MB Civic

By Wendy Everett  |  June 13, 2006  |  The Boston Globe

LAST YEAR was the 50th anniversary of the polio vaccine — a vaccine so powerful that it has all but eradicated the disease for millions of Americans. The same thing could be done for cervical cancer.

Last week, the Food and Drug Administration approved a new vaccine that prevents cervical cancer — an enormous advance in the war on cancer and for women worldwide. However, the approval is only a first step. In order to save the lives of thousands of women, we must face the challenges of a beleaguered system for financing and disseminating vaccines and find new ways to ensure their adoption.

Vaccines are one of the greatest public health achievements. The threats posed by smallpox, polio, or typhoid are nearly nonexistent in the developed world. Vaccines ensure that each one of us lives a longer and healthier life.

Unfortunately, that success has bred complacency. The more effective vaccines have become in eradicating diseases, the less Americans have come to appreciate their value and importance to their health.

Over the past three decades, declining financial incentives and increasing costs of producing safe and effective vaccines have reduced the number of companies engaged in the development of vaccines from 25 to five. There needs to be ways of supporting, not suppressing, the quest to develop life-saving vaccines.

Despite the fact that vaccines are among the most cost-effective public health interventions, there is not equal access for everyone. The Institute of Medicine recently stated that the fragmented healthcare payment model has created increasing disparities in access to vaccines. State and federal budget cuts have only made this problem worse. There needs to be a more equitable system of paying for vaccines, so that everyone can get these important drugs.

Today, one child in five does not receive the full set of recommended vaccinations. The numbers are worse for adolescents. The current healthcare system is not set up to provide regular preventive care and immunizations for these young adults. Immunization at all ages needs to be a high priority. Systems and tools to support that goal must be developed.

With Thursday’s FDA approval of the first vaccine for the prevention of cervical cancer, there is an opportunity to celebrate the power of vaccines and to repair the broken health care system. Doing so will ensure that young women have access to this lifesaving innovation.

It cannot begin soon enough. Most cervical cancers are caused by the human papillomavirus, a common virus that results in a costly disease. A staggering 80 percent of all women have had the virus at one time. The financial toll is estimated at $6 billion a year. The vaccine has shown, in clinical trials, to be 100 percent effective in preventing the specific strains of the virus, which causes 70 percent of cervical cancers.

The New England Healthcare Institute recently convened a panel of specialists to create a road map to adoption of the HPV vaccine. In addition to providing incentives for vaccine discovery and development, the panel made three recommendations.

First, to extend this vaccine to all young women, regardless of their socioeconomic status, race, or insurance coverage, public and private financing needs to be improved. Second, parents, adolescents, physicians, and policymakers must be engaged in educational campaigns about the importance of vaccines in general and the HPV vaccine in particular. Third, there must be faster, more efficient ways of delivering vaccines to young women, perhaps through community clinics, schools, pharmacies, and maybe even malls.

Adopting this road map may be the best shot at defeating cervical cancer.

Dr. Wendy Everett is president of the New England Healthcare Institute, a nonprofit collaborative of healthcare leaders.