Vaccines = complacency and false hope - continue with pap smears
- From: J <nexsw@nvalid,anon>
- Date: Sat, 11 Aug 2007 06:33:53 -0400
<http://www.canada.com/nationalpost/news/story.html?id=1e156d0b-b3f4-47f4-b080-430ccfce001d&k=45622>
Published: Tuesday, August 07, 2007
It has been called "the medical breakthrough of the 21st century" and the
most significant development in women's reproductive health since the
Pill. Yet the same week that Ontario announced it was offering all Grade 8
girls a vaccine that could prevent cervical cancer, the country's medical
journal carried an article from experts questioning the merits of the
vaccine.
Such is the controversy around the HPV vaccine, which protects against the
human papilloma virus associated with about 70% of cervical cancers:
Hailed by some as a rare example of the government recognizing women's
reproductive health care needs and derided by others as a case where
powerful lobbying and marketing are winning out over science.
Vaccination programs are slated to begin in schools in Ontario, Nova
Scotia, Prince Edward Island and Newfoundland and Labrador in September.
It is already offered free to girls in Australia and in some U.S. states,
including Texas and Virginia.
Some Canadian scientists and women's health groups say that because this
rare cancer is well controlled in Canada, mass inoculation is not only
redundant but could undermine existing, more comprehensive protections
like Pap testing.
But cervical cancer can still be deadly, and so the vaccination has
advocates. About 1,400 Canadian women will be diagnosed with cervical
cancer this year, and 400 will die.
The vaccine has been backed by the Society of Obstetricians and
Gynecologists of Canada and the Canadian Cancer Society, and in announcing
her government's vaccination program, Sandra Pupatello, Ontario's Minister
for Women's Issues, said: "There has never been an issue around women's
health that has had this level of unanimity. It wasn't a difficult
decision."
Gardasil, which is the only cervical cancer vaccine on the market, is the
most expensive childhood vaccine developed for mass use. The federal
government has allocated $300-million to vaccinate girls ages nine to 13,
but broad inoculation is estimated to cost much more, according to the
Canadian Medical Association Journal, which prices a single round at about
$2-billion.
Gardasil protects against two strains of HPV associated with about 70% of
cervical cancers. It does not protect against other HPV strains, the other
30% of cervical cancers or other sexually transmitted diseases.
It will not protect most women because they have already been exposed to
HPV, the world's most common STD in women and men alike. (There may be as
many as 200 HPV strains.)
The vaccination seeks to immunize girls before they become sexually
active.
Merck Frosst, which produces Gardasil, says its clinical trials followed
20,000 females for an average of 3.5 years; only 241 subjects were
followed for five years, and no one for longer. The youngest girls were
followed for only 18 months; only 100 nine-year-olds were included. This
group is assumed not to be sexually active or infected, when neither may
be the case. Many types of HPV infection have been demonstrated in
children, even in newborns.
Ms. Boscoe, of the Canadian Women's Health Network, said the ads had a
powerful impact: "It suggested there was a cervical cancer epidemic in
Canada, and that a vaccine could cure it." She said that the roughly 400
women "who died of cervical cancer in this country last year didn't die
because we don't know what to do, they died because we weren't caring for
them. Either they didn't come in for care, or we didn't follow up on
them."
The women most threatened by cervical cancer in the West as well as around
the world are poor. In Canada, they are likely to be immigrants with
language and cultural barriers, or aboriginal, or isolated, with
disabilities or with their immunity compromised by stress and poor
nutrition, and without access to Pap screening.
.
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