A vaccine success story

In a remarkable announcement regarding the first vaccine which is primarily aimed at preventing a cancer causing virus from affecting our young, a national survey has revealed that the prevalence of human papilloma virus (HPV) has dropped by half among teen age girls. The vaccine, first approved in 2006, is recommended for girls and young women between 11 and 26. The Center for Disease Control and Prevention’s Advisory Committee on Immunization also recommends that males ages 11 to 21 should be vaccinated against the human papilloma virus (HPV), the most common sexually transmitted disease in the United States. 

Although most patients are unaware, up to 80% of sexually active people will be exposed to HPV at some point in their life, and be at risk for infection of their penis, anus, mouth or throat. It is estimatated that 79 million Americans are infected with the virus.  On October 25 the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to recommend that males ages 11 to 21 should be vaccinated against the human papilloma virus (HPV), the most common sexually transmitted disease in the United States.  Most will overcome the infection with no long term effects, but in some people the infection leads to cellular damage which may lead to cancers of the cervix, vagina and anus in women and cancer of the penis and anus in men. Evidence has linked HPV infections with throat cancers in both sexes as a result of oral sex; one study found 70% of “oropharyngeal” cancers are related to HPV infection. Researchers from the University of Texas have even reported a relation between HPV and cardiovascular disease, but this is preliminary and needs confirmation.

At any given time, about 1% of sexually active men have genital warts from HPV, and each year the virus leads to 5,600 throat cancers, 1,500 anal cancers and 400 penile cancers. Men who have sex with men are 17 times more likely to develop anal cancer than men who have sex only with women, and patients with HIV infection are at higher risk to develop long term complications from HPV infection.

Currently there is no test for HPV in men, and there is no treatment or cure. Condom use may lower the chance of HPV infection, but are not 100% effective. Because HPV is so common and usual invisible to the infected patient, the only sure way not to get it is to not have sexual contact.

The HPV vaccine only protects against new infections; it has no effect on established infections. That is why it is recommended vaccination be given at age 11 or 12, before sexual activity has begun. The protocol is a series of three shots (the second 1-2 months after the first and the third 6 months after the first). It is very safe and effective, with no serious side effects.

Unfortunately, the HPV vaccine has become politicized. There are some who believe vaccinating pre-teens for a sexually transmitted disease may encourage early sexual behavior. There is no evidence for this. A former presidential candidate claimed that the vaccine was associated with a risk of subsequent mental retardation. This was unfortunate and irresponsible as there is so such link.

Parents need to discuss whether their children should receive the HPV vaccination with their pediatrician, and make a decision based on his/her medical advice. For more information on human papilloma virus, go to the CDC website at: www.cdc.gov/hpv/WhatIsHPV.html.