Friday, June 09, 2006


This is the name of the new vaccine which is expected to prevent cervical cancer by blocking:

infection from human papillomavirus, which is spread through sexual contact. The Food and Drug Administration today permitted Gardasil for females ages 9 through 26, with the goal of inoculating girls before they may become sexually active.

About half a million women are diagnosed with cervical cancer each year. The approval raises the possibility that a cancer may be eliminated within a generation, specialists said. It is also a victory for Merck, the fourth-biggest U.S. drugmaker, which has focused increasingly on vaccines and may generate $3 billion in annual sales from Gardasil alone.


Gardasil shots will be given in three doses over six months, with each dose costing $120, Merck said. Affordability may help determine whether [sic] how effective the drug in quelling cervical cancer, since 80 percent of the cases are in poorer countries.

So far so good. But the road from the approval of the vaccine to it reaching the girls and women that need it still has roadblocks. In poorer countries a major one will be lack of money. Three hundred and sixty dollars is more than the annual income of many of this world's poor people. Unless some form of financial subsidy is provided, most women will not have access to the vaccine.

Then there is the sex roadblock. A virus that is transmitted by sex! What will people say if we vaccinate our unmarried daughters? This is going to be a problem in many of the poorer countries:

"We found that some Asian women in Britain are afraid even to get tested for HPV infection, because they say if it is positive they will be killed, never mind that their husbands probably gave it to them," says Szarewski. She feels that such attitudes may mean that HPV vaccination may be a non-starter in such communities.

Greg Zimet of Indiana University in Indianapolis is more optimistic. His surveys in the US show parents overwhelmingly favour getting their daughters vaccinated. "Doctors tend to fear the worst," he says.

But some problems have already surfaced. India is planning to do its own clinical trials, but will not test the vaccine in young girls. "This is not possible until around the age of marriage in India," Ganguly says.

Once licensed, the vaccine should be given to younger girls, he says. "But people will say 'My girl is very virtuous, why vaccinate?' It will be a real challenge, not like other vaccines."

And not only in poorer countries. In the same April article, an American wingnut made her objections known:

In the US, for instance, religious groups are gearing up to oppose vaccination, despite a survey showing 80 per cent of parents favour vaccinating their daughters. "Abstinence is the best way to prevent HPV," says Bridget Maher of the Family Research Council, a leading Christian lobby group that has made much of the fact that, because it can spread by skin contact, condoms are not as effective against HPV as they are against other viruses such as HIV.

"Giving the HPV vaccine to young women could be potentially harmful, because they may see it as a licence to engage in premarital sex," Maher claims, though it is arguable how many young women have even heard of the virus.

You might think that this attitude is only going to be a problem for the daughters and wives of wingnuts. But you might be wrong, for reasons explained here:

The real battle over the vaccine will be in the coming weeks as the CDC's Advisory Committee on Immunization Practices (ACIP) issues their recommendations for how the vaccine should be administered. While the ACIP decisions are non-binding, its recommendations set the standard by which states decide if they will mandate vaccination, insurance companies choose to cover the cost, and doctors decide how to advise their patients. Their decision on June 29 will determine whether or not we will be on our way to eradicating an STI that affects 80% of women by age 50 and is at the root of almost all cases of cervical cancer.

The only member of the 15-member panel to publicly state his opinion about making the vaccine routinely available is Reginald Finger. Dr. Finger nominated himself to the ACIP after the ultra-conservative Focus on the Family was asked to provide a list of scientists to nominate for various federal boards. Dr. Finger (sorry, I can't get over that name) describes himself as a liaison between the CDC and Focus on the Family. He says, "Focus on the Family wants to have good relationships at CDC - and I can help make those happen."

He has also said that if "people begin to market the [HPV] vaccine or tout the vaccine that this makes adolescent sex safer, then that would undermine the abstinence-only message." For the record, Finger would also be wary of approving an HIV vaccine, should one become available.

I'm not sure about the eighty percent infection rate cited, but it is certainly correct that the wingnuts have avenues to affect the availability of Gardasil in general. As they appear to prefer death to sexual non-abstinence (though only for women) I'd keep an eagle's eye on ACIP. To find out how you can give your opinions to ACIP, go to

Make this little thought experiment: Suppose that there was a similar cancer, with similar death rates, also sexually transmitted, but affecting only men. Do you think that the same arguments would have been brought forward by our wingnuts and many of the traditionalists in other countries? Would we be sitting here reading arguments against making a vaccine against such a cancer available?