Wednesday, May 09, 2007

Just say "no" to cancer prevention?

I have to admit that when I think of the issue of HPV vaccination from a public health perspective, it's a slam dunk! However, if I had a young daughter, would I race her into the doctor's office to be vaccinated? Professor R. Alta Charo discusses the issues surrounding HPV vaccination in the latest issue of the New England Journal of Medicine:
Cancer prevention has fallen victim to the culture wars. Throughout the United States, state legislatures are scrambling to respond to the availability of Merck's human papillomavirus (HPV) vaccine, Gardasil, and to the likely introduction of GlaxoSmithKline's not-yet-approved HPV vaccine, Cervarix, which have been shown to be effective in preventing infection with HPV strains that cause about 70% of cases of cervical cancer. At the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP) has voted unanimously to recommend that girls 11 and 12 years of age receive the vaccine, and the CDC has added Gardasil to its Vaccines for Children Program, which provides free immunizations to impoverished or underserved children.

Yet despite this federal imprimatur, access to these vaccines has already become more a political than a public health question. Though the more important focus might be on the high cost of the vaccines — a cost that poses a genuine obstacle to patients, physicians, and insurers — concern has focused instead on a purported interference in family life and sexual mores.
Click here to read the entire full free-text article (registration required).

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