A Welcome Pharmaceutical

It’s not anything close to a leap back to the era of free love, but it is a step toward safer sex and preventing cancer. In June, the Food and Drug Administration (FDA) announced that it had approved Gardasil as a vaccine against strains of the human papillomavirus (HPV), which can cause cervical cancer in women. Subsequently, the Center for Disease Control’s Advisory Committee on Immunization Practices (ACIP) recommended that girls receive the vaccine routinely at age 11 or 12. The vaccine offers a major breakthrough in women’s health as it will help prevent cervical cancer and genital warts. Harvard, too, has made it easier for the University community to reap the benefits of the vaccine: Starting Sunday, University Health Services (UHS) will offer Gardasil inoculations. We welcome both the ACIP’s recommendations as well as Harvard’s decision to provide the vaccine.

The United States averages 9,710 new cases of cervical cancer and 3,700 deaths from cervical cancer each year. Worldwide there are 470,000 new cases and 233,000 people killed from the cancer per annum, making the disease the second most common cancer in women and increasing the significance of the vaccine’s development. The vaccine works by preventing the transmission of four of the more than 100 different strains of HPV, including some of the strains that substantially increase a woman’s risk of developing cervical cancer. Additionally, the vaccine blocks the transmission of some of the strains that cause genital warts. Two of the strains of HPV that Gardasil blocks cause 70 percent of cervical cancer, and the other two strains cause 90 percent of the cases of genital warts. So while Gardasil will not eliminate cervical cancer or genital warts, it will greatly reduce the number of new cases. Moreover, the vaccine is over 95 percent effective in preventing the transmission of these strains.

The potential benefits to women’s health, including the tremendous numbers of potential lives saved, makes opposition to the vaccine all the more troubling. Certain conservative religious groups’ have attacked the ACIP’s recommendations not on the grounds that the vaccine is unsafe—the vaccine cannot infect a person with HPV, and side-effects are minor—but rather because of fear that giving the vaccine to all girls will lead to an increase in sexual activity. Such an argument not only ignores the fact that women can contract HPV through non-consensual sex, but also reflects a dangerously naïve mindset. The idea that young people can, and should, be scared into abstinence is simply false and leads uninformed teens to engage in unsafe sexual behavior. Rather, teens should be educated on the practices of safe sex and the risks associated with sexual intercourse so that they can make smart informed decisions and protect themselves with Gardasil, regardless of their sexual choices.

The treatment, however, is a bit pricey. The vaccine consists of three separate shots administered over six months and costs about $360, a price that is a reach for many U.S. families and an impossibility for most in developing nations. While Merck, Gardasil’s manufacturer, has stated that it is committed to providing Gardasil to the developing world and is working with the Gates Foundation to do so, it remains to be seen if and how this will be done, as many other vaccination programs for the impoverished have faltered. (In the United States, Gardasil is included in the federal Vaccines for Children program, which provides vaccines for underprivileged U.S. children.)

Gardasil is not a panacea for preventing cervical cancer: It isn’t absolutely effective, and women should continue to undergo regular cervical cancer screening. But the health benefits of the vaccine are already promising. We commend both the FDA and UHS for making the vaccine more readily accessible, and we commend the ACIP for its recommendations.