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DH awards contract for HPV vaccine

The contract to provide the vaccine against HPV (human papillomavirus), was today awarded by the Department of Health to pharmaceutical company GlaxoSmithKline for their vaccine "Cervarix".

An adjudication was carried out to carefully examine the vaccines offered against a wide range of criteria such as their scientific qualities and cost-effectiveness. Cervarix won over its main rival, Gardasil, manufactured by Sanofi Pasteur MSD.

The contract is to supply the vaccine that protects against cervical cancer and precancerous cell changes in the cervix caused by HPV viruses. Cervarix guards against the two strains of the HPV virus which cause 70% of cases of cervical cancer, the second most common cancer in women worldwide.

The vaccine will be made available to girls aged 12-13 years old from September of this year and from September 2009 the vaccine will also be delivered to girls up to 18 years in a two year catch-up programme.

Health Minister Dawn Primarolo said: "This vaccine could save the lives of 400 women a year. It is a an exciting opportunity to immunise young girls against the future risk of cancer, the impact of which will be felt by women and their families for generations to come."

The Joint Commitee on Vaccination and Immunisation (JCVI) which provides independent expert advice to ministers on vaccination, examined a wide range of evidence before recommending in June 2007 that a HPV vaccination programme be routinely introduced for 12-13 year old girls. The vaccination programme also has support from Cancer Research UK and the cervical cancer charity Jo's Trust.

According to a government press release the cost of the vaccine is commercially confidential. It will be purchased by the Department of Health who will supply it free of charge to the NHS. The Department of Health will provide an additional £8.9m to PCTs - just over £55k for an average sized PCT - to support the implementation of the programme. This funding will pay for, for example, nurses to give the vaccine.

However, this decision hasn't been universally welcomed. The manufacturer of Gardasil, which protects against four strains of the HPV virus, has warned that the decision made by the UK authorities choosing a two-type HPV vaccine for their immunisation campaign over their four-type vaccine, will be selling UK school girls short.

"We regret that school girls in the UK, unlike most of their peers in Western Europe, the USA, Australia, New Zealand and Canada, will not benefit from the unmatched cervical cancer protection and additional benefits provided by the world's leading HPV vaccine, Gardasil", commented Dr Nicholas Kitchin, UK Medical Director of Sanofi Pasteur MSD.

This was echoed by Lisa Power, Head of Policy at Terrence Higgins Trust, who said: "While we welcome any advance at all we are very disappointed at the short-sightedness of this decision. By failing to choose the vaccine with the widest coverage, the Department of Health is condemning Britons to a further increase in genital warts and other cancers which could have been prevented.

"They are saving pennies to spend pounds later. Most European countries have taken the sensible decision to protect their population from both cervical cancer and genital warts simultaneously, but it seems that the UK is fated to be not just the poor man of Europe, but also the warty one."

Do you think the Department of Health has made the right decision? Your comments:
(Terms and conditions apply)

"I think the Gardasil vaccine is surely the best option. It covers more strains of the cervical cancer virus. So once again the DH has got it wrong. I will def be paying for this privately for my girlfriend." - Vincent, Kent

"Re cervarix vaccine versus gardasil; how do we rationalise our decision to give cervarix when a patient/parent asks for gardasil as they are aware gardasil offers protection from genital warts? This is bound to happen at some point in the campaign. Patients are far more informed/educated than officals realise" - Catherine Farnworth, Cheshire

"Yes. Having seen the Cervarix clinical material the level of protection Cervarix offers for girls against cervical cancer is much better than Gardisil. This decision seems to have covered the long term because let's remember, these vaccines are prophylactic and as such need to provide protection for a long time. Cervarix offers the highest levels of antibodies that have been maintained for the longest period of time. I certainly want to make sure my daughters are well protected against cervical cancer because this is the condition that could kill them. For me
Cervarix is the vaccine that offers the best protection against cervical cancer." - Jim, Scotland

