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Columbia Spectator Staff

Though Katie Brinn, CC '12, received the Gardasil vaccine during her senior year of high school, she said she would not have paid almost $400 to get the vaccine at Columbia Health Services. Across Broadway at Barnard, it's a different story. The vaccination, which protects against strains of HPV, a sexually-transmitted infection that can lead to cervical cancer, is administered in three injections and is usually not covered by health insurance. With each shot costing $130, those seeking the vaccine at Columbia Health Services will pay a total of nearly $400 for the full vaccine dosage. At Barnard Student Health Services though, students can receive all three shots for free. Columbia Health Services explained these cost disparities in a statement, saying that Barnard can afford to tailor its services to its female population. "Columbia (Morningside), like all schools around the country including Barnard College, seeks to provide services in a cost-effective manner to benefit as many students as possible. The vaccinations provided free of charge at Columbia are appropriate for our entire student body, while Barnard is a separate college for women and has structured its student health service in accordance with their population," the statement read. But for students like Brinn, issues of cost can speak to larger problems with the system. Some experts in the health care field argue that the biggest impediment to those wishing to receive the vaccine, and thereby help prevent cervical cancer, is its cost. "This is a very expensive vaccine," said Shobha Krishnan, a gynecologist at Barnard Primary Care Health Services, whose book, "The HPV Vaccine Controversy: Sex Cancer, God, and Politics" was released in June 2006. Krishnan, a member of the Medical Advisory Board of the National Cervical Cancer and International HPV Cancer Coalition, said, "At the moment, the vaccine is free to us, but this depends on insurance and how each health services [clinic] negotiates with insurance systems. Insurance companies do cost-analysis, and it is hard to translate what we do here at Barnard across to other practices. At Columbia, the scenario is very different." That's because the vaccine is still recommended only for "permissive use" in men, she said, and schools have to negotiate with insurance companies to get vaccines that are important to all of its student population. In October 2009, the Centers for Disease Control and Prevention recommended a permissive-use policy for the HPV vaccine in men. "Essentially this is saying that yes, men will get benefits [from the vaccine], but at this time it isn't cost effective to vaccinate males because they aren't as affected, and so the CDC cannot make a public policy recommendation," Krishnan said. The CDC web site says that while HPV is very common in men and women, most men with HPV will never develop health problems from it. But even if the cost-effective benefit is not there now, Krishnan said that men should still be targeted equally in HPV-awareness campaigns. "We cannot put the stigma of this STI on women alone," she said. Although "students are definitely taking advantage" of the free vaccine, Krishnan said, "we are seeing more and more students over the last three years who have already had the vaccine before they come into Health Services after entering college." In the future, cost might not be as great a hurdle to the wider use of the vaccine. "As with anything else that's new, the price is really high," she said. Cost, though, is not the only concern. "It really comes down to education and awareness," Krishnan said, adding that students at Barnard with free access to the vaccine as well as other related services are not likely to take advantage if they are not aware of the surrounding issues. For some students, the price discrepancy between Barnard and Columbia is surprising. "I think it's kind of shocking that it's $400," Jennifer Stepanyk, BC '11, said of Columbia's fees. "It's really prevalent. ... Most people desire to get that." Others felt more strongly about the divide. Kate Husband, a student in the Graduate School of Architecture, Planning, and Preservation, said, "For Barnard to offer it free and Columbia to not step up to the plate and do the same is not really looking out for women's health." Madina Toure contributed reporting. elizabeth.foydel@columbiaspectator.com

HPV Health Care Columbia Health Services Barnard College Health Services
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