Ministry's $177m vaccine gamble

OPINION: The Gardasil programme's not going too well, is it?

This is the anti-HPV vaccine that everyone got so excited about because of its potential to stop cervical cancer before it starts. No wonder people got excited cancer's a pig of a disease and this was one of the first vaccines that looked effective against it in trials involving about 20,000 young women.

So it's interesting that the uptake of the programme is so small, so far. The Ministry of Health's aim is to have 95 per cent of Year 8s vaccinated each year from 2011 on. It's spending $177 million to try and achieve this, and an ongoing $16m a year to maintain the routine.

It's a laudable aim after all, vaccination only provides population benefits if most of the population is covered.

But so far, in 2009, most of the way through the first round of vaccinations, only 14 per cent of eligible schoolgirls in MidCentral Health district have taken up the shot. Nationally, so far, the figure is worse only 8 per cent. Nobody knows yet if the Ministry of Health will hit its 95 per cent target, and therefore whether the money will be well spent.

It's all somewhat doubtful. Vaccination isn't a magic bullet and there's been all sorts of informed-choice parental backlash against vaccine programmes in the past two decades, even against long-running and well-proven vaccines against baby-killer diseases such as polio, diphtheria and measles.

Gardasil is particularly fraught. Many parents of 12-year-old girls the youngest of the school-based target groups for the most part haven't got to grips with the necessity of their little girls needing a vaccine to protect them against a cancer that is sexually transmitted. I'll repeat, most mums and dads think 12-year-olds are still little girls no matter what their height, shoe size or stage of reproductive maturation.

Lots of families, for very good reasons, choose not to hold the safe-sex conversation with their daughters until they are older and closer to an age when it is relevant.

But the 12-years age was chosen to protect girls who start sex earlier than the age of consent and are vulnerable. There's no point pretending it doesn't happen, because it does so the ministry's approach could be called pragmatic, at least.

What has upset some health commentators and parents is the way the ministry has marketed and handled the Gardasil programme. The Manawatu Standard recently reported concerns about consent issues and a lack of good information about what the vaccine really does. Information packs sent to parents, through schools, were skimpy, and a DVD shown to the girls was subsequently withdrawn by the ministry, because it didn't cover all the issues properly.

Women's Health Action policy analyst Christy Parker blames the slow uptake of the vaccine on this bad marketing, saying it created distrust among parents.

So are we wasting $177m? Only time will tell.

- © Fairfax NZ News