Switzerland has become the eighth European country to recommend human papillomavirus vaccination to prevent cervical cancer for girls starting secondary school and the UK is expected to follow suit very shortly.

Merck & Co's cervical cancer vaccine Gardasil, which is also marketed by Sanofi-Aventis, has been recommended by the Swiss Federal Office of Public Health, as part of a general human papillomavirus vaccination programme of 11 to 14 year-old girls, the Sanofi Pasteur MSD joint venture has confirmed. The authorities also recommend a catch-up vaccination programme for girls aged 15 to 19 during five years, while vaccination of women aged 20 and older should be decided on an individual basis.

The Swiss authorities said that medico-economic analyses have concluded on a "very favourable" cost/benefit ratio in support of the programme, though they note that HPV vaccination “is a primary prevention measure that complements but does not replace screening for early detection of cervical cancer”.

Didier Hoch, president of Sanofi Pasteur MSD, said that each year in Europe, 15,000 women die from cervical cancer despite screening for early detection, while hundreds of thousands of women are diagnosed with precursors of cervical cancer and other genital HPV diseases, including vulvar and vaginal cancer and genital warts. “Recognising the great medical need and the high quality of our data”, he noted that the European Union licensed Gardasil within just nine months compared to a usual review time of 13-15 months and “we are gratified that health authorities recognise the vital need to rapidly implement vaccination."

At the moment, Gardasil, which targets HPV types 6, 11, 16, or 18 is the only licensed jab in Europe for the prevention of cervical cancer, while GlaxoSmithKline's vaccine, Cervarix, is currently under review by EU regulators. Switzerland follows Austria, Germany, Italy, France, Norway, Luxemburg and Belgium in recommending vaccination and media reports in the UK suggest that a ninth country will soon be added to the list.

UK committee likely to recommend jab

The UK's Joint Committee on Vaccination and Immunisation is expected to recommend on Wednesday that girls be vaccinated against HPV in their first year of secondary school, starting in September 2008, to be followed by a catch-up programme of all girls in the country aged 12 to 16. Final details of any vaccination programme will be decided by the Department of Health.

Parents will be able to choose to exclude their children from being vaccinated against HPV, and many could follow the example of some families in the USA who believe that a vaccine could encourage girls to have unprotected sex. However, a member of the committee, Syed Ahmed, told The Times that “surveys show the vast majority of parents are in favour of the vaccine. I don’t think girls are thinking about cancer when they decide whether or not to have sex. They are more concerned about becoming pregnant or catching chlamydia or gonorrhoea.”

The committee also claims there is little evidence of any side effects, which are outweighed by the benefits, but there has been a shift of opinion of late, especially in the USA, which suggests that may not be the case. Most recently, Judicial Watch, a US public interest group set up to investigate government corruption, released documents obtained from the Food and Drug Administration under the Freedom of Information Act spotlighting 1,637 reports of adverse reactions to Gardasil since its approval in June last year. More seriously, three deaths were also associated with the vaccine.

A Sanofi Pasteur MSD spokesman responded to that report by telling PharmaTimes World News that such spontaneous adverse event reports show a temporal rather than causal relationship and he added that the data need to be systematically evaluated before the company and the regulators can make an accurate judgement.