By the time we are adults, infection with Human Papilloma Viruses (HPV) is very common. In the US, more than half of all adults have been infected. There are about 150 different HPV types, most of which cause no symptoms because our immune systems effectively eliminate or control the infection. A few types, however, can cause genital warts. In 5-10% of infected women, a chronic infection occurs that results in pre-cancerous inflammation of the tissues of the cervix. If undetected by a Pap smear test and left untreated, after 15-20 years some of these cases will become cancerous. Infection with HPV is the cause of nearly all cervical cancers in women. About 12,000 American and 5,200 Thai women die each year from cervical cancer. HPV is also a growing cause of cancers of the rectum and the throat in middle age men and women.
Fortunately, there is an effective vaccine to protect against the most serious types of HPV infection. The USCDC recommends that all 11 or 12-year-old girls get three shots of HPV vaccine over a 6-month period to protect against cervical cancer. I sometimes suggest waiting until your child is 14-15 years old, assuming she/he is not sexually active, and use the vaccination as an excellent opportunity to establish open and positive sex education with their children.
For the HPV vaccine to work best, it is important for preteens to get all three doses shots before any sexual activity begins. It is possible to be infected with HPV the very first time they have sexual contact with another person. Girls and young women ages 13 through 26 should get HPV vaccine if they have not received any or all doses when they were younger. The HPV vaccine is also licensed, safe, and effective for males ages 9 through 26 years. CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not get the three recommended doses when they were younger.
Some important considerations:
- An annual GYN exam with a PAP smear test is still required for sexually active women, even if they have been vaccinated against HPV
- The 3-dose vaccine series costs about 7,000 baht (not including administration charges)
- Since the HPV vaccine is relatively new, we do not yet know if boosters will be required later in life to maintain the immunity