Norway and Luxemburg are the latest countries to provide girls aged between 11 and 12 with vaccination against the human papillomavirus as part of their national vaccination programmes.

A catch up vaccination will also be available for girls up to 16 years of age in Norway, while Luxemburg’s High Counsel of Public Health, the CSH, said it will provide the vaccine to girls aged between 13 and 18.

The two Scandanavian countries follow Austria, Germany, Italy and France in recommending the vaccine to girls to prevent cervical cancer and other human papillomavirus (HPV) diseases.

Catering to public demand

In March 2007, the German authorities added HPV vaccination to their national vaccination programme four months ahead of schedule, accelerating the introduction on the back of high public interest in the vaccine as well as the need to define vaccination standards.

The German Standing Commission for Vaccination at the Robert Koch-Institut (Stiko) said it recommended the universal vaccination of girls aged 12 to 17 years in order to reduce the burden resulting from cervical cancer in Germany. It states that vaccination should be completed prior to the first sexual intercourse.

Several German health insurance funds, which together cover almost 60% of the population, have been fully reimbursing HPV vaccination since December 2006. The remaining health insurance funds are expected to follow.

Vaccination to start in Italy this month

In Italy the Minister of Health, Livia Turco, announced in March that vaccination of 12 year-old girls can start as soon as the vaccination centres at regional level are ready. The Ministry of Health has allocated the budget and the first regions are expected to start vaccination sometime this month.

And in France the High Counsel of Public Health, the CSHPF, recommended the universal vaccination of 14 year-old girls against HPV (types 6, 11, 16 and 18) for the prevention of precancerous and cancerous cervical lesions, as well as the prevention of genital warts. The CSHPF also recommended offering vaccination to girls and young women aged 15 to 23 years who have not yet had sexual relations, or in the year following the start of their sexual activity at the latest.

The CSHPF noted that vaccination does not replace screening and that women must be screened, whether they are vaccinated or not. Xavier Bertrand, the French Health Minister, said that reimbursement of HPV vaccination by the National Social Security system would be decided before July 2007.

These recommendations highlight the positive response in Europe to Merck & Co’s Gardasil, the only HPV vaccine on the market at the moment, although in the USA, there has been considerable opposition to proposals of compulsory vaccination with the treatment.

Texas takes the initiative

In February, Texas Governor Rick Perry announced mandatory HPV vaccination programmes for girls aged 11 and 12 and employed an executive order to bypass any opposition in the legislature, making Texas the first state to require that girls receive the HPV vaccine. Despite considerable opposition, Perry said he was backed by the US Centers for Disease Control's advisory committee on immunisation practices last June which recommended Gardasil be routinely given to young girls.

HPV is the leading cause of cervical cancer, which results in nearly a half-million diagnoses and 240,000 deaths each year. In Europe, around 15,000 women die from cervical cancer each year despite screening for early detection.