The Truth about the HPV Vaccine

You have probably heard the exciting news about the vaccine to prevent cervical cancer. It is called Gardasil® and it was approved by the FDA in June of 2006. Although it is very exciting that the first vaccine to prevent cancer has been developed, it is not the panacea some people make it out to be. For instance, it is not very effective in women who have already become sexually active. Secondly, it will be 20 years before we will see the impact of this vaccine on cervical cancer rates. Before we talk about the vaccine, here are some other things I think you should know about HPV:

v     It is a sexually transmitted infection that is responsible for almost all cases of cervical cancer and most cases of anal cancer (which occurs more frequently in women and gay men).

v     The lifetime risk of getting HPV is 75-90%. Most of us will get it in our lifetime.

v     The vast majority of people infected with HPV never know it; they never develop warts or abnormal pap smears because it is a transient infection (their bodies clear the infection).

v     Human Papilloma Virus (HPV) is a double stranded DNA virus encased in a protein capsid. This protein capsid is what the vaccine is made from and what enables the body to form immunity to HPV. In other words, Gardisil® is not a "live" vaccine.

Here is some important information about the Gardasil® vaccine:

v     It is a quadrivalent vaccine. It protects against 4 types of HPV; 6 & 11 (90% of genital warts) and 16 & 18 (70% of cervical cancers).

v     Over 20,000 women have been studied and the vaccine has been found to be very safe. Safety monitoring will continue as the vaccine is used in the general population.

v     It should not be given during pregnancy but can be given while breastfeeding.

v     The vaccine was found to be nearly 100% effective in preventing precancerous lesions (high grade dysplasia and adenocarcinoma in situ) in women who were not previously infected with HPV. The vaccine was about half as effective in the general population.

v     The vaccine should be given to girls who have not begun having sexual intercourse. Ideally it should be administered between the ages of 11-12.

v     The vaccine is recommended for ages 11-26 but can be given as early as age 9. Note: In a national CDC study, 19% of 8^th graders had already had sex and 10% had 3 or more partners. That's why it should be given at such a young age!

v     Currently, there is no test to determine whether a woman already has the 4 types of HPV found in the vaccine but there may be a test available in the next couple of years.

v     The vaccine is given in a series of 3 shots at 0, 2 and 6 months and can be given with other immunizations.

v     The cost ranges from $120-150 for each shot. Eventually it will be covered by the federal vaccine program so that low income families will have access to it.

v     Women still need Pap smear screening after they have been vaccinated and they should be reminded about the importance of safer sex practices.

v     The long term efficacy of the vaccine is not known, if immunity wanes a booster shot may be needed in the future.

v     The vaccine has not been approved for use in males yet, this may change.