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The HPV Vaccine: Separating Fact and Fiction

What is HPV?. Human Papillomavirus (HPV)The most common sexually transmitted infection (estimated 20 million in 2005)CDC estimates that half of all sexually active individuals catch HPV during their lifetime. There are over 60 strains of HPV. HPV Infection. Most infections clear up on th

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The HPV Vaccine: Separating Fact and Fiction

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    1. The HPV Vaccine: Separating Fact and Fiction The University of Toledo College of Medicine Student to Student Program

    2. What is HPV? Human Papillomavirus (HPV) The most common sexually transmitted infection (estimated 20 million in 2005) CDC estimates that half of all sexually active individuals catch HPV during their lifetime. There are over 60 strains of HPV

    3. HPV Infection Most infections clear up on their own. However, a persistent infection can lead to: Warts (mainly genital) Precancerous Lesions Cervical Cancer Vaginal / Vulvar Cancers Penile and Anal Cancers

    4. How is HPV transmitted? HPV is transmitted primarily through sexual activity. However, any contact with genital skin can pass on HPV The male condom has shown little effect in stopping the spread of HPV. HPV can be spread to a child during birth.

    5. Basic Anatomy

    6. Genital Warts Warts are flesh-colored growths 2 out of 3 individuals who have sexual contact with a person with genital warts will also get them. 90% of all genital warts are caused by HPV types 6, 11, 16, and 18

    7. Cervical Cancer Two main types: squamous cell and adenocarcinoma HPV types 16 and 18 account for 70% of all cervical cancer cases. Smoking and dietary factors also involved Decreased circulating vitamin A

    8. Cervical Cancer Persistent HPV infection is necessary to cause cervical cancer. It takes between 2-10 years for the cancer to spread beyond cervix. Once it has invaded other tissues, death usually occurs in 3-5 years in untreated or unresponsive patients.

    9. Cervical Cancer

    10. Incidence Comparisons

    11. Epidemiology 12,000 new cases of cervical cancer diagnosed last year. Half of all cases diagnosed during midlife (age 35-55) Cervical cancer used to be the number one killer of women, but rates have declined 74% between 1955 and 1992 due to the PAP test.

    12. Pap Test Pap smears test for pre-malignant and malignant changes to the cervix. Part of the routine gynecologic visits. Involves removing cells from outer cervix

    13. Pap Smears Normal Pap: Squamous Cells

    14. The HPV Vaccine Named Gardasil, approved by FDA in June 2006 Administered in a 3-shot series (like the Hepatitis B vaccine), over 6 months

    15. How the Vaccine Works Vaccine is recombinant, meaning small virus-like particles were grown in yeast. There is no risk of becoming infected with HPV through inoculation. This vaccine also does not contain the preservative Thimerosal. When tested 1 month after the 3-dose series, 99.5%-99.8% of women tested had antibodies to the 4 strains of HPV.

    16. How Long Does it work? It is unclear whether immunity is life-long (mainly since original clinical study subjects are still being followed). With many vaccines, a booster shot has been shown to be necessary after 10-15 years. Additional guidelines will come out as information becomes available.

    17. Vaccine Side Effects Allergic reactions are rare Those who have bad reactions following the initial shot should not receive the rest in the series. Common Side effects: Pain at the injection site (about 8 people in 10) Redness or swelling at the injection site (1 in 4) Mild fever (100 degrees Fahrenheit) (1 in 10) Itching at the injection site (1 in 30) Moderate fever (102 degrees Fahrenheit) (about 1 in 65)

    18. What does the vaccine protect against? The vaccine inoculates against four strains of HPV. (6, 11, 16, and 18) These strains account for 70% of all cervical cancer cases, and 90% of genital warts.

    19. Vaccination Recommendations Vaccine is approved for females ages 9-26 (the population used in the clinical trials). The American College of Obstetricians and Gynecologists (ACOG) recommends routine vaccination in girls at age 11 or 12, with first reproductive health care visit between ages 13 and 15.

    20. Does the Vaccine Prevent Cervical Cancer? The vaccine protects against the HPV viral strains (16 and 18) that account for 70% of all cervical cancers. Vaccinated individuals still should receive routine Pap smears to test for cervical cancer.

    21. Is the Vaccine a Treatment for Cervical Cancer? The vaccine is only effective as a prophylactic. Cannot be used to treat cancer. Also, will not give immunity if the person is already infected that particular strain of HPV (6, 11, 16, 18)

    22. HPV and Men HPV in males can cause genital warts. HPV infection has also been linked to penile and anal cancers. There is no test for HPV currently available for the male population. Vaccination of men is not being recommended at this time.

    23. Final Thoughts The vaccine protects against common strains of HPV, but not all forms. This vaccine helps protect against the most common cause of genital warts and cervical cancer. It is not a substitute for currently used cervical cancer screening.

    24. Final Thoughts It does not protect against any other STD, many of which are very serious. It does not prevent pregnancy. It does not alleviate the risks associated with sexual activity. The best way to prevent the spread of sexually transmitted infections (STIs) is through abstinence.

    25. Final Thoughts This vaccine is not intended to encourage sexual activity in young adults, as it provides no protection against other STIs. However, when a person does decide to have sex, the HPV vaccine can help reduce the damaging effects of a common sexually transmitted virus.

    26. Questions?

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