Answering Parents' Questions about Gardasil

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Every year in the United States,roughly 3 million sexually active adolescents and young adults between 15 and 25 years old contract an HPV infection. Currently,Gardasil® is the only vaccine approved by the FDA to protect against four HPV types.Here we provide you with valuable information to answer parents' questions about HPV vaccination.

CANCER PREVENTION

Human papillomavirus (HPV) is the leading cause of sexually transmitted diseases among young people and young adults. Of the more than 100 different types of HPV viruses, about 40 different types infect the genital tract. Of these, HPV types 16 and 18 are responsible for 70 percent of cervical cancers and between 50 and 60 percent of other genital tract cancers, including penile, anal, vulvar and vaginal cancers. Types 6 and 11 are responsible for roughly 90 percent of genital warts.

Recommended by the Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practices, Gardasil protects against HPV types 16, 18, 6 and 11.While the vaccine is highly protective against types 16 and 18, other types of HPV also affect the genital tract and can lead to cervical dysplasia. Another vaccine which will protect against types 16 and 18, Cerverix®, is in clinical trials and awaiting FDA approval.

Even with the HPV vaccine, adolescent girls should continue to have Pap smear screenings within three years from becoming sexually active - and have general physical and gynecological (if sexually active) check-ups, including sexually transmitted infection screening annually.

VACCINATION RECOMMENDATIONS

The HPV vaccine is recommended for girls ages 11 to 12, but it can be given as early as 9 years of age and as late as 26. The vaccine is a three-dose series that is administered at month 0 and then again two and six months later. Most insurance companies are paying for the vaccine, which generally costs between $140 and $160 for each shot. Medicaid and Vaccine for Children's Programs cover the cost of this vaccine.

Side effects are minimal. The most common include redness, tenderness and sometimes a small amount of swelling at the injection site. Long-term side effects and immune responses are not known at this time, but vaccine manufacturers have ongoing, long-term clinical trials planned to address these questions. Studies also are ongoing with use of the vaccine in older women and males.

A SENSITIVE BUT IMPORTANT CONVERSATION

Vaccinating before a girl becomes sexually active is optimal for protecting against the HPV types that cause cervical cancer, since so many are exposed to the virus after becoming sexually active. Some families are concerned that vaccinating for HPV might condone sexual activity among teens and pre-teens. Parents are more likely to have their daughters vaccinated if they receive education and information about HPV and Gardasil.

Marcia Shew, MD

Associate Professor of Clinical Pediatrics
Division of Adolescent Medicine
Indiana University School of Medicine

317-541-3400
mshew@iupui.edu