The FAQ on the HPV Vaccine
What if you could protect your daughter against cervical cancer, a disease that kills 4,000 American women every year and often strikes during the reproductive prime years? What if, with just three shots, you could also keep her safe from one of the most common sexually transmitted diseases?
In June 2006, the U.S. Food and Drug Administration approved the world’s first-ever cancer vaccine. Called Gardasil, it can protect your little girl from cervical cancer and HPV. The vaccine is recommended to be administered to girls as young as 9 years old. It appears most parents choosing the vaccine for their daughters are bypassing discussion of HPV and sexual activity until a later and more appropriate date.
But there nonetheless figures to be plenty of discussion about the vaccine. Texas became the first state to require the vaccine for sixth-grade girls when Governor Rick Perry signed an executive order mandating it in 2007. The lobbyist for Gardasil's manufacturer, Merck, is Perry's former chief of staff, the New York Times reported. That did not sway the governor's decision, a spokesman for the governor told the Times.
No matter what you might think about government intervention for this vaccine, the experts seem to agree: Today’s young girls need all the protection they can get.
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The U.S. Food and Drug Administration says Gardasil can effectively prevent cervical cancer and gential warts for preteens, but notes “compelling evidence” that the vaccine is less valuable to teenage girls and young women already exposed to the viruses that can cause those conditions. Plus, the FDA says the new vaccine could worsen cervical cancer for women who already have it (diagnosed or not).
So, even though the vaccine is recommended for girls as young as nine and up to young women in their mid-20s, there are questions about its effectiveness as girls become adults. Here are the most frequently asked questions about the new vaccine:
First, a quick review:
Gardasil protects against four different types of human papillomavirus (HPV). HPV, a sexually transmitted disease (STD) is the most common cause of cervical cancer in women. In fact, HPV is fairly common—about half of all sexually active adults acquire genital HPV in their lifetime, and more than 6 million Americans are newly infected every year, according to the Centers for Disease Control and Protection.
One of the most important things to know about HPV is that it’s really a group of viruses and includes more than 100 different strains. Only about a dozen of these strains have the potential to cause cervical cancer. Of these “high-risk” strains, HPV types 16 and 18 cause about 70 percent of all cervical cancers. They are, without a doubt, the riskiest of HPV’s high-risk strains.
Luckily, Gardasil, which is manufactured by Merck and Co., is designed to protect women against HPV types 16 and 18. The vaccine also protects women against HPV strains 6 and 11, which do not cause cervical caner, but instead are responsible for nearly 90 percent of all cases of genital warts.
The vaccine is actually a series of three shots administered over a six-month period, and it is only recommended for young women ages 9 to 26. While men can’t develop cervical cancer they can carry the virus and help spread it. In rare instances, HPV infection in men can also lead to anal or penile cancer.
As for side effects: There may be some tenderness, swelling and redness where the injection goes, but that’s about it.
Here are more answers to common HPV vaccine questions:
How much does it cost?
Each shot costs $120, according to Deb Wambold, a spokesperson for Merck vaccines.
So, three pokes in the arm at $120 per poke adds up to $360 . Keep in mind, however, that this total doesn’t include the cost of the doctor’s visit or possible markup—it only covers the cost of the vaccine as stated by Merck.
Is it covered by insurance?
The uncomplicated answer : Yes
“Right now, there are 120 different insurance plans in the U.S. that have agreed to cover Gardasil,” says Wambold. This means that 96 percent of the nation’s insurance companies offer some coverage for Gardasil, she says.
But the complicated answer: Maybe
Even if your insurance company offers coverage for Gardasil, this doesn’t automatically mean your immunization is covered. Everything depends on what type of plan you’ve chosen, says Wambold who encourages people to call up their insurance companies and see. If your provider didn’t cover Gardasil last year, check with them again. “Many insurance companies updated their coverage at the start of the New Year,” says Wambold.
When Wambold was asked about "accessibility," she answered that the only problem they've seen is when doctors say '"I'm not administering it because my patients' insurance isn't covering it." Most public health officials are recommending that you call the doctor ahead of time, just to make sure the vaccine is available.
What if I’m underinsured or uninsured?
Vaccinating adults: In May 2006, Merck added Gardasil to its Patient Assistance Program— great news for anyone who is uninsured or unable to afford the vaccine. Merck’s Patient Assistance Program allows adults (ages 19 and older) to receive free vaccinations of Gardasil. The snags are this: You must find a doctor who normally provides Merck vaccines to their patients, and they must work in a private practice. You must also fill out a form stating your need, and the doctor’s office will then fax your form to Merck for approval. The standard turnaround time for approval is about 10 minutes, so, in theory, you can fill out your form and receive your shot in the same visit.
Vaccinating children: In November 2006, the CDC added Gardasil to its Vaccines for Children Program. This means that Medicaid-eligible, uninsured, underinsured and Native American girls ages 9 to 18 can now receive Gardasil vaccinations free of charge. More than 45,000 sites across the country provide this service, including hospitals, rural health centers and private and public clinics, according to the CDC.
Does the vaccine require an initial screening, like an HPV test or Pap smear?
The CDC’s Advisory Committee on Immunization Practices doesn’t require young women and girls to receive an initial screening (Pap smear or otherwise) in order to be eligible for the HPV vaccine.
Does the invention of Gardasil make Pap tests obsolete?
Many women may wish this were true, but Gardasil doesn’t replace an annual Pap test. Women who have been vaccinated with Gardasil should still receive regular Pap tests and continue to be screened for cervical cancer, according to the National Cancer Institute. Here’s why:
The vaccine protects against HPV types 16 and 18, strains are responsible for most—but not all—of the cervical cancer cases. About 30 percent of the time, an entirely different high-risk strain (such as HPV type 31 or 45) causes the cancer. Also, the vaccine doesn’t work retroactively; if a woman is sexually active and exposed to HPV type 16 or 18 (or both) before immunization, she won’t be protected from these strains upon vaccination.
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