Cervical cancer vaccination not ready until 2010


IT MAY be 2010 before a full cervical cancer vaccination programme will be available to women in the Republic, due to a combination of budgetary constraints and information technology problems in the health service, it has emerged.

Last week Minister for Health Mary Harney said she would decide before August 15th on a firm date for the commencement of a national cervical cancer vaccination programme.

She told journalists there were two issues that would determine her final decision. "How quickly can we introduce it? And, secondly, will we have the resources to introduce it in the context of the current budgetary situation?" she said.

Ms Harney has been advised by both the National Immunisation Advisory Committee of the Royal College of Physicians in Ireland and the Health Information and Quality Authority (Hiqa) that a three-part vaccine programme should be available free to 12-year-old girls.

A Hiqa value-for-money report published in June recommended that a vaccine against the human papilloma virus (HPV) be given to 12-year-old girls along with a catch-up vaccination programme for 13-15 year olds.

Cancer of the cervix (neck of the womb) is caused by certain types of HPV, with evidence of infection found in 99 per cent of women with cervical cancer. There are two HPV vaccines approved for use: Gardasil and Cervarix. Both are active against HPV strains found in almost 70 per cent of women with cervical cancer.

The Hiqa report said the annual cost of vaccinating 12 year olds would be €9.7 million, while the catch-up programme for 13-15 year-old girls would be €29.2 million. It estimated the cost per child would be just under €400.

Sources in the health service said that, even if the go-ahead was given early next month, it would be September 2009 at the earliest before a comprehensive, school-based vaccine programme could commence.

But it is understood that ongoing delays in upgrading IT systems in the HSE means it is likely to be September 2010 before national HPV vaccination begins.

And even if the Department of Health negotiated a preferential deal with the makers of one of the two HPV vaccines - as was done by the Department of Health in the UK - Ms Harney is under financial pressure to fund other preventive health measures such as a screening programme for bowel cancer.

A vaccination programme for cervical cancer will be introduced in Northern Ireland and Britain from September.

Meanwhile, research carried out by the National Cancer Registry (NCR) has found that just one in 20 GPs has administered cervical cancer vaccine to a patient. The finding suggests that, despite the availability of the HPV vaccine, parents have decided to wait for a free vaccination programme rather than opt to pay for the immunisation.

The unpublished study of almost 900 family doctors carried out last year found that two-thirds of doctors would be happy to administer the vaccine to a sexually active girl under 16, while 56 per cent of doctors said they would immunise a sexually inactive girl under 16.

Some four in 10 family doctors would like to see HPV testing carried out alongside the taking of smear tests as part of the national cervical cancer screening which is due to begin this autumn. But researchers note "the scientific evidence of the effectiveness of HPV testing as an adjunct to smears is inconclusive".

"There is very strong demand among GPs for national guidelines on the use of HPV testing and vaccination.

"Given the complexity and rapidly changing nature of the evidence on HPV testing and vaccination, it is likely that other types of professional education initiatives may also be of value," the authors conclude.