Do You Want to Spare Your Daughter a Colposcopy and LEEP?
Between 50%- 75% of adults will acquire some type of human papilloma virus (HPV) if they are sexually active. This is particularly likely if they, or their partner, have had more than one partner. The FDA has recently approved the first vaccine (Gardasil ®) which prevents HPV infections linked to cervical cancer, abnormal PAP smears, and even genital warts. Here are some points to consider if you are thinking about immunizing your daughter - or yourself.
Who Should Get Vaccinated?
The FDA has approved Gardasil for females between the ages of 9 and 26. The greatest number of persons acquiring HPV are young women 15 to 24 years old. The vaccine is most protective for women who have not yet become sexually active. Thus, if a woman is virginal the vaccine might still be given if she over 26 years of age.
Acquiring the virus when a teenager is particularly worrisome. In a young woman there is a proportionally larger area of a more delicate, vulnerable tissue (glandular epithelium) on the face of the cervix. With time this tissue is replaced by squamous epithelium which provides a thicker protective layer—more like our external skin. Viruses are opportunists. The mild tissue trauma of intercourse coupled with a more fragile cervical skin could make it easier for the virus to gain entry.
One well done study by Ho and colleagues (1998) followed older adolescents over three years. At the end of the study some 43% became HPV positive. This confirms the ease with which HPV can be passed between sexual partners. Surprisingly, of this group of newly infected women, only 9% continued to show persisting evidence of HPV. In many cases, especially with the "low risk" subtypes of HPV, a competent immune system can appear to clear the evidences of viral infection. Yet HPV can be acquired and be "dormant". Then, in times of a lowered immune function (e.g., pregnancy, chronic illness, or use of immune suppression drugs), dormant viruses such as herpes and HPV can produce significant infections.
Which Vaccine Should You Choose?
There are more than 30 types of HPV which are sexually transmitted. These have been classified into "low risk" and "high risk" subtypes. HPV subtypes 6 and 11 are considered to be low risk. They are linked primarily to the cauliflower-appearing genital warts, and low grade cervical lesions (eg LGSIL, CIN 1). Subtypes 16 and 18 are considered to be high risk as they are linked with persisting HPV infections and severely abnormal PAP smears. These two high risk subtypes are the probable cause of about 70% of cervical cancers.
The currently available Gardasil vaccine provides protection for all four of the HPV subtypes mentioned above. Another vaccine, "Cervarix" will likely be available in the near future. The Cervarix vaccine has been shown to protect from HPV high risk subtypes 16 and 18. Both vaccines have been shown in large research studies to provide 100% protection for the high risk subtypes.
OK, What Are the Downsides to Getting an HPV Vaccine?
Both vaccine require a series of three injections spread over a six month period. Currently it is not known if a booster shot would be needed when the woman is older to help keep her immunity at a protective level. Studies are ongoing to try and answer this question
While most major insurance companies are hopefully going to cover the cost of this vaccine, paying for the series of injections would be $360.00 if paid out of pocket. If a low income young woman is covered by the Vaccines for Children Program, this vaccine is paid for by the program.
Gardasil is a non-live virus type of vaccine. It does not contain the controversial ingredients thimersol or mercury. There is not enough long term data to suggest that it can be given during pregnancy. There are several medical conditions (eg immune suppressed) where a vaccine may not be as effective.
Like many other immunizations where an injection is required there is the trauma of getting "a shot". The most common side effect of this injection was redness and swelling at the injection site—this was experienced by about 25% of subjects receiving the vaccine. Other less common side effects were soreness or itching at the injection site, or low grade fever.
Are You Going to Get This, Jane?
Alas, I am too old, and have had too many sexual partners over my early life. But if I had the opportunity I would certainly do this. My parents had me vaccinated against smallpox. This was considered routine at the time. Some countries routinely vaccinate for tuberculosis. I believe all parents have to consider the pluses and minuses of giving preventative vaccines to some pathogen their child may never encounter. HPV is an infection that a majority of persons will contract. In my professional opinion this vaccine offers advantages to women not yet sexually active.
For more in depth information consider reading this report from the Centers for Disease Control (CDC): Recommendations of the Advisory Committee on Immunization Practices.
