The reason for preventing HPV goes way above and beyond the HPV lesions themselves Robin as I hope you know--we are trying to prevent cervical cancer.  So any physician who told you that if you don't get the vaccine before you're sexually active, it's a waste of time needs to go back to school.

I know you can understand this Robbin--I read your blogs.  And since there are 120 sub-types of HPV your "simple" approach would miss preventing some of the cervical cancers that could be prevented.

I hope I'm making this clear to you.  We want to prevent as much certical cancer in as many women as we can.  So while for sure we would rather vaccinate them at ages 9-12 there is still a very compelling reason to try to get everyone vaccinated even after they become sexually active.

In medicine, keeping it simple (as you phrase it) could still cause women to get cervical cancer who should not have.  

The reason HPV vaccine is still given after people is sexually active, Robbin is that some of the subtypes of HPV that cause cervical cancer (first developing in the endocervix which is why Pap Smears are done with some type of brush scraping cells from the endocervix where cervical cancer first develops) is that some of the subtypes of HPV don't appear in earlier age patients so ACOG and CDC and every infectious disease article in the medical literature on the vaccine and on HPV shows that there is still value in giving the vaccine after somoene becomes sexually active because there are still HPV types that cause cervical cancer

1) Both in the female who gets these types ***after she is sexually active***
2) And in the male who can give these types to the female during sex ***after or when he or she*** becomes sexually active

From the ACOG statement on HPV that you can read or not read for yourself:

"Obstetrician–gynecologists should advise patients and parents that HPV vaccines are most effective in preventing genital cancers when administered before the onset of sexual activity. ***However, sexually active individuals can receive some benefit from the vaccination because exposure to all HPV types prevented by the vaccines is unlikely in persons aged 13 years through 26 years***"

Human papillomavirus (HPV) is a group of more than 120 different viruses. Infection with HPV is associated with the development of anogenital cancers (including cervical, vaginal, vulvar, and anal), oropharyngeal cancer, and genital warts. Approximately 40 HPV genotypes are primarily sexually transmitted from person to person (eg, genital–genital contact, oral–genital contact, and sexual intercourse) and infect the oral, anal, or genital areas of men and women. However, only 13 genotypes have been shown to cause cervical cancer (1). Approximately 70% of all cases of cervical cancer are caused by HPV genotypes 16 and 18, and 90% of cases of genital warts are caused by HPV genotypes 6 and 11 (2).

Each year in the United States, cervical cancer is diagnosed in more than 12,000 women, and nearly 4,000 die from the disease (3). In addition, there are more than 1 million cases of abnormal cytology screening results that require evaluation (4, 5). Although the implementation of cervical cytology screening programs and treatment of precancerous lesions has led to a decrease in deaths from cervical cancer in the United States, such deaths still occur. Approximately one half of all cases of cervical cancer are found in women who have never had a Pap test, and another 10% occur in patients who have not had one within the past 5 years (6). Both ongoing cervical cytology screening and HPV vaccination are needed to help reduce these deaths."

https://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Adolescent_Health_Care/Human_Papillomavirus_Vaccination

Cervical cancer can come from several sub-types of HPV virus, all of which are not acquired until after the male or female (covered both sexes there didn't I?) are sexually active.  To further prevent these cervical cancers as the ACOG statement makes clear and simple above, we do vaccinate people after they become sexually active--at least those of us who know what we're doing.


-- Modified on 3/16/2014 9:58:44 AM