Thursday, June 25, 2009

Public Service Announcement

Hey you teens and twenty somethings! This is test....of the emergency Ladydid, do not walk to your's office? Ok ok. HPV: human papillomavirus. I'm sure everyone's seen about a bajillion of those Gardasil commercials by now with the little girls jumping rope, right? Well, I've decided that this blog might be a good way for me to do some much needed research. I myself, despite being a female in the appropriate age bracket for this vaccine, don't actually know much about it. Currently, I am not vaccinated. And, as I'm soon going to find out, this may need to be remedied. Onward, research, tally ho!

So, for starters, let's begin with the virus itself, before discussing the vaccine. There are over 100 different strains of HPV, affecting between 20 and 24 million people in the US alone. Estimates say about 5.5 million people contract the virus each year; about half of all women by age 50 have been infected at least once. Now please, don't scream yet. Most strains of HPV aren't too problematic. It's still a sexually transmitted disease, so in general, it's not pleasant. Warts are the most common symptom of HPV strains, and can occur on various parts of the body, including: the genitals, tongue, larynx, soft palate, tonsils, face, neck, elbows, wrists, knees, and hands. There are different types of warts; for a better idea of the type of warts, visit here. HPV strains 6 and 11 often produce external genital warts, while strains 16 and 18 do not cause visible warts. In the latter two strains, the warts are internal, occuring on the cervix or anus, and are only visible with a colposcope. Strains clear up on their own 90% of the time before two years. If the individual has a compromised immune system, treatment may be required to clear up the infection. For external warts, cryotherapy (freezing), laser removal, or surgery may be required. Scars might form. Various chemicals may also be used (requiring frequent application), but are generally less effective, and take longer. These include: trichloroacetic acid, imiquimod, and podophyllin toxin. I am not saying these methods are ineffective-they just aren't as consistent. Individuals with compromised immune systems may continue to have outbreaks of genital warts from the virus.

Now, for the vaccine. Gardasil is produced by Merck, and is touted to prevent infection from strains 6, 11, 16 and 18. The first two strains cause almost 90% of genital wart outbreaks, while strains 16 and 18 are responsible for about 70% of cervical cancer cases. Gardasil is approved for women between the ages of 9 and 26, according to Merck's website. They are not encouraging young girls to have sex-they are simply providing possible immunity to the more common strains of HPV. The vaccine works best on young women, although it's not currently clear if there's a resistance to HPV built up as women age. Females who haven't yet had sex are the best candidates, since they are more likely to receive full immunity from those four types of HPV. If the individual has already been in contact with a particular strain, the vaccine cannot help. Currently, no tests have been performed to determine if the vaccine would be beneficial for males as well. People can be born with HPV. There is currently no way of determining which strains have been contracted if the infection (warts or other signs) has already cleared up. Latex condoms may help prevent some strains of HPV from being contracted, but it's not a guarantee. HPV is contracted through skin to skin contact (be it oral, anal, or vaginal sex). The vaccine does not prevent all forms of cervical cancer, and is not a treatment for HPV-it's merely a prevention for four strains.

So, should you get it? Should I get it? Really it comes down to personal choice. There hasn't been any major long term study performed, since the drug is brand spankin' new. Pregnant females should NOT receive the vaccine. I can't tell you to have your child vaccinated. I would suggest you talk to your daughter, and get her to talk to you about it. Sex should not be a taboo topic. Talk to your doctor. Weigh your options. Would you rather take the chance of contracting one of the two potentially cancer causing forms of HPV the vaccine can protect you from (if you haven't already had it), or would you rather risk some possible unknown side effect sometime down the line? Would you rather talk to your daughter about sex now, when it's embarrassing and she might be "too young", or would you rather take the chance that she'll have sex and contract a nasty strain that could have been prevented? Oh, and if you have a yeast allergy, do NOT get the vaccine. That would be bad.

On an aside, I was unable to find any data discussing the number of HPV strain 16 and 18 outbreaks that did not result in cervical cancer during life. I'm curious just how many people have these strains and don't develop cervical cancer from them. It'd be cool if someday we can determine which strains people have contracted, and compare that to the number of cancer cases caused by the strains.

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