HPV vaccine: nuova revisione della letteratura in Canada
il Canada è decisamente lo Stato che più si sta ponendo domande circa il vaccino contro il cancro della cervice dell’utero, o meglio il vaccino contro il Papilloma virus ritenuto responsabile del cancro della cervice dell’utero (non dell’utero, della cervice dell’utero, dovrò spiegare la differenza visto che molti in Italia pare non l’abbiano colta).
Il documento è una revisione della letteratura esistente sul vaccino, compresa quella fornita dalla casa farmaceutica produttrice per l’approvazione del vaccino da parte del FDA, e si pone come domanda se, allo stato attuale delle conoscenze sul vaccino, è necessaria una vaccinazione di massa.
La risposta (tradotta sempre in modo pessimo da me) è:
La revisione della letteratura rivela un sufficiente numero di domande senza risposta che portano a concludere che un programma di vaccinazione universale è, al momento, prematuro e potrebbe avere non intenzionali conseguenze negative per gli individui e la società nel suo insieme.
Human papillomavirus, vaccines and women’s health: questions and cautions
Abby Lippman, PhD, Ryan Melnychuk, PhD, Carolyn Shimmin, BJ and Madeline Boscoe, RN DU Abby Lippman is with the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Que., and the Canadian Women’s Health Network. Ryan Melnychuk is with the Department of Bioethics, Dalhousie University, Halifax, NS. Carolyn Shimmin is with the Canadian Women’s Health Network, Winnipeg, Man. Madeline Boscoe is with the Women’s Health Clinic, Winnipeg, Man.
Correspondence to: Dr. Abby Lippman, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 av. des Pins Ouest, Montréal QC H3A 1A2; fax 514 398-4503; firstname.lastname@example.org
The federal government’s recently announced $300 million investment toward a program for vaccinating girls and women with the currently available human papillomavirus (HPV) vaccine Gardasil, framed by some as a way to prevent cervical cancer in Canada, has generally been welcomed by a wide range of commentators. However, although HPV infection is necessary for the development of cervical cancer and the vaccine may prevent primary infection with HPV types 16 and 18 (currently thought to be the cause of about 70% of cervical cancer cases1), we propose that these facts be assessed within a broad context before immunization policies are implemented. A careful review of the literature, including that submitted by the manufacturer with its application for approval of Gardasil, reveals a sufficient number of unanswered questions to lead us to conclude that a universal immunization program aimed at girls and women in Canada is, at this time, premature and could possibly have unintended negative consequences for individuals and for society as a whole.
In this article we summarize some of the main questions and concerns that need to be addressed before there is a full-scale rollout of an HPV vaccination program (for supplementary material go to www.cwhn.ca/resources/cwhn/hpv-brief.html). These closely reflect issues raised in the analytical framework created by Erickson and colleagues2 in the context of the development of the National Immunization Strategy and support efforts to ensure a comprehensive and systematic evaluation of all relevant factors before decisions regarding the implementation of a new immunization program are made. As well, they echo some of the research questions identified as important in the final report from the Canadian Human Papillomavirus Vaccine Research Priorities Workshop, held in Quebec City in 2005.3 We hope raising these questions now will contribute to the deliberations necessary to ensure a responsible and transparent evidence-based decision-making process.
Dipartimento di epidemiologia, Biostatistica e Medicana Occupazionale