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Editor: Katharine Van Tassel
Akron Univ. School of Law

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Monday, October 31, 2005

Political Agendas and Health

The Washington Post contains an article today discussing the new cervical cancer vaccine that should be available next year.  According to the Post, the vaccine appears to be almost 100 percent effective against the most common cancer-causing strains. By the end of the year, Merck hopes to be in the process of gaining FDA approval to sell the shots.  Sounds good to me --- but wait --- this vaccine might somehow encourage girls to have sex so we need to be extra careful not to make it mandatory . . . . . . 

Groups working to reduce the toll of the cancer are eagerly awaiting the vaccine and want it to become part of the standard roster of shots that children, especially girls, receive just before puberty.

Because the vaccine protects against a sexually transmitted virus, many conservatives oppose making it mandatory, citing fears that it could send a subtle message condoning sexual activity before marriage. Several leading groups that promote abstinence are meeting this week to formulate official policies on the vaccine. . . . .

The vaccine protects women against strains of a ubiquitous germ called the human papilloma virus. Although many strains of the virus are innocuous, some can cause cancerous lesions on the cervix (the outer end of the uterus), making them the primary cause of this cancer in the United States. Cervical cancer strikes more than 10,000 U.S. women each year, killing more than 3,700. . . .

Exactly how the vaccine is used, however, will be largely determined by the Advisory Committee on Immunization Practices, a panel of experts assembled by the Centers for Disease Control and Prevention in Atlanta. The panel issues widely followed guidelines, including recommendations for childhood vaccines that become the basis for vaccination requirements set by public schools.

Officials of both companies noted that research indicates the best age to vaccinate would be just before puberty to make sure children are protected before they become sexually active. The vaccine would probably be targeted primarily at girls but could also be used on boys to limit the spread of the virus.

"If you really want to have cervical cancer rates fall as much as possible as quickly as possible, then you want as many people to get vaccinated as possible," said Mark Feinberg, Merck's vice president of medical affairs and policy, noting that "school mandates have been one of the most effective ways to increase immunization rates."

That is a view being pushed by cervical cancer experts and women's health advocates.

"I would like to see it that if you don't have your HPV vaccine, you can't start high school," said Juan Carlos Felix of the University of Southern California in Los Angeles, who leads the National Cervical Cancer Coalition's medical advisory panel.

At the ACIP meeting last week, panel members heard presentations about the pros and cons of vaccinating girls at various ages. A survey of 294 pediatricians presented at the meeting found that more than half were worried that parents of female patients might refuse the vaccine, and 11 percent of the doctors said they themselves thought vaccinating against a sexually transmitted disease "may encourage risky sexual behavior in my adolescent patients."

Conservative groups say they welcome the vaccine as an important public health tool but oppose making it mandatory.

"Some people have raised the issue of whether this vaccine may be sending an overall message to teenagers that, 'We expect you to be sexually active,' " said Reginald Finger, a doctor trained in public health who served as a medical analyst for Focus on the Family before being appointed to the ACIP in 2003, in a telephone interview.

Someone please make this stop! [bm]

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