HPV AND THE HPV VACCINE
HPV or genital human papilloma virus is the most common sexually transmitted virus in the USA. There are more than forty (40) types of HPV. 20 million new cases of HPV are diagnosed each year.
Most HPV infections don’t cause any problems and over ½ of sexually active individuals have HPV infections sometime in their lifetimes. HPV can’t be cured however the diseases that HPV causes can be managed.
HPV can cause cervical cancer. Additionally, HPV can infect the rectum, anus, penis and scrotum. In females, it can additionally cause cancers of the vagina and vulva (external parts –labia and the surrounding skin) and cause cancers of the throat and mouth.
The most important thing to remember is that there exists ways to prevent the diseases caused by HPV. We have available in the USA the HPV vaccine. The vaccine commonly given is Gardasil. This vaccine is a “quadrivalent” vaccine, as it is effective against the four common major serotypes of HPV. Gardasil is an inactivated –not live- vaccine (like a tetanus vaccine).
As mentioned Gardasil protects against the most common HPV types. These four types cause 70% of cervical cancers and 90% of genital warts. It also protects against 70% of vaginal cancers and 50% of vulvar cancers and its protective effects are long lasting.
Gardasil is recommended for females beginning age 11-12 and can be given as young as 9 and usually given between ages 13-26. It is given in 3 divided doses with minimal spacing between the doses of 1,2 and 6 months. It is also suggested for young men as boys manifest antibodies against viruses once vaccinated even more effectively than their female counterparts. This would aid in the prevention of the spread of HPV to their sexual contacts. If a female is vaccinated appropriately before their first sexual contact, the vaccine protects against 100% of the diseases caused by the 4 MAJOR HPV types. The protection is not fool proof because there are other HPV types as mentioned and many cause a variety of manifestations. It is therefore still very important to continue with prevention visits once sexually active.
Also, as suggested the HPV vaccines have been approved for adolescent males. In young men Gardasil helps protect against 90% of genital wart cases.
Again vaccination protects against the MOST COMMON HPV types and has cross- protection abilities. It has been shown, statistically, that in the parts of the USA with the highest incidence of cervical cancer these same states have the lowest vaccination rates.
The safety of the HPV vaccines has been well established. Common side effects are vaccine site issues. The injection site may have bruising, swelling, itching or tenderness. Other temporary complaints include dizziness, fever, nausea and vomiting. There are, of course, allergic reactions and although these can be serious, they are extremely rare.
I explain to my patients that the risk of a dangerous situation with an HPV vaccine is much less than the ones we take getting into a car daily.
This author believes with the changing pap smear guidelines and the decreased prevention visits encouraged by poor and expensive insurance coverage that “an ounce of prevention is worth a pound of cure” and encourages her patients to obtain the Gardasil HPV vaccine.
Dr. Tuckey-Larus has been named one of America's Top Obstetricians and Gynecologists by the Consumer's Research Council of America.
Congratulations to Dr. Corinne Tuckey-Larus who received an Honorable Mention for being voted the "Best Bedside Manner" in the 2013 Our Health magazine!
You can reach her here.
