Patients slow to sign on for the three-dose vaccination
Back in October 2006 the U.S. Centers for Disease Control and
Prevention’s Advisory Committee on Immunization Practices
recommended a vaccine that would prevent nearly 70 percent of
cervical cancer. Just last month, the CDC officially accepted the
recommendation in a move that will make the vaccination accessible
not just through private insurances but also in low-cost and
no-cost public clinics.
Patients slow to sign on for the three-dose vaccination
Back in October 2006 the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommended a vaccine that would prevent nearly 70 percent of cervical cancer. Just last month, the CDC officially accepted the recommendation in a move that will make the vaccination accessible not just through private insurances but also in low-cost and no-cost public clinics.
The vaccination is Gardasil, created by Merck, and it protects against infection of four common types of the Human Papillomavirus, or HPV.
HPV, which has more than 100 types, is the most common sexually transmitted disease, according to local physician Ralph Armstrong. In the United States, about 6.2 million people get the disease each year, according to the CDC.
“If you are looking at a lifetime of women, 80 percent of all women have been exposed to HPV,” said Armstrong, who works as an obstetrician-gynecologist. “About 60 percent show they have been exposed because they have antibodies, but they have no evidence of the disease.”
Most types of the virus cause no symptoms or minor symptoms and go away on their own.
But several types of the virus have more severe symptoms and have no cure.
HPV types 6 and 11 cause nearly 90 percent of genital warts. Types 16 and 18 are known to cause 70 percent of cervical cancers.
In San Benito, residents have shown mild interest in the vaccination since its release, Armstrong said.
“I’m a little surprised,” he said. “But we have given it here in the office and there are other physicians who have given it.”
Armstrong conducted a free lecture on HPV and the new vaccination for women who had questions about it.
“A big part is educating people on the community level because a lot of people think, ‘It can’t happen to me or it can’t happen to my daughter,'” he said.
The San Benito Public Health department has received some calls from families wanting more information about the vaccine.
“We’ve had some phone calls from parents to see if we had it,” said Kathy Boulware, a supervising public health nurse for San Benito County. “It’s new and it’s a matter of supply catching up with demand. Eventually it will be everywhere.”
Gardasil requires a series of vaccinations before it is effective – a second dose two months after the first dose and a third dose six months after the first dose. Because of this, the County Public of Health will not be offering it at regular low-cost and no-cost vaccination clinics. Instead the department will take appointments for the vaccination when they have enough of it to meet the three-dose requirement.
Without insurance, the vaccine goes for $120 per dose.
In the United States about 10,000 women are diagnosed with cervical cancer each year, according to the CDC. Nearly 4,000 women die from it each year.
“This can prevent cervical cancer,” Boulware said. “It’s something that is a very important vaccination for people to get.”
Worldwide, the morbidity rate is even higher for those diagnosed with cervical cancer since women in some countries don’t have access to pap smears, a test that can identify precancerous cells on the cervix in time for treatment.
“We will be able to decrease it not just in our country, but worldwide,” Armstrong said.
Cervical cancer is the second leading cause of cancer deaths in women around the world.
While much of the hype around the vaccination since it was released in Oct. 2006 has been around vaccinating girls before they enter their teens – since the vaccination is most effective in girls and women who have not been exposed to HPV – the shot is authorized for women up to age 26.
“It is important to get patients before their first episode of intercourse,” Armstrong said. “But even if [patients] have been exposed to one type of HPV, it will still protect them against the other three.”
Doctors do not test for specific types of HPV, Armstrong said, but research has shown that the chances of a woman having all four types of HPV that Gardasil protects against is less than 1 percent.
The clinic trials found the vaccine to be effective for five years and it has mild side effects. The most common are pain at the injection site, redness or swelling at the site and a mild fever.
Because other HPV viruses than the ones immunized against by Gardasil can cause genital warts or cervical cancer, regular check ups are still important, Armstrong said.
“(Patients) should still get the annual pap test and they shouldn’t participate in risky sexual activity,” he said.
Clinical trials are already under way to see if the vaccination works on males and some states have legislation in the works that will mandate the vaccine for all incoming sixth-grade girls.
“A lot of people don’t like that,” Armstrong said. “People need to be comfortable with it, learn about it, and understand its importance first. Then it should be required.”
For now, he recommends patients within the age bracket for which the vaccine has been licensed – 9 to 26 – receive the vaccination.
“It works best when everybody gets it,” Armstrong said. “It’s just a matter of time before men and boys will also have [the vaccine].”
By the Numbers
10,000 – Number of U.S. women diagnosed with cervical cancer each year.
3,700 – Number of U.S. women who die from cervical cancer each year.
70 percent – percentage of cervical cancer linked to HPV 16 and 18 which can be prevented by Gardasil.
9-26 – ages of females for which the vaccine is licensed.
Information courtesy of the Centers for Disease Control and Prevention.
