HPV Vaccine: A Little Pain Now, Cancer Protection Later

Being in a mutually faithful monogamous relationship with someone who has had no other or few prior sex partners can reduce the risk of HPV. Condoms will lower the chance of catching or spreading HPV, but does not prevent HPV entirely since some areas of the skin are uncovered.

A recently released vaccine will prevent infection with the types of HPV that cause the most disease. The vaccine can prevent the two types of HPV that cause 90 percent of genital warts and the two types that cause 70 percent of the cervical cancers.

The Gardasil vaccine, manufactured by Merck, is approved by the Food and Drug Administration for use in females between the ages of 9 and 26 years old, and the U.S. Centers for Disease Control and Prevention has recommended it for all girls between 11 and 12 years old.

Three shots are given over six months at a cost of approximately $360. A federal program called Vaccines for Children will provide free vaccine for girls younger than 19 years old who are uninsured, are on Medicaid or do not have health insurance that covers the shots.

Why Is the HPV Vaccine Recommended at Such a Young Age?

The vaccine is most effective if given before females becoming sexually active. There is less benefit if you are already infected with one of the four types of HPV in the vaccine.

The CDC bases its recommendations on surveys of teenagers about when they become sexually active. The young age does not mean this is when most girls begin to have sex, but rather when a significant portion report becoming sexually active. Parents should talk with their children and determine when it is appropriate for their child to consider getting vaccinated.

If I Get Vaccinated, Can I Stop Having Pap Tests?

No. There are some types of HPV that are not covered by the vaccine. A Pap test will detect abnormal cells if you are infected with one of these types. Also, we are unsure how long the vaccine will prevent HPV infections so there may be a need to get a booster dose in about five years.

The Future of HPV Protection

An additional HPV vaccine is likely to be approved early this year. This vaccine is also intended to prevent the initial infection with HPV so it is also recommended for young women.

There are current trials that are studying the use of HPV in men and older women. A more potent HPV vaccine, which produces a vigorous immune response, is being tested as a treatment for genital warts. Finally in the near future, DNA technology could replace the Pap test with a rapid, simple, accurate and affordable test to screen for all high-risk HPV strains.

While no one enjoys getting shots, the mild pain experienced by young women from the HPV vaccine injection is well worth the future benefits in protecting against cervical cancer.

Dr. Douglas Holt is director of the Hillsborough County Health Department in Tampa, Fla., and a professor in the Division of Infectious Disease and International Medicine at the University of South Florida College of Medicine.

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