Drugs, sex, money and power: An HPV vaccine case study

Abstract

In this paper we compare the experiences of seven industrialized countries in considering approval and introduction of the world's first cervical cancer-preventing vaccine. Based on case studies, articles from public agencies, professional journals and newspapers we analyse the public debate about the vaccine, examine positions of stakeholder groups and their influence on the course and outcome of this policy process. The analysis shows that the countries considered here approved the vaccine and established related immunization programs exceptionally quickly even though there still exist many uncertainties as to the vaccine's long-term effectiveness, cost-effectiveness and safety. Some countries even bypassed established decision-making processes. The voice of special interest groups has been prominent in all countries, drawing on societal values and fears of the public. Even though positions differed among countries, all seven decided to publicly fund the vaccine, illustrating a widespread convergence of interests. It is important that decision-makers adhere to transparent and robust guidelines in making funding decisions in the future to avoid capture by vested interests and potentially negative effects on access and equity.

The Early Benefits of Human Papillomavirus Vaccination on Cervical Dysplasia and Anogenital Warts

“…[3][4][5] As randomized controlled trials of the vaccine showed it to be highly efficacious in preventing vaccine-type-specific precancerous cervical lesions and AGW, 6,7 the vaccine received a great deal of attention from the scientific and medical communities, as well as from the general public. 8 Currently, the qHPV vaccine is available in .100 countries, many of which also have national qHPV immunization programs. 9 These programs are generally aimed at immunizing young girls before the onset of sexual activity when the possibility of previous HPV infection is low (eg, ages 9-13 years).…”

Controversy Undermines Support For State Mandates On The Human Papillomavirus Vaccine

“…1 Medical professionals, public health experts, politicians, and parents disagreed about the merits of legislative mandates concerning the HPV vaccine. 2,3 Although many in the medical community supported the vaccine for its protective potential, other groups and parents criticized the mandates. Some opposed immunizing preteen girls against a sexually transmitted disease or believed that the vaccine would encourage sexual promiscuity.…”

Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study

“…[2][3][4] As one of the first cancer-preventing vaccines, this vaccine received expedited approval in several countries and was the subject of intensive marketing, lobbying and public health campaigns around the world. 5 By 2012, it had been approved in almost 100 countries, many of which also implemented nationwide HPV vaccination programs aimed primarily at immunizing young girls before the onset of sexual activity. 6 Despite the popularity of large-scale immunization programs, HPV vaccination has faced a great deal of controversy regarding unanswered questions about the real-world effects of this vaccine.…”