So far, Gardasil (the new HPV vaccine) is recommended for girls and young women who have not yet become sexually active. As far as I can tell, the main reason that it hasn’t been widely recommended for women older than that is that they are much more likely to have already been exposed to the types of the HPV virus that the vaccine is designed to protect against.
The main basis of this argument against vaccinating women older than their early 20s is cost/benefit analysis; taking into account medical statistics for large numbers of women in their mid-20s or older, the cost of the vaccination series ($360 for 3 shots, more or less) is unlikely to be counterbalanced by the corresponding reduction in cervical cancer treatment costs.
However, on a more personal note, I was diagnosed with and treated for cervical cancer six years ago (presumably caused by one fo the HPV types covered by the vaccine), and all of my numerous Pap tests since my treatment have been completely negative for HPV. However, all of the regular annual Pap tests I’d ever had in my life up until my cancer diagnosis had also been normal, so for whatever reason, the cellular abnormalities went from undetectable to cancerous inside a year, rather than over the prolonged, multi-year period that is typically the case. The prospect that this might happen again really freaks me out - I got off relatively easily with a LEEP last time, but if things had progressed even another few months, the treatment (and its outcome) might have been MUCH worse.
Frankly, I don’t ever want to go through that experience again, and the last time I went in for a Pap, my doc brought up the idea of having the HPV vaccination anyway, even though I am outside the recommended age range. Should I think more seriously about this? What are the biological mechanics of it?
I can’t explain the mechanism of action for Gardasil, but I can point out the fact that the FDA has so far not approved it for women 27-45, meaning it can’t be marketed toward women in that age range although doctors can recommend it. I assume that age range applies to you, but I don’t know. And as far as the cost goes, it’s not clear how long the effectiveness lasts. It may wear off in time, in which case you might have to consider a booster shot.
There’s been little evidence of side effects for the drug to this point, so the risk might be low, but if you’ve already had the disease a vaccine is supposed to prevent - even if something else was responsible for your cervical cancer, I believe most people do get a (usually brief, undamaging) strain of HPV at some point - what’s the point of the vaccine?
Yep, that’s my age range. And yep, my doctor recommended it. I have no idea whether my insurance would cover it - they have covered off-label uses of other items in the past when the doctor made a good case for it.
To prevent a recurrence. Having had the disease does not create immunity to recurrences. And I REALLY don’t want a recurrence.
But this is a vaccine for HPV, not cervical cancer. While you can’t be immune to cancer, at least as far as I know, I don’t know if you can be immune to the relevant strains of HPV.
Obviously I would check with my insurance company first. But it would be easy enough to time at least one visit to coincide with an annual exam anyway, and I can’t imagine my doc would charge extra for the few seconds it would take to administer the shot. And if I decide it makes medical sense, I may well be willing to pay out of pocket.
Immunity to the relevant cancer-causing strains of HPV is the whole point of the vaccine, and the available evidence suggests that upward of 95% of cervical cancer is caused by the HPV virus. So in a sense, yes, it is possible to be immune to certain types of cancer.
I’m sorry, that wasn’t clear at all on my part. What I was trying to say is this: Gardasil is a vaccine for a few strains of HPV, two of which are the most commonly responsible for cervical cancer. I don’t know if you are already immune to the strain you already contracted. If you are already immune to that strain, considering the effectiveness of the vaccine in people who have already had HPV, there may be little point in getting the vaccine now.
Over here (Ireland) the government is rolling out a scheme to vaccinate all 12-year-olds for a type of HPV (forget which vaccine they’re using). They are doing something similar in England (and IIRC France). Is there anything like that being done in America?
It’s been state-by-state; I believe some places are requiring the vaccine for school admissions, and it is now required in the appropriate age range for immigration purpsoes. But as far as any nationwide government campaign, not yet. Much of the opposition has been from conservative religious groups who say that it will encourage girls to have sex (sigh), but my thoughts on that subject are best reserved for the Pit.
I don’t believe I am immune to the strain I already contracted (16), or if there is even a reliable way to test that. But even if I am immune to one strain, what about the others that can cause havoc? I sure wouldn’t mind being immune to those, too.
It’s been mandated in Virginia, and the same briefly happened in Texas, but I think that’s it so far. The mandate in Texas was rescinded because the chief lobbyist for the vaccine used to work for the governor. It’s been debated in other states, and initially, there was some very intense lobbying for greater compulsory vaccination, but it’s been scaled back lately because there was something of a backlash against the company.
Right, that’s a question I can’t answer. I do know there are two strains that cause most of the cancers, so there is at least one you haven’t had. And Gardasil also provides immunity to two strains that cause genital warts. Hopefully some doctors here, and yours, can answer this question. I’m not sure how the immunity offered by the vaccine is affected by your previous case.
I don’t know what the situation is in all states, but our pediatrician said that my daughter should have the vaccine in a few years when she’s going into high school. She made it sound like that’s their regular routine now.
Virginia has backed off on requiring it for admission to the 6th grade, which was (at one point) supposed to take effect this year. As my daughter Moon Unit is entering 6th grade, this was of concern to me (and I would have exempted her).
[IMHO hijack]This veers into IMHO territory (apologies), but my own reservations - which are dramatically different from Eva Luna’s interest of course - are associated with the fact that these laws have been passed entirely as a result of heavy lobbying by the company which stands to make a lot of money if the vaccine is mandated. As in - money, not health, is the sole motivator. This does not inspire my trust in the product. As noted in the NY Times article, there are a lot of questions regarding the benefits, and for many reasons I’m not eager to be among the first to jump onto this bandwagon, not until more is known about the long-term benefits and side effects. Oh, and the “it’ll give 'em permission to be sexually active”? That is such complete and utter idiocy.
[/IMHO hijack]
Back to the OP: I gather your own case of cervical cancer is presumed to be related to HPV. Would a vaccine affect your immunity to a virus you’ve already been exposed to? I can see where, if say your case was caused by virus A, but the vaccine covers A through D, then it would protect you against B-D, but I’d be surprised if it did anything about virus A. It would seem to be harmless at least, just not as beneficial as if you got the vaccine at a younger age before you caught the intial case.
Correcting myself here: I did some googling and it looks like the law is still in effect (they backed off of backing off :rolleyes: ) BUT it doesn’t take effect until October 1 - in other words it won’t count until fall of 2009. This would explain why the school was insistent we provide documentation of her TDAP vaccination, but not HPV.
Oh - and we probably will have her vaccinated, but not for 2-3 years at least.