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Cervical Cancer Vaccine

A rival to the cervical cancer vaccine Gardasil is set to be launched in Australia amid evidence it protects women aged up to 45.

The manufacturer hopes its drug, Cervarix, will also be included in the national immunisation program.

Free vaccinations of Gardasil began for schoolgirls earlier this month and will become available through GPs for women aged 18 to 26 from July.

The two drugs, both of which are based on research by 2006 Australian of the Year Professor Ian Frazer, claim to protect against 70 per cent of cervical cancers caused by the sexually-transmitted human papilloma virus (HPV).

But while Gardasil is not registered for use in women older than 26, manufacturer Glaxo Smith Kline (GSK) said clinical trials showed Cervarix worked for women aged up to 45.

Older women are more likely to have already acquired an infection to the common virus and thereby developed an immune response.

But the drug company said they would still benefit from the vaccine because they are at risk of catching a different type of the virus.

And evidence indicated HPV infections in older women were more likely to be persistent than in younger women, increasing the risk of developing cervical cancer, the manufacturer said.

The company hopes its vaccine will be on the market in Australia by the middle of the year.

The government's advisory body, the Australian Drug Evaluation Committee (ADEC), at its latest meeting so it had "no objection" to Cervarix being registered in Australia.

The company is still in negotiations with the Therapeutic Goods Administration to finalise the product information included with the drug so it can be registered in Australia and go on sale.

The drug company have also applied to the Pharmaceutical Benefits Advisory Council (PBAC) for the drug to be included on the national immunisation list.

"We are waiting for the decision at the moment," spokeswoman Bernadette Basell said.

"It's difficult to give any clear timeline at this stage as it depends on when the PBAC makes the decision."

A health department spokeswoman said she could not confirm GSK's applications because they were subject to commercial in confidence laws.

AAP

Launched nine months ago with the blessing of the United States Federal Drug Administration, Merck's long-heralded remedy for cervical cancer has been predictably controversial. Any new vaccine is going to raise safety concerns, but one designed to prevent a sexually transmitted disease while targeting young girls, as Gardasil does, had family values groups on high alert. Any element of compulsion would be strongly contested.

And yet compulsory regimes were exactly what the drug giant lobbied strenuously for alongside its public advertising campaign ("You could be one less life affected by cervical cancer") late last year and through to February -- when public reaction caused it to desist. Working through Women in Government, a group representing female legislators around the US, Merck persuaded a number of states to make vaccination a condition of attending school for girls aged 11 and 12. Around 20 states moved in this direction -- with provision for parents to withdraw their daughters -- but nearly all attempts have been stalled by opposition from parents.

Gardasil is controversial not only because it is new and untried on wide scale, but because it is different to other childhood vaccines. Most are aimed at diseases easily spread in schools: measles, mumps and whooping cough, for example. The genital human papillomavirus (HPV) that Gardisil targets is sexually transmitted. It is a disease eminently avoidable given a good human standard of behaviour. Gardasil therefore represents a new departure in medicine, where vaccines are used to protect people from the consequences of poor behaviour.

New, and yet not new. The great precedent for medicalising self-control is the contraceptive pill, and four decades of popping pills to avoid the natural consequences of sexual intercourse makes it easy for many people to accept the HPV vaccine as a legitimate insurance policy against self-harm.

Indeed, Gardasil is not even the first vaccine to be used in this way, as an article in the Washington Post points out. In the 1990s the United States added vaccination against hepatitis B -- a disease that, in the US, spreads mainly through sex and shared hypodermic needles -- to those already given to infants, even though children represented a small percentage of those infected. That move was advocated by the American Academy of Pediatrics, which said: "We are notably poor soothsayers in predicting which child will be put at high risk by future behaviour. Pediatricians must initiate, then, an insurance policy for young patients that matures in adulthood."

This time round the AAP is urging a go-slow approach -- at least since the public backlash against Merck's strong-arm tactics became evident. The last thing health professionals want to see is entrenchment of the anti-vaccine mentality that has grown up around the MMR (measles, mumps, rubella) vaccine and its alleged links to autism.

One does not have to be a vaccine sceptic, however, to question the use of immunisation as behavioural insurance. Prevention is certainly better than cure, but when prevention means systematic short-circuiting of the human faculties of conscience and will it is a highly dubious approach. It is no longer just a matter of preventing a physical evil but of relativising a human good -- not just any human good but the spiritual and moral powers that define humanity.


More. Sourced as a public health issue

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