Gardasil Vaccine- Is it right for you??

I have been asked by many patients about the Gardasil vaccine from Merck, so here goes.

Gardasil is a vaccine that has been recommended for females starting at age 12 to protect against certain strains of HPV (human papilloma virus) that if infected, can lead to a higher risk of cervical cancer. Gardasil is the first HPV vaccine to be released in the United States and has been actively and aggressively marketed by Merck. In fact , Merck has been lobbying many state legislatures to make their vaccine a MANDATORY requirement for school.

The vaccine works by getting the body to produce antibodies to certain select strains of HPV, thereby preventing the actual virus infection which could lead to cervical cancer. In theory, that is just what the vaccine could do. In reality, we do not know what will happen. My hope is that the vaccine will work as advertised, but as has happened in the past with vaccines, we find out other effects many years later.

I have attached a few links to this newsletter.

1) From Good Morning America-

http://abcnews.go.com/Health/story?id=5620282&page=1

2) From the New England Journal of Medicine-

http://content.nejm.org/cgi/content/full/359/8/821

3) Also form the New England Journal of Medicine-
http://content.nejm.org/cgi/content/full/359/8/861

4) Gardasil website from Merck

http://www.gardasil.com/

What I find interesting from the second link is the discussion of cost effectiveness as a population instead of the effectiveness in an individual. This happens to be a pet peeve of mine. When I am in a room with a patient, I do not think of how treating this patient will affect the population. I am solely considering my individual patient's health and the most cost effective.

It seems that our government and insurance plans are more worried about overall costs than about individual's health. That is just plain and simple wrong and it is not how I practice.

But getting back to Gardasil. My hope is that the vaccine is proven effective long term. Preventing cervical cancer would rank up there with eradicating polio and measles. However the data proving Gardasil's effectiveness is a long way away. I am also waiting for more safety data before I recommend the vaccine. I will, however, administer the vaccine if you believe it is warranted for your own personal or individual needs. Just please refer to more than just the data given by Merck, as their financial interests and your individual health interests may not be compatible.

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness

For past issues of the newsletter please click here.

8-26-08 ADDENDUM TO ABOVE:

The following is a link to a Judicial Watch report on the Gardasil-FDA Approval process.
http://www.judicialwatch.org/documents/2008/JWReportFDAhpvVaccineRecords.pdf