| They probably could’ve saved themselves a lot of trouble if they’d come up with a cure for lung cancer. But no, they had to go and develop a vaccine against cervical cancer, the only cancer you can get through sex. As a result, when Merck launched its campaign for Gardasil, the "first vaccine intended to prevent cervical cancer in women" and wanted to vaccinate girls as young as nine, it raised familiar right-wing, anti-sex arguments that it would turn these girls into a bunch of pre-marital-sex-having sluts. One U.S. cartoon showed a lineup of young girls entering "The Best Little Whorehouse in Texas," with the word "whore" scratched out and replaced with the word "vaccine." To the left were your usual anti-big-pharma "this is just another drug-pushing, profit-mongering plot by pharmaceutical companies" arguments.
What there wasn’t in all the dust-up was a clear idea of what the cervical cancer vaccine means to us regular folk, going about our business, suddenly freaking out that sex will give us cancer but leery about dropping half a grand to get shot up with a vaccine we know little about. It’s a little more complex than those simple, sing-song-y Gardasil ads of young girls chanting: "One less, I wanna be one less…," so stay with me here.
There are over 100 strains of the human papillomavirus (HPV), about 30 per cent of which can be sexually transmitted. Most HPV strains, as with most cold viruses, work their way through our systems and cause little long-term harm. The four strains that the vaccine protects against are believed to lead to an estimated 70 per cent of cervical cancer cases and 90 per cent of genital warts in women.
HPV is spread through skin-to-skin contact, making condoms less than 100 per cent protective and, while pap smears can screen for pre-cancerous cells on the cervix allowing for early detection, an estimated 50 per cent of women who develop cervical cancer weren’t getting regular pap smears.
According to Doctor Laurie Eliot, a gynecologic cancer surgeon at the Juranvinski Cancer Centre in Hamilton, Ontario and many others like her, vaccinating young girls before they’re sexually active would protect them where these other methods fail. Eliot predicts that early across-the-board vaccination would bring exposure rates down from a whopping current 70 per cent to an estimated 30 per cent.
But here’s the thing. Of that 70 per cent that have been exposed to the virus, only two per cent will actually be exposed to the nasty cancer-causing strain of the virus, says Dr. Wilfred M. Steinberg of the Department of Obstetrics and Colposcopy at St. Michael’s Hospital in Toronto.
There are about 1200-1300 new cases of cervical cancer a year in Canada, resulting in about 300 deaths, says Steinberg. Considering the Gardasil vaccine costs $480 (three shots at about $160 each), is the "herd vaccination" approach really the best "bang for our buck" as Steinberg puts it.
Besides, do we really think the 50 per cent of women who weren’t going for pap smears — often due to the fact that they come from lower socioeconomic backgrounds – are suddenly going to seek out and shell out this kind of money for a vaccine, he adds?
"This is a tremendous breakthrough in that science has come up with the first vaccine against cancer and from here going to leap frog down the road," says Steinberg.
"But now it’s up to us physicians, health organizations, pharmaceutical companies etc. to discuss how to use this new breakthrough most effectively."
For example, rather than put all our eggs into one (hopefully) catch-all preventive cure basket, "we need to come up with cost-effective ways to prevent exposure and couple it with improved screening that doesn’t miss the underclass and would help identify at-risk groups, so we can target our resources selectively" says Steinberg.
But, again, because we’re talking about sex – be it "high-risk groups" (reminiscent of the political hot potato of naming high-risk HIV groups) or immunizing nine-year-old girls against an STD, "you’ll always get someone’s nose out of joint" he adds.
In fact, noses got so out of joint, Merck has backed off its efforts to make the vaccine mandatory for young girls in the U.S. Of course, notes Steinberg, men infect women so, ideally, we should be vaccinating both men and women, but testing on men is just beginning now. Maybe, once that’s complete, we can lose the obsession with the sexual behaviour of teenage girls and get on with that business of curing cancer we’re otherwise always so keen on. |
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