Human Papillomavirus Vaccine
Ontario, Canada, this fall is scheduled to launch a program that would provide Merck'shuman papillomavirus vaccine Gardasil at no cost to all eighth-gradegirls in the province, government officials announced on Thursday, the Toronto Star reports (Ferguson, Toronto Star, 8/3).
Disease
Gardasilin clinical trials has been shown to be 100% effective in preventinginfection with HPV strains 16 and 18, which together cause about 70% ofcervical cancer cases, and about 99% effective in preventing HPVstrains 6 and 11, which together with HPV strains 16 and 18 cause about90% of genital wart cases, among women not already infected with thesestrains (Kaiser Daily Women's Health Policy Report, 7/18). Canada's health ministry, Health Canada, last year approved Gardasil for girls and women ages nine to 26 (Gillespie, Toronto Star, 8/2).
TheCanadian government in March announced that it is including about $258million in the 2007-2008 budget to help pay for provincial HPV programs(Kaiser Daily Women's Health Policy Report,3/21). The national government plans to provide 117 million Canadiandollars, or about $111 million, over three years for Ontario's program,which aims to vaccinate 85,000 eighth-grade girls this fall, Toronto's Globe and Mail reports. Provincial officials plan to call on the national government for permanent funding (Campbell, Globe and Mail, 8/2).
According to the Star,provinces individually are deciding the details of the programs,including what age group to vaccinate. Ontario is the first province todevelop an HPV vaccine program. Nova Scotia officials in June said theywould vaccinate seventh-grade girls, and Prince Edward Island officialshave said that sixth-grade girls will receive the vaccine.
About 400 women die of cervical cancer each year in Canada, according to the Star. In Ontario, about 550 women are diagnosed with cervical cancer and 150 die of the disease annually, the Star reports (Toronto Star, 8/2).
Related Commentary
In a related commentary published online in the Canadian Medical Association Journal on Wednesday, Abby Lippman, an epidemiologist at McGill Universityin Montreal, and colleagues wrote that there is no urgent need forwide-scale cervical cancer vaccinations in Canada because deaths fromthe disease have been declining, Reuters reports.
"A careful review of the literature ... reveals a sufficient number ofunanswered questions to lead us to conclude that a universalimmunization program aimed at girls and women in Canada is ...premature and could possibly have unintended negative consequences forindividuals and for society as a whole," the researchers wrote.
Moreneeds to be known about Gardasil, including whether factors such assmoking or poor health influence its effectiveness and the duration ofimmunological protection, they said, adding that without a publiceducation campaign, misunderstanding about the vaccine could leadteenagers to practice unsafe sex (Egan, Reuters, 8/2).
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