Marketing Conquers Science ... A cancer vaccine with political will

http://ilena-rosenthal.blogspot.com

http://www.canada.com/components/pri...ce001d&k=45622

Excerpts:

The youngest girls were followed for only 18 months; only 100
nine-year-olds were included.

Madeline Boscoe of the Canadian Women's Health Network said: "It's
scary to think of vaccinating a whole generation of nine-year-old
girls in this country based on a hundred ... The duty around evidence
here should be so much higher."


Gardasil protects against two strains of HPV associated with about 70%
of cervical cancers. It does not protect against other HPV strains,
the other 30% of cervical cancers or other sexually transmitted
diseases.

It will not protect most women because they have already been exposed
to HPV, the world's most common STD in women and men alike. (There may
be as many as 200 HPV strains.)

~~~~~~~~~~~~~~~~~~~~`

A cancer vaccine with political will
Marketing conquers science, HPV Critics say

Dawn Rae Downton
National Post


Tuesday, August 07, 2007



CREDIT: Jessica Rinaldi, Reuters
Nurse Nancy Brajtbord administers a shot of Gardasil, a vaccine
against human papilloma virus, to a 14-year-old patient in Dallas.

It has been called "the medical breakthrough of the 21st century" and
the most significant development in women's reproductive health since
the Pill. Yet the same week that Ontario announced it was offering all
Grade 8 girls a vaccine that could prevent cervical cancer, the
country's medical journal carried an article from experts questioning
the merits of the vaccine.

Such is the controversy around the HPV vaccine, which protects against
the human papilloma virus associated with about 70% of cervical
cancers: Hailed by some as a rare example of the government
recognizing women's reproductive health care needs and derided by
others as a case where powerful lobbying and marketing are winning out
over science.

Vaccination programs are slated to begin in schools in Ontario, Nova
Scotia, Prince Edward Island and Newfoundland and Labrador in
September. It is already offered free to girls in Australia and in
some U.S. states, including Texas and Virginia.

Some Canadian scientists and women's health groups say that because
this rare cancer is well controlled in Canada, mass inoculation is not
only redundant but could undermine existing, more comprehensive
protections like Pap testing.

But cervical cancer can still be deadly, and so the vaccination has
advocates. About 1,400 Canadian women will be diagnosed with cervical
cancer this year, and 400 will die.

The vaccine has been backed by the Society of Obstetricians and
Gynecologists of Canada and the Canadian Cancer Society, and in
announcing her government's vaccination program, Sandra Pupatello,
Ontario's Minister for Women's Issues, said: "There has never been an
issue around women's health that has had this level of unanimity. It
wasn't a difficult decision."

Gardasil, which is the only cervical cancer vaccine on the market, is
the most expensive childhood vaccine developed for mass use. The
federal government has allocated $300-million to vaccinate girls ages
nine to 13, but broad inoculation is estimated to cost much more,
according to the Canadian Medical Association Journal, which prices a
single round at about $2-billion.

Gardasil protects against two strains of HPV associated with about 70%
of cervical cancers. It does not protect against other HPV strains,
the other 30% of cervical cancers or other sexually transmitted
diseases.

It will not protect most women because they have already been exposed
to HPV, the world's most common STD in women and men alike. (There may
be as many as 200 HPV strains.)

The vaccination seeks to immunize girls before they become sexually
active.

Merck Frosst, which produces Gardasil, says its clinical trials
followed 20,000 females for an average of 3.5 years; only 241 subjects
were followed for five years, and no one for longer. The youngest
girls were followed for only 18 months; only 100 nine-year-olds were
included. This group is assumed not to be sexually active or infected,
when neither may be the case. Many types of HPV infection have been
demonstrated in children, even in newborns.

Madeline Boscoe of the Canadian Women's Health Network said: "It's
scary to think of vaccinating a whole generation of nine-year-old
girls in this country based on a hundred ... The duty around evidence
here should be so much higher."

But her biggest concern is the complacency that widespread vaccination
might engender among girls and women about their sexual health.

Gardasil's best case is a 70% case for cervical cancer reduction, not
prevention, whereas condoms and Pap tests are nearly 100% effective,
not only against all cervical cancers but against all STDs. Because it
has been studied for only five years, Gardasil is not yet able to
demonstrate either long-term benefits or side effects and has not been
shown to prevent cervical cancer. Its record in preventing
pre-cancerous cervical lesions is at best only 46% better than a
placebo.

When vaccination for girls was allotted $300-million in the March
federal budget, critics alleged pressure from drug manufacturer Merck
and physicians' groups with which the company has commercial ties, as
well as from Merck lobbyists who had once been advisors to Stephen
Harper.

In the run-up to the budget, Merck's "Tell Someone" TV commercial ran
night after night through January and February, featuring girls and
women musing about "the cervical cancer virus." By means of what
appeared to be a public service message, Canadians were suddenly aware
about cervical cancer and HPV and its threat to women's health.

Ms. Boscoe, of the Canadian Women's Health Network, said the ads had a
powerful impact: "It suggested there was a cervical cancer epidemic in
Canada, and that a vaccine could cure it." She said that the roughly
400 women "who died of cervical cancer in this country last year
didn't die because we don't know what to do, they died because we
weren't caring for them. Either they didn't come in for care, or we
didn't follow up on them."

The women most threatened by cervical cancer in the West as well as
around the world are poor. In Canada, they are likely to be immigrants
with language and cultural barriers, or aboriginal, or isolated, with
disabilities or with their immunity compromised by stress and poor
nutrition, and without access to Pap screening. Ms. Boscoe wonders
whether a vaccine will serve these hard-to-reach populations any
better.

Dr. Ryan Melnychuk, a virologist at the Canadian Centre for
Vaccinology at Dalhousie University, said Gardasil might be redundant
because there are already highly effective screening and treatment
programs. Besides, he said, some experts think that HPV, like the
chicken pox virus, is best left alone.

"We might alter the natural history of infection," Dr. Melnychuk said.
"Who knows what will happen? With chicken pox -- typically a
relatively mild childhood infection -- we've learned that vaccine
protection [lasts] only 10 years or so. Thus, the infection typically
experienced at [age] six now occurs later, with worse outcomes. There
are similar concerns with Gardasil."

In their editorial in the latest issue of the Canadian Medical
Association Journal, epidemiologist Dr. Abby Lippman and colleagues
wrote this about the HPV vaccine: "It is time to take a breath and
reflect on what we know and what we don't know ? Individual girls and
women, as well as policymakers, can make truly informed decisions
about vaccinations only when they have all the evidence, and today,
there are more questions than answers."

Ilena Rose wrote:
http://ilena-rosenthal.blogspot.com

http://www.canada.com/components/pri...ce001d&k=45622

Excerpts:

The youngest girls were followed for only 18 months; only 100
nine-year-olds were included.

The vaccine is routinely recommended for girls 11 and 12, at least in
the US.

http://www.cdc.gov/vaccines/vpd-vac/...fault.htm#vacc

For accurate information about the vaccine:

http://www.cdc.gov/vaccines/vpd-vac/hpv/default.htm

or talk to your doctor.

Jeff