CONCERN HAS been expressed about the decision of Minister for Health, Mary Harney, not to implement in full a comprehensive immunisation programme against the virus which causes cancer of the cervix in women. DR MUIRIS HOUSTON, Medical Correspondent reports
The Minister announced yesterday she has asked the Health Service Executive (HSE) to prepare a plan for the introduction of a human papillomavirus (HPV) vaccination programme for 12-year-old girls to commence in September 2009. The vaccine will be given free in primary schools to 12-year-old girls. A complete course will require three injections given over a six-month period.
However, Ms Harney has decided for budgetary reasons not to implement a once-off vaccine programme for 13 to 15 year olds, as an expert group had advised her to do. Parents here who elect to vaccinate their older daughters privately now face costs in the region of €600.
The health technology assessment of HPV vaccine carried out for the Heath Information and Quality Authority (HIQA) published in June recommended that a catch-up programme be offered to 13 to 15 year olds at a once-off cost of €30 million.
Health ministers in Britain and Northern Ireland, where a free vaccine programme begins next month, will implement a catch-up programme for girls up to the age of 18.
A number of medical sources have also expressed concern at the conditional nature of the Minister's statement. Ms Harney made it clear the preventive programme would only go ahead if the HSE produced a plan that was cost-effective and one that would guarantee an 80 per cent uptake among 12 year olds.
"I intend to seek Government approval for the programme and for the required funding in the autumn, based on the implementation of a plan that can be shown to be cost-effective, in terms of delivery costs and uptake rates," she said.
The annual cost of HPV vaccination for 12-year-old girls is €9.7 million, according to the report prepared for HIQA. But the Minister said yesterday she expected the HSE to engage in "negotiated dialogue" with the manufacturers of Gardasil and Cervarix, the two commercially licensed HPV vaccines, with a view to obtaining cheaper vaccine to reduce the overall cost of the programme.
Medical sources said last night that achieving an 80 per cent uptake when three individual vaccinations are involved would be challenging. Possible parental objection, on religious or ethical grounds, would also make it difficult to achieve a high uptake, at least initially, they said.
Fine Gael health spokesman Dr James Reilly gave a cautious welcome to Ms Harney's plan. But he said he was concerned about the decision not to have a catch-up scheme for 13 to 15 year olds.
The commencement of cervical cancer vaccination was welcomed by the Irish Cancer Society. However it, too, expressed disappointment the programme will be confined to 12 year olds. It said a programme for girls up to 15 "would increase the number of cancers prevented by a potential factor of 13.8 per cent and would therefore speed up the positive impact of such a programme". The Irish Family Planning Association also welcomed Ms Harney's announcement.