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NEJM Articles Question Cervical Cancer Vaccines | cialis online

NEJM Articles Question Cervical Cancer Vaccines

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More questions about the cervical cancer vaccines Gardasil and Ceravix have been raised by two articles in the the New England Journal of Medicine (NEJM). Gardasil, Merck & Co.’s vaccine, was approved by the U.S. Food & Drug Administration (FDA) in June 2006. Ceravix, made by GlaxoSmithKline, has not been approved by the FDA yet, but is widely used in Europe.

The makers of both vaccines claim they prevent the strains of Human Papillomavirus  (HPV) most responsible for causing cervical cancer. But in Western countries, like the U.S. and Great Britain, regular screening via Pap tests has already greatly reduced incidences of cervical cancer and deaths. But even after vaccination, regular Pap tests are necessary because the shots don’t protect against all HPV strains known to cause the cancer. Both Gardasil and Ceravix are given as a series of three injections, and can cost as much as $1,000 to complete, and unlike most vaccines, they don’t save health systems money.

The first NEJM article details a Harvard analysis of the vaccines’ cost effectiveness. To measure the health benefit of vaccination, the researchers looked at the cost savings from preventing cervical cancer with the vaccine and Pap tests compared with prevention via the tests alone. A treatment is typically considered cost effective if it is less than $50,000 or $100,000 for one additional year of life

The Harvard analysis predicted that it would $43,600 to extend life expectancy by one year when girls are vaccinated at 12. When girls up to age 18 are included in the analysis, that ratio rises to $97,300 and to $153,000 through age 26, the study found. That’s because vaccination is less effective after a woman is sexually active, and may have already been exposed to HPV.

However, the analysis assumed that Gardasil and Ceravix will be effective for life – something that is as of now unknown – and that women get regular screenings to detect the first signs of cervical cancer. If the vaccine’s protection against HPV stops after 10 years, the cost of vaccinating preteen girls would more than triple to $144,100 per year of life gained, the study said. In those case, the researchers said that cervical cancer prevention through Pap testing alone would make more sense from a cost standpoint.

In the NEJM article, an editorial, Dr. Charlotte J. Haug contends that the uncertainty surrounding the vaccines provides reason to be cautious. According to her editorial, Gardasil and Ceravix were studied in clinical trails for at most six and a half years. It is still not known how long the immunity will last, or whether eliminating some strains of HPV will decrease the body’s own immunity to other strains. “Despite great expectations and promising results of clinical trials, we still lack sufficient evidence of an effective vaccine against cervical cancer” Dr. Haug writes.

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