BMJ  2005;331:1081 (5 November), doi:10.1136/bmj.331.7524.1081-a

Letter

Details of HPV immunisation need not delay decision

The first 150 words of the full text of this article appear below.

EDITOR—Lowndes and Gill are upbeat in their appraisal of the future for primary prevention of cervical cancer by immunisation.¹ But they then deliver a long list of questions that they suggest should be answered before starting human papillomavirus (HPV) vaccination. For most of their questions, this timing is not supported by recent historical precedent.

Without doubt ascertainment of the HPV types currently causing cancer, data for which are available in the United Kingdom,² is central to the modelling and cost effectiveness studies with which we must assume the Health Protection Agency and others in the UK are already engaged. Certainly, as for all recent new vaccines, cost is likely to be a key determinant. Likewise, careful evaluation of vaccine acceptability to children and parents will be important, although it should be pointed out that universal immunisation against hepatitis B, primarily a sexually transmitted disease and a cancer causing . . . [Full text of this article]

Institute of Child Life and Health, Department of Clinical Sciences at South Bristol, University of Bristol, Bristol BS2 8AE Adam.Finn@bristol.ac.uk

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