Debating the New Vaccine Here Are Some Facts about Human Papilloma Virus and Cervical Cancer

Gov. Deval Patrick recently joined a widening group of officials nationwide touting a vaccine against human papilloma virus (HPV) approved by the U.S. Food and Drug Administration just last year.

The vaccine, which goes by the trade name Gardasil, was developed to prevent cervical cancer and other diseases in females caused by certain types of genital HPV. Gardasil protects against four types of the virus, which together cause 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of cervical cancers and 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of genital warts cases. The HPV vaccine is given through a series of three shots over a six-month period. The second and third doses should be given two and six months after the first dose.

Patrick’s budget would pay for free vaccinations for more than 72,000 girls between ages 9 and 18. The governor points to Massachusetts’ status as one of only 10 states with universal childhood vaccine distribution programs. In the Bay State, all routinely recommended vaccines are available free of charge to children through 18 years of age.

“These programs and services encourage healthy living practices and can prevent serious health problems in the future,” Patrick said of this and other health care-related agenda items. “These investments not only save lives but also reduce treatment costs in the future.”

Following are a series of questions and answers about the vaccine, provided by the Centers for Disease Control and Prevention.

The HPV vaccine is recommended for 11- and 12-year-old girls, and can be given to girls as young as 9. Why is it recommended for such young girls?

Ideally, females should get the vaccine before they are sexually active. This is because the vaccine is most effective in those who have not yet acquired any of the four HPV types covered by the vaccine. Girls and women who have not been infected with any of those four HPV types will get the full benefits of the vaccine.

Females who are sexually active may also benefit from the vaccine. But they may get less benefit since they may have already acquired one or more HPV types covered by the vaccine. They would still get protection from those types they have not acquired.

The vaccine is not recommended for pregnant women. There has been limited research looking at vaccine safety for pregnant women and their unborn babies. So far, studies suggest that the vaccine has not caused health problems during pregnancy, nor has it caused health problems for the infant, but more research is still needed.

What about vaccinating boys?

We do not yet know if the vaccine is effective in boys or men. It is possible that vaccinating males will have health benefits for them by preventing genital warts and rare cancers, such as penile and anal cancer. When more information is available, this vaccine may be licensed and recommended for boys and men as well.

How long does vaccine protection last?

The length of immunity is usually not known when a vaccine is first introduced. So far, studies have followed women for five years and found that women are still protected. More research is being done to find out how long protection will last, and if a booster vaccine is needed years later.

It is not yet known how much protection someone would get from receiving only one or two doses of the vaccine. For this reason, it is very important that girls and women get all three doses of the vaccine.

Does this vaccine contain thimerosal or mercury?

No. It is made up of proteins from the outer coat of the virus (HPV). There is no infectious material in this vaccine.

What exactly is HPV, and how is it related to cervical cancer?

Genital HPV is a common virus that is passed on through genital contact, most often during vaginal and anal sex. About 40 types of HPV can infect the genital areas of men and women.

While most HPV types cause no symptoms and go away on their own, some types can cause cervical cancer in women, a disease that was expected to strike 9,700 women and kill 3,700 in 2006, according to the American Cancer Society. These types also have been linked to other less common genital cancers — including cancers of the anus, vagina, and vulva. Other types of HPV can cause warts in the genital areas of men and women, called genital warts.

At least 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of sexually active people will get HPV at some time in their lives. Every year in the U.S., about 6.2 million people get HPV. It is most common in young women and men who are in their late teens and early 20s. Anyone who has ever had genital contact with another person can get HPV. Both men and women can get it — and pass it on to their sex partners — without even realizing it.

HPV is not the same as HIV or herpes. While these are all viruses that can be sexually transmitted, HIV and herpes do not cause the same symptoms or health problems as HPV. There is no treatment for HPV, but there are treatments for the health problems that the virus can cause, such as genital warts, cervical cell changes, and cancers of the cervix, vulva, vagina, and anus.

Will those who have been vaccinated still need cervical cancer screening?

Yes. The vaccine will not protect against all types of HPV that cause cervical cancer, so vaccinated women will still be at risk for some cancers. Also, some women may not get all required doses of the vaccine (or they may not get them at the right times), so they may not get the vaccine’s full benefits. In addition, women may not get the full benefit of the vaccine if they receive it after they’ve already acquired one of the four HPV types.

What other HPV vaccines are available?

Another HPV vaccine is in the final stages of clinical testing, but it is not yet licensed. This vaccine would protect against the two types of HPV that cause most cervical cancers.

Are there other ways to prevent cervical cancer?

Regular Pap tests and follow-up can prevent most, but not all, cases of cervical cancer. Pap tests can detect cell changes in the cervix before they turn into cancer, and they can also detect most, but not all, cervical cancers at an early, curable stage. Most women diagnosed with cervical cancer in the U.S. have either never had a Pap test, or have not had a Pap test in the last five years.

Are there other ways to prevent HPV?

The only sure way to prevent HPV is to abstain from all sexual activity. Sexually active adults can reduce their risk by being in a mutually faithful relationship with someone who has had no other or few sex partners, or by limiting their number of sex partners. But even persons with only one lifetime sex partner can get HPV if their partner has had previous partners.

It is not known how much protection condoms provide against HPV, since areas that are not covered by a condom can be exposed to the virus. However, condoms may reduce the risk of genital warts and cervical cancer. They can also reduce the risk of HIV and some other sexually transmitted infections, when used all the time and in the right way.