Conservatives Oppose New Cervical Cancer Vaccine
December 22, 2005
A new vaccine that protects women against cancer-causing strains of the human papilloma virus (HPV) is at the center of yet another controversy at the Food and Drug Administration (FDA). Although it is generally accepted that the vaccine is effective against the most dangerous strains of HPV, which are responsible for about 70 percent of all cases of cervical cancer, vaccine opponents claim that making it a regular part of childrens' vaccine protocol would encourage young women to be more sexually active. Women's health advocates are urging that it become part of the regimen of pre-puberty vaccines, since HPV is spread primarily through sexual contact. The FDA will be meeting in early 2006 to make final determination on the vaccine's availability.
National Organization for Women President Kim Gandy condemned religious and political extremists for opposing a vaccine that will eliminate most cases of cervical cancer. "I lost my grandmother to cervical cancer, and have two daughters who might be spared that fate with this vaccine. Opposing an effective vaccine that would save hundreds of thousands of women's lives with the vacuous assertion that it would lead to promiscuity is inexcusable," Gandy said.
How the HPV vaccine will be used will largely be determined by the Center for Disease Control's Advisory Committee on Immunization Practices. The Committee's debate will center on a choice between mandatory vaccination just prior to puberty or selective vaccination of young people considered "at risk." The latter option would entail a questionable invasion of privacy to determine who is or may become sexually active, assuming those behaviors could even be reliably predicted. One member of the panel, Dr. Reginald Finger, has served as a medical analyst for the arch-conservative group Focus on the Family. Finger has said that some claim the vaccine may send a message to teens that they are expected to be sexually active. The Christian Medical and Dental Associations reported that parents have called to say that the new vaccine "will sabotage our abstinence message," which presumably relies on a fear of cancer death to promote abstinence.
Although criticism of the HPV vaccine is not being aired much in public, more strident opposition to broad access is likely to be exercised behind closed doors. "The FDA has caved to right wing extremists before. For three years now, pressure from birth control opponents has led the political appointees at FDA to override both science and medicine in delaying over-the-counter sale of Plan B Emergency Contraception (EC). We cannot let that happen with this vaccine. Women must demand that our lives and our health come first," said Gandy.
"Proponents of good science-based health care policies have much to be concerned about with the Bush administration's appointees, who seem to have supplanted fact and reason with religious zealotry," Gandy noted.
Research Shows Vaccine Highly Successful — In early December, a briefing on Capitol Hill reviewed the status of cervical cancer vaccine research, highlighting the breaking news about success rates in clinic trials. The Kaiser Family Foundation and Women's Policy Inc. sponsored the event; a report is available online.
Each year it is estimated that 300,000 women worldwide die due to cervical cancer, including almost 4,000 in the U.S. Cervical cancer is the second most common cause of cancer deaths in women worldwide. The leading cause of cervical cancer is the human papilloma virus (HPV). There are over a hundred strains of the HPV virus; however, two forms, types 16 and 18, are responsible for an estimated 70% of cervical cancer cases. Two pharmaceutical companies, Merck & Co. and GlaxoSmithKline, have developed a vaccine against the two strains of HPV which usually lead to cervical cancer. In Merck's clinical trials, the vaccine, Gardasil, has proven 100% effective in preventing early-stage cervical cancer and precancerous cervical lesions. GlaxoSmithKline's HPV vaccine, Cervarix, shows equally promising results with a stronger immune response found in girls ages 10 - 14 than in older adolescents. Merck has filed for priority FDA review of its HPV vaccine.
Scientists have called the results of clinical trials stunning, noting that it is rare for a vaccine to have 100% effectiveness and that these results suggest that the vaccine would have the most beneficial impact in developing countries.
Most Widespread STD Virus — HPV is the most common sexually transmitted viral infection in the U.S. It is estimated that 75% of the population has been exposed to HPV at one point in time, and at least half of U.S. adults have been infected, though not all with the deadliest strains. HPV can cause abnormal growths on the cervix which can sometimes turn cancerous. Though detection methods for HPV are available, their effectiveness is limited. For example, the DNA test for HPV has only been approved by the FDA for women aged 30 and older. In women under 30, the test is used only when Pap test results are inconclusive. Thus, better ways to combat the virus are desperately needed.
Early detection tools, such as the Pap test, have made death from cervical cancer less common in the U.S. than in many countries. Most of the deaths occur in countries where early detection and treatment services are not available. According to Deborah Saslow, director of Breast and Genealogical Cancer at the American Cancer Society, the vaccine could prevent at least 70% of the deaths from cervical cancer. In the U.S., it is minority women who have the highest incidence of cervical cancer: Hispanic women followed by African-American women, Asian women, and Pacific Islander Women respectively. This vaccine would greatly aid these women of color who are hit hardest by the virus.
Unfortunately, a vaccine is not yet developed to protect women who have already been exposed to HPV. That is why it is particularly important that the new vaccines be administered to pre-adolescent girls who have not yet become sexually active. This could save thousands of women's lives each year in the U.S. and hundreds of thousands around the world. This is a huge breakthrough in women's health. The FDA must approve these critically important advances in preventative medicine and assure that the vaccines are administered broadly in order to save women's lives.
Cervical Cancer Screening Month — The National Cervical Cancer Public Education Campaign reminds women that cervical cancer is the only cancer for which we know the cause. Nearly all cervical cancers (99%) are caused by the human papilloma virus (70% are caused by the two strains that the vaccine targets) and HPV can be detected through regular screenings before it causes cancer. January, which has been designated as Cervical Cancer Screening Month, presents an opportunity to get an HPV test. You can register for an annual exam reminder by going to their website.
Also, you may want to find out if your health insurance plan covers the HPV test as a "screening" test for women 30 and older by calling the HPV Patient Help Hotline's toll-free number, 1-866-895-1HPV (1-866-895-1478). You will need to provide the hotline with your insurance company's name and the group number and then the hotline will be able to determine whether the costs of the HPV tests will be covered. If it is not covered under preventative services, the patient may have to pay a deductible amount before your plan pays for the test.
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