Considerations regarding the proposed keypoint 5 (HPV vaccine)

Keypoint 5 for consideration: “Include HPV vaccination in registration” (see topic).

“Regarding the potential impact of HPV vaccination on cancer incidence and mortality, perhaps one of the important issues to consider is whether the reporting of vaccinated people should be mandatory and should be linked with the cervical screening registers”. 

The following article was published recently (1st Oct. 2007):

A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program.
S Kulasingam, L Connelly, E Conway, JS Hocking, E Myers, DG Regan, D Roder, J Ross, and G Wain, Sex Health. 2007; 4: 165. [MEDLINE Citation]

From the title and the abstract it is obvious that (at least) in Australia there were considerations to add the HPV-vaccine to the national cervical cancer screening program.

In my opinion the HPV-vaccination is a serious subject to discuss since it may have a great economic burden either to the social security systems or to the individual citizens.

Currently, there are many who strongly support the HPV-vaccination and others who examine its cost-effectiveness. However, personally I think that this matter should be considered carefully since “a strategy being cost-effective does not mean that the strategy saves money, and just because a strategy saves money doesn’t mean that it is cost-effective” (American College of Physicians: “Primer on Cost-Effectiveness Analysis”, Effective Clinical Practice, September/October 2000; see link: http://www.acponline.org/journals/ecp/sepoct00/primer.htm).

Nevertheless, I think that the registration of the vaccinated cases is a necessity since it will allow follow-up and population comparisons in the long run.

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Regarding the above views (expressed before the EUROCHIP meeting in Varenna in October 18th, 2007), the following articles quoted:

1. quote: “Long-term follow-up studies are planned through the Nordic cancer registries to assess duration of HPV protection” in Correlating immunity with protection for HPV infection, I Frazer, Int J Infect Dis. 2007; 11 Suppl 2: S10. [MEDLINE Citation]

2. quote: “Nordic cancer registries are providing ongoing long-term pharmacovigilance” in Overview of the clinical development and results of a quadrivalent HPV (types 6, 11, 16, 18) vaccine“, LL Villa, Int J Infect Dis. 2007; 11 Suppl 2: S17. [MEDLINE Citation]

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