The routine vaccination against cervical cancer for pre-teen girls in the US is emerging as a concern to some parents and doctors as more and more states go down this path.
According to Women in Government, a non-profit, bi-partisan organization of women state legislators, who recently issued a report on the progress of the fight against cervical cancer across the US, 45 states have introduced legislation or resolutions to protect against cervical cancer and 40 of them have enacted on them.
Some 12 or more states have also introduced bills for compulsory vaccination of young teenage girls, following the Food and Drug Administration (FDA) approval in June last year of the drug Gardasil, the world’s first and only vaccine against the human papillomavirus (HPV).
HPV is known to cause cervical cancer and other sexually transmitted diseases.
Gardasil is made by Merck and Co, and would be administered over 6 months, by injection, at months 0, 2 and 6. The drug would cost about 360 US dollars to administer per patient and is covered by most insurance companies against side effects, which are said to be minor.
The FDA recommended that the vaccinations take place before girls become sexually active. The policy makers and legislators are broadly in agreement with this, hence the 12 or more states who have now legislated for compulsory vaccination.
Other public health bodies such as the Advisory Committee on Immunization Practices (ACIP) have also advised that girls be routinely vaccinated at the age of 11 or 12.
The argument is that it is the most reliable way to secure the results shown in the clinical trials which achieved 95 per cent protection against HPV strains that together cause 70 per cent of cervical cancers.
However, a new voice appears to be emerging now that the issue is grabbing the attention of the people who will be directly affected by it.
While politicians, lobby groups, legislators and policy makers have been wrestling with the issue at the broad level of public health, with their eye firmly fixed on targets to reduce the large numbers of women who die from cervical cancer in the US every year (the figure is just under 4,000), some parents and practitioners have started voicing their concerns about how this affects the lives and development of individual girls and their families.
They are saying that drawing attention to this issue at such a young age might actually backfire into encouraging girls to start having sex earlier, putting their health and psychological development at even higher risk. There are also voices expressing worries about the fact that at this age girls are too young to be in doctors’ surgeries being exposed to sex education that they may not be ready to deal with.
Meanwhile other groups have expressed concern about political lobbying on the part of Merck and Co and the revelation that they also contribute undisclosed sums to support the work of Women in Government. Merck themselves say they have been above board with their support for the push toward nationwide vaccination, pointing out the drug’s safety record and the lives that could potentially be saved.
In some cases, the politicians who supported this move are starting to have doubts, saying that things are perhaps happening too fast. In one particular case, Democrat Senator Delores Kelley, of Baltimore County, is talking about delaying her support for the bill that she once promoted, because she thinks people should wait to see how this settles down and take a more deliberate approach.
It would appear that the debate essentially hinges on the conflict between the public health agenda – to reduce the deaths as quickly and safely as possible – and the rights of parents to determine what happens to their children and when.
Written by: Catharine Paddock
Writer: Medical News Today