HPV Vaccine: Immersed in Controversy

Abstract

There has been substantial media coverage of the quadrivalent human papillomavirus (HPV) vaccine since the Food and Drug Administration approved Gardasil (Merck & Co., Inc.) on June 8, 2006. The most vocal complaints maintain that its use will promote promiscuity among teenagers, and condemn proposed mandated use for school entry. Some also question evidence for the vaccine's safety. There have been concerns raised by both providers and patients regarding financial barriers to access. Still others argue that additional populations could benefit who have not been included in current recommendations. Clarification of these issues is essential to advance optimal use of this important new vaccine. There is strong evidence to support HPV vaccine as an effective, safe, and efficient public health measure. School mandates are valuable tools to reduce disparities in availability of immunizations. The time has come to consider universal funding as a means to improve access to all recommended vaccines.

Is There Something Else Beyond Cost-Effectiveness Analysis for Public Health Decision Making?

“…32 In the United States, where the HPV vaccine is not provided by universal program, the age of vaccination of girls (11 to 12 years), and moral aspects, such as the possible consequences on the promiscuity of adolescent users, were discussed. 33 Discussions for the same interventions in developing countries has a different focus. The center of interest is on identifying the optimal purchasing mechanisms to provide cost-effective vaccines.…”

Human papillomavirus disease and vaccines

“…47 Even though FDA has not approved the quadrivalent vaccine for use in women over age 26 years, vaccine administration may still be beneficial for individuals who have not been infected with each HPV type included in the vaccine. 48 However, it is important to note that insurance companies are unlikely to cover the cost of vaccination in women over age 26 years since the vaccine is not approved for women in this age group.…”