Gardasil: The Cervical Cancer Vaccine
The best way to prevent cervical cancer is to avoid getting infected with human papillomavirus (HPV). Because HPV is sexually transmitted, practicing safe sex and limiting the number of sexual partners can help reduce risk. A vaccine can protect against the major cancer-causing HPV strains in girls and young women who have not yet been exposed to the virus. Regular Pap tests remain the most effective way of catching cervical cancer while it is in its earliest precancerous stages and preventing the development of invasive cervical cancer.
Two vaccines are approved by the FDA to prevent either human papillomavirus (HPV) or cervical cancer: Gardasil and Cervarix.
Gardasil is approved for:
- Girls and women ages 9 - 26, for protection against HPV-16 and HPV-19, the HPV strains that cause most cases of cervical cancer. It also protects against HPV-6 and HPV-11, which cause 90% of cases of genital warts.
- Boys and young men ages 9 - 26 years to prevent genital warts
Cervarix is approved for:
- Girls and women ages 10 - 26 for protection against HPV-16 and HPV-19, the HPV strains that cause most cases of cervical cancer.
- Cervarix does not protect against genital warts.
- Cervarix has not been approved for use in boys or men.
Two steps generally take place before any vaccine is widely used. First the FDA approves the vaccine. Next, organizations such as U.S. Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Cancer Society (ACS) make recommendations about who should routinely receive the vaccine.
Current immunization guidelines recommend:
- Routine vaccination for girls ages 11 - 12 years. The vaccine should be administered in 3 doses, with the second and third doses administered 2 and 6 months after the first dose. The HPV vaccine can be given at the same time as other vaccines. Either Gardasil or Cervarix may be used, and one vaccine can be substituted for another in the 3-dose series.
- Girls as young as age 9 can receive the vaccine at their doctors’ discretion.
- Girls and women ages 13 - 26 who have not been previously immunized or who have not completed the full vaccine series should get vaccinated to catch up on missed doses. [The U.S. Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) recommend catch-up doses for ages 13 - 26. The American Cancer Society (ACS) recommends catch-up for ages 13 - 18. The ACS suggests that women ages 19 - 26 discuss with their doctors the relative risks and benefits of vaccination.]
- Women should not get the vaccine during pregnancy.
- The ACIP recommends against routine use of HPV vaccine to prevent genital warts in boys and young men. This means that an individual doctor may still decide to use it on a specific patient. However, use of the vaccine is not recommended for most boys and young men.
The HPV vaccine can only prevent -- not treat -- HPV infection, genital warts, and cervical cancer. Because the vaccine cannot protect females who are already infected with HPV, doctors recommend that girls get vaccinated before they become sexually active. Studies indicate that the vaccine is nearly 100% effective in preventing cervical cancer and genital warts (caused by the HPV types covered in the vaccine) when given prior to HPV exposure. However, young women who are sexually active may still derive some benefit from the vaccine, at least for protection against any of the four HPV strains that they have not yet acquired.
The most common side effects of the vaccine include fainting, dizziness, nausea, headache, and skin reactions at the injection site.
These vaccines do not protect against all types of cancer-causing HPV. Women should receive regular screening to detect any early signs of cervical cancer. For girls and women who have been sexually active before they receive the vaccine, screening still provides the best protection against cervical cancer.
Condoms provide some protection against HPV as well as other sexually transmitted diseases.
Male circumcision may possibly reduce the risk of HPV, but it does not completely prevent it. Men who are circumcised should still use condoms.
Regular Pap tests are the most effective way to diagnose cervical cancer when it is still in its earliest, most curable stages. Women over age 30 may also want to have an HPV test along with their Pap smear. [For more information, see Diagnosis and Screening section of this report.]