shot to be complementary to , for women at least, routine pap/health care and other recommended preventative services. For men its obviously much more complicated, but the last studies I looked at noted that cervical cancer and certain kinds of anal cancer do appear to be on the rise, and perhaps head and neck cancer as well in non-smokers--all suspected to be linked to hpv. Since there is now a shot which might reduce some of that risk, and my patient asked, I recommended it.

And yes, never having sex, never using IV drugs, or never doing anything might reduce your risk of disease. For a population I'm not sure if an appropriate mitigation strategy for reduction in cervical cancer would be to ban all sex for unmarried women. Abstinence only Sex education is a very interesting topic which I can't stand to hear about anymore. Is Abstinence only cervical cancer prevention next?

3) I think Gardasil is a safe shot. I am trying to think about the potential risks of vaccines, and I would be firmly in the camp that vaccines and development of modern sanitation systems probably has helped public health than most other interventions. Mind you, I just had a very long and fruitless conversation with a friend also about HPV shot. Most of her information came from the Mercola web site and articles. And a friend of a friend of hers who did " her own research " and decided that her newborn did not need any vaccines. Mind you, she found in her own research that pertusis/whooping cough is " easily treated with 2 weeks worth of antibiotics, so why subject my child to the dangerous and toxic DTAP shot. " Or that she apparently sells her own homeopathic cure for whooping cough.

I gave up then, as I do now.

December 7, 2011

Sorry, but I think it is ridiculous that we would have to preauthorize any

treatment or test.

If a man wants a gardasil shot, let him pay for it.

Personally I am not fond of gardasil for my patients as the data is really not

in for cancer prevention. It's just another big Pharma experiment that we as

physicians are putting our patients thru.

Steve Horvitz

> >

> >> **

> >>

> >> Sharon....I am the mother of four daughters and two adult sons. I feel

> >> differently than you do because newer research is showing the original

> >> glowing reports aren't completely panning out. My daughters feel there is

> >> important lifestyle choices that work 100% of the time....but they do take

> >> self control. They have not had the shot...one is a nurse. But even without

> >> self control....it grieves me that California removed parental rights on

> >> little girls for some sort of greater good. That is an abuse of the state's

> >> power....but then they were going to ban circumcision. It's flustering

> >> because often you find doctors quoting pharmaceutical literature without

> >> looking beyond it.

> >>

> >> ------------------------------

> >> * ;

> >> * To: * < >;

> >> * Subject: * Re: Appeal to Insurance about

> >> Gardasil shot--for a man!

> >> * Sent: * Tue, Dec 6, 2011 4:33:53 AM

> >>

> >> *I like that the guy is willing to get a vaccine to protect his future

> >> female partners from cervical cancer and I also like that Dave is wiling to

> >> help get insurance to cover.*

> >> *

> >> *Sharon

> >> in my role as mother of and doctor to various teenage girls

> >>

> >

>

> --

>

> MD

>

> ph fax

>

December 7, 2011

yayyyy....

so hurrah for me who gets the gardasil so i can partyyy...

is there a vaccine for HIV?

(geez... im in a mood)

grace