Reprinted from the Health District's quarterly publication mailed to district residents (Spring 2007)
TOPIC: Frankly speaking — new vaccine for girls guards against cervical cancer
 
by kelly serrano

A year ago it was unlikely most people had ever heard of “HPV,” much less were aware that human papillomavirus is the most common sexually transmitted virus and the one known – and likely only – cause of cervical cancer.

But with the Food and Drug Administration’s approval of Gardisil, a vaccine that prevents four strains of HPV, last summer, the virus is becoming a common subject among girls, their parents and their doctors.

The vaccine protects against four strains of HPV, two of which cause 70 percent of all cervical cancer cases and two that cause 90 percent of genital warts cases. It is recommended for girls as young as 9 and up to age 26 – but preferably before they become sexually active.

While regular Pap smears have greatly reduced deaths from cervical cancer, the National Cancer Institute estimates 11,150 American women will be diagnosed with it this year, and 3,670 will die from it.

“To me, this was a tremendous advancement in preventive health care,” says Dr. Bruce Cooper, Health District medical director.

Many local doctors’ offices began offering the vaccine last summer. More recently, the Centers for Disease Control approved Gardisil for its Vaccines for Children (VFC) program, making it affordable for girls through age 18 without insurance, who are Medicaid-eligible or who are Native Americans or native Alaskans. The Larimer County Department of Health and Environment, which will administer the vaccine as part of the VFC program, has it.
where to find Gardisil
Many local doctors’ offices offer the vaccine, but call to confirm. Gardisil maker Merck charges $120 for each of the three doses, though cost may vary by healthcare provider. Most major insurance companies cover vaccines recommended by the CDC, but check with your insurance. Uninsured girls may be able to get the vaccine at low cost at their doctor’s office if the pro-vider participates in the VFC program.

The Larimer County Department of Health and Environment has vaccine through the VFC program, which covers those without insurance, those who have Medicaid or are Native Americans and native Alaskans. Cost is $15 per dose to cover administration costs, but the vaccine will not be denied based on ability to pay. The health department also may be able to assist girls who have insurance that does not cover vaccines.

Colorado State University’s Hartshorn Health Center has vaccine available for its students. Cost is $140 per shot, payable upfront. The center does not file insurance, but students can get a receipt for possible reimbursement through their own insurance company.

 more info?

Parents of patients at the Fort Collins Youth Clinic are asking that their daughters receive the vaccine oftentimes before their doctors suggest it, says Dr. Beth Ballard. Doctors are recommending girls age 11 and older receive the first of three doses over six months during well-care exams.

“It protects girls against HPV, which is the only known cause of cervical cancer,” Dr. Ballard says. “If you protect them before the onset of sexual activity, then you reduce their lifetime risk of cervical cancer by about 70 percent.”

According to the health department, national studies show that 29 percent of high school freshman girls and 62 percent of high school senior girls have had intercourse, and 8 percent and 13 percent of them, respectively, were forced.

But intercourse isn’t necessary to spread HPV; it can be spread through other forms of genital-to-genital contact, Dr. Cooper says. Women who have not been sexually active before marriage can get it from their husband if he was. And once a female is infected with the cancer-causing strain, the vaccine isn’t going to work.

The strains of HPV that cause cervical cancer often remain invisible for years before the lesions that are precursors to cancer finally appear, Dr. Cooper says.

But even if they receive the vaccine, women need to take other measures to protect their health, says Chandra Klein, immunization supervisor for the health department.

“The HPV vaccine is a wonderful thing, but it doesn’t replace the annual Pap smear, and it doesn’t prevent all sexually transmitted diseases,” she says.