New Hampshire to provide Gardasil at no cost to girls

New Hampshire Department of Health and Human Services officials on Wednesday announced plans to become the first state to provide Merck's human papillomavirus vaccine Gardasil at no cost to girls ages 11 to 18 as part of a state program that offers immunizations to minors, the AP/Nashua Telegraph reports (Love, AP/Nashua Telegraph, 11/30).

FDA in July approved Gardasil for sale and marketing to girls and women ages nine to 26.

According to Merck, the vaccine -- which is given in three injections over six months and costs $360 -- in clinical trials has been shown to be 100% effective in preventing HPV infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, in women who do not already have the virus, and it is about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases.

Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in June at a meeting of the American Society of Clinical Oncology in Atlanta (Kaiser Daily Women's Health Policy Report, 11/2).

New Hampshire's program, which is funded by the federal government and private insurers, has budgeted $4.8 million for Gardasil and is scheduled to begin immunizations next month (AP/Nashua Telegraph, 11/30).

Insurance companies will pay about $3.6 million, or 75% of the estimated cost of the program. State health officials said that vaccinating every girl will be difficult, particularly because of the three-dose requirement, New Hampshire Public Radio's "NHPR News" reports.

The state health department estimates that about 17,000 girls will receive Gardasil next year, which is about 25% of those eligible.

Although CDC's Advisory Committee on Immunization Practices has recommended that women up to age 26 receive Gardasil, women older than 18 are not eligible for the New Hampshire program, Michael Dumand of the state Immunization Program said.

Alina Salganicoff of the Kaiser Family Foundation said those women should not be overlooked, adding, "[T]his is the group of women that are most likely to be uninsured, to be low-income, and there aren't any public sources of financing to pay for the vaccine" (Gorenstein, "NHPR News," New Hampshire Public Radio, 11/29).

A transcript and audio of the New Hampshire Public Radio segment are available online.