Related Topics: Technorati Tags: human papilloma virus, HPV, vaccine, STD, Gardasil, cervical cancer, womens health
Who Should Get Vaccinated?
The FDA has approved Gardasil for females between the ages of 9 and 26. The greatest number of persons acquiring HPV are young women 15 to 24 years old. The vaccine is most protective for women who have not yet become sexually active. Thus, if a woman is virginal the vaccine might still be given if she over 26 years of age.
Acquiring the virus when a teenager is particularly worrisome. In a young woman there is a proportionally larger area of a more delicate, vulnerable tissue (glandular epithelium) on the face of the cervix. With time this tissue is replaced by squamous epithelium which provides a thicker protective layer—more like our external skin. Viruses are opportunists. The mild tissue trauma of intercourse coupled with a more fragile cervical skin could make it easier for the virus to gain entry.
One well done study by Ho and colleagues (1998) followed older adolescents over three years. At the end of the study some 43% became HPV positive. This confirms the ease with which HPV can be passed between sexual partners. Surprisingly, of this group of newly infected women, only 9% continued to show persisting evidence of HPV. In many cases, especially with the "low risk" subtypes of HPV, a competent immune system can appear to clear the evidences of viral infection. Yet HPV can be acquired and be "dormant". Then, in times of a lowered immune function (e.g., pregnancy, chronic illness, or use of immune suppression drugs), dormant viruses such as herpes and HPV can produce significant infections.
Which Vaccine Should You Choose?
There are more than 30 types of HPV which are sexually transmitted. These have been classified into "low risk" and "high risk" subtypes. HPV subtypes 6 and 11 are considered to be low risk. They are linked primarily to the cauliflower-appearing genital warts, and low grade cervical lesions (eg LGSIL, CIN 1). Subtypes 16 and 18 are considered to be high risk as they are linked with persisting HPV infections and severely abnormal PAP smears. These two high risk subtypes are the probable cause of about 70% of cervical cancers.
The currently available Gardasil vaccine provides protection for all four of the HPV subtypes mentioned above. Another vaccine, "Cervarix" will likely be available in the near future. The Cervarix vaccine has been shown to protect from HPV high risk subtypes 16 and 18. Both vaccines have been shown in large research studies to provide 100% protection for the high risk subtypes.
OK, What Are the Downsides to Getting an HPV Vaccine?
Both vaccine require a series of three injections spread over a six month period. Currently it is not known if a booster shot would be needed when the woman is older to help keep her immunity at a protective level. Studies are ongoing to try and answer this question
While most major insurance companies are hopefully going to cover the cost of this vaccine, paying for the series of injections would be $360.00 if paid out of pocket. If a low income young woman is covered by the Vaccines for Children Program, this vaccine is paid for by the program.
Gardasil is a non-live virus type of vaccine. It does not contain the controversial ingredients thimersol or mercury. There is not enough long term data to suggest that it can be given during pregnancy. There are several medical conditions (eg immune suppressed) where a vaccine may not be as effective.
Like many other immunizations where an injection is required there is the trauma of getting "a shot". The most common side effect of this injection was redness and swelling at the injection site—this was experienced by about 25% of subjects receiving the vaccine. Other less common side effects were soreness or itching at the injection site, or low grade fever.
Are You Going to Get This, Jane?
Alas, I am too old, and have had too many sexual partners over my early life. But if I had the opportunity I would certainly do this. My parents had me vaccinated against smallpox. This was considered routine at the time. Some countries routinely vaccinate for tuberculosis. I believe all parents have to consider the pluses and minuses of giving preventative vaccines to some pathogen their child may never encounter. HPV is an infection that a majority of persons will contract. In my professional opinion this vaccine offers advantages to women not yet sexually active.
For more in depth information consider reading this report from the Centers for Disease Control (CDC): Recommendations of the Advisory Committee on Immunization Practices.
Related Topics: Technorati Tags: human papilloma virus, HPV, vaccine, STD, Gardasil, cervical cancer, womens health
5 Comments:
Jane, thank you for your insightful report on the HPV vaccine.
You mention that you’re too old for the vaccine; however, even though you may be older than the recommended age for the vaccine, it is equally as important to know about and get the HPV test with your Pap if you are 30 and older.
