The San Antonio Metropolitan Health District, through its Vaccine Study Center, is an active participant in the ongoing clinical trials of Merck’s human papillomavirus vaccine, a major breakthrough in the ongoing effort to protect women from cervical cancer.
The vaccine’s recent approval by the Food and Drug Administration has been greeted enthusiastically by public health officials around the world.
HPV is one of the most common sexually transmitted diseases, affecting an estimated 50% or more of sexually active adults at some point of their lives. The cervical cancer that it can cause kills 290,000 women a year worldwide, including 3,500 in the United States alone. The vaccine protects against the two types of human papillomavirus that are responsible for 70% of the cervical cancer cases. It also can offer protection against two other viruses that cause 90% of genital wart cases.
FDA’s approval is just the first step in a process of integrating the new vaccine into public health’s arsenal of essential and effective weapons in our battle against cervical cancer. Issues of availability and cost need to be addressed. The series of three shots is estimated to cost $300 to $400.
Metro Health is awaiting a policy statement to be issued by the Advisory Committee on Immunization Practices that would allow it to be added to the inventory of vaccines available through the Vaccines for Children Program. We also need to ask ourselves how this promising new treatment will be made available to women and girls worldwide. It will not and should not replace our existing screening procedures.
Since the new vaccine will protect against a sexually transmitted disease, it should be administered before the onset of sexual activity. In the United States, approximately half of all high school students have been sexually active. FDA approved the vaccine for use in females age nine to 26, and the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends universal administration to girls 11 to 12 years old.
Important decisions still must be made on the most appropriate age to offer it, mandatory versus voluntary compliance, and how to design effective education programs to gain the public’s support and acceptance.
On balance, this development holds great promise for significantly reducing cervical cancer deaths worldwide, especially in developing countries. Public health needs to be at the table as next steps are planned to assure availability and access.
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