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Merck’s free vaccines good news for the uninsured

The drug company giant Merck’s decision to provide free vaccines for the uninsured is especially good news in Mississippi.

“Removing financial barriers to access to life-saving vaccines for poorer adults is important,” said Walter A. Orenstein, M.D., director of the Emory Program for Vaccine Policy and Development. “This program is a bold step to try to assure that lower-income adults can receive the benefits vaccines have to offer.”

The program is important anywhere there are uninsured people, but it is especially helpful in Mississippi because of the low average per capita income, said Dr. Sandor Feldman, professor emeritus of pediatrics and the retired chief of pediatric infectious diseases at the University Mississippi Medical Center.

“For the vaccines Merck makes, and there are a lot of them, there is good potential for people to be vaccinated who wouldn’t otherwise,” Feldman said. “The vaccines they have are good vaccines and will have a very positive impact for the population that needs them. Overall, having vaccines available to people who can’t afford them would be of benefit to good health.”

There are immediate and obvious benefits to people being vaccinated and hence not becoming ill. Longer term, a healthier population always has great economic benefits, Feldman said. Businesses experience lower absentee rates, and individuals have lower costs for healthcare.

One of the vaccines has only been licensed recently. It is a vaccine for human papillomavirus (HPV), which can cause genital warts and cervical cancer. Feldman said about 3,000 to 4,000 women per year in the U.S. die from cervical cancer, and there are about 10,000 new cases of cervical cancer in the country per year. In Third World countries, the rates are even higher.

There are about 80 strains of HPV. The Merck HPV vaccine has four strains, two that are most commonly associated with cervical cancer and two most commonly associated with genital warts. The types of viruses that cause genital warts are not necessarily associated with cervical cancer.

“Genital warts, in terms of general health, it isn’t like HIV,” Feldman said. “You don’t end up dying. But it is a common sexually transmitted disease, uncomfortable and can have complications. Cervical cancer can end up being fatal.”

Feldman said it isn’t known how long the virus will be effective. No one knows if someone vaccinated at 15 will still be protected at 85.

Merck also has a vaccine for Hepatitis B, a serious disease that can cause lifelong infection, cirrhosis of the liver, liver cancer, liver failure and death. And there is a Merck vaccine for Hepatitis A, which can be spread by food contamination or poor sanitation.

Other vaccines the company produces include those for measles, mumps and rubella, pneumonia, chicken pox and shingles. Shingles is a type of chicken pox virus, but is manifested differently and tends to occur in older people.
Feldman said that for a generally healthy workforce, the pneumonia and shingles vaccines are most likely to be of benefit.

A benefit to the workforce could be parents not missing work to stay at home with children who are ill because of lack of vaccination.

“But keep in mind our state has excellent rates for immunization,” Feldman said. “We have been very proactive as a state for vaccines for children. The Merck program will have more of an impact on some of the adult vaccines, and maybe for some of the adolescents.”

The Merck program will begin in the fall, and company sales representatives will be letting healthcare providers know about the offering.

“Sales reps will be going out aggressively and telling physicians about the program,” said Maggie Kohn, spokesperson for Merck. “Physicians can fill out and fax in a form at www.merckhelp.com in order to participate when the program launches in the fall.”

Kohn said another company offering that might be of interest is a free guide to making medicine affordable. This is not just about Merck assistance programs, but covers 475 private and public assistance programs.

“The issue of the uninsured is such a big issue for every state that we are trying to put resources out there to help folks,” she said.

The “Merck Guide to Affordable Medicine” can be ordered by calling 1-888-MERCK38 or by visiting the Web site www.merckhelp.com

It is a misconception that it is primarily the unemployed who don’t have health insurance. Kohn said that research has shown 80% of the uninsured have jobs.

“That was really surprising because initially there was a perspective that it was primarily unemployed and low-income people without insurance,” Kohn said.

Last year Merck launched a discount prescription drug program, and the company already had a free prescription program to help those without healthcare insurance. Forms must be filled out by a patient’s physician in order for qualified participants to get free medicines delivered in the mail for a year. Last year, Merck sent medicines to 700,000 patients.

“It is a real help for those people who need it,” Kohn said. “You can be making $80,000 a year, and not have health insurance. We wanted to start a program to help that kind of patient. It doesn’t seem there is any one face for the uninsured. They are working or unemployed and no specific age.”

This program will be available to physicians in private practice who provide Merck vaccines to patients who meet the criteria for the program: adults who have no insurance coverage and with a limited income (an annual household income that is less than $19,600 for individuals, $26,400 for couples or $40,000 for a family of four).

However, Merck recognizes that sometimes exceptions need to be made based on a patient’s individual circumstances. Individuals who do not meet these criteria may still qualify for the vaccine program if both they and their physician attest that the patient has special circumstances of financial and medical hardship.

Contact MBJ contributing writer Becky Gillette at bgillette@bellsouth.net.

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