INSIDE

Health Matters

By Virginia Lester,
RN, MSN, ARNP

The HPV viruses are highly prevalent and target specific epithelial cells. These are the cells that are found in the cervix, anus, vagina, vulva, penis, mouth and sinuses. Persistent infection of these organs from certain types of HPV viruses can lead to cancer. Cervical cancer is the second most common cancer occurring in women worldwide. HPV infection is the most commonly diagnosed sexually transmitted disease in the U.S. An estimated 75 percent of sexually active men and women have been exposed to HPV at some point in their lives and more than 20 million people are affected. The use of condoms to prevent sexually transmitted diseases is a good recommendation. However concerns are raised about HPV prevention in that skin-to-skin transmission may occur.

The opportunity to prevent any type of cancer is welcomed and should not be viewed as a moral or judgmental issue. The Centers for Disease Control, the American Cancer Society and the American College of Obstetricians and Gynecologist have all recommended that Gardisil be given to all girls aged 11-12 years with consideration given to all females ages 9-26 years of age.

The vaccine appears to have a safe risk or side effect profile. The most often reported reactions have been mild injection site swelling and pain.
Data from safety studies after one year of use and more than five million doses distributed by the end of March 2007 show more than 99 percent of females aged 15-25 years had developed antibodies against the HPV virus. In another study more than 90 percent of the females who had received the vaccine had normal PAP screens.

Mathematical models have been used to examine the cost-effectiveness of HPV vaccination. One study suggested that vaccination of the entire United States population of 12 year-old girls would prevent more than 200,000 HPV infections, 100,000 abnormal PAP smear examinations and 3300 cases of cervical cancer. Extending vaccination to both men and women is predicted to be more beneficial in reducing the burden of HPV infection, although cost-effectiveness cannot be predicted yet. Vaccines for men are still being developed and the costs may be higher. Given that this is a new vaccine, the duration of protection and the need and intervals for booster vaccines will need to be developed.

The HPV vaccine will not eliminate the need for continued and regular PAP screening for all females, Screening should begin three years after the first sexual encounter or at age 21 and continue yearly until age 30 at which time the possibility of extending the tests to every three years can be possible. This is a decision made by your health care provider based on risks and previous normal PAP tests.

Gardisil vaccine costs around $120 per dose or $360 for the full course. Many insurance companies will pay a portion of the costs. The Washington State Immunization Program has made it available for girls aged 9-19 who are unable to pay for the vaccine. The three doses are given over a six-month period. The Point Roberts Clinic has state supplied vaccine available for immunizations. Call the clinic for an appointment.

Invluenza Vaccine
Influenza vaccine time is quickly approaching. The clinic will be giving flu vaccine starting approximately the middle of October. Please call for an appointment or attend one of the scheduled vaccine clinics. Young children and older adults are encouraged to receive flu vaccine because of the increased health risks associated with the illness.