Q&A: The HPV Vaccine

M. D. Anderson Cancer Center
Date: January 2010
Duration: 4:46

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The following is a presentation from the University of Texas, M.D. Anderson Cancer Center.

Doctor Helen Rhodes, Associate Professor in M.D. Anderson's Department of Gynecologic Oncology, answers the most common questions about the HPV vaccine.

Dr. Rhodes:
The HPV vaccine is a quadrivalent vaccine. Meaning it produces an immune response in women that are vaccinated against 4 types of HPV. And those 4 types are 6, 11, 16, and 18. 6 and 11 types have been linked to genital warts, and 16 and 18 cause 70% of cases of cervical cancer worldwide, and a similar percentage of cases of high-grade dysplasia of the cervix.

Who should get it? Right now the FDA has approved vaccination for girls and women ages 9 to 26, and boys and men in the same age group.

The original studies done, prior to FDA approval of the vaccine in 2006, were based on 4 years of data; 4 years of effectiveness data and safety data. Now it's been an additional 2 to 3 years since the vaccine was approved and the data is still just as strong. Will we need to have a booster as we did with the chickenpox vaccine? We don't know yet. But these women that were in the original studies are continuing to be followed for, what we call immunogenicity; how effective is their immune system response after being vaccinated.

This is a very important point, because again there are more high-risk HPV types than just numbers 16 and 18, and there are more HPV types that are low-risk than just 6 and 11. So even though you get vaccinated, you're only protected against 4 of the 40 types known to infect the genital tract. So you still need to undergo screenings with a PAP test for cervix cancer.

That's a good question. And a woman needs to decide if she wants to be vaccinated against 4 of the types when she knows there's other types that she would not be vaccinated against. But remember, 16 and 18 cause 70% of the cases of cervical cancer. And 6 and 11 cause 90% of the cases of genital warts. So you're doing yourself a lot of good by protecting yourself with those odds. But you still need to go in and get screened, not 100% effective. And no vaccination is 100% effective.

All vaccines have the general risk of swelling at the injection site, pain, redness, soreness of the muscle where the vaccine was administered. My understanding of the data is that there's no relationship between the HPV vaccine and these adverse effects, or these adverse events. Meaning they were going to occur anyway, most likely, in the general population over that time period. One would expect a certain number of cases of neurological events, pulmonary events in the general population over a time period. And my understanding of the data is that you cannot link the vaccine to these events.

I have been surprised at the general acceptance of the vaccine by patients and by mothers of young girls getting vaccinated. And my understanding is that all insurances are covering the costs of the vaccine, which is administered in 3 doses over a 6 month time period. So there are 3 shots that need to be given. And I haven't seen any problems, really with insurance not covering the costs of the vaccination.

For more information about the HPV vaccine and cervical cancer, visit the Focused on Health website at www.MDAnderson.Org/focused.

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