HPV vaccine

Gardasil, one of two currently available HPV vaccines, protects against types 6, 11, 16 and 18 of the human papilloma virus (HPV), which are sexually transmitted diseases that are endemic in the human population and which are carried by about half of sexually active men and women.[1][2] These strains of HPV have been associated with 70% of cervical cancer cases and may also play a role in the development of other types of cancer.[3] In June 2006, the U.S. Food and Drug Administration approved the first HPV vaccine based on observance of elevated antibody levels in a double-blind clinical trial involving over 20,000 subjects.[4] In addition to cancer, HPV can also cause other unwanted diseases such as genital warts.[5] It is a common virus that is easily spread during sexual contact.

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The HPV vaccine does not protect against other sexually transmitted diseases (e.g., chlamydia, herpes, hepatitis, trichomoniasis, gonorrhea, syphilis, HIV/AIDS, etc.). The vaccine is recommended for use by boys, girls, men, and women ages 9 through 26, but not during pregnancy.[6]

The long-term consequences of the HPV vaccine are not known and there have not been any long-term studies. Children in the 9-year-old age group have been monitored for 18 months, and there have been no studies of possible longer-term risks of the vaccine. Between June 2006 and March 2014, there were 25,063 reports of adverse events compared to 67 million vaccinations with 92.4% of the adverse effects being non-serious.[7] Under clinical trial conditions, the reports of adverse or severe reactions were not any higher for those receiving the vaccine versus those receiving a placebo.

A study published February 28, 2007 in the Journal of the American Medical Association (JAMA)[8] estimated that the HPV types (6, 11, 16, 18) targeted by the vaccine are present in about 3.4% of women in the United States, as measured by vaginal swab.

Merck manufactures the HPV vaccine ("Gardasil") and sells it for $360 ($120 per shot in a three-shot series). Its package insert explains the limitations of the vaccine and describes its testing for safety and efficacy.[9]

Alternative means of protection against cervical cancer include abstinence, and condom use, which does not provide absolute protection, but does significantly reduce the likelihood of HPV transmission.[10][11] HPV infection can be detected by Pap smear which is effective if done regularly, but does not prevent infection, only allows for treatment to prevent progression from infection to cancer.[12]

Some conservatives oppose the use of Gardasil on young girls, on the basis that it could discourage sexual abstinence and promote promiscuity.[13][14] This concern has no bearing on reality.[15]

See also

References
  1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5633a5.htm
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231998/
  3. http://www.cancer.gov/cancertopics/factsheet/Risk/HPV
  4. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5602a1.htm
  5. Genital Warts, symtoms and causes
  6. Merck.com — Gardasil
  7. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6305a1.htm
  8. JAMA 297(8):813-819, February 28, 2007
  9. http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
  10. http://content.nejm.org/cgi/content/full/354/25/2645
  11. Report to Congress 2004: Prevention of Genital Human Papillomavirus Infection, Centers for Disease Control and Prevention, Gerberding, J.L., M.D., M.P.H. (January 2004): pp. 3-4.
  12. http://www.cdc.gov/std/HPV/STDFact-HPV.htm#cancer
  13. "Who's Afraid of Gardasil?", Karen Houppert, The Nation, March 8, 2007.
  14. Gardasil: What Every Parent Should Know about the New HPV Vaccine, Moira Gaul, Family Research Council.
  15. Jena AB, Goldman DP, Seabury SA. Incidence of Sexually Transmitted Infections After Human Papillomavirus Vaccination Among Adolescent Females. JAMA Intern Med. Published online February 09, 2015. doi:10.1001/jamainternmed.2014.7886. Telling quote: "Human papillomavirus vaccination was not associated with increases in STIs in a large cohort of females, suggesting that vaccination is unlikely to promote unsafe sexual activity."
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