Demand for a free vaccine against cervical cancer is outstripping supply in New Hampshire, which was the first state in the country to approve free distribution of the vaccine, which protects girls against four strains of a sexually transmitted infection called human papillomavirus, or HPV.
Although new vaccines usually take years to catch on, Merck , the maker of cervical-cancer vaccine Gardasil, spent millions advertising the drug on television and in magazines, raising awareness and creating demand for the drug.
New Hampshire planned to vaccinate only about one-quarter of eligible girls this year, according to Mary Ann Cooney, the state's public health director. Advertising has stimulated demand, so the state's supplies aren't keeping pace.
"There's a huge demand for it," said Dr. Elizabeth Sanders of Sanders Family Medicine in Concord. "I've got to say that the public is clamoring for it."
People seeking the vaccine outside the state's free program typically pay about $360 for the three required shots, which are spread out over six months.
The U.S. Food and Drug Administration recently approved the vaccine for girls and women ages 9 to 26 years. The state's free vaccine is available only through age 18.
Although HPV is only transmitted through sexual contact, it's common enough that about half of all men and women are infected at some point in their lives, according to the Centers for Disease Control and Prevention. The agency recommends that girls get the vaccine when they are 11 or 12 so they will have immunity before they become sexually active.
Doctors predicted demand would be high when the program started in January. Some practices, like Penacook Family Physicians, have developed a priority list of patients who should get the vaccine first. Others, like Dartmouth-Hitchcock in Concord, have encouraged parents to see if their health insurance will pay, which reduces demand for free vaccinations.
But many families that use Capital Region Family Health Center in Concord don't have insurance or have only limited insurance. The center has focused on vaccinating girls ages 11 and 12 in accordance with the CDC guidelines.
Penacook Family Physicians, on the other hand, has put 18-year-olds at the head of the list. Nurse-practitioner Ardell Currier and her colleagues reasoned that those patients would soon be too old for the free program.
Cooney said the state's experience so far could lead to changes in the program.
"The good part is, we've learned something in this and can probably anticipate what we need to do in the coming months with the contracts," Cooney said.