HPV vaccine now approved for those up to 45 years old

Dr. Cristina McClure, an obstetrics and gynecology physician at Vero Beach’s Partners in Women’s Health and Cleveland Clinic Indian River Hospital, has a bit of good news to share about the human papilloma virus (HPV).

In June, the Centers for Disease Control’s Advisory Committee on Immunization Practices voted to approve the use of HPV vaccinations for men and women up to age 45.

Ideally, men/boys and women/girls should be vaccinated before becoming sexually active, around age 12-14.

However, recent studies have shown that somewhere between 60 percent and 80 percent of the U.S. population has been exposed to the HPV virus at some point in their life – so some protection, even later in life, is deemed preferable to no protection at all.

The U.S. Food and Drug Administration says “there are over 100 different types of HPV.” Some variants may cause relatively benign – though still undesirable – problems such as genital warts, while others can lead to far more serious problems including cancer of the cervix, vagina, vulva and anus. Still others can result in oropharyngeal cancers of the head, neck and throat.

And, according to McClure, “they are even implicated in some skin cancers.”

Merck Manuals points out that “the risk of developing oropharyngeal cancer is 16 times higher in HPV-positive patients” than it is in those who’ve been protected from these viruses by vaccine.

The latest HPV vaccine targets nine specific variants including HPV 16 and 18, which “cause 70 percent of cervical cancers,” McClure says. The vaccine also protects against an additional 20 percent of cervical cancers, “so, you are basically covering yourself against 90 percent of the causes of cervical cancer in the United States” by getting vaccinated.

McClure speaks with a sense of urgency when noting that those who are “immunocompromised” are at far greater risk.

“The No. 1 patient population we see here in this office are pregnant patients,” says McClure, “and [many of them] are immunocompromised” because of their age.

“Some of these women,” McClure continues, “are now getting pregnant in their 30s. They may have been with the same partner for a long time, but they’re more immunocompromised because they are a little bit older and we are seeing them have higher rates of HPV affecting their cervix.”

According to the Mayo Clinic, “when women are exposed to HPV, their immune systems usually prevent the virus from doing serious harm.”

But usually isn’t always.

That’s because, as the Rochester, Minn., institution explains, “the virus survives for years” inside the body and can aggressively re-emerge should the immune system become compromised.

It may seem downright sexist, but the CDC also says “most men who get HPV (of any type) never develop any symptoms or health problems,” and only a tiny minority will develop genital warts, cancers of the penis, anus or head, throat or neck.

“Most women,” says the CDC, “find out they have HPV when they get an abnormal Pap test result during cervical cancer screening.”

Even though “more than 20 million Americans have some type of genital or oral HPV infection,” according to Johns Hopkins Medicine, and despite the fact the CDC calls it the country’s “most common sexually transmitted infection,” HPV remains one of the least talked about viral infection in the country.

More awareness of HPV itself and the effectiveness of the latest vaccine would have a big impact.

“They have tracked results in the reduction in HPV in countries that universally vaccinate,” says McClure, and those results “showed a more than 90 percent reduction in HPV-related diseases when children are vaccinated prior to their sexual debut. And in some cases, vulvar and vaginal cancers have been reduced by over 97-to-99 percent.”

Getting vaccinated as late as age 45 may not yield quite such impressive results but it’s definitely worth having a discussion with your primary care or obstetrics and gynecology physician.

Dr. Cristina McClure is with Partners in Women’s Health and Cleveland Clinic Indian River Hospital. She can be reached at 1050 37th Place, Suite 101, where the phone number is 772-770-6116.

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