Tuesday, August 01, 2006

Cervical Cancer Vaccine

Most cases of cervical cancer in the world are caused by the human papilloma virus (HPV).. Recently the FDA (U.S. Food and Drug Administration) approved Gardasil, a vaccine against the HPV. CDC's National Immunization Program (NIP) and the federal Advisory Committee on Immunization Practices (ACIP) have recommended the HPV vaccine to be given to girls from 9 to 26 years old.

What is HPV ? HPV is a family of more than 100 types of viruses which may be transmitted sexually. At any time 20 million to 40 million Americans may be infected with HPV, and the incidence is increasing. Many cases of the infection may not show any symptoms and many may resolve spontaneously. However, some types of HPV may cause genital and anal warts and other types may cause cervical, anal or rectal cancer. The transition to cervical cancer may take 5-10 years. The condom is limited in preventing infection because it does not prevent all skin- to- skin contact during sex.

Who should receive the vaccine? Girls from 9 to 26 years old are recommended to receive the vaccine. The vaccine is most effective if it is given prior to infection by the virus. It does not protect against all types of HPV so routine Pap smears are still necessary (sorry ladies). The vaccine is given in 3 doses over a 6 month period (0, 2 and 6 months) and will cost about $360.00 total.

Is the vaccine safe? According to the FDA, "The safety of the vaccine was evaluated in approximately 11,000 individuals. Most adverse experiences in study participants who received Gardasil included mild or moderate local reactions, such as pain or tenderness at the site of injection." The vaccine can not infect you with the virus since it is a recombinant vaccine and not a live one.

How long will the vaccine last? It is unknown since this is a new vaccine but so far it has been effective up to 5 years. More data will emerge with time.

Is there a test for HPV? A test may be done during a Pap (Papinocalou) smear to detect the presence of HPV. This is recommended to be done in women 30 years or older if done for screening purposes because the prevalence of HPV is very high in younger women and often it may clear spontaneously.

Can the vaccine be given to men for protection against anal and genital warts and cancer? This is currently under investigation.

References: Center for Disease Control. Journal of the National Cancer Institute. Dr. Huyen Cao, Director of International Cellular Immunology, California Department of Health Services.
Photo: courtesy of wart resources.

Click here to read in Farsi.


Haleh said...

Dear Taraneh, As someone who has had abnormal PAP tests on and off for the past 6 years I was ecstatic to hear the news of this when it was released. As yet I think we in Australia don't have it available yet (funny, given that it was actually discovered by Aus scientists).

I shall be rushing to get my 18 year old vaccinated as soon as it's offered here (will have to check with our GP as it may well be available since I last asked).

Thanks for writing about it.

Dr. Taraneh Razavi said...

Dear Haleh

I am very glad that this post was useful to you. Please do ask your GP. The first dose of the vaccine given in my private office was given to my 19 year old niece.

alireza said...

Your interview with ZDNET was very interesting and informative for me.
I have translated it into persian.


specialistdoctor said...

hi doctor,
i am a gyn specialist from India.just started blogging.Article on ca cx vaccine was informative.

specialistdoctor said...

hi from India.
i am a new blogger.nice to read ur article

Anonymous said...

به شما تبريك ميگم و خوشحالم كه با يك هموطنم و نوشته هاي مفيدش آشنا شدم.

موفق باشيد

Dr. Taraneh Razavi said...

Dear Mohsen

Kheylee Mamnoon.

کوچولو-- یاورهمه said...

سلام ترانه خانوم
واقعاً در حق مردم لطف می کنید
فقط اومدم که ازتون تشکر کنم
و امیدوارم تو تمام مراحل زندگی موفق باشید
اینم وبلاگم اگه خواستین یه نگاهی بکنین:

GiListing said...

Though the price is high, but it seems that it's worth it !

Anonymous said...

The CDC site says that the vaccine is not advised for women over 27 years of age. Why is that?

Dr. Taraneh Razavi said...

The upper age limit of 26 is simply due to the fact that the vaccine has been studied in this age population so far. Studies are being conducted to establish the efficacy and safety in women older than 26. Another factor to consider is that the vaccine seems to be most effective if administered before the onset of sexual activity.

Anonymous said...

Dr. Taraneh,
My husband and I have been trying to get pregnant for awhile now. I had an abnormal pap test come back. I had HPV,but no warts and it wasn't really bad. My doctor said my body was fighting it. I started the first gardasil vaccine and then 3 weeks later I found out I was pregnant. After 5 weeks of pregnancy I miscarried. Could the vaccine be a posible cause? We are continuing to try again to get prenant. Should I get my next gardasil shot because it is due next week or should I skip it? Thank you.

Anonymous said...


Anonymous said...

Dr. Razavi,
I am twenty six. I turn twenty seven in about three months. I went to the health clinic to get Guardasil, and they told me that I could only get two dosages because of my upcoming birthday. My question is it worth getting only two if I am unable to get the third.

Dr. Taraneh Razavi said...

The complete vaccine series requires 3 doses. The age that you start the vaccine should not effect how many shots you get.