There’s a great site with really helpful information at:
http:www.theHPVtest.com
Women over the age of 30 are most at risk for cervical cancer and it’s the most easily prevented cancer IF you get tested with the right tests regularly and early enough. The HPV test actually identifies the HPV strains that cause cervical cancer, so you can find out if you have a problem even earlier than if you only have a Pap smear.
As a 11 year cervical cancer survivor, I didn’t have the benefit of the HPV test. If I had the test along with my Pap, the cancer would have been discovered long before I needed a hysterectomy.
Please get the test and tell all the women you know to do the same. It can save your life.
Gratefully and enthusiastically alive,
Mary Marcdante
Women’s Health Advocate
Speaker and Author of:
My Mother, My Friend
Living with Enthusiasm
www.marymarcdante.com
Jane,
In Febuaury I went in for my yearly PAP and my GYNO said I had a small bacterial infection, and she was going to test me for HPV and I had no idea what that was. I was scared and I did not say anything to my fiance yet because I did not know what it was. I did my research and found out what it is. So when I went back in to be seen she told me I had HPV and that she wanted me to have a colposcopy. I was like why? She explained things to me and let me tell you it is very uncomfortable. I later found out my results in 4 days when they tell you about two weeks that I had pre cancerous cells on my cervix and I was scared, and it had to do HPV had no idea. Because I do not have insurance I had to go through the state of california and go see a a different GYNO who was going to remove the cells and preform a LEEP. I couldnt do it in the office so I had to wait 3 1/2 months to have it done in the OR and its so uncomfortable and the next month after that. I wish the vaccine was available. I have to have PAPS every 2-3 months to make sure. If you have the oppurtunity to get the vaccine get it. Read up on HPV become aware. Going through all these procedures is not worth it and its painful and uncomefortable. Its good you posted this because younger girls need to know and see what we have to go through not having the knowledge they have available to them now.
I had a positive HPV result from an annual pap 3 years ago. My dr. basically told me it was like an STD and that husbad HAD to have been with someone else for me to have gotten it. I went home and SCREAMED at my husband b/c he had told me I was his first! However he is a very truthful and trustworthy person and he swears up and down that he has not. I have not been with anyone else either. After looking on the internet for some info, I found a little known fact that it is possible to be a carrier of the hpv virus. You can infect your partner even if neither of you has been with anyone else. We need to be telling people about this also, so that realationships are not ruined b/c people are speculating affairs are going on. I have had several people tell me I should leave my husband b/c this HAS to mean he HAS been unfaithful, but I believe him.(Thankfully my strain was not one of the ones that can cause cervical cancer and I have now had 2 negative paps.)
I was looking ion the internet but you can pretty much find any answer you're looking for there... even if it's not actually true. So I was wondering.. Is it true that it's possible to contract HPV through something other than sex, or even genital skin to skin contact? I've seen "facts" on toilet seats, hand to hand, hand to genital. What of this is actually true? or is it only sexually transmitted unless you're born a carrier?
Yes, could someone please QUANTIFY how many years the virus can lay dormant? You always see phrases like, "HPV can lay dormant weeks, months - even years", but don't scientists/doctors understand that marriages are riding on this??? Ten years ago I was diagnosed with precancerous cells on my cervix; after 2 freezings (not painful) they were gone, but the damage had only just begun. I had been married to my high school sweetheart for 20 1/2 years, so the first words out of my mouth when my doctor told me how I'd gotten it was "How long can it lay dormant in your body?". Of course he said it would depend on your immune system, but he said usually 2-5 years, possibly 10 years or more, no one really knew. When I asked if it could stay dormant for 20 yrs., he didn't really think that would be possible, but he wouldn't rule it out! Well of course my husband denied it, and I believed him... but that seed of doubt was planted. We really tried to work things out, but after 10 years of doubt, we just couldn't go forward. Our divorce was final this past Tuesday.
I FINALLY got the HPV test for the first time w/my last pap. It came back negative, but it did show markers for HPV 18, which my doctor explained meant that I had this particular strain at some point years ago. Not a lot of help, really!
I had the perfect marriage for 20 years, I really did. If I had a daughter, I would DEFINITELY have her vaccinated - sometimes what you know hurts much more than what you don't know.
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