Uptake of HPV vaccines must increase to reap rewards

There was positive news in the field of cancer vaccines this week. Merck & Co announced that its nine-valent human papillomavirus (HPV) vaccine V503 provides broader protection against HPV than its already-licensed quadrivalent HPV vaccine Gardasil. It protects against 97% of cervical, vaginal and vulvar pre-cancers caused by HPV types 31, 33, 45, 52, and 58, as well as protecting against the types covered by Gardasil (types 6, 11, 16, and 18). This efficacy study points the way for the company to eventually replace Gardasil with its new vaccine. Analysts quoted by the WSJ said annual sales could exceed $1 billion meaning this could be another blockbuster for the pharma giant. Sales from Gardasil in the last quarter were $665 million, driven by higher sales in the US as well as increasing use in boys and men aged nine to 26.

Meanwhile, GlaxoSmithKline’s HPV vaccine Cervarix, which protects against HPV types 16 and 18, could protect girls aged nine to 14 in just two doses, compared to the three dose schedule recommended for girls aged 15 to 25. A variation to the marketing authorization has been filed with the EMA, although a two-dose schedule is already approved in nine countries. A two-dose schedule will be more cost-effective for health care providers as well as offering increased convenience to practitioners and patients, and so could help increase uptake.

The US Centers for Disease Control (CDC) reports that each year in the USA an estimated 26,000 new cancers attributable to HPV occur: 18,000 among females (of which 11,500 are cervical cancer) and 8,000 among males (of which 5,900 are oropharyngeal cancers). Yet coverage in the US shows that 53% of girls aged 13-17 had received at least one dose, while 20% of boys of the same age had received at least one dose, according to data from 2012, the most recently available. This also showed that only 33.4% of girls and 6.8% of boys had received all three does in 2012. These numbers need to increase if the promised protection offered by the vaccine is to have an effect on future generations’ resistance to these cancers. Public health campaigns can help, but in the end it comes down to parents’ decisions over whether their children are exposed to an unnecessary cancer which is easily vaccinated against. When HPV is seen in the same vein as polio or small pox, parents might start to act and see these dangerous diseases for what they are. Then they’ll be demanding vaccines for their children that these pharma companies have worked so hard to develop.  A vaccine against cancer is something most oncology patients can only dream of, so why the delay in rolling this out to 100% of our young people?