Most pediatricians say they would be willing to give to boys and girls a vaccine that prevents infection with the sexually transmitted disease human papillomavirus, but some say "inadequate" insurance reimbursement, parental refusal and continuity of care could be barriers to the distribution of such a vaccine, according to a survey presented on Thursday at a CDC meeting in Atlanta, the New York Times reports (Altman, New York Times, 10/28). Merck earlier this month announced that its experimental HPV vaccine Gardasil was 100% effective in preventing transmission of HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. Merck said it will seek FDA approval of Gardasil this year and could begin marketing the drug late next year. GlaxoSmithKline's experimental HPV vaccine Cervarix has shown to be 100% effective in preventing transmission of strains 16 and 18 in early clinical trials, and the company plans to submit an application for approval in Europe and elsewhere in 2006, according to GSK CEO Jean-Pierre Garnier. GSK said it plans to recommend Cervarix for girls as young as age 10, while Merck has said it might lobby states to require the vaccine for all 12-year-old children before they can enter school. Some parents and health officials object to standardized HPV vaccinations for teenagers and are concerned that children would interpret them as permission to have sex (Kaiser Daily Women's Health Policy Report, 10/7).

Survey Results
Nicole Liddon of CDC and colleagues from the University of Colorado asked 431 members of the American Academy of Pediatrics -- a representative sample of the organization's 2,500 members -- to participate in the survey, and 298 responded. According to the results, 11% of respondents agreed that an HPV vaccine would encourage "promiscuous" sexual behavior, and 57% said they believe some parents would refuse to allow their young daughters to be vaccinated, according to the Times. In addition, 54% of respondents said it would be difficult to maintain the continuity of care required for Merck's vaccine, which is given as a series of three shots over six months. About two-thirds of respondents accurately said that HPV causes most cases of cervical cancer, and 54% incorrectly said genital warts are caused by the same strains of HPV that cause cervical cancer (New York Times, 10/28).