Gardasil® - The New HPV Vaccine: The Right Product, the Right Time? A Commentary (original) (raw)
Related papers
Assessing Mandatory HPV Vaccination: Who Should Call the Shots
Journal of Law Medicine & Ethics, 2008
In 2007, many legislatures considered, and two enacted, bills mandating HPV vaccination for young girls as a condition of school attendance. Such mandates raise signifcant legal, ethical, and social concerns. This paper argues that mandating HPV vaccination for minor females is premature since long-term safety and efectiveness of the vaccine has not been established, HPV does not pose imminent and signifcant risk of harm to others, a sex specifc mandate raises constitutional concerns, and a mandate will burden fnancially existing government health programs and private physicians. Absent careful consideration and public conversation, HPV mandates may undermine coverage rates for other vaccines.
International Journal of Cancer, 2019
The effectiveness of a vaccination program is influenced by its design and implementation details and by the target population characteristics. Using routinely collected population-based individual-level data, we assessed the effectiveness (against cervical dysplasia) of Manitoba's quadrivalent human papillomavirus (qHPV) routine school-based vaccination program and a short-lived campaign that targeted women at high-risk of developing cervical cancer. Females ≥9 years old who received the qHPV vaccine in Manitoba (Canada) between September 1, 2006, and March 31, 2013 (N = 31,442) were matched on age and area of residence to up to three unvaccinated females. Cox proportional hazards models were used to estimate qHPV VE against high-grade (HSILs) and low-grade squamous intraepithelial lesions (LSILs) and atypical squamous cells of undetermined significance (ASCUS). Among 14-17-year-old participants who had Pap cytology after enrollment, the adjusted qHPV VE estimates were 30% (17-58%) and 36% (21-48%) against the detection of HSILs and LSILs, respectively. There was, however, no evidence of program effectiveness among females vaccinated at ≥18 years of age and among those with a history of abnormal cytology, who were mostly vaccinated as part of the high-risk program. Estimates of VE for females vaccinated in the school-based program are consistent with the expected benefits from qHPV vaccination. No similar benefits were detected among women vaccinated at an older age, and those with abnormal cytology, who were targeted by the high-risk program. Further efforts should be targeted at achieving higher vaccine coverage among preadolescents, prior to the initiation of sexual activity.
Initial lessons learned in HPV vaccination
Gynecologic Oncology, 2008
In the recent period following the approval of the first vaccine targeted against human papillomavirus, it is imperative that we re-evaluate the past, present, and future of cervical cancer prevention. It is clear that the subject of vaccinating young women against a sexually transmitted infection has incited a candid debate among all groups involved. Therefore, we must make the most appropriate and accurate information available to the public and medical communities. The development of vaccines targeted against oncogenic human papillomavirus (HPV) types has made it possible to eliminate approximately 70% of all invasive cervical cancers in women worldwide. However, knowledge about HPV infection and cervical cancer, as well as the need to vaccinate against oncogenic HPV infection, is still lacking among women and physicians. This deficiency could be a key reason why some parents continue to have reservations about vaccinating their daughters. In order for HPV vaccination programs to be highly successful, multiple barriers must be overcome. Review of lessons learned to date has demonstrated that continued tailored and targeted educational and awareness initiatives are required for healthcare professionals, media, patients, and parents. This article also examines the impact of the HPV vaccination awareness campaign on media and public policy dynamics.
In a recent article published in le Devoir ("Appel urgent à un moratoire sur la vaccination contre les VPH," Le Devoir, October 5, 2015), we asked for a moratorium on the HPV vaccination program in Quebec, since our ongoing study and several others in Canada and around the world led us to question the hasty approval of this vaccine (what was its true safety and efficacy?), its administration without parents" fully informed consent, and the limitations of the current pharmacovigilance system in allowing us to properly understand the impact of this vaccine on young girls and women in Quebec. Since then, we have been criticized in some Canadian media and notably in Le Devoir (October 8, 2015). We are delighted that a debate about this vaccination is taking place in Quebec and elsewhere. This debate alone justifies our request for a moratorium.
Concerns around the human papilloma virus (HPV) vaccine
Indian journal of medical ethics
(1). The vaccine will be administered in three doses at the interval of 0, 2 and 6 months. Similarly, on August 13, 2009, the gujarat government launched a two-year 'Demonstration Project for Cancer of the Cervix Vaccine' in three blocks of Vadodara District-Dabhoi, Kawant and Shinorto immunise 16,000 girls between 10 and 14 years with three doses of gardasil. The gujarat state minister for health and family welfare claimed that this demonstration project would help the Centre to examine the possibility of introducing the vaccination project across the country (2). We are alarmed by this decision by state and union governments and we oppose the introduction of the vaccine on the following grounds:
Canadian school-based HPV vaccine programs and policy considerations
Vaccine
Preventing H PV-associated cancers throu gh publi cly funded vaccine programs i s a priority Canadian provinces and territories design and implement vaccination programs It is difficult to gather current and reliable data on HPV vaccination in Canada This paper describes each jurisdiction's current HPV vaccine program and coverage rates Considerations for poli cy development are discussed