Vaccine for Cancer-Causing Virus Could Spark Controversy -- GOPUSA

Vaccine for Cancer-Causing Virus Could Spark Controversy
By Patrick Goodenough
CNSNews.com International Editor
April 28, 2005

(CNSNews.com) -- A newly developed vaccine for a virus linked to cervical cancer is likely to be widely welcomed as a crucial tool in the war against the killer disease - but also looks set to trigger a new ethical debate.

Manufacturers of the vaccine for the human papilloma virus (HPV) say that in order to be effective, it must be taken before girls become sexually active, and so should be given to pre-teens.

HPV is a common sexually transmitted infection, which has multiple types, including types that are the leading cause of cervical cancer.

Health authorities say it's the second most common cancer in women after breast cancer, and in developing countries, more women of reproductive age die from cervical cancer -- about 250,000 a year -- than from any other form.

Although deaths in the U.S. are dropping each year as Pap smears become more routine, the American Cancer Society estimates that 3,710 women in America will die of cervical cancer in 2005.

Drug makers Merck and GlaxoSmithKline (GSK) are both testing vaccines -- tradenamed Gardasil and Cervarix respectively - and successful small-scale trials have been reported.

GSK's product has been shown to protect against the two types of HPV mostly responsible for cervical cancer, while Merck's aims to protect against those two types, plus another two that are responsible for genital warts.

Earlier this month the medical journal The Lancet Oncology reported that a small-scale trial of Merck's vaccine found it had cut infection rates for cervical cancer and genital warts by 90 percent.

Both vaccines are now being tested in larger, final-stage trials, ahead of applications for approval in the U.S. and elsewhere. Analysts predict substantial profits for the drug giants.

Research at the Indiana University School of Medicine, reported in The Journal of Infectious Diseases last January, found that four out of five sexually active adolescent girls were infected with HPV -- a higher rate than previously reported.

Because HPV is sexually transmitted, to be effective it needs to be given before exposure to the virus - that is, before sexual activity begins.

How parents are likely to respond to the idea of vaccinating young daughters for a sexually transmitted virus remains to be seen.

Medical College of Georgia researchers last year examined the issue, and found that 24 percent of 575 parents of 10-15-year-olds were opposed to the idea.

However, a brief educational program helped to change the attitude of some, the researchers said. Having learned more about the about HPV and cancer risks, 37 percent of the initially-opposed parents opted for the vaccine for their children.

"We were concerned that parents may worry about vaccinating their children because it could be viewed as condoning sexual activity at an earlier age," Dr. Daron G. Ferris, director of the college's Gynecologic Cancer Prevention Center, said in a statement at the time. "Our study showed that this is not the case."

Once the HPV vaccines receive approval, however, the issue could heat up.

Abstinence

HPV has already long been the subject of controversy, as part of broader debates around sexually transmitted infections, promotion of condom use and sexual abstinence.

Early last year, conservative groups supportive of abstinence welcomed a statement by the Centers for Disease Control and Prevention that "the surest way to avoid transmission of sexually transmitted diseases, including HPV, is to refrain from genital contact."

The CDC also said that "the use of condoms should not be a substitute for routine screening with Pap tests to detect and prevent cervical cancer."

"The only 100 percent sure [HPV infection] prevention is sexual abstinence until one enters a mutually monogamous marriage with an uninfected person," Concerned Women for America said in a statement last February. "Sex outside of marriage brings many health risks, including high-risk types of HPV."

Asked this week about the HPV vaccine, Scott Phelps of the Abstinence and Marriage Education Partnership cited a recent letter in which he raised concerns about giving the vaccine to youngsters.

"We're all for preventing cancer, but is this really the way to do it - by shooting this stuff into our kids?" he asked.

"What are the side effects in these young children? And are they told what the vaccine is for? I'd be interested to listen in on that discussion."

Phelps said issues like the HPV vaccine were a reminder that "we do what we do [that is, promote abstinence] so that these types of 'solutions' will not be necessary."

Leslee Unruh, president of the Abstinence Clearinghouse, said in an article on the group's website that the money spent on developing the vaccines and which parents would have to pay for it "would be much safer spent on abstinence education."

New Scientist magazine recently quoted Bridget Maher of the Family Research Council as voicing concern about giving the vaccine to young girls.

"Abstinence is the best way to prevent HPV," she said. "Giving the HPV vaccine to young women could be potentially harmful, because they may see it as a license to engage in premarital sex."

No clear link seen

Asked for the views of America's largest faith-based physicians' body, Christian Medical and Dental Associations associate executive director Dr. Gene Rudd said this week that unless currently unknown medical risk/benefit problems arose, he would not oppose an HPV vaccine and doubted many of his Christian colleagues would either.

"Rather, I would welcome a development that would greatly reduce the disease and death caused by HPV," said Rudd, an Ob/Gyn physician.

"While we should be concerned about healthcare decision-making that could encourage poor sexual choices, I do not see a clear linkage between the decision to accept this vaccine for a six year-old child, or even age 12, and subsequent sexual decisions," he added. "The vaccine decision will likely be made by the parent."

Rudd also pointed out the risk of marrying a spouse who was already infected.

"Even parents who teach and expect their child to be virtuous should allow for the possibility that their child might someday marry a person who had previously acquired HPV," he said. "We would want protection in that circumstance."