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Guest Column
The U.S. Food and Drug Administration (FDA) has approved Gardasil, a vaccine that is effective against four types of human papillomavirus (HPV), two of which cause 70 percent of cervical cancer cases. The vaccine, which is a product of Merck & Co., Inc., has been approved by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) for use in females ages 9 to 26. According to medical research, HPV is the primary cause of 99 percent of cervical cancers. Based on that information alone it would appear that everyone would support mandatory vaccination of all women. But that is not the case. Parent and family groups are opposed to states mandating the vaccine because they think the vaccination violates parental rights and because of safety concerns related to side effects. A National Vaccine Information Center analysis of reports made to the federal Vaccine Adverse Event Reporting System about side effects found reports of headaches, dizziness, loss of consciousness, seizures, joint pain and Guillain-Barre Syndrome. Concerns about possible side effects have also been raised because the use of Gardasil in combination with other childhood vaccines has not yet been studied. But public concerns about the vaccine have not stopped some elected officials. Bills to make the vaccination mandatory have now been introduced in 39 states and the District of Columbia. While cervical cancer is a bigger problem in less developed countries, causing the deaths of about 250,000 women each year, it is no longer a major killer in the U.S. In fact, cervical cancer does not even make the list of the 10 leading causes of cancer deaths among women. According to medical researchers, the best prevention against a fatal case of cervical cancer is for women to undergo regular Pap tests which detect abnormal cells in the cervix so they can be treated before they turn into cancer. According to John T. Schiller, Ph.D., of the National Cancer Institute's Center for Cancer Research, cervical cancer can almost completely be prevented using current procedures such as Pap tests. Consequently, the vaccine's primary benefit to most U.S. women will be the reduction of the number of abnormal Pap test results rather than independently reducing the fatality rate of a disease that is preventable without the vaccine. The HPV vaccine will be of enormous benefit to low-income women in the U.S. that don't have access to these life-saving exams, and especially to women in less developed countries, if it is administered before they contract the virus. If they are already sexually active and have the virus, the vaccine is of no benefit, which is the justification U.S. health officials use for targeting pre-adolescent girls for vaccination. But is nationwide vaccination of sixth grade girls really necessary? Not according to Dr. Diane M. Harper, one of the lead researchers involved in the development of the vaccine, who says that the nationwide vaccination of sixth grade girls is not only not necessary, it is not advisable. As the director of the Gynecologic Cancer Prevention Research Group at Dartmouth University Medical School, Dr. Harper led two of the biggest HPV vaccination trials and has spent 20 years working on an HPV vaccine. In an interview with KPC Media columnist Cindy Bevington, Dr. Harper said, "It is silly to mandate vaccination of 11- to 12-year-old girls." She added, "Giving it to 11 year olds is a great big public health experiment." In another interview on March 26 with the British publication The Guardian, Dr. Harper voiced concerns about the consequences of administering the vaccination to school girls because the vaccination will only be effective for five to 10 years with only an assumption that they will be protected. Harper told The Guardian, "We're vaccinating against a virus that attacks women throughout their whole life and continues to cause cancer. If we vaccinate girls at 10 or 11 we won't know for 20 to 25 years whether it is going to work or not. That is a big thing to take on." Governors and state legislators need to hear what Dr. Harper and other experts have to say before rushing to mandate the HPV vaccines. Harper said, "To mandate now is simply to Merck's benefit, and only to Merck's benefit." Harper is not alone in this view. Dr. Jon Abramson, chairman of the CDC's Advisory Committee on Immunization Practices, the committee that recommended approval of the vaccine, told the Washington Times that he and other members of ACIP told Merck representatives that the vaccine should not be mandated. Avaccine against the strains of HPV virus that cause cervical cancer is of enormous value to women, especially those that cannot get regular gynecological exams, and could save hundreds of thousands of lives worldwide. However, according to Dr. Harper and other experts, forcing 11-year-old girls to get the vaccination is of little value except to the pharmaceutical companies that need the U.S. market to help recover their costs for development. Consequently, states should not mandate the vaccination of school girls. Instead, they should make the vaccine available to young women on a voluntary basis with parental consent. And given the importance of exams such as Pap tests, states should also make sure that lowincome women have access to these proven life-saving exams as well.
Gary Palmer is president of the
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