Concerns about Gardasil

Seven's On Call with Dr. Jay Adlersberg
August 20, 2008 3:32:28 PM PDT
The human papillomavirus vaccine can be used to prevent cervical cancer. But before you decide if it's right for you or your daughter, know there are still uncertainties about it. Gardasil is the vaccine designed for girls 12 through 26. Its makers are advertising directly to consumers and they are paying doctors to lecture about it. But an article in Thursday's New England Journal of Medicine talks about its cost, and there is controversy about its real value to young women.

Women such as 26-year-old Danielle Jean are the best ones to get Gardasil, a three-shot vaccine against the four types of HPV most likely to cause cervical cancer. Though a pap test can find the cancer early and cure it, the vaccine prevents it.

"That part of the body was not paid attention to when I was younger," she said. "Now, they're paying attention to it. I think it'll save lives."

Save lives, but at what cost? The shots have caused almost 10,000 adverse reactions, 94 percent of which were minor, such as headache, nausea and fever. The worst, however, include paralysis and some fatalities.

There have been deaths reported soon after women had received the Gardasil vaccine, but the Centers for Disease Control and the FDA say there is no clear evidence that the deaths were caused by the vaccine.

Also, because the vaccine is so new, it's not clear how long immunity will last.

"It's not uncommon among other vaccinations," said Dr. Samantha Feder, of St. Luke's/Roosevelt Hospital. "Other vaccinations will require booster shots along somebody's lifetime."

Women will still need pap tests, as there are some strains of HPV not covered by the vaccine. The shots may make women feel falsely protected, and more likely to miss their paps. But Dr. Feder says that regardless of these issues, the vaccine is important.

"In general, I would say that the risks of this vaccine are far outweighed by the benefits," she said.

Danielle came to that conclusion on her own.

"If the doctor says it's right for you, you have a better chance than surviving cervical cancer," she said. "So I think it's worth the risk."

The three shot series can cost $1,000. Another expert said the alternative is aggressive pap testing to cure cervical cancers. He said that when programs like that were started in the U.S., deaths from the disease fell 90 percent. It will not be known for decades how the vaccine will impact on cervical cancer.


STORY BY: Dr. Jay Adlersberg


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