FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

ALL FEMALES -- FROM 11 TO 26 -- SHOULD GET NEW HPV VACCINE

Question: My doctor has recommended that I get the new HPV vaccine. None of my friends have gotten it yet. I hear it’s expensive. Should I get it, and if so, why?
Answer: Since you didn’t give me any specific information about your medical history or your age, I’ll confine my remarks to a general overview of the new vaccine you are asking about. It protects against some of the more dangerous strains of HPV, the Human Papilloma Virus.

There are about 100 HPV strains, but four types -- 6, 11, 16 and 18 -- cause most of the significant medical problems. These problems include cancer of the cervix, precancerous cervical lesions, precancerous vaginal lesions and less dangerous, but highly contagious, genital warts. These viral strains are all sexually transmitted, and the conditions they can cause may have no symptoms.

It’s important to note that each of these four strains is associated with specific conditions. Types 16 and 18, for instance, are responsible for 70 percent of cervical cancer cases. On the other hand, 6 and 11 cause about 90 percent of genital warts.

Cancer of the cervix can be life threatening because there are usually no symptoms of the disease until it is in the late stages. Genital warts can be on the inside of the vagina or on the external genitalia. They are skin-colored growths that can be painful. They do not turn to cancer, but it can take several treatments before they are gone. They can be spread even if you don’t know that you have them.

The new HPV vaccine has been tested around the world for several years and has been found to be safe and effective against the four strains most likely to cause problems. It is one of the new “high-tech” vaccines that do not rely on killed or weakened viruses. Instead, it uses just a few proteins that have been extracted from the virus to awaken your body’s immune system so that it can ward off an attack by live viruses.

The Centers for Disease Control (CDC) recommends that all girls 11 or 12 years old be vaccinated. The reason for such early vaccinations is that these shots work best if given before exposure to HPV. It’s also being recommended that girls and women 13 to 26 receive the vaccine regardless of their Pap test results. No recommendations are being made at this point for older women or for males.

Anyone who is sexually active is at risk for contracting HPV. It is estimated that 50 percent of all sexually active people have HPV. Even if you already have HPV, you may benefit from the vaccine. It’s unlikely that you are infected with all four of the types that the vaccine protects against.

The HPV vaccine is given in a three-dose shot series. It is usually well tolerated but can cause some redness at the injection site. You should discuss side effects and allergies with your physician before taking this or any vaccine. Once you start the series, make sure you complete all three shots.

Of course, this vaccine only protects against HPV. It does not protect against any other sexually transmitted diseases or pregnancy. If you think you might be pregnant or want to get pregnant in the near future, you should tell your doctor before starting this vaccine.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.