Vaccine OK for preteens, panel says

ATLANTA — Preteen girls should be given a new vaccine to prevent the most common cause of cervical cancer, a panel of experts said here Thursday at the Centers for Disease Control and Prevention.

The Advisory Committee on Immunization Practices, which advises the CDC on vaccine policy, voted unanimously to recommend that all 11- and 12-year old girls be immunized to prevent infection with human papillomavirus, or HPV. The vaccine is given by injection in three doses over six months.

The committee said the vaccine series can be given to girls as young as 9 years old, at the doctor's discretion.

"We're trying to provide the vaccine to girls before the onset of sexual activity," said Anne Schuchat, director of the CDC's National Center for Immunizations and Respiratory Diseases. She called the recommendation a "huge breakthrough for women's health and cancer prevention."

The ACIP designated it for 11- and 12-year-olds to coincide with other vaccines recommended for that age group, but also recommended that females 13-26 be immunized.

Some conservative groups have expressed concern that the vaccine might be required by state health departments for admission to schools, but that topic was not raised by committee members. "I don't know of any state considering (requiring) it at this time," said William Schaffner of Vanderbilt University School of Medicine, a liaison to the ACIP for the National Foundation for Infectious Diseases. He said decisions on school entry requirements are made by state health departments.

The vaccine, Merck's Gardasil, won approval by the Food and Drug Administration on June 8 and is licensed for girls and women 9 to 26 years old. It is given in three doses over six months, at a retail cost of $120 per dose, making it one of the most expensive vaccines recommended for children.

It is likely to be covered by insurance, Schuchat said, and will be added to a list of vaccines provided at government expense to uninsured or underinsured children under the Vaccines for Children program. Merck is negotiating with CDC on a reduced price for the VFC program, she says.

Getting preteens into a doctor's office three times in six months may be a challenge, but it's doable, says adolescent medicine specialist Amy Middleman of Baylor College of Medicine. "It is not always easy, but we think this vaccine is so exciting that it will draw teenagers in," and lead to wider discussions of risk-prevention, says Middleman, a liason to the ACIP for the Society for Adolescent Medicine.

The vaccine targets four types of HPV that cause 70 percent of cervical cancer and 90 percent of genital warts. HPV is the most common sexually transmitted infection in the nation, infecting 6.2 million each year, says the CDC.