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J Epidemiol Community Health 62:570-571 doi:10.1136/jech.2008.074740
  • Editorial

Human papillomavirus (HPV) vaccination and the development of public policies

  1. Abby Lippman
  1. McGill University, Montreal, Quebec, Canada
  1. Professor A Lippman, McGill University, Montreal, Quebec, Canada; abby.lippman{at}mcgill.ca
  • Accepted 4 February 2008

Through heavy, profit-driven marketing, cervical cancer has been (re)constructed in the past couple of years in North America almost solely as an independent vaccine-preventable disease. With the heady mix of young girls and their sexual behaviour as background, and an open-ended advertising budget providing memorable catch-phrases,1 the powerful major story-tellers (pharmaceutical companies, physicians and their organisations, the media) have constructed a gripping story comprising a feared disease (cancer), a unique product (the human papillomavirus (HPV) vaccine, Gardasili) to address it, and hyped promises of prevention. This presentation has all too often silenced, or at least marginalised, other ways of talking about cervical cancer (and HPV infection), at the same time arousing controversies, confusions and conundrums in the minds of many.

In July 2006, the Canadian regulator for vaccines officially approved Merck’s HPV vaccine, Gardasil. In February 2007, NACI (the federal National Advisory Committee on Immunizations) released its report recommending the use of the vaccine for females aged 9–13. Immediately thereafter, in March 2007, the federal government announced in the budget speech an allocation of CDN$300 million for the express purpose of purchasing Gardasil to immunise young girls.

This hastily made decision parallels the Gardasil phenomenon in the USA, which has been characterised by a headlong rush to establish mandatory vaccination programmes for as many young girls as possible, as quickly as possible. Western European countries have been more leisurely, although many have already adopted some vaccination policy. Interestingly, Australia only did so after negotiating down the price and getting assurances that costs would be covered if a booster were ever to be needed.2

But while the question could be asked in both Canada and the USA “why the hurry?” – especially when there is no epidemic of infection and the mortality rates from cervical cancer have been …

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