Jeanne Faulkner 10/2007
Who wouldn't want to be One Less woman to get Human Papilloma Virus (HPV) and cervical cancer? You've seen the ads full of super-cool young women busy with alt-girl activities like skateboarding and hip-hop. Their mothers stand protectively near by stating statistics about Gardasil while their daughters play basketball, jump rope and drum in garage bands. These girls are on the cutting edge - the first generation to receive vaccinations that protect them from cancer.
Gardasil is a vaccination that protects against four types of HPV- a sexually transmitted disease responsible for 70% of cervical cancer and genital warts. According to the Department of Health and Human Services, Centers for Disease Control and Prevention, HPV is actually a group of 100 different viruses. More than 30 HPVs are sexually transmitted, infecting the genital area of men and women. Approximately ten of those 30 can lead to development of cervical cancer.
Most HPV-infected people (currently 20 million Americans) never know it because they don't have symptoms and recover without any associated problems. More than 6 million new cases crop up annually. Research shows that for 90% of women with cervical HPV, it becomes undetectable within two years. These are the low-risk viruses that cause mild Pap test abnormalities and sometimes genital warts. Though neither is pleasant, they're not particularly dangerous. "High risk" HPVs are the main risk factor for cervical cancer. Though these too may become undetectable within two years, persistent infection can cause major trouble. The National Cancer Institute says approximately 11,000 American women will be diagnosed with cervical cancer this year. Nearly 3,700 will die. Yikes!
How do you avoid getting HPV if it's so common? Having sex with an infected partner causes the vast majority of HPV infections. Even casual contact can spread the virus. Most people don't know they have HPV so it's difficult to determine whether your partner is infected. Limiting the number of sexual partners you have reduces your risk. Condoms also decrease risk somewhat but HPV can live on skin not covered by condoms and infection can still occur. The best way to avoid getting HPV? Get vaccinated!
Dr. Janet Gibbens, an OB/GYN with Women's Health Today, says, "We're excited about this - a vaccine that prevents cervical cancers associated with HPV. We think everyone eligible to receive vaccination should do it, whether they're sexually active or not."
There's the conflict – the recommended target group to receive the HPV vaccination series (three injections over six months) is 10-12 year-old girls; long before they're expected to be sexually active (and before likely exposure to HPV) to provide the best chance of immunity. The vaccine is also recommended for 13-26 year-old girls/women (regardless of sexual history) who haven't received or completed the vaccine series.
Many parents are uncomfortable vaccinating their daughters for a sexually transmitted disease when they're far too young for sex. Karen Parker Linn, Certified Nurse Midwife with Women's Health Today says, "We realize it's hard for many parents to consider. One moment you see your daughter playing with dolls and the next you're imagining her sexually active. It's a huge leap in thought but the optimal time to have our daughters vaccinated is between 10-12 years of age."
How about older women? The FDA hasn't completed testing on women over 26 and will consider licensing the vaccination for these women after it's proven safe and effective.
The national conversation seems to alternate between outrage and relief. One group is angry we'd consider vaccination for STDs in young girls; arguing it encourages promiscuity or exposure to risky behaviors because girls think they're "safe." Another group is grateful there's finally some protection to prevent our daughters from a serious and sometimes fatal disease. Many states are discussing making HPV vaccinations mandatory though currently only Virginia has passed a law.
These are important factors to consider when facing the decision to vaccinate. Dr. Gibbens says, "it's like the polio vaccine our babies receive. Were not planning on exposing them to polio but life happens. If they're exposed to diseases they've been vaccinated against, at least we know they're protected." Most children receive vaccination for Hepatitis B during routine childhood vaccinations. Guess what? That's an STD too.
New information is coming in all the time about health, wellness and preventative measures to keep our children healthy through adulthood. CNN reported in September 2007 that Gardasil partially blocks infection by 10 strains of HPV on top of the four types targeted. That boosts protection, at least partially, to 90% of strains causing cervical cancer, according to data presented by Merck (maker of Gardasil). Our job at Women's Health Today is to help parents and patients sort this information out, become informed and comfortable enough to make solid choices. We're in it together.