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 with strains 16 and 18, which together cause about 70% of cervical cancer cases, and 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, 6/30). The Washington Post and Atlanta Journal-Constitution recently published an editorial and opinion pieces related to Gardasil. Summaries appear below.

Editorial
Washington Post: Although there were "predictions" that some conservative groups would oppose recommending Gardasil for girls ages 11 and 12, the lack of "political controversy" possibly could be attributed to the "unquestioned worth" of the vaccine, which has no known side effects and is effective against four strains of HPV, a Post editorial says. Even though the vaccine cannot replace a "frank discussion of the dangers of sex," pediatricians should provide Gardasil to their female patients before the girls become sexually active, parents should allow their preteen girls to receive the shot and the vaccine should be as routine as other inoculations so that "9,700 fewer American women will be diagnosed with cancer each year," according to a Post editorial. Whether to mandate the vaccine for young girls will be determined by the states, and "local legislators probably will not consider it until after the first few years of widespread use," the editorial says, concluding, "By that time, its worth and safety may be so clear that state legislatures will experience the same welcome consensus" (Washington Post, 7/7).

Opinion Pieces
Maureen Downey, Atlanta Journal-Constitution: Though some social conservatives and abstinence-only advocates "reacted warily" to ACIP's recommendation that all girls ages 11 and 12 receive Gardasil, the response among conservatives "[f]ortunately ... was muted" because they understood that the vaccine would protect against cervical cancer and genital warts, Journal-Constitution editorial board member Downey writes in an opinion piece. "[G]iven how deadly cervical cancer is, the health benefits of widespread vaccination overwhelm other concerns," Downey concludes (Downey, Atlanta Journal-Constitution, 7/7).

Linda Klepacki, Atlanta Journal-Constitution: Focus on the Family and its "allies" support ACIP's recommendation that all girls ages 11 and 12 be vaccinated but have voiced concern for the "rights of parents as the medical decision-makers for their children," Linda Klepacki, a sexual health analyst for Focus on the Family, writes in a Journal-Constitution opinion piece. "[D]eciding about a vaccine against a disease or infection that is sexually transmitted is not as clear-cut for parents as deciding about other immunizations," she writes, adding, "The one certain truth is that the HPV vaccine does not, in any circumstance, negate or substitute God's message of sexual abstinence until marriage and sexual faithfulness within marriage." Klepacki says, "Attempting to reduce the risk of a life-threatening disease solely by viewing teen sexual activity as a foregone conclusion -- the solution proffered by the HPV vaccine -- puts our children in the bull's-eye of heartache and ill health," concluding, "Government has no right to place them there" (Klepacki, Atlanta Journal-Constitution, 7/7).















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