Human papillomavirus is the most commonly transmitted viral infection. Although there are many types, many do not cause problems and often times go unnoticed clearing up on their own. However, a handful of strains can progress into a nightmare– cancer– specifically cervical cancer. Usually spread between sexually active men and women, it does not require penetration to cause infection but can also be spread via skin-to- skin genital contact as well. Once infected, it takes about 15-20 years to develop into cervical cancer for those women with healthy immune systems, but those who are immunocompromised cancer may develop in only 5-10 years!
Thankfully, there is a vaccine to combat this common infection. Primary prevention begins as early as the ages of 9-14 in order to ensure that the vaccine is given before becoming sexually active. Currently, there are three vaccines that protect against HPV 18 and 16 which are known to cause a whopping 70% of cervical cancer, the third vaccine also protecting against another 20% of cervical cancer. Although post-marketing surveillance and clinical trials have shown that these vaccines are very safe and effective against preventing viral infection against HPV, these vaccines are not effective if the virus has already been obtained such as in unvaccinated sexual active individuals.
Although it was originally approved for people ages 9-26, the Food and Drug Administration (FDA) recently expanded its approval for the vaccine Gardasil 9 in 2018 to also include men and women between the ages of 27- 45. The vaccine is taken in two doses with several months separating each dose for those 9-14, and those who are older it is given in three doses. The reasoning for expanding the age range of individuals who are vaccinated stems from the fact that although many individuals will or have already encountered strains of HPV, the probability that they have encountered all of the nine strains that Gardisal 9 protects against is unlikely, and thus there is added benefit to vaccinating the older population. The FDA based their decision on data of the original Gardisal vaccine which included 3200 women ages 27-45 where the long-term follow up showed Gardisal was effective in preventing genital warts, persistent infections, and precancerous lesions. The version of Gardisal 9 that is currently on the market was approved in 2014 and doubled the number of strains that it protects against.
Although the vaccine has helped to prevent countless infections, many people were skeptical of the vaccine when it first became available for administration. The vaccine can cause allergic reactions, fainting, blood clots, and less likely Guillain-Barre Syndrome (GBS). However, the big opposition came when 56 girls had died from the vaccine as of September 2010, as well as deaths of 6 children in vaccine trials in India. Many people feared that it was a money making scheme from big pharma with the vaccine being one of the most expensive on the market. However, the vaccine has been nearly 100% effective in preventing precancerous lesions in HPV strains 16 and 18 and also genital warts. In fact between the years 2014-2017 29 million doses of Gardisal 9 had been administered and only 4 confirmed cases of GBS were reported and fatality rate of zero, meaning although negative side effects are possible they are not probable.
The vaccine has definitely done way more good than harm!
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