KEY POINTS:
For decades, medical researchers have dreamed of developing vaccines that prevent cancer.
A particular area of interest has been cervical cancer, if only because deaths from it have been forecast to jump fourfold to a million a year by 2050, mainly in developing countries.
Unsurprisingly, therefore, Queensland immunologist
Ian Frazer was feted in 2006 when his team produced a vaccine that was shown to give complete protection against the two strains of the human papilloma virus (HPV) that cause 70 per cent of cervical cancers.
Australia and Britain quickly seized on Gardasil and introduced routine immunisation. It seemed churlish when the Government here decided not to fund the vaccine in last year's Budget.
Happily, that situation has now been remedied. The Prime Minister confirmed yesterday that the Government will spend $164 million over the next five years on a cervical cancer immunisation programme. From September, a vaccine, presumably Gardasil, will be offered free to 300,000 females aged 12 to 18. This programme will not proceed without opposition, of course. No immunisation campaign does these days, no matter how safe or effective a vaccine is shown to be.
There will be other strands to intensify the debate this time. The most controversial, arising from the fact that the vaccine is best given before females become sexually active, will centre on the message being sent to girls as young as 12 that, as one morals campaigner put it, the vaccination is a licence to be promiscuous. There is little, however, to support the idea of such a link, as the Catholic Church, among others, acknowledges. Almost everyone who is sexually active risks being exposed to HPV, so common is the virus. Promiscuity does not heighten that threat.
Experience in Britain, where 70 to 80 per cent of schoolgirls are expected to take part in a Government programme, suggests that age will not, in fact, be the main stumbling block. Instead, parents are more likely to be concerned over whether they know enough about the vaccine and its long-term safety.
As elsewhere, ignorance and inconvenience, rather than a deeply felt aversion, will be the main reasons for non-vaccination. That suggests an awareness campaign must be an integral part of the New Zealand programme.
It should be directed especially at Maori and Pacific Islanders, who have a higher rate of cervical cancer.
Most people should not have to be reminded of the deadliness and devastating effects of cancer. But they may need to be informed of two studies published last year in the New England Journal of Medicine that confirmed the effectiveness of Gardasil. And they need to know that the United States Food and Drug Administration found no causal relationship between the vaccine and the widely publicised death of three young women within days of having received it. They also need to be told that, while cervical cancer is less of a problem here than overseas, thanks to the effectiveness of the national screening programme since 1991, it still kills about 60 women a year. Thousands of others go through the stress of receiving an abnormal smear test, as well as the invasive procedures that follow.
Most importantly, parents need to recognise that if a reasonably safe vaccine is available, it makes sense to take the precaution. A price tag of about $450 for a three-dose course means Gardasil would normally be out of the question for most low-income families. The Government programme puts it within reach.
It is expected to save about 30 lives a year. That is the bottom line. Cervical cancer may be only the eighth most common cancer among New Zealand women, but in its case there is a means of prevention. That opportunity should be taken.
