Cervical cancer vaccine

[General my General!]

Human papillomavirus is the cause of almost all cases of Cervical cancer, as well as other reproductive cancers(much rarer). There are over 100 subtypes of HPV, of these there are several that cause cervical cancer. The most common subtypes are HPV 16 & 18, and both of these are cancer-causing (over 10-30y). Estimates are that these 2 subtypes are responsible for about 70% of cervical cancers.

As some of you may know, 2 vaccines have been developed since 2006 for the prevention of Cervical cancer, one by GSK, another by Merck. The vaccine works by producing immunity against 2 subtypes of the Human papillomavirus (HPV), namely HPV 16 & 18 (one of the vaccines also protects against 2 less common types).

The vaccines are meant for women aged 14-26y.

Currently several developed countries have added or are considering of adding these to their national vaccine programs. Unfoturtunately, the vaccine costs about 300$ ( 3 shots costing 100$ each over 6mth period). So many developing countries (and people) cannot afford these without outside funding.

In Lebanon, there is currently no initiative from the MOH on this, although a few GPs may be offering it.

The rationale behind this is that HPV is sexually transmitted from the male to the female, therefore women should be vaccinated before the onset of sexual activity.

So far, studies have shown that rarely there are minor side-effects, the vaccine is relatively very safe. And protection is assured for 5y (probably more but that's the longest duration of studies so far).

(PATH: Publication : Vaccine Resource Library)

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In my personal opinion, there is no need to rush after new trends or medicines, but if you are expecting to be sexually active with a partner for the first time in the next year or less (regardless of age), then it might be worthwhile to consider getting the vaccine, despite the cost. Check with your GP first.

[PhoenixResurrection]

As u said, I would prefer to wait before rushing into such new vaccines...
I still remember the hepatitis B vaccine and the associated adverse reactions (inc. multiple sclerosis).

[Rors]

Good, the price dropped a bit, it was around 450 $ when it first came out.
The thing is you're gonna pay 300$ to get a vaccine that will not cover you 100%. It is true that HPV 16 and 18 are the most common and widespread, but there is still a risk of 30% of infection with other subtypes (boy are those numerous), and 300$ is huge a cost for such an elevated residual risk.
If people can afford it, why not, it IS minimising the chance of getting cervical cancer by 70%., and so far i haven't heard of any reports of severe undesirable side effects. I can get more accurate details later on.

[Sirius]

From Wiki

Commencing in 2007 The Australian federal government began funding a voluntary program to make the Gardasil vaccine available free of charge to women aged between 12 and 26 for a period of two years, with an ongoing vaccination program for 12-13 year olds as part of the pre-existing high school vaccination program.

In Australia, the Australian government and the PBS (Pharmaceutical Benefits Scheme) have approved the vaccine for use and in 2007 began a nationwide vaccination program free of charge to schoolgirls in years 7 to 12. These programs are run by local councils with funding and vaccine supplies coming from the government. The subsidization approval process, however, appears to have been heavily influenced by political interference from politicians of all political parties, and by the Prime Minister who publicly advised that it would be approved (before approval). In addition, women between 18 and 26 years of age at the time of the first dose may receive the vaccine for free upon request from their general practitioner. After June 2009, the program will be scaled down to 12–13 year old girls only. Australia also approved Gardasil for boys 9–15 years old, but Australia is not providing government funding for vaccinating boys.

The researcher behind the discovery of the cervical cancer vaccine was Australian, which was why Australia was the first to pass this vaccine free of charge to all girls/women between the ages of 12 and 26. It was all over the news here. It took alot of lobbying to put the vaccine on PBS and thus provide it for free on the government's expense.

[General my General!]

Originally Posted by PhoenixResurrection

As u said, I would prefer to wait before rushing into such new vaccines...
I still remember the hepatitis B vaccine and the associated adverse reactions (inc. multiple sclerosis).

I agree. So far the side effects from HPV vaccine are very minimal, even relative to other vaccines. Studies have been ongoing for at least 6 years so far.

On HBV, a few studies did suggest such a link, but so far investigations into it have turned this idea out. The WHO vaccine safety committee concluded there is no causal link. Most authorities do not suggest a link. But yeah the picture's not as clear as one would like I guess.

Originally Posted by Rors

Good, the price dropped a bit, it was around 450 $ when it first came out.
The thing is you're gonna pay 300$ to get a vaccine that will not cover you 100%. It is true that HPV 16 and 18 are the most common and widespread, but there is still a risk of 30% of infection with other subtypes (boy are those numerous), and 300$ is huge a cost for such an elevated residual risk.
If people can afford it, why not, it IS minimising the chance of getting cervical cancer by 70%., and so far i haven't heard of any reports of severe undesirable side effects. I can get more accurate details later on.

Yeah I think it's a pretty good investment, even if it covers 70%...I mean, better that than a new stereo or purse. Of course I agree if it's going to cost someone relatively a lot, then definitely the money's better spent somewhere else...the last thing people should do is get crazy over the vaccine ... especially in Lebanon bi seer ekher mouda hehe.

