Prophylactic HPV vaccines: the Finnish perspective

Finland is a country with a dual role in the human papillomavirus (HPV) field. Finnish scientists have pioneered in HPV research and participated in international HPV vaccine trials, but officially Finland is reluctant to implement HPV vaccines into its national vaccination program owing to the reasons discussed in this article. In contrast to other European countries, Finnish authorities were reluctant to initiate the evaluation process for HPV vaccines after licensure. Instead of prompt implementation, it was decided that a long-term prospective (Phase IV effectiveness) study to evaluate the bivalent HPV vaccine in a randomized community trial should be started. in addition, the Finnish authorities refuse to accept the compelling scientific evidence on the efficacy and safety of HPV vaccines. They report that cervical cancer (CC) is effectively controlled by the national screening program, despite the fact that CC in Finland has increased very rapidly since 1992. The Finnish perspective on HPV vaccines appears to postpone all critical decisions until the second half of the 201 Os. This will have two direct consequences: 1) every year of delay means that an entire birth cohort (>60,000 girls and boys) will lose the opportunity of being offered the state-of-art cancer prevention provided by prophylactic HPV vaccines; and 2) given the declining trends of CC elsewhere, within a few years Finland will fall among the countries with a high incidence of CC. It is the personal conviction of this author that there are no sustainable arguments remaining that advocate continuing this Finnish perspective on HPV vaccines any further.