Globe Editorial
EACH YEAR, about 3,900 women die of cervical cancer in the United States. In time, that toll should decline significantly with the approval of the first vaccine against the disease on June 8. But the greatest potential benefit of
Gardasil prevents cervical cancer by protecting against some of the strains of the all-too-common human papillomavirus (HPV), which is sexually transmitted and responsible for the vast majority of cervical cancer cases. Health officials worry that one obstacle in Gardasil's public acceptance will be parents' concern that vaccinating their daughters before they become sexually active will signal approval of pre-marital sex. To minimize this issue, health officials prefer to talk of Gardasil as a vaccine against cancer and not against HPV.
Another obstacle is Gardasil's cost, more than $300 for the three shots. This country has a patchwork of federal and state programs to provide children's vaccines at no or little cost to low-income families. Gardasil's relatively high cost will put a strain on those programs, which are already under budget pressure in many cases. Funds should be appropriated to make sure no child or young adult -- Gardasil is also aimed at a ``catch-up" population into the mid 20s -- is deprived of the vaccine because of its cost.
On the private side, however, insurers generally cover vaccines that have approval of the Food and Drug Administration. The Institute of Medicine, an advisory panel of the National Academies, recently reported that the fragmented system of public and private payment prevents many children from getting all recommended vaccinations. Gardasil should not be allowed to fall victim to this weak spot in the healthcare system.
A third obstacle to the widest possible use of the vaccine is the fact that it requires three shots over six months. Many children in the target age group do not see physicians on any regular basis so health officials think administration of the vaccines might best be done in other locations, such as neighborhood health centers, schools, pharmacies, or the health clinics that some retailers are starting within their big-box stores. Vaccine providers will have to notify young people when they are due for their second and third shots.
The vaccine will not protect against all HPV types or all cervical cancer, so that even vaccinated women will still be advised to get Pap smear tests and HPV screens. But the life saving benefit the vaccine could provide justifies all the efforts that will have to go into making sure it is affordable and easily accessible to young women.
© Copyright 2009 Globe Newspaper Company.
