And you thought the human papillomavirus vaccine was only for 10-to-26-year-olds. Not anymore! Starting this week, there’s a new HPV/cervical cancer vaccine on the (Australian) market for older women.
According to the Sydney Morning Herald, the vaccine, Cervarix, is going to be targeted toward Australian women between 27 and 45 years old — that is, women too old to make the cut for Gardasil, the HPV vaccine that has caused such a brouhaha in the United States. (Gardasil has been approved for girls and women between 9 and 26 years old.)
Just to keep you up to date on what’s going on down under, Australia recently launched a nationwide vaccination program wherein every Australian schoolgirl will receive the Gardasil vaccine over the next two years. Similar efforts in America have been knocked down for reasons including those enumerated by Missouri House member Robert F. Onder (R) in Monday’s Kansas City Star — e.g., HPV is spread sexually, so it should be up to the parents to decide whether their daughters should be vaccinated; maybe the strains of HPV that caused cancer 20 years ago (and that the vaccine protects against) are no longer the strains that cause cancer, etc., etc. (Click here, here and here for some previous Salon coverage of the debate.)
Having just watched a friend lose his mother to cervical cancer, perhaps I’m a bit biased, but I completely disagree with that logic. First, just because HPV is often spread by sexual contact does not mean we shouldn’t vaccinate against it. (I’d love to see what Onder would say about an HIV vaccine.) Second, I find it hard to believe that these two strains of HPV — 16 and 18 — have somehow evolved over the past 20 years to become benign (they’re currently responsible for 70 percent of cervical cancer cases). Sure, there might be other HPV strains out there that have evolved to cause cancer, but that’s not a reason not to get vaccinated against 16 and 18. That’s like saying that you shouldn’t bother wearing a bike helmet because there’s a chance you could also break your leg.
But I digress. The main criticism of this new vaccine (which has been approved for women ages 10-45, so it’s not just for over 26-year-olds) is that by the time most women are 27 years old, they’ll have been sexually active for at least a few years — which is the amount of time it usually takes to be exposed to HPV types 16 and 18. Also, it’s expensive. But the drug’s maker, GlaxoSmithKline, has applied for a government subsidy for the vaccine. (Gardasil is free in Australia for younger women, thanks to Australia’s National Immunization Program.)
Also, just because the vaccine may be less effective for older, sexually active women than for their younger, virginal counterparts doesn’t mean it wouldn’t benefit anyone over 26 (the oldest age that Gardasil has been approved for). There are plenty of things in life that we do without any guarantee that they’ll really help us in the long run — like taking nutritional supplements, for example. Until there’s an easy, accurate test to determine whether women have already been exposed to those two particular strains (right now, tests can tell you if you have one or more of 15 high-risk strains, but can’t distinguish among them), I think the more access to vaccines that we can provide, the better.
(Important to note, too, is the difference between the rival vaccines: Gardasil also protects against HPV types 6 and 11, which are often associated with genital warts. Cervarix just covers 16 and 18, but has been shown to produce stronger, longer-lasting protection than Gardasil.)