Monday, September 18, 2006

shoot 'em up

My baby sister is going to college. She has her extra long twin sheets, mini refridgerator, and a little something extra. My baby sister has the HPV vaccine.

More specifically, she has the first shot in a series of three that protects against four strands of the human papilloma virus. Similar to the Hep B vaccine, the vaccination is provided in three doses - the second two months after the first and the third six months after the first.

The vaccine, Gardasil, appears to be 100% effective against HPV-16 and HPV-18, the strains that account for 70% of cervical cancers. It is almost as effective with HPV-6 and HPV-11 which cause 90% of genital warts.

The vaccine is approved for women and girls between the ages of 9 and 26. Clinical trials are underway to examine effectiveness with boys and men.

So, what about women over the age of 26? Since HPV is so widespread, is it assumed that those over 26 have been exposed? What about the women over 26 who have managed to avoid exposure through abstinence, safer sex, and luck?

And what of the women who have been exposed to one, but not all four types of HPV the vaccine offers protection against? Say you've had abnormal paps, but not warts, shouldn't you have access to the vaccine to prevent warts in the future, not to mention further abnormal paps from the other strain(s) of HPV?

Now that the vaccine is available, is there access? I know my sister was able to get the hook up in rich white suburbia but what about lower income neighborhoods? Will insurance and medicaid subsidize? Will it be available for free or on the cheap with other vaccinations? Can I ethically advocate vaccination to my teenagers in the Bronx, knowing that the series of shots cost $360?

So many questions. I suppose we will see.

http://www.webmd.com/content/article/123/115099.htm
http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm#hpvvac2

3 Comments:

Blogger Amber said...

I've had an abnormal pap and warts... and I'll be 27 in October. My gyno still recommended I get the vaccine.

I've gotten 2 of the 3 shots. (It costs $450 here.)

My gyno said she thinks capping the "recommended age" at 26 is silly. She said, "What, like 30-year-olds don't have sex?"

She said she would recommend the vaccine for any of her patients, even if they've been exposed to HPV... because the vaccine may protect against future exposure to a different kind of HPV.

9/18/2006 5:09 PM  
Blogger Bint Alshamsa said...

Hello,

I'm a new reader. Personally, I'm really excited about this vaccine. My daughter's pediatrician doesn't seem to think it's all that urgent that we vaccinate her because she's "not a teenager yet" which I think is pretty stupid for him to say.

To answer your question for this area. We're middle class and we live in Louisiana. It's available but, in true southern style, they seem to be taking their time about discussing it with patients.

11/16/2006 9:34 PM  
Anonymous Anonymous said...

Yes, you can ethically advocate HPV vaccinations for poor teenagers in the Bronx. There is an excellent Clinton-era program called Vaccine for Children (http://www.cdc.gov/nip/vfc/default.htm)which provides free vaccines to Medicaid, uninsured and underinsured persons under 19 y/o. This includes the HPV vaccine.

4/16/2007 10:38 PM  

Post a Comment

<< Home