"NO... and I have yet to read a clear reason for the choice. The only conclusion must be on a pure cost basis. I'm glad to see so many of you appreciate the misery caused by genital warts, and just to correct Kate in Kent, of course ALL strains of HPV are spread by sexual contact - does she suggest that genital warts are somehow deserved but cervical cancer is not? What a dismal wasted opportunity to protect our children from both warts and cervical cancer." - Sue, High Wycombe

"I am a school health adviser and am directly involved in this campaign. As the aim of this vaccine is to prevent cervical cancer I am in favour of Cervarix. From the up-to-date research received we have been told that there is no price difference between the two vaccines and that Cervarix is more effective against cervical cancer in the long term." - Lynne Jones, Chester

"I am amazed that the government has bypassed Gardasil for Cervarix. It's total madness, yet again this country is going for second best. What was the reason for the choice?" - Linda Barnes, Birmingham

"Once again, the government has got it wrong - it might be for cancer prevention but if saving some people misery and heart ache can be achieved at the same time - why not? I will encourage my children to ensure their daughters are given Gardasil; obviously it will have to be done privately because of the poor decision this government has made. Also, where do we stand morally, knowing we are, as nurses, giving an intervention when we know there is a better one out there?" - Teresa, Essex

"Yet again the DH has gone for the lowest bidder. Have no lessons been learnt by this government? I for one have paid for my daughter to have the Gardasil vaccine. Why prevent two strains when four can be prevented?" - Jackie Davies, The Midlands

"No - as always the DH has not looked long term. Having two daughters, one who will have the injenction next year, I feel strongly that she is NOT getting full coverage." - Jean, Cumbria

"No. First, why not cover four types instead of two? Sexual health goes hand in hand with cervical cancer and especially as we are not yet vaccinating boys. Second, you can't interchange vaccines so someone started on Gardasil can't finish the course with Cervarix and vice versa, and as a practice we have already started vaccinating girls who will just miss out on the programme with Gardasil." - Mandy, London

"No. If you can protect against four strains why use the one that protects against only two?" - Maria McAleenan, NI

"While I appreciate that the added two strains of HPV in Gardasil only affect a very small percentage of women or girls, I think that if you are one of these women the impact on your individual life can be just as devastating. I think this is a short-sighted move by the government." - Hazel, Glasgow

"No. While immunising girls against cervical cancer, the main aim of the campaign, we could also have given this extra benefit and saved the NHS the future cost of treating genital warts. I think an opportunity has been missed to protect future generations against the misery of genital warts." - Wendy Hall, Solihull

"Both the vaccines cost the same to manufacture, so why choose one with less coverage? Under the Freedom of Information Act I cannot understand why the government cannot justify its contractual reasoning (it's our taxpayers' money) to choose Cervarix over a vaccine tried and tested in other countries. Are our young people getting an inferior deal?" - Jackie, Perth, Scotland

"No. It is an inferior vaccine offering less protection and there is far less data to show that it is effective. The DH is driven purely by price." - Erica, Slough

"No - why is a sexually transmitted problem not worth  preventing? What about the cost of treating genital warts, which are a common problem that are often distressing for those who get them. You do not have to be promiscuous to catch them." -  Helen, Essex

"No. I would prefer my child to have four in one." - Sharon Norbury, Canterbury Surgery

"Yes. How do you know that Cervarix offered is cheaper than Gardasil? The aim is cancer prevention, not genital wart prevention." - John, Sunderland

"Yes. The aim is NOT to prevent sexually transmitted warts but to prevent cervical cancer. This sounds like sour grapes from the manufacturers of Gardasil." - Kate, Kent

"I think it is appalling that the DH has gone for the less coverage, cheaper option of Cervarix instead of the four-in-one Gardasil HPV vaccine. I would want my daughter to be protected by Gardasil as stated. The DH is saving pennies without thinking of the long-term cost of treating genital warts and the morbidity of having them." - Julie Balmer, Wigan