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Cervical Cancer Vaccine To Be Studied

A proposal to require young girls to be immunized with a new vaccine that protects against cervical cancer had the potential to be one of biggest health-care bills to pass the General Assembly this year.

Hundreds of thousands of sixth-grade girls would be protected by the drug industry's first cancer vaccine. Some strains of human papilloma virus (HPV), a widespread, sexually transmitted virus that can cause cervical cancer and genital warts, would be stopped in their tracks. This month, the Virginia General Assembly became the first legislative body in the nationy to mandate that girls receive the vaccine.

But Maryland's legislation was quickly withdrawn by its House and Senate sponsors in January. Many teachers and school administrators objected that too many students are missing school because their parents have failed to make sure they have other required immunizations.

Another reason was that Merck, the drug manufacturer that stood to earn hundreds of millions of dollars its cervical cancer vaccine, called Gardasil. Merck was lobbying heavily for passage. And lawmakers apparently were concerned that they looked like the industry was influencing them.

A bill passed both chambers this week and is now headed to Gov. Martin O'Malley's desk. But it's nothing like the original. An existing legislative committee that studies cervical cancer will create a sub-committee to study the HPV vaccine.

"The concern was that the pharmaceutical industry was pushing this more than the public health industry," explained Del. Peter A. Hammen (D-Baltimore), chairman of the House health committee. "We need to take a step back and do more deliberative work on this issue."

Lisa Rein

By Phyllis Jordan  |  April 3, 2007; 12:01 PM ET
Categories:  General Assembly  
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Comments

"the pharmaceutical industry was pushing this more than the public health industry."

Certainly true. The data just isn't there for study of long-term effects, which is why reputable organizations balked at sanctioning a full-scale public rollout.

On the average, there are 200-220 cases of cervical cancer reported in MD annually. The longetivity of the vaccine is also unknown -- (studies have been limited to 5 years). The % of cc cases for women under 30 (national aggregate) is 7.8%. Given that (1) the vaccine target is young girls and the vaccine longetivity is unkown, and given that (2) the HPV (types 16&18) is correlated to only 70% of HPV-related cervical cancer lesions, an actual reduction in cervical cancer as a result of mandatory school-age vaccination is actually unproven until we have better data for vaccine duration.

Safety & efficacy will not be resolved in the near-term. I would expect the subcommittee to focus on ensuring broad access for voluntary vaccination via, say, the federal VFC program, for minors without health insurance plans that would otherwise cover the cost. Second, the vaccine is not a substitute for regular pap screenings -- improving accessibility for all women, particulary in rural & disadvantaged areas to pap screening should be a priority.

Posted by: District21voter | April 3, 2007 4:21 PM | Report abuse

Bravo, common sense!
Time for public health physicians to make decisions, not lobbying from Merck.
Shouldn't more of us be awake here?

Posted by: J J | April 3, 2007 9:18 PM | Report abuse

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