Kaiser Daily Women's Health Policy Report Summarizes HPV Vaccine-Related Editorial, Opinion Pieces

CDC's Advisory Committee on Immunization Practices, which drafts recommendations and schedules for the administration of vaccines in the U.S., last week unanimously voted to recommend that all girls ages 11 and 12 receive Merck's human papillomavirus vaccine Gardasil. FDA last month approved Gardasil -- which is given in three injections over six months and will cost $360 -- for sale and marketing to girls and women ages nine to 26. According to Merck, Gardasil in clinical trials has been shown to be 100% effective in preventing infection in women who do not already have HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and is about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in Atlanta at a meeting of the American Society of Clinical Oncology. The ACIP recommendation also allows for girls as young as nine to receive the vaccine and recommends that girls and women ages 13 to 26 receive Gardasil. Although the vaccination should be given before a girl begins sexual activity, sexually active girls and women still should receive Gardasil, the recommendation says (Kaiser Daily Women's Health Policy Report, 7/7). The Washington Post and the New York Times recently published an opinion piece and an essay related to Gardasil. Summaries appear below.

Opinion Piece
Peter Sprigg, Washington Post: Although the development of Gardasil is a "tremendous medical achievement and a boon to public health," two "important concerns" should be highlighted in moving forward, Sprigg, vice president for policy at the Family Research Council, writes in a Washington Post opinion piece. One such concern is providing "accurate" information to the public "about what the vaccine does and does not prevent," and another is making vaccination optional, Sprigg writes. According to Sprigg, "[c]laims that 'the new vaccine, when used appropriately, will virtually eliminate cervical cancer' are simply false," and advocates should ensure the public understands that the vaccine is "only '100% effective' against the strains of HPV it targets, leaving 30% of cervical cancer cases untouched." In addition, "[m]andating vaccination may be justified when the disease in question is easily transmitted through casual contact or blood," but HPV strains that can cause cervical cancer are "transmitted only through sexual contact," Sprigg writes. Therefore, "[b]ehavioral self-restraint and vaccination are not mutually exclusive, since even someone who practices abstinence and fidelity could be exposed to HPV through sexual assault or marriage to an infected partner," he adds, concluding, "But, as with other public health issues, such as smoking, we should not limit ourselves to risk-reduction strategies when risk elimination is the ultimate goal" (Sprigg, Washington Post, 7/15).

Essay
Roni Rabin, New York Times: "A shot that protects against cancer sounds like a great idea, at first," but "we already know how to prevent cervical cancer in this country, and we've done a darn good job of it," Times writer Rabin writes in an essay. According to Rabin, the "secret weapon" is Pap tests. The "battle against cervical cancer has been a success story," Rabin writes, adding that due to preventive care, cervical cancer "has gone from being one of the top killers of American women to not even being on the top 10 list." According to Rabin, "If current trends continue, by the time my [nine]-year-old daughter is 48, the median age when cervical cancer is diagnosed, there will be only a few thousand cases of the cancer in women ... even without the vaccine." Therefore, "perhaps we could redirect the public money that would be spent on this vaccine ... to make sure all women in the United States get preventive health care," Rabin writes. However, for the "hundreds of thousands of women worldwide" and "high-risk" women living in the U.S. who do not have access to Pap tests and the follow-up care required, "the vaccine should be an option," Rabin adds. "[B]y all means, let's keep stamping out cervical cancer," Rabin writes, concluding, "Let's make sure women and girls get Pap smears" (Rabin, New York Times, 7/18).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.



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