Minister for Health announces cervical cancer vaccine program

Piste

Article here

Basically the minister for health wants to vaccinate all 12 year old girls against the cervical-cancer HPV virus (well two strains of it anyway)

For those of you with daughters, would you consent for them to get this vaccination? There was a program on channel 4 the other week about this injection as the vaccination program has been introduced in the UK for all 12 year old girls, and then a catch-up program for 12-16 year olds.

The HSE won't be offering the catch-up service thouh due to costs.

For those of you over 12, would you go private and shell out €800 for the vaccine?

My mum offered for me to get it but after weighing up the pros and cons, and also factoring in that I may have already been in contact with the virus, thus rendering the vaccination redunadant, I decided against it.

Nevyn

www.tellher.ie

I would consider it but only after some research into which strains they are vaccinating against.

r3nu4l

Thaedydal wrote: »

www.tellher.ie

I would consider it but only after some research into which strains they are vaccinating against.

The GSK vaccine is bivalent, vaccinating against HPV 16 and 18
The Merck/Sanofi vaccine is quadrivalent, vaccinating against 4 strains; HPV 6, 11, 16 and 18.

HPV strains 16 and 18 account for 70% of all cases of HPV infection. However HPV strains 6 and 11 are important too.

IMO the quadrivalent vaccine is the better vaccine as it provides better protection but the bivalent vaccine will certainly reduce cervical cancer too.

This link refers to some scientific information on the Quadrivalent vaccine.

This article compares the efficacy of both vaccines.

This article looks at practice and policy for both vaccines.

Piste

Thaed yeah I saw that site after picking up a leaflet in work about the vaccine, but it is a Merck promoted-site so I'd wonder if it's completely unbiased.

That's interesting about the different vaccines protecting against different strains, the C4 documentary never mentioned that and the NHS has gone with the GSK vaccine.

r3nu4l

Piste wrote: »

That's interesting about the different vaccines protecting against different strains, the C4 documentary never mentioned that and the NHS has gone with the GSK vaccine.

There is uproar in the UK over the choice of the GSK vaccine. Most programs in the world have chosen the Merck vaccine because it also protects against genital warts.

The GSK vaccine is cheaper therefore will save the NHS a lot of money in the short-term but we will still have to treat genital warts caused by HPV 6 and 11 which will cost more in the long run...

BBC News.

Seems Ireland are following the UK lead...


EDIT: BTW, Declaration of conflict. I've written extensively about the science of the Quadrivalent vaccine for Merck as part of my job. However, I do firmly believe it is the better choice. I've also worked for GSK in the past so I've no inherent bias.

Piste

GSK it an English company too, so that could have something to do with it.

I would imagine given that the Merck vaccine is more comprehensive that it will be more expensive, and the HSE don't do expensive.

r3nu4l

Piste wrote: »

GSK it an English company too, so that could have something to do with it.

Don't be such a cynic...

<_<

Piste

Afaik GSK has a factory here in Ireland too so that may swing things in their favour.



"use us or you'll lose jobs" :pac:

So I don't know nothing about cervical cancer.
Piste how do you know that you have been in contact with HPV?

Nevyn

Moonbaby the site www.tellher.ie and http://www.cdc.gov/STD/HPV/STDFact-HPV.htm
is what you want.

The Sweeper

You can come into contact with HPV through having unprotected sex.

I did some conference work for the National Institute for Clinical Excellence in the UK when they were discussing their ongoing approach to the problem of HPV and STDs in young people. Some of the products they were discussing and promoting were home HPV and chlamydia test kits. I went and bought one after the day conference to see what all the fuss was about.

The test kit is a self-administered swab kit. You pull a long cotton bud out of a plastic tube, push it into your vagina much the same way as you'd push in a tampon, then swirl it around firmly. There are very simple instructions with the kit.

When you pull the swab back out, you put it straight back into the plastic tube it came in - there's a tinfoil pocket at the bottom of the tube with some liquid in it, and this time you push the swab through the pocket into the liquid at the bottom. You shake it gently to ensure the swab is coated with the liquid, and then, if you have HPV or chlamydia, the swab will change colour.

