Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, February 19, 2008

Breakthrough Vaccines

The government of Canada announced it would provide $300-million as a new pro-active health initiative, to assist the provinces in providing for the free administration of the new drug Gardasil in schools, to teen-age girls. Seems very forward-looking and enterprising, looking after the health of young women, to prevent cervical cancer, a truly deadly, sexually-transmitted disease.

When such initiatives are announced, with a wide coverage such as this represented, the acceptance rate among the target group is generally in the 80% range, according to Dr. Ian Gemmill, medical officer of health for the Kingston, Ontario region. Ontario was the first province to take advantage of the federal government offer, and began administering Gardasil in schools, targeting girls before they would be expected to become sexually active.

Figures just released appear as a questionable value judgement on the part of parents, unwilling to permit their grade 8 daughters to accept the vaccine. Approximately 53% across the board were given the first of the required three injections of Gardasil. The vaccine has been accepted as fully effective in the prevention of four strains of HPV (human papilloma virus).

Two of these strains are the causative of fully 70% of cervical cancer cases, of which 1,300 new cases present each year, resulting in approximately 400 deaths in the province. The drug has been celebrated as a highly effective treatment, although no one appears to know whether there will be side effects surfacing in the future, nor for how long the drug remains effective.

The immunization program has been received in some quarters with a big question mark, with an epidemiologist at McGill University raising an alarm over what is not known about the vaccine. Writing in the Canadian Medical Association Journal, warning that such a universal program is premature, given that there is always the possibility of unintended results.

We've seen more than ample "unintended deleterious results" to peoples' health when further research into efficacy as opposed to side-effects has resulted in side-effects sometimes more gravely injurious to health than the original condition that drugs were being used to control. At which time new findings are published, government agencies take a second look, and withdraw their seals of approval.

A good case in point was the 1950s - 1960s use of the drug Thalidomide, prescribed to combat nausea in pregnant women. The drug, synthesized by Chemie Grunenthal of Germany, and in use in 46 countries world-wide, turned out not to be the harmless sedative it was presumed to be. Thalidomide turned out to be the horror drug of the century, its use causing dreadful deformities in thousands of babies around the world.

Pharmaceutical companies aggressively encourage the use of their new products. They vouch for the safety of their use, having put their drugs through experimental testing and monitoring the results to ensure efficacy and safety. It's also very true that those same pharmaceutical companies take great care to suppress research results proving inimical to their cause, publishing only those results that enable them to extol the virtues of their products.

All manner of drugs have been removed from use after aggressive marketing has successfully seen them certified by trusting governments, allowing them to be placed them on the market. And when anecdotal evidence eventually thrusts itself into public awareness, causing independent researchers to take a second look, the pharmaceutical companies take on a strenuous self-defence, still claiming the effectiveness of their product.

It doesn't seem all that difficult to get a lot of doctors on board, accepting the use of medications and clamouring for their use. When menopausal women were urged to use hormone replacement therapy, with family physicians, gynaecologists and other specialists attesting to its value as a deterrent against bone loss and strokes, let alone its purported value in expunging all those uncomfortable hormonal-imbalance indicators like hot flashes, women acceded to their professional acumen.

We all know where that led, and how medically questionable the use of HRT protocol is today. For one lone dissenting voice in the field of medicine, the counterbalance of hundreds of expert opinions weighing in on the need for and efficacy of Gardasil resulting in a slight majority of acceptance against the questioning remainder, we have a result that has seen half of the target group inoculated, the remainder not.

Despite the raised voices of approval by infectious disease and paediatric specialists, there are critics who quietly state their apprehension with respect to the haste with which the process for the administration of the vaccine has been approved, a trifle unsettling. Unsettling also is the fact that many of the scientists clamouring for the unquestioning use of Gardasil have received consulting fees from the manufacturers, Merck and Glaxo.

What is important now, given the message of a 50% acceptance rate, is that further research into the vaccine's long-term safety of use, a better understanding of its efficacy longevity, potential side-effects, and more practical education elucidating both, be given to the parents of girls in Ontario.

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