In March 2008, researchers at the Centers for Disease Control and Prevention (CDC) released results of a new study of adolescents and sexually transmitted diseases. This first national study of four common sexually transmitted diseases (Human Papillomavirus, Chlamydia, genital herpes and Trichomoniasis) among girls and young women (ages 14 to 19 years) found that one in four are infected with at least one of these diseases. Given how common sexually transmitted diseases are among girls and young women, the availability of Gardasil is good news.
In 2006, the Advisory Committee on Immunization Practices (ACIP) voted to recommend Gardasil, the first vaccine developed to prevent cervical cancer and other diseases caused by certain types of genital human papillomavirus (HPV). Gardasil protects against four types of HPV (types 6, 11, 16 and 18), which together cause 70% of cases of cervical cancer and 90% of genital warts cases.
The Food and Drug Administration (FDA) recently licensed this vaccine for use in girls and women, ages 9-26 years of age and the CDC has added Gardasil to its Vaccines for Children Program. Both the CDC and the North Carolina Division of Public Health recommend the vaccine for all 11-12 year old girls as well as girls and women 13-26 years of age who did not receive it when they were younger, and advise that it may be given to girls as early as age 9.
As Gardasil is a new vaccine, it is not surprising that families of girls and young women may have many questions about the vaccine, HPV, and cervical cancer. Are you prepared to answer their questions?
Human Papillomavirus, commonly called HPV, is a group of viruses that includes more than 100 different types. About 30 of these types can be transmitted sexually. According to the Centers for Disease Control and Prevention, HPV is the most common sexually transmitted infection in the United States. Most people with HPV will never have any symptoms and will never know they are infected. For most women, the body will rid itself of the virus over time. Some types of HPV; however, can cause cervical cancer or abnormal cells in the cervix that can become cancerous. Other types can cause genital warts.
Studies have shown that Gardasil is nearly 100% effective against HPV types 16 and 18 which cause approximately 70% of cervical cancer cases and against HPV types 6 and 11 which cause approximately 90% of genital warts cases.
The vaccine does not protect against other types of HPV that are not included in the vaccine, some of which can also cause cancer. The vaccine does not cure HPV infection and it does not cure genital warts, precancer or cancer. Gardasil will not prevent about 30% of cervical cancers and about 10% of genital warts, nor will it prevent other sexually transmitted diseases. Regular PAP smears are still needed to screen for cancers and precancerous conditions of the cervix, and adolescents still must take steps to avoid exposure to other sexually transmitted diseases.
At this time, Gardasil is only proven effective for people who have not already been infected with HPV. For this reason, it is important to vaccinate before sexual activity begins. Research is underway on the effectiveness of the vaccine for older women. The vaccine is not recommended for pregnant women.
The FDA has licensed Gardasil as safe and effective. This vaccine has been tested for safety in more than 11,000 girls and young women ages 9-26 years. These studies have shown no serious side effects. The most common side effects of the vaccine are pain, swelling, itching and redness at the injection site; fever; nausea; and dizziness.
It is not yet known how long the vaccine will protect girls and young women against HPV. Research is being done to find out how long protection will last and if a booster vaccine will be needed. Current research has shown the vaccine to offer protection for at least 5 years.
The vaccine is given in a series of three injections over a six month period. The retail price of the vaccine is $120 per dose ($360 for the full series of three shots). Some private health insurance carriers cover the cost of the vaccine. CDC has added Gardasil to its Vaccines for Children Program which provides no-cost immunizations to Alaska Natives, American Indians, Medicaid-eligible children and some uninsured and underinsured children through age 18.
Cervical cancer is the second most common cancer in women in the world (470,000 cases worldwide each year/233,000 deaths each year)
In North Carolina:
373 women were diagnosed with cervical cancer (2004)
It is the law!
In North Carolina, local departments of health are required to distribute information about HPV and the vaccine, through schools, to all parents of children in grades five through twelve.
Sources: North Carolina State Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Food and Drug Administration
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