I tried getting a crude calculation of lives saved if use of the vaccine was done for all 14-26y women in Lebanon...but we really lack good data on HPV types and cervical cancer incidence (WHO estimates 260 cases and 130 deaths/y, national cancer registry 10 cases or so, ... really vague). We definitely need better reporting, and more research on it too.

Ok this is very very crude so don't quote me ...
Total 14-26y women = 380,000
Cost per vaccine = $300
>>>Total cost = $114 million
Minimum coverage duration for group = 5y
Annual mortality from Cervical cancer = 130 (WHO estimate)
>>>Deaths avoided per year = 130 x .70 = 91
>>>>Lives saved in 5y = 455

Cost per life saved = $114 million / 455 = $250,000.

Not to put a price on a human life, but yeah it probably is worth more than that in cost-benefit terms. Of course this is with the limited data we have, and considering that the only cost is the vaccine itself (not all materials, etc.).

I think $114million can be better invested elsewhere, but yeah if we manage to get some sort of mass subsidization one day from donors, might be worthwhile, especially since the Pap screening is totally not working out right.

[General my General!]

Originally Posted by Sirius

From Wiki


The researcher behind the discovery of the cervical cancer vaccine was Australian, which was why Australia was the first to pass this vaccine free of charge to all girls/women between the ages of 12 and 26. It was all over the news here. It took alot of lobbying to put the vaccine on PBS and thus provide it for free on the government's expense.

Very interesting! Seems like a lot got invested in that...at least they aren't funding for boys, yet hehe. Pharma's influence is pretty scary, especially with govt. Btw if you happen to find any article or news criticism on that, please do share! Thanks

[Dalzi]

Originally Posted by General my General!

Very interesting! Seems like a lot got invested in that...at least they aren't funding for boys, yet hehe. Pharma's influence is pretty scary, especially with govt. Btw if you happen to find any article or news criticism on that, please do share! Thanks

Yes, a lot of funding goes towards cancer research in Australia, especially cervical, breast, and skin cancer.

Here's a link to The Cancer Council NSW where you'll find more information...

The Cancer Council NSW

About the cevical cancer vaccine...

The Cancer Council New South Wales :: Cervical Cancer Vaccine Fact Sheet

[General my General!]

Originally Posted by Dalzi

Yes, a lot of funding goes towards cancer research in Australia, especially cervical, breast, and skin cancer.

Here's a link to The Cancer Council NSW where you'll find more information...

The Cancer Council NSW

About the cevical cancer vaccine...

The Cancer Council New South Wales :: Cervical Cancer Vaccine Fact Sheet

Thanks Dalzi. I had meant more info about any criticism for the Aussie govt for funding it.

[Sirius]

Criticism in Australia

As of 22 May 2007, 7 Victorian schoolgirls from Sacred Heart Girls' College were briefly hospitalized after receiving an injection of the Gardasil vaccine and were taken to the Monash Medical Centre. One was temporarily paralyzed. Health authorities do not believe that these are directly related to the vaccine.

Reports of adverse reactions to the new HPV vaccine Gardasil are escalating. One particularly heart-wrenching example is the story of 12-year-old Brittany who lost all feeling in her leg and collapsed two weeks after receiving the Gardasil vaccine.

The following is from the Sydney Morning Herald:
"It is not uncommon for girls of this age group to react to vaccinations in ways that are not necessarily physical in origin."

Professor Frazer said there was no reason to be concerned and it was common for young women to faint after receiving injections.
"It's not what's in the injection, it's the injection process itself and it's entirely avoidable just by having young girls lie down for a minute or two," he said.
"...hospital staff told teachers at the school at the time that the girls' reactions were not related to the vaccination itself"

from Wiki

[SaadTam]

This kind of reaction is normal..and could've happened with any other vaccine, and not specifically the Gardasil !
Besides Gardasil has been out for quite a while, thus making it safer than the newer Cervarix. I don't think such transitory rare episodes are criteria to exclude taking this vaccine !
And Rors...why pay for a vaccine that would only REDUCE risks..and not eliminate them?!?!:
Mate...medicine is ALL ABOUT percentages and probabilities...and never was a 100% trade
Sometimes we think of the "reducing risks" slogan INDIVIDUALLY...as in: I will have 50% less chance of contracting a disease !
Look at it this way:

Reducing risk is just the medical way of saying: Look at the person on your left, look at the person on your right.....before 2 of you could get sick...now only one.....now that's a change !!

As for PhoenixResurrection, Gardasil has been out there for quite a while, and other than normal rxn's to vaccines, nothing has been reported......hope they're not hiding anything of course...hehe

Here in Belgium for example...it's covered by social security...as long as you apply for the first injection before the age of 16 minus one day
In Lebanon I think they should similarly apply strict criteria.....hek the people won't start rushing..and going after the "mouda"