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Spring 2011

HPV Vaccine Is First Ever Developed to Prevent a Type of Cancer


VS-Spring2011-HPV VaccineThe human papilloma virus (HPV) vaccine — the first vaccine designed to prevent a type of cancer — has been increasingly embraced by parents and the medical community since the U.S. Food and Drug Administration approved it in 2006.

The most widely used HPV vaccine, Gardasil, protects against the two strains that cause the majority of cervical cancers, as well as the two HPV subtypes responsible for roughly 90 percent of genital warts cases. In addition to being offered to preteen girls, it is recommended for older girls and young women up to the age of 26 who have not yet received it.

“The fact that we now have a simple and safe way to provide protection against viruses that are the causative agent for approximately 70 percent of cervical cancers and at least 50 percent of precancerous lesions is a huge deal,” says UCLA gynecologic oncologist Sanaz Memarzadeh, M.D., Ph.D.

HPV is the most common sexually transmitted infection in the United States; it is believed that at least half of sexually active people acquire one of the virus’ more than 40 strains during their lifetime, in most cases without knowing it. Dr. Memarzadeh explains that for a majority of carriers, the immune system clears the virus before it causes any symptoms or abnormalities. But for some, she says, HPV produces cell changes that can lead to cancer — cervical as well as less common but equally serious malignancies, including cancers of the vulva, vagina, anus, and head and neck.

Dr. Memarzadeh notes that although the HPV vaccine is aimed at only two of HPV’s cancer-causing subtypes, recent studies suggest that it may also carry some protective benefit against other strains that share its key genetic elements. Because the HPV vaccine does not prevent all cervical cancers, women are strongly urged to continue obtaining regular Pap smears even if they have been vaccinated.

The vaccine, generally given as a series of three shots over a six-month period, is typically recommended for girls at about the age of 11, says Kellie Ernzen Kruger, M.D., internal medicine-pediatrics specialist at UCLA Medical Center, Santa Monica. “Ideally, we want to vaccinate before the onset of any sexual activity,” Dr. Kruger explains. However, she adds, even for nonimmunized older girls and young women who might have been exposed to the virus through sexual activity or who know they are HPV positive, it is unlikely that they have all of the strains the vaccine prevents; thus, the vaccine is recommended for them as well. Dr. Kruger notes that the vaccine is considered highly safe and causes no significant side effects.

Initially, Dr. Kruger heard concern from some parents about the potential for their children to receive the wrong message from being given the vaccine. Administration of the vaccine is accompanied by counseling designed to convey what it protects against and what it doesn’t, as well as the other risk factors associated with sex. When all of this is explained, Dr. Kruger says, “most parents are very supportive of giving this to their daughter.”

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