The test kits are useful because they overcome the aversion a LOT of young women have to going for a pelvic exam. This aversion is exacerbated by the lack of symptoms - you can fool yourself into thinking nothing's wrong and therefore you don't go and get examined.

While I appreciate the concept of the vaccine, I'm not sure if I'd send my 12 year old to have it (if I had a 12 year old!). I'd rather make sure she was educated about the importance of safe sex and the availability of home test screening kits - if you're too chicken to have a pelvic exam, you should at least be availing of the opportunity to test yourself! I'd like to know more about the vaccination, but if it was proven harmless, then no harm getting it.

Reku

Minesajackdaniels wrote: »

While I appreciate the concept of the vaccine, I'm not sure if I'd send my 12 year old to have it (if I had a 12 year old!). I'd rather make sure she was educated about the importance of safe sex and the availability of home test screening kits - if you're too chicken to have a pelvic exam, you should at least be availing of the opportunity to test yourself! I'd like to know more about the vaccination, but if it was proven harmless, then no harm getting it.

Surely it's best to employ as many countermeasures as possible, or are there significant potential sideaffects to the vaccine? It's not like having the vaccine is going to make people any more likely to have unprotected sex anymore than sex education makes them more likely to have sex.

Can people still be carriers of the strains after vaccination? If not then they should consider full carpet bombing and give males the vaccination too, try wipe out the strains much like smallpox (but keep up the vaccinations since unlike smallpox this could readily be reintroduced to the populace and spread without obvious outbreak until it's too late).

WindSock

Of course, you are in Australia now Majd. You can just walk into any old health clinic and get all those tests done for free and have the results back within a couple of minutes. I made sure I availed of their services to the fullest while I was there. I can't believe the difference between our health systems.

Minesajackdaniels

Minesajackdaniels wrote: »

You can come into contact with HPV through having unprotected sex.

You can come into contact with HPV via protected sex also.
Condoms do not provide total protection against warts, they are transmitted via skin to skin contact, not fluids.

tallaght01

Big +1 on this vaccination programme from me.

HPV 16 and 18 have to be the big targets. In a situation, where finances are limited, I think we should be targetting our resources at strains 16 and 18, which will cause cancer, as opposed to 6 and 11, which are pretty low risk.

I think the cost/benefit analysis for vaccinating against 16+18 will be favourable. Less sure about cost/benefit of vaccinating against 6+11, in terms of the alternative available for that kind of money.

Piste

Moonbaby wrote: »

So I don't know nothing about cervical cancer.
Piste how do you know that you have been in contact with HPV?

Oh I don't *know* it for certain, just saying there is a chance.



I hear the government is also rolling out a new smear testing campaign where women between 25 and 45 will be contacted every three weeks to go for a smear test.


To me every three weeks seems a little excessive.

spaceylou

Piste wrote: »

I hear the government is also rolling out a new smear testing campaign where women between 25 and 45 will be contacted every three weeks to go for a smear test.


To me every three weeks seems a little excessive.

Haha, it sure does seen as it seems to take longer than that to get the results back!!! Maybe they mean they will contact women every three weeks or so until they go and get it done!! Nothing like a bit of nagging to get people to stop procrastinating! :pac: Can't see it happening though, especially when it costs so fecking much to get done.

Back to the main topic though, I think its a great idea to introduce the vaccine but all the conditions that Harney has placed on it make me skeptical about it being introduced within the announced timeframe....I mean how do you guarantee 80% take up before the fact, and saying that it must be cost effective - it will be a few years before we see the benefits especially when they refuse to introduce a catch-up for teenagers so how are they going to measure the cost effectiveness???

mydarkstar

Piste wrote: »

I hear the government is also rolling out a new smear testing campaign where women between 25 and 45 will be contacted every three weeks to go for a smear test.


To me every three weeks seems a little excessive.

I think it's every 3 YEARS not 3 weeks

http://cancerscreening.ie/cervical.html

r3nu4l

tallaght01 wrote: »

as opposed to 6 and 11, which are pretty low risk.

I think the cost/benefit analysis for vaccinating against 16+18 will be favourable. Less sure about cost/benefit of vaccinating against 6+11, in terms of the alternative available for that kind of money.

