To vaccinate or not?
Many of you by now have heard in the media about the newly approved HPV Vaccine by Merck. It is a Quadrivalent vaccine which means it protects you against 4 viral strains: 6, 11, 16, and 18. There are over 100 different types of HPV viruses. About 60 of them cause the ‘common warts’ you see on hands and feet. About 40 strains cause mucosal infections of the genitals, anus, and respiratory tract. Those are divided into ‘high risk types’ (16, 18) and ‘low risk types’ (6, 11). The high risk types are better known as the viral strains that can turn into cervical cancer if left undetected and untreated. The lower risk types are more likely to cause the external genital warts and lower risk cervical changes on pap smears that resolve on their own most of the time.
Cervical cancer in the United States is estimated at 9,710 cases with 3,700 deaths. Of these 3,700 deaths, 70% are caused by the viral strains 16 and 18. There are an estimated 0.5 to 1 million cases of genital warts. Ninety percent of those are caused by viral strains 6 and 11. There is now a vaccine to help prevent you from contracting this virus and getting cervical cancer and/or genital warts in women. The vaccine is reported to be 100% effective in those females who have not been exposed to HPV. Men have an 80% lifetime chance of contracting the HPV virus that can cause genital warts and penile cancer in men. Now do not panic men, they are currently doing research on the vaccine in men aged 16 to 23. Penile cancer is very rare and fortunately accounts for less than 1 % of all cancers in men. The risk is higher though in uncircumcised men. They hope to approve the vaccine to prevent HPV infection in boys/men soon. Stay tuned.
Currently the vaccine is recommended for 11-12 year old girls. Females aged 13 to 26 years old can also receive the vaccine. It is most effective in females who have not been exposed to the HPV virus through vaginal intercourse. In those females it is 100% effective. The vaccine was less effective in females who have already been exposed to the HPV virus, and it does not treat existing HPV, genital warts, pre-cancers or cancer of the cervix. Females would still be protected against the 4 viral strains in the vaccine if they have not yet been exposed to them. But, there is no way to tell what viral strains you have been exposed to if you have been sexually active.
The vaccine is a 3 shot series costing about $135.00 per dose and $405.00 for the full series. Most side effects are rare and most of the time includes a sore arm muscle. The length of time the immunity will last is unknown. There may be a booster that needs to be instituted 5 years later, but that is yet to be determined. Once getting the vaccine, it does not exclude females from regular annual cervical pap screening. The new guidelines state this screening exam should occur by age 21, or within 3 years of first intercourse.
To vaccinate, or not to vaccinate, that is the question. Go to http://www.cdc.gov/std/hpv/STDFact-HPV-Vaccine.htm for more information.
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