Gardasil not provided at most New York City health clinics

Merck's human papillomavirus vaccine Gardasil is not provided at most New York City health clinics, and girls and women who are eligible for no-cost or low-cost vaccination often are told they must pay for it, according to a report released on Wednesday by Public Advocate Betsy Gotbaum, the New York Sun reports (Solomont, New York Sun, 3/8).

FDA in July 2006 approved Gardasil, which costs $360, for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. CDC has added Gardasil to its Vaccines for Children Program, which provides no-cost immunizations to children ages nine to 18 covered by Medicaid, Alaska Native and American Indian children, and some uninsured and underinsured children (Kaiser Daily Women's Health Policy Report, 3/1). For the report, Gotbaum and her investigators called New York City health clinics posing as parents of 12-year-old girls seeking information about the availability of the vaccine and its cost, the New York Daily News reports. The report found that none of the city's 11 health clinics designated to treat sexually transmitted infections provide Gardasil, and the city's five immunization centers do not stock the vaccine (Lite, New York Daily News, 3/8). According to the report, 35 of the 67 city-run clinics that offer care to children and teens said they carried Gardasil (New York Sun, 3/8). Only 17 of the clinics that carried the vaccine did not charge out-of-pocket costs, and one clinic charged patients without insurance $510 (Gotbaum release, 3/7). Thirty-two of the clinics said they did not stock the vaccine, according to the report (New York Daily News, 3/8).

Reaction
"Given the number of women diagnosed with cervical cancer, it's clear the city can't ignore this health crisis," Gotbaum said. Officials from the New York City Health and Hospitals Corporation, which runs the city clinics, on Wednesday said its hospitals and clinics have carried Gardasil since November 2006, but added that the corporation "will conduct additional training for clinical and nonclinical staff who may also be asked about the availability of the vaccine" (New York Sun, 3/8). The corporation in a statement also said it is "committed to making this vaccine available regardless of a patient's ability to pay." According to the New York City Department of Health and Mental Hygiene, four of the city's immunization centers will have Gardasil available in the coming months (New York Daily News, 3/8). Health department officials also said they have distributed 50,000 doses of Gardasil to doctors in the city through the VFC program (New York Sun, 3/8).

The report is available online. Note: You must have Adobe Acrobat to view this report.