British Columbia To Launch Program To Provide HPV Vaccine To Sixth-Grade Girls Next Fall If Approved, Official Says

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Pediatrics / Children's Health;  Women's Health / Gynecology
Article Date: 13 Aug 2007 - 9:00 PST

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The Canadian province of British Columbia will begin providing Merck's human papillomavirus vaccine Gardasil at no cost to all sixth-grade girls in the province in September 2008 if the program is approved, Perry Kendall, B.C.'s provincial health officer, said on Tuesday, Toronto's Globe and Mail reports (Drake, Globe and Mail, 8/8). The Canadian government in March announced that it is including about $258 million in the 2007-2008 budget to help pay for provincial HPV programs. Canada's health ministry, Health Canada, last year approved Gardasil for girls and women ages nine to 26.

Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with HPV strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these strains (Kaiser Daily Women's Health Policy Report, 8/3).

According to a spokesperson for B.C.'s Ministry of Health, the national government plans to provide 40 million Canadian dollars, or about $38 million, over three years for B.C.'s program. Kendall said that "catch-up" vaccines also are being recommended for ninth-grade girls during the first three years of the program to cover girls in grades seven, eight and nine when the program begins. According to Kendall, the annual cost to implement his plan would be about 18 million Canadian dollars, or about $17 million, if it covers girls in the sixth- and ninth-grades. Girls in these two grades are being targeted because there already are provincial vaccine programs for sixth and ninth grades, Kendall added.

Kendall said that although only about 40 women die annually from cervical cancer in B.C., providing girls with vaccines could reduce the number of women who develop precancerous lesions as a result of HPV by 70%. "So about 3,500 or 4,000 women wouldn't have to go through that each year ... which is a substantial benefit," Kendall said. According to Kendall, no vaccine in B.C. is mandatory, and parents can opt their daughters out of the program. However, based on surveys, it is expected that 85% of parents in the province will allow their children to be vaccinated, he added (Globe and Mail, 8/8).

Other provinces individually are deciding the details of their programs, including what age group to vaccinate. Ontario is the first province to develop an HPV vaccine program. Nova Scotia officials in June said they would vaccinate seventh-grade girls, and Prince Edward Island officials have said that sixth-grade girls will receive the vaccine (Kaiser Daily Women's Health Policy Report, 8/3). Newfoundland also has announced plans to start a vaccination program this fall (Globe and Mail, 8/8).

Related Editorial
It is to "Canada's credit that 'moral' considerations were excluded from the decision to license" Gardasil and allocate funding to provinces to provide the vaccine to school-aged girls, a National Post editorial says. However, one "can't help but notice" that Gardasil is "being hustled through by governments from experimental status to near-total ubiquity at a rate that may be unprecedented in the annals of modern medicine," the editorial adds.

"In the face of endorsements of Gardasil by gynecologists ... it is hard to have expected the provinces to pass up cash which may not be there three years from now, when the initial federal funding runs out," the editorial says. However, the "result is that thousands of Canadians schoolgirls will soon be administered, at great expense, an unproven drug," according to the editorial.

The "real question is whether the federal government's" funding "could have saved more lives if it were spent on other, more proven health technologies," the editorial says, concluding that if "science, instead of politics, were driving this issue, perhaps someone in Ottawa would have asked it" (National Post, 8/8).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.