Low uptake of cervical cancer vaccine

Few Irish women have availed of a vaccine which protects against most cases of cervical cancer even though the vaccine has been…

Few Irish women have availed of a vaccine which protects against most cases of cervical cancer even though the vaccine has been available here since November.

Dr Shirley McQuade, medical director of Dublin Well Woman Centre, said that only three women were in the process of getting the vaccine to date through Well Woman's three Dublin clinics.

"I think uptake is low mostly because people are not aware of it," she said.

"But the cost is going to be prohibitive," she added.

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The vaccine is geared towards women aged nine to 26 and is given in three doses over six months. To receive it costs almost €600.

Dr Gráinne Flannelly, consultant obstetrician and gynaecologist at the National Maternity Hospital, said the best evidence for the vaccination working was when it was given to women before they became sexually active, that is before they become exposed to the human papilloma virus (HPV) which causes cervical cancer.

"Women exposed to the HPV virus should wait for further evidence before going out getting a loan to pay for a vaccination that may not work for them," she said.

"So the message really is in the interests of preventing cervical cancer in women who have had sex, you need to concentrate on delivering cervical smears to those women on a regular basis, ideally in the context of a national cervical cancer screening programme," she added.

Dr McQuade said many women were not even aware that HPV was a cause of cervical cancer and there needed to be education around this before people could be offered a vaccine to protect against HPV.

The vaccine has the potential to prevent up to 70 per cent of cervical cancers caused by HPV but it is not yet known how long it works for or if booster jabs will be required at a later stage.

"The people who will benefit most from it will be teenagers and the best way to deal with that cohort would be some sort of national vaccination programme through the schools because teenagers are notoriously difficult to get hold of in general practice," she said.

"I think it should be made available as a vaccination programme in schools like rubella was," she added.

She said 90 per cent of the population had to be treated for the vaccine to be really effective or to give what is called "herd immunity". Therefore a national vaccination programme was required.

"I don't think it's a medical card issue," Dr McQuade added, referring to the fact that its cost is not covered under the medical card scheme.

The Department of Health said yesterday its chief medical officer has requested the advice of the National Immunisation Advisory Committee on the potential public-health benefit and appropriate use of the vaccine.

Issues to be examined included the effectiveness and cost effectiveness of the vaccine, categories of women who should be vaccinated, immunity duration and booster requirements, it said.

Another cervical cancer vaccine called Cervarix is likely to become available later this year and its understood the department wants to see if one brand is more effective than the other before making any decision.

Around 70 women die in the Republic each year from cervical cancer.

Rates here are among the highest in Europe, which has been attributed to the absence of a national cervical screening programme.