Thursday, June 22, 2006

HPV vaccine news and speculation

This story from CDC Prevention News seems to cover most of the bases on the new vaccine against HPV:

"Cervical Cancer Vaccine: For Women Already Exposed to HPV, Shots May Not Be as Helpful" Los Angeles Times (06.19.06):: Shari Roan

On June 8, the Food and Drug Administration (FDA) approved Merck & Co.'s vaccine Gardasil, which protects against the two HPV strains responsible for 70 percent of all cervical cancers and two strains that cause genital warts. On June 29, the National Advisory Committee on Immunization Practices will meet and is expected to recommend routine vaccination for girls ages 11 and 12.

FDA approved the vaccine for use in females ages 9-26. Because around half of all US teens have sex before age 18 (6 percent before age 13), public health officials say the three-shot series should be administered at a young age. But for sexually active teens and young women who may have already been exposed to HPV, it is less clear whether Gardasil will be of benefit.

Gardasil does not cure HPV, but it may help people who have one strain of the infection from being infected by other strains. A test can determine whether women are infected with HPV, but it cannot specify which strains they have. Hence, HPV-infected women would not know whether Gardasil, which protects against strains 16 and 18, would still be useful.

Also, it is not known how effective Gardasil would be in conferring immunity in women older than 26, as trial data focused on younger women. Merck said it is currently studying the vaccine's efficacy in women up to age 45.

Women should continue to get routine Pap smears, which look for cell changes caused by HPV that can lead to cervical cancer. Even girls who receive Gardasil will likely need regular Pap examinations, said Dr. Mark Wakabayashi, director of gynecologic oncology at City of Hope. "There are still going to be one-third of the HPV strains out there that will cause cervical cancer" and are not blocked by Gardasil, he noted.

The next question is whether this vaccine will become mandatory for young women. There's a rumor that legislation on the subject will be introduced in the 80th session, come January.

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