By- Dr. Amy Movius

Human Papilloma Virus (HPV) is the most common sexually transmitted disease in the United States. Its presence is by no means a comment on the lifestyle of those infected, but rather an indication of the scope of this virus. Most sexually active adults – i.e. most adults – will be infected with HPV at some point in their life. Also, it is estimated that ONE HALF of adolescents and young adults who are sexually active are currently infected. This group tends to be infected soon after becoming sexually active.

There are many types of infectious HPV; most of these infections are both temporary and silent and so go unnoticed. However, some types of HPV cause genital warts, other types cause cancer.

HPV is responsible for nearly all cervical cancer and most other genital cancer in women and men.

In 2006, vaccination against HPV was approved and recommended for routine administration to girls and young women, age 9 to 26 yrs. Last week, the CDC ACIP1 voted to recommend routine vaccination of all males as well, starting as early as age 9yrs. The HPV4 vaccine (Gardasil, Merck) protects against 4 types of HPV that account for 70% of cervical cancer and 90% of genital warts. The vaccine for boys is administered in exactly the same way as for girls. A series of 3 injections over 6 months is recommended as a routine part of early/pre-adolescence health care (age 11-12 ideal). At this age, the immune response to vaccine should be strong and is prior to onset of sexual activity. It is recommended that women up to 26yrs of age and men to 21yrs of age (likely to increase) also receive vaccine if they have not yet done so.

The HPV vaccine has been studied in thousands of people in many different countries with no serious safety concerns. There is no risk of being infected by the vaccine as it contains no infectious material. Neither is there any evidence that HPV vaccination increases the likelihood of a young girl (or boy) engaging in sex. The vaccine is most effective before any sexual activity – and therefore any possible HPV exposure – has occurred.

Genital warts, genital cancer, cervical cancer, anal cancer….without question, these are uncomfortable topics for discussion. Avoidance isn’t really an option, however. Cervical cancer used to be the most common cause of cancer death in women. Improvement in detection (pap smears) and treatment have helped but every year 12,000 women are diagnosed with cervical cancer and 4,000 die. Widespread vaccination during pre-adolescence, before exposure is an issue, can stop this problem before it ever starts. Immunization is the best way to prevent HPV infection and will ultimately decrease the total amount of virus in circulation, keeping future generations better protected as well.

Footnote: 1. Center for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP)

Reference:
1. ACIP Recommends HPV Vaccine for 11- to 12- Year-Old Boys. www.medscape.com, October 25, 2011
2. HPV Vaccine Information for Clinicians – Fact Sheet. Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention. Page last updated September 15, 201
3. HPV FAQs www.aap.org

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