> Children and Parenting > Health and Environmental Concerns > vaccinations

This fall BC joined the ranks of all the other Canadian provinces to offer the controversial human papillomavirus (HPV) vaccine to girls as young as nine. There’s been tremendous hype surrounding Gardasil, which protects against some of the strains of the virus that cause cervical cancer.

But just as vociferous as many doctors’ support of the vaccine is the fervent public opposition. Although many health professionals and drug-industry analysts say the vaccine has promise, they also say that there are still plenty of reasons to question Gardasil’s safety and benefits.

Fast-Tracking Approval

Gardasil, which is produced by pharmaceutical giant Merck Frosst, was fast-tracked for approval by Health Canada in March 2007. (The US approved it in 2006.) However, short-term safety studies are only wrapping up this month, and long-term safety studies will still take years.

Few are as familiar with Gardasil as Dr. Diane Harper, a professor of community and medicine at New Hampshire’s Dartmouth Medical School, who has been involved in the research and clinical trials of the vaccine. She’s not against it; in fact, she says it’s “100 percent effective” in females aged 16 to 24.

Caution and Concern

However, she has taken the bold stance of speaking out about its pitfalls. The fact that it’s being given to girls who still haven’t reached the double digits concerns her. Relatively few girls aged nine to 15 were enrolled in clinical trials of Gardasil, yet those in this age range represent a priority target population for mass vaccination.

“There is no way we can ethically do studies to prove efficacy in younger people,” Harper tells alive, adding that at age nine, immunological systems are still developing. “This is one of the age ranges we know least about.”

Although the vaccine is largely safe in older groups, Harper cautions that it’s early in the game, and crucial knowledge is still missing. Not surprisingly, Merck hasn’t invited Harper back for any future contracts. She says she’s even been denied jobs at various universities, which told her flat out that they’d be worried about what would happen to funding they receive from Merck if they were to hire her. But for Harper, it all comes down to being able to sleep at night.

“I have to be honest,” Harper says. “I see a lot of my colleagues who are not speaking out. They have to deal with their conscience, and I have to deal with mine.”

The Art of Disease Mongering

The frenzy around the vaccine has all the hallmarks of disease mongering, says Alan Cassels, a drug-policy analyst at the University of Victoria.

“It’s certainly the language of disease mongering: exaggeration of the prevalence to sell the cure,” says Cassels, who co-wrote the book Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients (Greystone Books, 2005).

Others point to Merck’s aggressive advertising campaign as a sign of hyping the disease. The Canadian Women’s Health Network (CWHN) has urged governments to mount public education campaigns to “quell the unfounded anxiety that has been instilled by marketers of the vaccine, that HPV represents a ‘new’ or ‘imminent’ threat.”

Calgary mother Susan Pederson won’t be vaccinating her two daughters. “I hate how it’s being marketed,” Pederson says. “There’s so much pressure. I’m so bothered by how people are being guilted into it … The drug is still in trials. I don’t want my daughters to be guinea pigs.”

Cervical Cancer by the Numbers

At a cost of about $400 for the three-dose vaccine, Gardasil protects against four strains of HPV, which cause about 70 percent of all cervical cancer cases. However, the virus often never reaches that stage. Rather, the body clears it out on its own, fuelling opponents’ argument that the vaccine isn’t crucial in the first place.

The statistics alone show that there is no cervical cancer epidemic in this country. According to the Canadian Cancer Agency, there were 1,300 new cases of cervical cancer in 2008, compared with 22,400 cases of breast cancer and 11,300 cases of lung cancer in women.

Gail Johnson is an award-winning Vancouver writer.

Source: alive #314, December 2008