UCSB Student Health is now offering the new vaccine for the Human Papilloma Virus (HPV), one of the most common sexually transmitted infections.
The Federal Drug Administration approved the vaccine, Gardasil, from Merck and Co. this past June. Out of the 100 types of HPV, Gardasil will protect against HPV types 6, 11, 16 and 18. HPV types 16 and 18 cause about 70 percent of cervical cancer cases, and HPV types 6 and 11 cause 90 percent of all genital warts cases, said J. Thomas Cox, director of the Gynecology and Colposcopy Clinic at Student Health.
Cox was one of seven physicians on the FDA Data and Safety Monitoring Board for the vaccine trial.
“HPV is so common that 80 percent of all sexually active people get one or more of these HPV types in their lifetime,” Cox said.
According to the Center for Disease Control and Prevention, 3,952 women died from cervical cancer in 2002.
The HPV vaccine is available at Student Health for $149 per dose for 3 doses.
Currently Student Health Insurance does not cover this vaccine, however students who have insurance outside of Student Health may be covered. Cox said women should check with their insurance company to see if they are covered.
Elizabeth Downing, M.D., director of Student Health, said Student Health Insurance will hopefully cover Gardasil by next year.
“CDC is supposed to come out with an official recommendation in November,” Downing said. “We anticipate there will be federal and state funding for those eligible.”
There is no treatment for HPV, Cox said, but in most cases the infection will not lead to cancer.
“[Cervical cancer] is a very rare cancer, and usually it will clear up on its own, but we can’t predict who doesn’t clear it,” Cox said.
Although cervical cancer symptoms may not appear for 15 to 30 years after exposure, HPV infections may lead to genital warts within two to four weeks.
Except in cases where it causes genital warts, Cox said most people with HPV do not experience symptoms. However, some women will receive abnormal Pap smear results.
Cox said Pap smears effectively detect developing cervical cancer, thus reducing incidences of cancer.
“One of the reasons cervical cancer is so rare now is that screening or getting a Pap test regularly has decreased the likelihood of getting cervical cancer by 75 percent in the U.S.,” Cox said.
For the most part, Cox said, people can only contract HPV by direct genital contact; however, using condoms lowers the risk of contracting HPV by 70 percent.
“HPV is not as well protected by condoms as HIV, but 70 percent is better than nothing,” Cox said.
Cox said HPV, especially type 16, causes other genital cancers including vulval, vaginal, penal and 80 percent of anal cancers.
“So the vaccine given to a woman before she is exposed to any of these types will be protected from 90 percent genital warts and 70 percent cervical pre-cancers, cervical cancers and abnormal Pap smears associated,” Cox said.
The vaccine is not effective if the woman has already contracted all four HPV types that the vaccine protects against, but the vaccine is still effective if the person has contracted less than the four types.
“We do know from the trials that the vaccine does not produce a bad reaction, i.e. it’s not bad for someone who has had one or more of these types,” Cox said.
The CDC recommends Gardasil for women between the ages of nine and 26.
Cox said women who are pregnant or who may become pregnant during the process should not get vaccinated.
“The primary recommendation of the CDC is to give the vaccine at the age of 11 or 12 before the onset of sexual activity, but they also gave the option of 9 and 10 if the doctor felt that was an appropriate time to give it,” Cox said.
Cox said the vaccine has a minimum age limit of nine because medical officials are unsure how long the vaccine will last. Patients can only receive the vaccine until age 26 because current Gardasil studies have only been conducted up to that age.
“This is all based on the age issue rather than whether they got it before, because there’s no sure way to tell if they got it or not,” Cox said. “The benefit is really related to the likelihood to one being exposed to one or more of these HPV types. The sooner you get it, the better.”
Currently, studies are being conducted to see if women between the ages of 27 and 55 show a positive response to the vaccine. Regarding recent studies, Cox said males, before they became sexually active, showed a stronger response to the vaccine than women. Cox said he expects the vaccine is helpful for men who are sexually active.
“The data will be completed in 2008, so hopefully the coverage will be extended,” Cox said.
Cox said there is a long-term study in Norway involving 6,000 women who have been previously vaccinated. The study subjects will have blood tests and Pap smears every six months until 2018.
“This way we’ll know ahead of time whether a booster shot is needed ten or more years down the road,” Cox said.