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Twenty years on from the Cartwright inquiry

Hon Steve Chadwick
Associate Minister of Health

5 August 2008 Media Statement
Twenty years on from the Cartwright inquiry

Associate Health Minister Steve Chadwick today acknowledged the 20th anniversary of the Cartwright Report, noting how far New Zealand has come since the release of the Report in August 1988.

“The Cartwright Report was hugely significant for the women involved, and for the New Zealand health system more widely. The Report acknowledged the public outrage over research at National Women's Hospital with insufficient regard to consumer’s rights, well-being and safety,” Steve Chadwick said.

“However, the legacy of the Cartwright Report saw the rebalancing of power relationships between professionals and patients across the entire health system.”

Recommendations from the Report led to the establishment of ethics committees, the Health Information Privacy Code and the office of the Health and Disability Commissioner.

“The Cartwright inquiry also led to the establishment of the National Cervical Screening Programme, and cervical cancer incidence has reduced by around 50 per cent and mortality by around 65 per cent since the programme began in 1990.

“Earlier this year we announced $164.2 million of new funding over five years for a major immunisation programme to fight cervical cancer. This is a further step in the battle against cervical cancer. Today’s grandmothers remember the ‘unfortunate experiment’ and this free vaccine is an investment in protecting their granddaughters and future generations.

“The Gardasil vaccine is shown to be safe in large clinical trials involving more than 20,000 girls and young women. This programme provides an opportunity for young women to be protected against the virus that causes most cervical cancers.

“In the long term, it is expected that about 30 lives a year will be saved. And there will be fewer abnormal smear results, which means less stress for those women who may require extra tests, diagnoses and invasive treatments.

“We are making a concerted effort to ensure young women and their parents have access to full information from credible sources and are supported to make well-informed decisions.”

The Ministry of Health is sending an update to around 5,000 stakeholders today, including all GPs, including a fact sheet that can be copied and given out to young women or their parents, and other resources are being developed.

The additional resources will be distributed to GPs this month and includes information about the programme, the vaccine side effects, and questions and answers. There will also be social marketing activities to inform people and guide them to other sources of accurate information.

MOH fact sheet attached and for more information visit: www.moh.govt.nz/immunisation

--

Human Papillomavirus (HPV) Immunisation Programme – MOH factsheet
This is an immunisation programme to protect girls and young women from HPV infection and from developing cervical cancer later in life.

Who is eligible?
Girls born on or after 1 January 1990 will be eligible for free HPV vaccine (called GARDASIL®) beginning with the oldest girls first.

From 1 September 2008, GARDASIL® will be available to young women born in 1990 and 1991 from their family doctor, practice nurse, or health clinic. From 2009, girls aged 12 to 18 will be offered the vaccine. Most will receive it at school. Eligible girls or young women who paid for the first or second doses before the programme started can receive the vaccine free from September 1 2008. Your health care provider can tell you more about when eligible girls and young women can receive the free vaccine.

Why vaccinate?
Every year in New Zealand about 160 women will be diagnosed with cervical cancer and 60 will die from it. More than 99 per cent of all cervical cancer is linked to infection with HPV.

About the vaccine
GARDASIL® protects against the two HPV types that cause 7 out of 10 cervical cancers (types 16 and 18) and the two HPV types that cause 9 out of 10 genital warts (types 6 and 11).The vaccine contains virus like particles made from the outer shell of the virus, which are not live and cannot cause infection. GARDASIL® contains a small amount of aluminium - used in many vaccines to improve the body’s immune response to the vaccine. The vaccine does not contain thiomersal.

The vaccine is injected into the upper arm. Three injections are given over a 6-month period at 0, 2 and 6 months.

For best protection girls need to be vaccinated before they are likely to be exposed to HPV, which means before they start having any sexual contact. It is recommended eligible women who are sexually active still have the vaccine as they are unlikely to have been exposed to all the HPV types the vaccine protects against.

How safe is the vaccine?
GARDASIL® was shown to be safe during large clinical trials involving more than 20,000 girls and young women. The following reactions may be expected after vaccination - injection site pain, redness or swelling at the injection site, a general feeling of unwellness, mild fever. Very rarely people may have a severe allergic reaction (anaphylaxis). This usually happens in the first few minutes after vaccination, which is why people are asked to wait at their doctor’s surgery or health clinic for 20 minutes after their vaccination.

As with other vaccines, New Zealand’s Centre for Adverse Reactions Monitoring will record any reactions reported after HPV vaccination and provide regular reports to the Ministry of Health.
There is also ongoing monitoring internationally of the girls and women involved in the clinical trials.

How effective is the vaccine?
Results from studies at five years after vaccination report that protection remains good. The vaccine was effective at preventing infection with HPV in 96 per cent of women. These studies will continue to monitor the long term protection the vaccine provides. International experts do not expect that booster doses will be required but this will also be monitored.

Will young women still need to have smear tests?
About 30 per cent of cervical cancers will not be prevented by this HPV vaccine, so immunised women should receive regular cervical smear tests, beginning from the age of twenty.

Why aren’t boys being immunised as part of the free programme?
The vaccine is licensed for use in boys aged 9 to 15 years, but is not funded for boys as part of this national cervical cancer prevention initiative. The Ministry is monitoring ongoing international research about the effectiveness of vaccinating boys.


ENDS

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