Human Papilloma Virus and its Vaccine

The Human Papilloma Virus, or HPV, is one of the most common viruses around.  It causes local infections in human skin and mucous membranes.  We come into contact with it on a daily basis.  Most of the time, it does nothing.  It simply falls off of us like a piece of lint or dirt.  Our immune system is able to fight it off.  But sometimes it gets into our skin, or other membrane, and causes a local infection at that spot.  Why is it able to infect sometimes and not others?  It depends on the amount of the virus, how long it stays there, whether the contact is one time or repeated, whether our skin is intact or damaged, if any friction or pressure is applied, the strength of our immune system, and other factors.

The HPV virus has over 100 different strains.  Many of them cause warts.  That is why some people have warts.  The virus gets into normal skin cells, causes them to grow abnormally, and a wart is formed.  Sometimes the wart stays there permanently.  Sometimes it goes away after a few months or years.  This happens when our immune system notices that there is something abnormal there, and destroys it.  It is then replaced by normal skin.

Some strains of the HPV virus cause cancer, including cancer of the cervix (in women), cancer of the penis (in men), and cancer of head and neck (mostly in young men).  Women can avoid cervical cancer by getting Pap tests.  Men can avoid penile cancer by being circumcised.  Other strains of HPV cause genital warts (warts on or around the penis, vagina, or anus).  Yes, there are people who get warts in those areas, and also cancer.

Fortunately, there is now a vaccine that protects against the major strains of the HPV virus.  It is called Gardasil, and it protects against the two most common cancer-causing HPV strains, and the two most common wart-causing HPV strains.  After receiving the series of three Gardasil shots, you become immune to those four strains of the HPV virus.  You can still be affected by other, less common strains of HPV, but they are less likely.

The Gardasil vaccine is now being given to all American boys and girls at age 11.  For those who did not receive it at age 11, it is given up to the age of 26.  Most people over 26 have already been infected with several strains of HPV, so vaccinating them would not do as much good.  It would still be worthwhile if the vaccine were free.  However, it is currently not cost effective to vaccinate everyone over 26.  Individuals over 26 who wish to be vaccinated anyway can do so by paying for the vaccine themselves, but it will not be covered by health insurance.  The vaccine is safe.  Other than the cost, there is no reason not to get it.

There has been some controversy about the HPV vaccine, not because of safety, but because of morality.  HPV is often transmitted through sexual contact.  Some people believe that giving Gardasil to an 11-year-old will encourage the 11-year-old to go out and have sex.  So they oppose the vaccine on that basis.  I do not believe that vaccination will have that effect.  Most 11-year-olds do not know what diseases are being prevented when they get their shots.  We may tell them they are getting a Tetanus shot, but they do not know what Tetanus is, or how it is acquired.  They have never seen a person with Tetanus, and they do not know what it is like.  They can find that out later if they like.  The same is true for HPV.  They can find out later if they like.

Gardasil is one of the first vaccines that can actually prevent cancer.  It is a great advance in our medical technology.  Hopefully more cancer vaccines will become available in the future.