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The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in Atlanta Thursday recommended that 11- and 12-year-old girls be routinely vaccinated by Merck`s cervical-cancer vaccine Gardasil against the sexually transmitted virus that causes cervical cancer. The panel also recommended that doctors could administer the vaccine to girls as young as 9 years of age at the physicians and parents discretion, and for women up to age 26 who have not previously been vaccinated against the sexually transmitted human papillomavirus (HPV).
But some educators and conservative groups say decisions about the vaccine should be left to parents. “We think this is a matter of parental rights and parental control,” said Peter Sprigg of the conservative Family Research Council. “Parents have the rights to make these decisions for their kids.”

Women’s health experts argue that requiring the vaccine is the most effective way to combat the disease. “Unless you force people to get it, penetration is low,” said Cosette Wheeler of the University of New Mexico, who conducted clinical trials of the vaccine.
“It’s a wonderful thing. It’s good news all around,” said Dr. Connie L. Trimble, associate professor of gynecology and obstetrics and pathology at Johns Hopkins’ Sidney Kimmel Comprehensive Cancer Center, in Baltimore. Trimble is working on a therapeutic vaccine for people already infected with the virus.

The idea is to vaccinate girls before they ever get infected with the virus. About 15 percent of U.S. 15-year-old girls are already infected with at least one strain of HPV, said Dr. Carol Baker of the National Foundation for Infectious Disease. Cervical cancer is far more deadly in the developing world. Worldwide, it affects 470,000 women and kills 233,000 each year. Merck and some international health groups have said they are committed to making Gardasil available in the developing world, but the World Health Organization is already struggling to provide a worldwide $3.50 vaccine against five major killer diseases.

Gardasil, the vaccine blocks four types of the human papillomavirus, or HPV, two of which are believed to be responsible for 70 percent of the 15,000 cervical cancer cases cervical cancer and genital warts. It is available now, and will have to go through an official process before it becomes part of the regular immunization regimen. Girls who are not poor enough to qualify for the federal program but who do not have adequate private insurance may have difficulty obtaining Gardasil. Most states have programs to vaccinate those who fall between the health system’s cracks, but budgets are already strained.

Manufactured by Merck & Co., the vaccine is among the most expensive ever produced. A full, three-shot series costs $360. While private insurers and the federal Vaccine for Children program will cover the vast majority of girls, Claire Hannan, director of the Association of Immunization Managers, said there are still thousands who fall between the cracks. They include those whose insurance plans don’t cover vaccines or have high deductibles. The federal program also does not cover women above age 18. To provide the vaccine to everyone who should get it, the states would have to pay for those who cannot afford it.

The approval could make for blockbuster sales for Merck, with some analysts predicting annual sales of more than $3 billion within the next few years. “Merck has already been shipping Gardasil since its approval. We model Gardasil sales of $3.2 billion in 2010,” said Dr. Tim Anderson, Senior Pharmaceutical Analyst at Prudential Equity Group. “I think this is going to be a great cancer prevention tool but it is not going to be effective for about 10 years,” said Baker.
After the first of the $120 shots is given, the patient waits two months for the second shot and then gets the third at six months. No one knows how long the $360 immunization effort is effective, but clinical trials suggest that protection remains in place after four years.

Some health officials had girded themselves for arguments from religious conservatives and others that vaccinating youngsters against the sexually transmitted virus might make them more likely to have sex. But the controversy never materialized in the panel’s public meetings.
Merck officials said that in the past 18 months they met with several conservative and religious groups to educate them about the vaccine and the illnesses it is designed to prevent.

Earlier this year, the Family Research Council, a conservative group, did not speak out against giving the HPV shot to young girls, they mainly opposes making it one of the vaccines required before youngsters can enroll in school, said the group’s policy analyst, Moira Gaul.
Another organization, Colorado-based Focus on the Family, was even stronger in voicing fears that states would require schoolchildren to get HPV shots.

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• Recomendation of cervical cancer