Peter B. Bach, 10.20.09, 06:32 PM EDT
Is Merck’s Gardasil the best solution for cervical cancer?
On Wednesday Atlanta will be the stage for the latest act in the Gardasil vaccine saga. There, members of the Vaccines for Children Advisory Committee will vote on whether Merck‘s Gardasil–which prevents infection with the cervical-cancer-causing Human Papilloma Virus (HPV)–should be given to boys. They voted “yes” for girls three years ago.
The panel will struggle with the ethics of giving a vaccine to boys when the primary purpose of doing so is to keep them from spreading the sexually transmitted virus from one girl to another. It will struggle with the biology that shows the vaccine only covers 70% of the virus strains that cause cervical cancer. And if panel members vote “yes,” it will mean doctors should give the vaccine to boys and insurance companies should pay for it.
They need to think about this carefully, but not because of ethics or biology. Gardasil vaccination to prevent cervical cancer is predicated on two incorrect assumptions: 1) that we will not make any meaningful progress in cervical cancer treatment over the next several decades, and 2) that we have no better approach to preventing it today.
As far as cancer-treatment progress, the panel needs to remember that prevention does not pay off until the disease you are trying to prevent would strike. This lag in benefit is 45 years in cervical cancer vaccination. Girls are 12 when they get the vaccine; women are 57 years old on average when they die of cervical cancer. For today’s girls, the potential payoff will be in the year 2054.
Comment from Leslie
Make sure that you do read the entire article