The recently available human papillomavirus, or HPV, vaccine has some limitations, including the fact that extensive testing in women older than 26 has not been completed, and those women are often sexually active and might have been exposed to the virus already.
Gardasil has ignited a controversy because legislators in various states want to mandate the vaccine for young girls, which those who oppose the mandate say would bring the topic of sex into conversation at an early age. At local health centers, the vaccine’s distribution comes with high prices and that aren’t always covered by all insurance companies.
A study being conducted at the Women’s Health Initiative at the Pacific Women’s Health Center in Eugene is looking at a gel that may lead to a treatment for HPV in adults.
Jan Stafl, a doctor at the clinic, said the gel may “improve immunity” and suppress HPV when used during the early stages of infection. He said the gel has the potential to reduce visible signs of HPV, genital warts, and prevent cervical cancer.
Stafl said the gel is the first therapy for HPV patients that boosts the immune system and addresses patients who may not benefit from the vaccination, which is targeted at those who aren’t sexually active.
“Once the lesions have occurred, the vaccine won’t help,” he said.
Current treatment for HPV patients calls for freezing the cervix or removing the lesion, Stafl said.
The gel isn’t available on the market yet, but is in the last stage of testing before being approved by the Food and Drug Administration, Stafl said.
The 21-month clinical research study is taking place in Eugene and 29 other cities across the United States and Canada with women ages 18 to 40 who have received an abnormal Pap smear result or have been diagnosed with high-risk HPV.
Although a vaccine was approved by the FDA last year, the vaccine’s price might still steer away some students.
At the University Health Center, lead nurse Jayne Carey said she has received positive feedback from students since the center started offering the vaccine last fall.
Carey estimated the health center vaccinates 150 to 200 people each month for HPV.
“It was very welcomed, and people called with the expectation that we would be giving it,” she said. “Often, students had the first dose elsewhere and were glad to follow-up here.”
Carey expects the health center will continue to vaccinate more students.
“People are starting to become more aware of it,” she said.
The price of the HPV vaccination, however, is higher in comparison with other vaccinations and may bar some students from getting the vaccination. The three-series HPV vaccination at the health center is $150 per shot. By comparison, the Hepatitis B three-series vaccination costs $33 per shot.
Carey said the price may go down in the future.
“Anytime a vaccine first comes out, it’s fairly expensive,” she said. “It’s probably a deterrent to some, but we see a lot of students that tell us, ‘I don’t care how much it costs, I want to get it.’”
Marlene von Friederichs-Fitzwater, director of University of California Davis Cancer Center’s Outreach Research and Education Program, said she hopes to see the price lower.
“If we don’t solve the cost problem, and it’s not available to everybody, that’ll be a big issue,” she said.
The vaccine has become controversial throughout the country. In February, Texas became the first state to require school-age girls to be vaccinated against HPV prior to the sixth grade. California, Washington and 30 other states and the District of Columbia are considering similar mandates. Conservatives and religious groups have opposed such legislation.
von Friederichs-Fitzwater is currently researching the attitudes, values and cultural differences toward the vaccination. Preliminary indicators have shown that some parents have concerns about the vaccination, she said.
“They think it might endorse the girl to be more sexually active and encourage that,” von Friederichs-Fitzwater said. “Many parents don’t want to have that discussion at a young age.”
Last month, drug-making giant Merck & Co. announced that it will stop its efforts to pressure states into making the vaccination of all young girls against a sexually transmitted disease mandatory.
Despite these issues, health experts say they hope college-aged students take advantage of the vaccination.
HPV causes genital warts and, in some cases, cervical cancer. In a study published last month in the Journal of American Medical Association, epidemiologists at the Centers for Disease Control and Prevention found that the disease is prevalent in 26.8 percent of females ages 14 to 59, and 44.8 percent of women ages 20 to 24.
The vaccination is targeted at females from ages 9 to 26 because original studies tested this age group.
von Friederichs-Fitzwater, a cervical cancer survivor, said the vaccination is considered safe and effective.
“This is the only cancer that’s preventable through a vaccination and regular Pap smear screening,” von Friederichs-Fitzwater said. “It’s a devastating disease to have. You have to go through all the chemotherapy and radiation treatment.”
She said that the vaccination doesn’t target all HPV strains but protects against the types that cause cervical cancer. She added that the vaccination is most effective if taken before women become sexually active.
“The sooner, the better,” von Friederichs-Fitzwater said.
She said the vaccination may still provide some prevention after a woman becomes sexually active.
Four studies, one in the United States and three multinational, conducted prior to 2006, showed that Gardasil wasn’t effective prior to infection, according to the FDA.
The vaccination isn’t being offered for males, but she said there are discussions in science circles about creating a vaccination for men because they can carry the disease.
von Friederichs-Fitzwater recommended that students still get regular Pap smear tests even if they get a vaccination.
“This is a new vaccine,” she said. “We’re not sure that it’s going to protect every single woman, and if someone were infected before they got the vaccine, it could still turn into cervical cancer.”
With practitioner consent, the health center will offer the vaccination for women older than 26.
Martha DeBroekert, a nurse for Lane County Public Health, said that some insurance companies aren’t covering the vaccination, and she recommended that people check with the individual company.
Lane County Public Health offers the vaccination for $132 for each shot, DeBroekert said.
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