Understanding Gardasil

The pharmaceutical company Merck has developed, as it says, "the world's first and only cervical cancer vaccine." Merck's assertion is not entirely true, but this cancer drug is still an innovation that some medical experts are ranking with the polio vaccine and antibiotics. Let's take a closer look at how the drug works.

Gardasil works by preventing the infection of the types of HPV that can lead to cervical cancer (HPV numbers 6, 11, 16, and 18 for future doctors out there). So when the FDA approved Gardasil, it did so for the prevention of cervical cancer, cervical pre-cancers, vulvar pre-cancers, vaginal pre-cancers, and the prevention of genital warts, among other more obscure conditions. A more accurate description of Gardasil, and the way the drug is described by the health care community, is an HPV vaccine.

Gardasil is injected three times over an eight-month period.
©2006 Publications International, Ltd.
Gardasil is injected
three times over eight months.

Like all vaccines, Gardasil works by introducing a benign or weakened form of the virus into the body. Essentially, the vaccine kick-starts a woman's immune responses to the disease without the patient having to be exposed to the actual virus.

The main ingredients of the vaccine are purified, inactive proteins that come from the HPV types mentioned above. Gardasil is an injected vaccine, so the patient must be able to receive shots. The full course of the vaccine is three shots, over an eight-month period.

There is no question that Gardasil is effective. In clinical tests, Gardasil prevented 100 percent of HPV 16- and 18- related cervical pre-cancers in the nearly 9,000 women who were given the drug (compared to 53 cases in women who were given a placebo). There was only one reported case of genital warts in the 7,897 women who participated in the study to test Gardisil's effectiveness in preventing HPV types 6 and 11. 

Though long-term studies are still pending, the women who took the drug reported very few problems, and only .01 percent of the subjects stopped taking Gardasil because of unpleasant side effects. The price tag of Gardasil is may seem hefty at $120 per dose, but this nothing compared to the health care costs of treating genital warts and cervical cancer.

The Impact of Gardasil

While Gardasil has many benefits and uses, recent advancements in treatment and screening have made cervical cancer almost 100 percent treatable. It can take up 10 years for an HPV infection to turn into cervical cancer, and regular Pap smears should catch a potential problem in its earliest -- and most treatable -- stage.

But cervical cancer still manages to take the lives of 300,000 women each year. How can this be? Many of the women who die of cervical cancer cannot afford regular gynecological exams because they do not have health insurance, or as might be the case in a third-world country, they do not have access to health care. 

Unlike other forms of cancer in which all segments of the population are equally at risk, cervical cancer is most fatal to women who live in poverty. These are the women who can be most helped by the vaccine. Of the 300,000 annual deaths from cervical cancer, about 10 percent of those women live in the United States. The majority of the deaths occur in Africa and Central America. Seen in this light, Gardasil is every bit the medical landmark that Merck describes in its press releases.

It is hard to know what to believe when a new drug hits the market. Generally, there is a chorus of exciting promises without much proof. While the "cervical cancer vaccine" might not be exactly what a marketing department would like you to believe it is, Gardasil can still save hundreds of thousands of lives. And that is a real cause for fanfare.

Gardasil's Fine Print
If you have seen pharmaceutical commercials, you know that they always end with a mouthful of disclaimers, delivered so quickly that you can barely understand the words. Here is some of the fine print regarding Gardasil:
  • Gardasil can help prevent cervical cancer, but it does not treat it.

  • As with any vaccine, Gardasil may not fully protect every person who takes the drug.

  • Gardasil does not protect against all the more than 100 forms of HPV.

  • Some of the possible side effects of Gardasil are fever and difficulty breathing.

  • Gardasil does not protect against all types of cervical cancer.

  • Gardasil does not replace regular gynecological screening.


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