Posted on Fri, Oct. 20, 2006

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Time for new vaccine

By JOAN BRADY AND LILLY FILLER

Guest columnists

Medical experts call the new human papillomavirus cervical cancer vaccine nothing short of a miracle. It is the first vaccine available that specifically targets cancer and that could ultimately eliminate cervical cancer.

Can a vaccine really eradicate cervical cancer in this generation of women? Who should be targeted to receive this vaccine? Who will pay? These are questions under consideration by state health officials and policymakers.

In January, Rep. Brady plans to introduce HPV cervical cancer vaccine legislation. The bill would add HPV vaccine to the list of required vaccinations for female students enrolling in the sixth grade at any South Carolina school, public or private, beginning with the 2009-2010 school year. The standard state regulations for vaccination exemptions would apply, including exemptions for religious and health reasons.

According to the American Cancer Society, cervical cancer is the second most prevalent cancer in women worldwide. Each year cervical cancer claims the lives of more than 4,000 women nationally. In South Carolina, about 200 new cases are diagnosed each year. The fiscal impact of all HPV-related diseases to the state are more than $25 million in health care costs.

In June the Centers for Disease Control Advisory Committee on Immunization Practices approved the vaccine Gardasil for girls and women ages 9 to 26. Gardasil protects against the most prevalent HPV types that cause 70 percent of all cervical cancer and 90 percent of genital warts.

HPV is a sexually transmitted virus. It is estimated that by age 50, 80 percent of women will be exposed to the virus.

It is recommended that the vaccine be administered at ages 11 or 12. Why require this vaccine at this age? Studies have found that the immune response to the virus is strongest in girls between ages 10 and 14, and twice as many antibiotics are produced. HPV infection rates peak when girls become sexually active in late teens and 20s. By targeting 11-year-olds, a stronger immune response is obtained and thus a more timely transmission protection. Ongoing studies are testing the effectiveness of the vaccine on boys and on women who are older than 26 years old.

The cost of the vaccine is about $360 (plus administrative fees) for the required three-shot series. Most major insurers already cover the vaccine as part of their standard immunization coverage. The CDC recommendation should mandate that the vaccine be included in the federal Vaccine for Children Program; the program provides immunizations for the state’s uninsured and underinsured children. Federal grants may also be available to provide the vaccine for the 19- to 26-year-olds.

Even though the legislation only requires the vaccination for sixth graders entering school, we want to ensure that it will be available to all young women in South Carolina.

The S.C. Commission on Women has identified the HPV vaccine as its No. 1 women’s health initiative for 2007. Parents and young women do not have to wait until the 2009 school entrance requirement to receive the HPV vaccine. The vaccine is available through most private physicians.

We can now eliminate this deadly cancer threat for our daughters and generations of women. That is a miracle.

Rep. Brady represents parts of Richland County in the S.C. House. Dr. Fuller is an obstetrician/gynecologist with Women’s Physicians Associates and chairwoman of the S.C. Commission on Women.