Vaccine for girls - Issue needs to be looked at carefully

The joint Oireachtas Committee on Health and Children has called for the introduction of a new vaccine programme to ensure that girls between the ages of 11 and 12 are protected against cervical cancer before they become sexually active.

The National Immunisation Advisory Committee has yet to recommend whether the vaccination should be used on a national scale to ensure that all girls are protected.

The new Gadasil vaccine prevents up to 70% of human papilloma virus (HPV) infections, which can cause cancer of the cervix. Up to 80% of sexually active women will suffer an HPV infection at some time in their lives. In most women the virus that can cause tumours will disappear over time, but some women have difficulty getting rid of it.

Cervical cancer kills 274,000 women each year worldwide. Ireland has one of the highest rates of cervical cancer in western Europe, with around 180 new cases diagnosed annually and more than 70 deaths a year from the disease.

Professor Walter Prendiville, president of the British Society for Colposcopy and Cervical Pathology, told the Oireachtas committee that the vaccination in combination with a screening programme could prevent up to 95% of cervical cancers.

It is vitally important, however, that the vaccine should be administered before girls become sexually active, because tests have found that the success rate of the vaccination is comparatively poor on people who have already been exposed to HPV.

A study published last October on sexual health and relationships in Ireland found that most of those in their 20s had sex for the first time before their 18th birthday. Hence medical experts advocate that girls between 11 and 12 years of age should be vaccinated.

The Food and Drug Administration in the United States approved Gardasil in June of last year, and the Advisory Committee on Immunization Practices approved the vaccination for children as young as nine years of age.

The vaccination has also been approved for use in the European Union, Canada, Australia and New Zealand. The vaccine is administered in three injections over a six-month period.

It would therefore cost around €450 to administer, when GP consultations are included.

It is not available on the medical card scheme or reimbursable under the community drug schemes, but this cost element should not be a factor when the benefits are so great.

The vaccination provides considerable protection against a dreaded disease. Immunising children will inevitably be controversial, because it raises moral and ethical issues.

Ultimately it is a matter for parents whether the vaccine would be given to girls as young as 12, but Dr Mary Horgan, consultant on infectious diseases at Cork University Hospital, believes that serious consideration should be given to the suggestion. “The sooner you give it the more protection you are giving,” she said.

Some people might fear that it would be seen as providing some kind of licence for promiscuity, but the earlier the vaccine would be administered would minimise that aspect while at the same time ensuing a tremendous degree of life-long protection. This is an issue that should be carefully considered in a mature way so that it can be part of the promised screening programme due to be rolled out later this year.

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