However, sometimes simple answers just create more questions, especially when it comes to our health.
Such is the case with Gardasil, the new vaccine developed by Merck that reduces the incidence of cervical cancer and other diseases in females caused by certain types of genital human papillomavirus, or HPV.Although Gardasil was recommended by the U.S. Centers for Disease Control and Prevention in June and accompanied by a mega advertising campaign, uncertainties and confusion surround the vaccine, HPV, and the health problems the vaccine can and cannot prevent.
Still, doctors are hopeful.
"(The vaccine) can reduce the incidence of cervical cancer. That's the bottom line," says Dr. John Willems, chief of the obstetrics and gynecology department at Scripps Clinic in San Diego. "We know that HPV is a major factor in the development of cervical cancer. This is something we've been waiting for 30 years. We're very excited that maybe in our lifetime we may see the end of cervical cancer."
Approximately 6.2 million people (female and male) under age 25 get HPV in the United States every year. And, according to the American Cancer Society, about 9,700 U.S. women will be diagnosed with cervical cancer and 3,700 will die from it this year.
To better understand the vaccine, HPV, cervical cancer, and how women and men will be affected, the San Diego Union-Tribune discussed some frequently asked questions with Willems; Dr. Cheryl C. Saenz, a University of California San Diego gynecologic oncologist; and the Centers for Disease Control. Here's what they had to say:
Q: What kind of protection does the vaccine offer?
A: The vaccine protects against four HPV types that are responsible for 70 percent of cervical cancers and 90 percent of genital warts.
There are more than 100 types of HPV, 30 of which affect the genital tract. And, 20 of those 30 HPV types are high-risk, Saenz says.
The vaccine is less effective in young women who have already been exposed to HPV. This vaccine is a prophylactic, not a treatment for existing HPV, genital warts, precancers or cancers.
Q: Who should get the vaccine?
A: The CDC recommends Gardasil for females 9 to 26 years old.
Q: Why is the vaccine only recommended for females ages 9 to 26?
A: The vaccine has been studied and tested for females only in this age group. However, research is under way on the vaccine's effectiveness in males and in women older than 26.
Q: Why is the HPV vaccine recommended for such young girls?
A: The vaccine is most effective and beneficial in females before they're sexually active and females who have not yet acquired any of the HPV types covered by the vaccine.
Q: How and when is the vaccine administered?
A: The vaccine is given in three injections over a six-month period.
Q: Should sexually active females get the vaccine?
A: Females who are sexually active won't get as much benefit from the vaccine because they may already have acquired one or more of the HPV types. However, the vaccine would still protect sexually active females from some of the other HPV types they have not yet acquired. Few women are infected with all four of the HPV types covered by the vaccine, the CDC says. Although there is a test to tell if a female has low- or high-risk HPV, the test doesn't specify if the virus strain is one covered by the vaccine.
Q: Should boys get the vaccine?
A: Research has not yet been completed to show that Gardasil is effective in boys and men. Vaccinating males might benefit them by preventing genital warts, along with penile and anal cancer, plus it may reduce the spread of the virus.
"Since 70 percent of anal and genital cancers are associated with HPV, and 20 percent of head and neck cancers are associated with HPV, (vaccinating men) would not only benefit their female partners, but also benefit men's own health concerns," Saenz says.
Q: How safe is the HPV vaccine?
A: The vaccine has been tested in more than 11,000 females, ages 9 to 26, without any serious side effects, according to the CDC. The most common complaint is slight soreness at the injection site, on the upper arm or upper thigh.
Unlike flu shots, this vaccine contains neither live nor killed virus. Instead, Gardasil is made of synthetic virus-like particles that mimic HPV in the body and trick the immune system into thinking it has been exposed.
Q: How long does the vaccine protection last?
A: It's believed that the immunity is at least five years. Time may show that it lasts even longer. More research is being done to find out if a booster shot is needed later on.
Q: How much does the vaccine cost?
A: The vaccine costs $120 per injection ($360 for the full series.) Many insurance plans will cover the vaccine, but some indicate they may not cover the vaccine for women older than 26.
Federal health programs such as Vaccines for Children (VFC) will cover the HPV vaccine.
Q: Where is the vaccine available?
A: It's available at a few clinics, private practitioners and hospitals. However, at some medical facilities, the vaccine isn't currently offered or is offered on a very limited basis. Gardasil should be more widely available in the near future.
Q: Do females who have been vaccinated still need cervical cancer screening?
A: The vaccine doesn't protect against all types of HPV that cause cervical cancer, so vaccinated females will still have some risks for cancer. Also, some females may not get all three injections or may not get them at the right time, so they may not get the vaccine's full protection.
Willems speculates that vaccinated women may need fewer Pap tests with more time in between tests.
Currently, the first Pap test is recommended for women within three years of sexual intercourse or by the age of 21. Annual Paps are advised until the age of 30. After that, if a woman has three normal annual Paps with no high-risk factors, she can get a test every two to three years.
Q: Is there a connection between HPV and herpes or HIV?
A: HPV is not the same as HIV or herpes. Although they are all viruses that can be sexually transmitted, HIV and herpes do not cause the same symptoms or health problems as HPV.
Q: How common is HPV?
A: The virus is so prevalent that by age 50, as many as 80 percent of women and men will have been exposed, Saenz says.
HPV is spread through genital contact. Because the virus usually has no symptoms, both men and women can get it and pass it to their sex partners without realizing it.
Q: Can HPV be treated?
A: There is no treatment for HPV. However, there are treatments for the health problems the virus can cause, such as genital warts and cancers of the cervix, vagina, vulva and anus.
Q: Are there any other ways to prevent HPV?
A: Abstaining from all sexual activity is really the only way to halt the risk of HPV. Mutually monogamous relationships can reduce the risk, but even persons who have had only one sex partner can get the virus if their partner has had previous partners.
Condoms don't provide complete protection against HPV because areas that are not covered by a condom can be exposed to the virus.
Q: Are there other ways to detect cervical cancer?
A: Most, but not all, cervical cancer can be detected by regular Pap tests. A Pap test can detect cervical cancer and cell changes at very early stages when the disease is usually still curable. Today, most cervical cancer cases happen to women who have never had a Pap test or don't have them on a regular basis, Willems says.
TO LEARN MORE
For more information about the HPV vaccine, HPV, or cervical cancer, talk to your health-care practitioner.
Also, check out the following Web sites and search for "HPV vaccine":
American Cancer Society, www.cancer.org
Centers for Disease Control and Prevention, www.cdc.gov
FDA Office of Women's Health's fact sheet on HPV: www.fda.gov
National Cancer Institute's fact sheet on HPV and cancer: www.cancer.gov