What You Should Know about HPV Vaccine

Genital human papillomavirus (HPV) infection is the most common sexually transmitted disease in the United States, according to the Centers for Disease Control and Prevention.

About 20 million people in the United States are already infected with this virus, and 6.2 million more get infected each year. HPV infection is spread by sexual genital contact, so if you are engaging in sexual activity, especially in sex without the use of a condom, you can get infected with HPV.

There are about 40 different types of HPV. Most of these infections don't cause any symptoms, so you will not know if you're infected, and they also go away on their own.

Cervical Cancer

Some types of HPV infection can cause cervical cancer in women, a cancer that is often discovered too late, at a stage that is too late to cure. HPV infection is the main cause of cervical cancer.

Each year in the United States, about 10,000 women get cervical cancer, and 3700 women die from it. Cervical cancer is the second leading cause of cancer deaths among women around the world. HPV infection is also associated with several less common types of cancer in both men and women.

HPV infection can also cause genital warts, as well as other types of warts in the upper respiratory tract.

Who Should Be Vaccinated?

There is still no treatment for HPV infection, but a new vaccine was recently approved that can prevent some types of HPV infection.

The new HPV vaccine is called Gardasil, and it can protect against the 4 types of HPV that cause cervical cancer and venereal warts.

The vaccine can be used by girls as young as 9 years old and up to age 26. However, the vaccine is most effective if it's given before the woman (or adolescent) has sex for the first time. Once you are infected, the vaccine can no longer prevent the disease.

Michael D. Seidner, MD, FACOG, of Hackensack University Medical Center, New Jersey, recommends that parents and teenagers ask their physicians about the HPV vaccine and follow the physicians' advice about who should be vaccinated and when.

Common Questions

Dr. Siedner has provided answers to some common questions about the vaccine.

1. Is the HPV vaccine safe?The new HPV vaccine is not a live virus vaccine. That means that you can't get infected with HPV when you are vaccinated. The vaccine can be given at the same time as other vaccines. There have been no safety problems other than minor side effects, such as temporary pain, redness or swelling, or itching at the injection site. Some people will get a mild or moderate fever. 
2. How is the vaccine given? The vaccine is given in 3 doses, that is, at 3 separate times. The second dose is given 2 months after the first dose, and the third dose is given 6 months after the first dose. 
3. How long will the vaccine last? It is not yet known how long the vaccine will protect you against HPV infection, because the vaccine has only been used for several years. That is why your doctor will continue to check up on you in the future, and you may need to get a booster shot. Right now, there's no test that can tell if you're still protected against HPV. But with time, more information will become available and your doctor should be able to provide you with new information in time. 
4. What if I have already been infected with the virus? It is unlikely that a woman would be infected with all 4 strains of virus that are included in the new vaccine—2 high-risk types (which cause cancer) and 2 low-risk types (which cause genital warts). But there are many other low- and high-risk HPV types that you can be exposed to. It is impossible to know at this time exactly which particular type(s) you will be infected with. That's why it's a good idea to get vaccinated. There is no downside, and the vaccine may decrease the amount of virus you already have. 
5. What happens if I get pregnant soon after receiving the vaccine? When the HPV vaccine was being tested, there were more than 1000 pregnant women who participated in the trials. No real difference was found in birth defects between women who got the vaccine and women who got a placebo injection ("fake" vaccine). 
6. How much does it cost? Each dose of the vaccine costs $120, so the total cost for the 3 doses is $360. Some insurers cover the cost of the vaccine, so you should check with your insurance before you get vaccinated to make sure you are covered. If your insurance dose not reimburse for it, talk to your doctor about it. 
7. If I get vaccinated, does it mean I no longer need to get Pap smears? No. Pap smears and routine physical exams will still be necessary, since we do not know how long the vaccine will protect you against HPV infection. Also, because many HPV types are not covered by the vaccine, you may still get infected or get cervical cancer in the future, so getting an annual Pap smear is very important. 
8. Will the vaccine promote promiscuity? Keep in mind that you can get many other sexually transmitted diseases besides HPV infection, and all those diseases can cause serious medical problems. Therefore, practicing "safe sex" with appropriate protection is important even if you are vaccinated with the HPV vaccine. 
9. How do you explain HPV infection to your teenaged daughter? In the same way that you may explain other dangers, including unsafe sex, you can explain the risks associated with HPV infection. Parents who are uncomfortable talking about it can make a separate doctor's appointment for their daughter. This will be an excellent opportunity for her to not only get the vaccine but also to meet the doctor and to ask any questions she may have about HPV or about any other sexual issues that she's concerned about.

For more information, check these websites:

• The Centers for Disease Control and Prevention
• The National Women's Health Information Center
• The National Cancer Institute