Cervical cancer vaccine target falls short: Report

By Dr. Ananya Mandal, MDApr 19 2011

Data from the Australian federal government shows that the target to immunize 80 per cent of 12-year-old girls against cervical cancer is not being met because many of them are failing to have all three doses of the vaccine. This potentially undermines the effectiveness of the $436 million program started in 2007.

This data shows that 83 per cent of girls had the first dose of the vaccine, but only 73 per cent received all three doses. Without all three doses, experts say, girls will have less protection against the two strains of human papilloma virus known to cause 70 per cent of cervical cancers. The highest percentage of girls to take up all three doses of the vaccine was in the Australian Capital Territory (80 per cent), ahead of Victoria and the Northern Territory (76 per cent). Tasmanian girls had the lowest uptake, at 64 per cent.

The cervical cancer vaccination program was announced by the Howard government in 2006 after the ground-breaking work of former Australian of the Year Ian Frazer led to the development of the Gardasil and Cervarix vaccines that protect against HPV. The Government chose Gardasil for its free national program, and provided the vaccine to girls aged 12-13, because the vaccine is most effective if given before girls become sexually active.

According to PapScreen Victoria manager Kate Broun this data suggested that more needed to be done to close gaps in the government vaccination program introduced in 2007. She added that the figures were encouraging “'for a newly introduced vaccination program in this age group” but could indicate a lack of knowledge about the vaccine. She added, “What we're concerned about is that there is a decline after each dose. We're hearing anecdotally that people don't realize three doses are required with this vaccine. Most states and territories are falling short of the minimum 80 per cent coverage health experts say we should be aiming for if we want to see a marked reduction in cervical cancer incidence.”

Ms Broun finally urged the government to release more detailed geographical data on girls immunized under the program to enable additional interventions in areas where coverage was low. “What we want to see is the release of detailed data from each state up to 2010,” she said. “'The Australian government needs to release this information to ensure we don't see gaps in vaccine coverage developing from area to area, meaning that some girls could be missing out on this potentially life-saving vaccine because of where they live or what school they attend.”

At present under the program vaccination against the virus continues to be offered to girls in their first year of secondary school but was also offered to women aged up to 26 as part of a limited “catch-up program” for older students and through GPs from 2007 to 2009.

Ms Broun said the number of young adults vaccinated in the community was a “notable success” of the program and compared favourably with adult vaccination programs for measles, mumps and rubella, which achieved coverage of about 10 per cent. Another Victorian study published last year also showed that the number of women and girls aged under 21 with vaginal lesions that cause cervical cancer had declined since the mass vaccination program was introduced.