By: Zosia Chustecka
August 20, 2008 — “There is good reason to be cautious about introducing large-scale vaccination programs” with the human papillomavirus (HPV) vaccines, because many essential questions are still unanswered. This is the conclusion of Charlotte Haug, MD, PhD, from the Journal of the Norwegian Medical Association, in Oslo, writing in an editorial in the August 21 issue of the New England Journal of Medicine.
“The real impact of HPV vaccination on cervical cancer will not be observable for decades,” Dr. Haug comments, but there has been pressure on policy makers worldwide to introduce the HPV vaccine in national or statewide vaccination programs.
Two HPV vaccines are marketed worldwide — the United States and Australia use Gardasil (Merck & Co), while the United Kingdom recently announced that it has chosen Cervarix (GlaxoSmithKline). A major target of these vaccination programs is girls between 12 and 13 years old, as the vaccine is most effective before the onset of sexual activity.
However, Dr. Haug questions how policy makers can make “rational choices about the introduction of medical interventions that might do good in the future but for which evidence is insufficient, especially since we will not know for many years whether the intervention will work or — in the worst case — do harm?”