In spite of the successful use of Pap smears to catch and treat pre-invasive cervical cancer, we still have women dying of cervical cancer every year. We now have the ability to prevent cervical cancer with a simple vaccine. In 2006 the first vaccination for HPV viruses became available. Since then, there have been 2 story lines surrounding HPV vaccination – one from a political perspective, one from a scientific perspective.
From the scientific perspective, HPV vaccination is one of many vaccinations which we routinely administer population-wide in order to prevent diseases such as chickenpox, measles, polio, etc. In the case of HPV, the vaccine prevents cervical cancer and cervical dysplasia, as well as genital warts. It has a role in other cancers as well, which are much rarer, such as oral and penile cancers. It is known that in order for any vaccine to be effective, at least 90% or more of the population needs to be vaccinated to significantly reduce the incidence of disease. It is expected that a single series of vaccinations should provide lifetime immunity; however, since the vaccinations have only been available for the last 12 years, the longevity of vaccination is unknown.
From the political perspective, because the HPV infection predominantly affects women it was recommended exclusively for young women and girls. As a result, when it was first introduced, it was recommended for women to be vaccinated before they became sexually active, between the ages of 11-26. The association of sexual activity with transmission of the virus caused concern. The concern was that it might send the message to young people that it was now okay and safe to have sex. An additional concern was that by vaccinating only half the population, the females, it would never have a chance of being truly effective for the population as a whole. Fortunately, 2 years after the vaccination became first available, recommendations were changed to recommend that both young men and boys and young women and girls get vaccinated. This change would theoretically lead to the whole population eventually being vaccinated. Given that the incidence of cervical cancer peaks at the age of 35, the age bracket in this recommendation had some logic. However, to be truly used as a vaccination to protect the whole population, it is more logical that everyone should be vaccinated irrespective of age group. Recently, the FDA moved towards this ultimate recommendation by advancing the age for both men and women up to the age of 45.
The physicians and staff at woman’s Specialists of Fayette join the American Academy of Pediatricians and the American College of Obstetrics and Gynecology in recommending that both men and women be vaccinated for HPV up until the age of 45, and perhaps beyond.