Cervical Cancer Vaccine Stops Viruses Tied to Cervix Scourge

Cervical Cancer Vaccine Stops Viruses Tied to Cervix Scourge
August 30, 2007

If you watch Oxygen network, "Sex and the City" reruns or any programming geared to young women, you're bound to have seen the commercial for Gardasil, the new HPV vaccine. It features women professing to be "one less" victim of Human papillomavirus, a virus that is often sexually transmitted and can lead to cervical cancer.

In 2006, the Food and Drug Administration approved Gardasil, which is the first HPV vaccine to prevent four of the more than 100 strains of HPV in girls and women age 9 to 26.

Because cervical cancer will affect an estimated 11,150 women in 2007, according to the National Cancer Institute, many doctors and women in the at-risk demographic say the vaccination is a victory for prevention.

"In my opinion, for girls and women who've never had HPV, Gardasil can prevent four strains of HPV that cause 90% of genital warts and about 67% of cervical cancers," says Bronwyn Fitz, physician director of colposcopy services at Planned Parenthood of New York.

While the ideal age for the vaccination is 11 or 12, before girls are sexually active, doctors are pushing for women up to the age of 26 get the shot as a preventive measure.

But some observers are apprehensive about the pervasive marketing of the vaccine and wonder if the drug, which costs at least $120 for each of the three injections, is an unnecessary expense.

Elana, 26, of Manhattan, balked at the price. "If this is such an impactful thing, it should be affordable," she said. "There are tons of commercials and marketing campaigns, but what they don't tell you is you have to put aside money in order to afford that."

Kate, 23, of Manhattan said, "It's been pushed so heavily, I feel a little bit like I'm being sold the 'product.'" Still, last year, a pap smear found abnormal cells on Kate's cervix. The abnormalities turned out to be benign, but Kate intends to get a Gardasil vaccination soon. "Having been through a scare with it, I'm willing to take another measure." Kate's insurer, Aetna, will cover the vaccinations in full, she said.

Indeed, HPV is one of the most common sexually transmitted diseases. However, Planned Parenthood's Web site states that "most HPV infections go away within eight to 13 months" and Gardasil's Web site acknowledges an HPV infection sometimes goes away on its own.

Although Gardasil's Web site states in several places, "Gardasil may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings," some professionals are critical that the vaccine detracts attention from pap smears, which are comparatively cheaper.

"I'm annoyed at Merck [the drug company] for the way they've presented this," said Dr. Steven Goldstein, a professor of obstetrics and gynecology at New York University. He is concerned that Merck's advertising for Gardasil will lead women, especially young women, to believe they are immune to all forms of HPV and that they will not practice safe sex or keep up with visits to their gynecologist. He adds, "The people who need it the most aren't going to get it" due to the price.

Sigrid Fry-Revere, director of bioethics studies at the libertarian Cato Institute, is also skeptical. "The only reason Merck is marketing it so heavily is because this is where the money is," she said. In her opinion, "pap smears have all but eliminated the need for a vaccine," which she characterized as "experimental." She feels the FDA approval process was "rushed," and while she recognizes that no adverse side effects have come up, she thinks the samples in the trials are relatively small.

But Planned Parenthood's Fitz, disagrees. "I wouldn't call it 'experimental'." Fitz attests the vaccine offers an advantage that pap smears do not: the HPV vaccine prevents women from getting four strains of the virus, while pap smears only test whether the HPV infection has already occurred.

"If we could prevent infection altogether, that would be better," she said.

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