Sunday, August 9, 2009

Gardadsil versus Cervarix – The Fight Against Cervical Cancer

Gardasil is a vaccine produced by Merck Pharmaceuticals for the prevention of cervical cancer caused by HPV, the Human Papillomavirus. There are over 100 different strains of HPV causing everything from the common wart found on the hands to cervical, vaginal, vulvar and anal cancers. Research continues to discover new cancers caused by this virus including oral, head/neck and certain lung cancers.

After extensive testing, Gardasil was approved for use in girls and young women in the US by the FDA in 2006. By the end of 2008, twenty-three million vaccines had been distributed for use. While there have been adverse effects reported after administration of the vaccine, both the FDA (Food and Drug Administration) and the CDC (Centers for Disease Control) have concluded that none of the 32 deaths reported were linked to the vaccine. Seven of these deaths were unable to be confirmed through a death certificate and the remaining deaths were from unrelated issues, or preexisting medical conditions.

Cervarix, also an HPV vaccine, is manufactured by GlaxoSmithKline located in the UK. It has currently been approved in 90 countries in Europe yet awaits approval by the FDA for use in the US.

Cervarix is said to protect against five of the high risk HPV strains which are known to cause cervical cancer. It will not however provide as much protection against genital warts. Gardasil currently covers two of these high risk strains as well as two strains causing genital warts. While Cervarix approval for use is expected this autumn, Gardasil, already approved for use in girls and women ages 9 through 26, awaits approval for use in boys and young men.

While not approved for the prevention of anal cancers, 90 to 99% of which are caused by HPV, Gardasil’s protection was extended by the FDA last year to include vulvar and vaginal dysplasias (abnormal cell growth) and cancers. It would make sense that the vaccine would also aid in prevention of anal and other HPV related cancers since it is these strains of the virus that cause the cancer. The vaccine works against these strains and it would appear this to be the case regardless of which body part is affected. Women having cervical involvement with HPV show a 37% increased risk of developing anal involvement.

Unfortunately, many parents are still not getting their daughters vaccinated. This may be a result of misinformation regarding the vaccine, or the belief that if their daughter remains celibate she won’t have to worry. Men transmit the virus and are typically always asymptomatic. There is currently no wide-scale commercially available test for men to determine if they have the virus. So, while celibacy is an option, it is not one that will prevent their daughters from contracting HPV. Why? Because there is no way to determine if her future husband has HPV and can just as easily remain celibate and still contract the virus from her husband. Parents can’t control nor test for the future husbands HPV status.

The fact is, vaccination has become an issue about sex more than prevention for the child. Do parents have these same types of issues when vaccinating their child against the chickenpox virus or the flu virus? No. Most information about HPV relates to cervical cancer, and while this is one of the significant cancers caused by the virus there are, as mentioned above, many others. Some believe that sexual intercourse is required to contract the virus. It is not. Simple skin to skin contact with an area infected with HPV is sufficient for transmission.

Much research is being done about transmission via foamites, inert objects which can carry the virus thus allowing for transmission via other means. This is already considered to be a fact by some within the medical community. With HPV now shown to cause oral and head/neck cancers kissing has not been ruled out as a means of transmission either. Do you prevent your daughter from kissing anyone as well?

The easiest and most significant means of protecting your daughter against the horrors of HPV induced dysplasia or cancer is through vaccination! Ultimately, it will not matter so much which vaccine you choose, just that you choose one!