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Summer 2007

Should Girls Get Vaccinated Against Cervical Cancer?

The controversy over whether the new human papillomavirus (HPV) vaccine should be mandatory for girls entering middle school should not obscure the fact that the vaccine has been shown to be highly safe and effective in preventing cervical cancer and genital warts. "It's remarkable that we now have an immunization that prevents cancer," says Martin Anderson, M.D., M.P.H., director of adolescent medicine at Mattel Children's Hospital UCLA.

HPV is the most common sexually transmitted disease in the United States, infecting approximately 6.2 million people each year, according to the Centers for Disease Control and Prevention. At least half of sexually active people acquire one of the virus' more than 30 strains during their lifetime. While most strains fail to produce symptoms and disappear on their own, certain strains are responsible for most cases of cervical cancer—diagnosed in more than 10,000 women each year in the United States and a killer of 3,700—as well as most cases of visible genital warts, which, although benign, are the source of considerable discomfort and emotional distress.

The U.S. Food and Drug Administration (FDA) approved the first HPV vaccine last year for girls and women ages 9 to 26 years old. The vaccine protects against two HPV strains that are responsible for 70 percent of cervical malignancies, as well as the two strains that cause approximately 90 percent of genital wart cases.

Shortly after the vaccine received FDA approval, the national Advisory Committee on Immunization Practices recommended that girls between the ages of 11 and 12 years be routinely vaccinated, before they become sexually active and at risk for acquiring the virus. That led many state lawmakers to introduce legislation to mandate the vaccine for girls entering sixth grade. (In California, such a bill was withdrawn.) Opponents have been vocal, concerned about issues ranging from the vaccine’s safety to the moral objection to a vaccine for a sexually transmitted disease.

"This is a very safe vaccine, and I see no downside to giving it to girls at the time they are having their compulsory pre-middle school physical," says Dr. Anderson.  For girls and young women who have already begun to be sexually active, and even for those who have acquired HPV, the vaccine is still recommended, Dr. Anderson explains, because the majority of infected women have only one of the four HPV strains that the vaccine prevents. Longer-term studies are needed to determine how long the vaccine remains effective; eventually, a booster shot may be required.





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