Wednesday, May 9, 2012

Human Papillomavirus (HPV) -- warning: some mature content!

     We have now had the human papillomavirus vaccine available for the last 5 years. The ongoing research into the vaccine has shown excellent protection for those young women who were first vaccinated 11 years ago when it was first being studied. We have actively recommended the vaccine to pre-teen and teen females over the last few years. Now there is an added recommendation to vaccinate the boys. We recommend this for our pre-teen and teen boys in the office. We have recently found that the insurance coverage is now very good and the vast majority of insurance plans are covering it for girls and boys. There are two vaccines, Gardisil and Cervarix. Based on many factors, we now recommend (as many national experts do) that the girls receive the Cervarix and the boys the Gardisil. Vaccinating the boys protects them from genital warts and their partners and spouses from possible cervical cancer. For boys and girls, the vaccine is a three part vaccine: one initially, one 2 months later, and the final dose 6 months after the first.
     More background on human papillomavirus (HPV): HPV is a family of viruses with different types. The different types infect the skin or mucous membranes. They cause genital warts, cervical cancer, throat and mouth cancers, and other cancers of the private parts. HPV is the most common sexually transmitted infection in the US. It is estimated 75-90% of sexually active people will become infected some time in their lives. It has been shown that between 20-25% of all women who are virgins at marriage become infected with the virus through their spouse. HPV is passed from one person to another through genital contact, usually during sex.
     Most people with HPV do not develop symptoms or health problems (with no symptoms, it can be hard to avoid passing to someone else). The body's immune system clears the HPV infection 90% of the time within 2 years. If it does not clear the infection, it may be months or years later that a pre-cancerous or cancerous change occurs. During this time, the vast majority of these people have no symptoms or signs of a problem (no warts, no pain, no abnormal bleeding or sores). Most people with cervical pre-cancer or cancer find out with their Pap smear by their gynecologist at their annual visit. Cervical cancer causes 300,000 worldwide deaths every year. Some women with cervical cancer require a hysterectomy and then are unable to have children.
     Occasionally families ask me if I believe that vaccinating the teenager against HPV is sending a wrong message. I do not believe this is true. Although the virus is spread through sexual contact, I do not believe protecting someone against HPV is sending the wrong message. I often will tell teens "we hope you are not sexually active until you are in a long-term, committed relationship, ideally marriage". And I do not believe anyone has ever abstained from sexual activity due to a fear of cervical cancer.
     So we remain big advocates for the vaccine to prevent cervical cancer. If you have questions, please discuss it with your physician. The following websites contain lots of good information.
CDC's information

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