Yeah but tallaght, up to 90% of all genital warts cases are caused by either HPV 6 or HPV 11. These need to be treated and can also recur therefore needing further treatment, incurring costs for the healthcare system. Vaccinating against these strains would reduce the cost burden to healthcare systems.

Also, 10% of Cervical Intraepithelial Neoplasia type 1 cases are caused by HPV 6/11 and while most of these are cleared by the immune system within months (or within two-three years), some do go on to develop into grade CIN 2 or CIN 3. That's a minor point but the cost benefits of vaccinating against all four strains really do add up imo. Perhaps not in countries with small populations such as Ireland but I can't understand NICE and the NHS not taking up the quadrivalent vaccine.

I do agree however that both vaccines are excellent and it's great to see any mass vaccination against HPV announced.

EDIT: Yes, Piste, every 3 weeks would be excessive I can't imagine many women being too happy at the thoughts of a smear test every 3 weeks!! :eek:

Crumble Froo

Piste wrote: »

I hear the government is also rolling out a new smear testing campaign where women between 25 and 45 will be contacted every three weeks to go for a smear test.

had a medical last week, and was informed that here in nz, they start that once you're 20 years old, and sexually active. it'll probably take me about 5 years to psyche myself up for the exam anyway...

Nevyn

http://www.vhi.ie/hfiles/hf-657.jsp#2

Who should have a smear test?

All sexually active women are at risk of developing cervical cancer. In young women, cervical cells changes are very common and most return to normal without treatment. Most screening programmes therefore usually begin at age 25. However, sexually active women of any age can ask their doctor for a smear test.

The Irish Cervical Screening Programme (ICSP) offers free cervical screening to women aged 25-60 years in the Mid-West area. This is now being extended to include the rest of the country.
Current screening recommendations include:

* Cervical screening be offered to all women aged 25-60.
* Women aged 25-44 should have a smear test every 3 years.
* Women aged 45-60 who have had 2 consecutive negative smear tests, only need to be screened every 5 years.
* Women who have an abnormal smear result may need more regular smear tests.
* Women who have had treatment for abnormal cervical cells will need annual smear tests for some years afterwards (depending on the severity of the cell changes).
* Women aged 65 and over who have had 3 normal test results in a row may not need any further screening.
* The recommendation that a woman should have a smear test 12 months after her first smear test has ceased (providing the smear was normal).
* Women who have never been sexually active may choose not to have a smear test as the risk of cervical cancer for them is very low.
* Women who have had a total hysterectomy (uterus and cervix removed) do not need smear tests. If all or part of the cervix has been retained you will need to continue having smear tests.
* Women who have had a total hysterectomy for cancer, or who had abnormal cervical cell changes at the time of hysterectomy, will need to have vault sampling. This is where a sample of cells is taken from the vagina near where the cervix used to be.

tallaght01

r3nu4l wrote: »

Yeah but tallaght, up to 90% of all genital warts cases are caused by either HPV 6 or HPV 11. These need to be treated and can also recur therefore needing further treatment, incurring costs for the healthcare system. Vaccinating against these strains would reduce the cost burden to healthcare systems.

Also, 10% of Cervical Intraepithelial Neoplasia type 1 cases are caused by HPV 6/11 and while most of these are cleared by the immune system within months (or within two-three years), some do go on to develop into grade CIN 2 or CIN 3. That's a minor point but the cost benefits of vaccinating against all four strains really do add up imo. Perhaps not in countries with small populations such as Ireland but I can't understand NICE and the NHS not taking up the quadrivalent vaccine.

I do agree however that both vaccines are excellent and it's great to see any mass vaccination against HPV announced.

EDIT: Yes, Piste, every 3 weeks would be excessive I can't imagine many women being too happy at the thoughts of a smear test every 3 weeks!! :eek:

Has the cost/benefit analysis been done? HPV 6 and 11 tend to cause pretty low grade tumours, which are mostly caught in time by the cervical smear programme. I think that's probably the issue. Vaccinating against cervical cancer is great, but it's a much higher priority than vaccinating against genital warts.

Would the extra money be better spent on something else? I don't know. I haven't seen the const/benefit stuff, but I figure that might be the reason that they're only rolling out the divalent vaccine.