August 29, 2010
Cervical cancer is the second leading cause of death from cancer world-wide. (Bridges, 2008) It is also the leading cause of cancer related deaths in the developing countries. (National Cervical Cancer Coalition) Ireland has one of the highest cervical cancer death rates in Western Europe and this rate is increasing by 1.5% per year. (The Irish Cancer Society, 2008 and Condon, D. 2005.) The implementation of a nationwide cervical screening programme for all women aged 25-60 years is called upon- urgently. Such a programme would reduce the incidence of cervical cancer by 80 %.( I.C.S. 2007) In the meantime the introduction of the Gardasil injection targeted initially towards the 9-26year old paves the way for reductions in the current trends for the future.
The National Cancer Institute purport “Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds, if all women were to take the vaccine and if protection turned out to be long-term. In the long-term the vaccine can reduce the need for medical care, biopsies, and invasive procedures.” Research for Gardasil vaccine protection started in America in the 1980s and was approved by the F.D.A. in 2006. The Global Health Commitments Group announced that Gardasil is approved in the U.S. for girls and women age 9-26yrs. Indeed 85 countries including Mexico, Australia, Canada, New Zealand, Peru, Brazil, Singapore, Korea and many countries in Africa are also included in a programme called the Gardasil Access Programme for those who cannot access the injection because of poverty. Ireland is included in its most recent launch but at a cost, which has lead to much debate.
Inadequate re-imbursement from the H.S.E. and Health Insurance companies for Merck’s HPV vaccine Gardasil is leading most General Practitioners to refuse to purchase the vaccine. This H.P.V. vaccine in clinical trials has been shown to be 100% effective in preventing infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing H.P.V. strains 6 and 11, which together with strain 16 and 18 cause about 90% of genital wart cases among women not already infected with the strain. (Kaisernetwork.org)(Washington Post May 2007.)
According to Niall Hunter the Gardasil vaccine course is set to cost €600 on average. €345 plus vat x3 vaccines plus the cost of General Practitioner consultations. Indications for Gardasil: To prevent the initial establishment of H.P.V. infections.
For maximum efficacy, it is recommended that it be given prior to becoming sexually active. It is essential to remember that Gardasil will not block all HPV infection types that can cause cervical cancer; therefore the vaccine should not be considered a substitute for cervical screening.
Administration. A course of three injections, 0, 2 months and six months later- Licensed for girls and women 9-26 years. Politics and Hurdles. There is a limited understanding by many people that H.P.V. causes cervical cancer. The difficulty of getting pre-teens and teenagers in to see the General Practitioner can be a feat in itself, let alone present themselves three times for injections. Expense. Longevity of the vaccine is unknown. The research studies were of short duration.
It is unknown whether the vaccines will last just a few years or for longer. Further studies are required.
Both men and women are carriers of H.P.V. To eradicate these H.P.V. strains, 6,11,16,18 men will eventually need to be vaccinated. (Science Daily) Homosexual men in Britain are being vaccinated with the Gardasil injection at Harley Street and other clinics in London. Many of this group are swabbed before vaccination to determine which if any, sub-types of HPV they may be carrying.
“If they have got a full house of HPV sub-types then there is no point in immunisation” Dr Cummins, Harley Street. Britain’s leading HIV and AIDS charity, The Terrence Higgins Trust, say that “the case for mass vaccination in men would depend on the outcome of future clinical trials.”
Key points to remember: Gardasil does not substitute for cervical screening…..so continue to encourage smear tests as required. Gardasil may not fully protect everyone who gets the vaccine. It does not protect against diseases due to non vaccine H.P.V. types.
There are more than 100 H.P.V. types. Gardasil will not protect you against H.P.V. types to which one may have already been exposed. Gardasil works best before any contact with certain types of H.P.V. hence the early age of administration. So the question is…….. Based on the information available…. “Would you pay the price ………of the vaccine or risk the disease? Not everyone is jumping on the Gardasil bandwagon without hesitation. How about you?