The HPV Vaccine
Human Papilloma Virus (HPV) affects close to eighty percent of people and commonly clears by itself. However, some people fail to clear the virus from their reproductive organs which leads to vagina, cervical and vulvar cancer in women as well as genital warts in male and females. This can be transmitted to others through genital contact such as through sexual intercourse (Legato, 564). HPV-16 is sixty percent sexually transmitted and Gardasil is effective in safeguarding against this strain. Carrying out routine pap tests is essential to screen out cervical cancer. This paper aims to explore the efficiency of Gardasil in protecting against HPV types 6, 11, 16, 18 and ultimately question its application for the sake of public health as part of the global debate. In my opinion, Gardasil is effective in protecting against the said HPV types and should be embraced as a vaccine particularly against cervical cancer. This decision has been influenced by epidemiological studies that have particularly demonstrated that its benefits outweigh the dangers.
Gardasil is a quadrivalent recombinant vaccine vaccine by Merck & Co. that is applied to protect four types of HPV that includes type 6, 11, 16, 18 (Markowitz et al. pr 1). Merck recommends a compulsory vaccination for school girls aged eleven, which has triggered a controversial debate. However, critics points out that the mandate is not necessary since some individuals have self clearance potential, it could overburden the current health programs and its not necessary since the long-term effect of the vaccine is still in question. On the same note, if the mandate was sex specific it would be questioned constitutionally and most importantly, the vaccine cannot entirely eliminate HPV. Gardasil is administered as three 0.5ml intramuscular injections within a period of six months. The second injection is administered 2 months following the first one while the third one at four months following the second dose. The vaccine contains proteins of the four HPV strains, an aluminum adjuvant, yeast protein, sodium chloride, L-histidine, sodium borate and polysorbate 80 (FDA pr.3; Barnacle et al. 4).
After a five years follow-up conducted by Pubmed in ten cases that were vaccinated with Gardasil from different parts of the world, the study concluded that Gardasil decreased precancerous cervical, vulvar and vaginal lesions linked to HPV 16, 18 and condylomas linked with HPV 6 and 11 (Ansstasiou-Fotaki et al. pr.1). According to the National Cancer Institute, the vaccine has been approved to “Prevent 100 percent of the precancerous cervical cell changes caused by the types of HPV targeted by the vaccine for up to 4 years after vaccination among women who are not infected at the time of vaccination” (Markowitz et al. pr 1). Gardasil is also demonstrated to be about thirty eight percent effective in cervical cancer that result from ten other HPV types.
In the U.S, thirty women are diagnosed with cervical cancer daily while eleven die as a result. This adds up to approximately twelve thousand women being diagnosed and about four thousand die annually as a result of cervical cancer in the US. Being the second prevalent cancer in women, four hundred are diagnosed while about two hundred and thirty three die annually in the whole world (FDA pr. 5).
From a study of about twenty one thousand females for assessment of the effectiveness of the vaccine, prior to FDA approval, half were given the control while the other half the vaccine. From this particular research, females who had not had prior HPV infection type 6, 11, 16 and 18 showed that the vaccine was effective in protecting against precancerous lesions, which later become cervical, vulva and vaginal cancers as well as safeguarding against genital warts arising from the types of HPV stated (FDA pr. 4).
In 2009, the Journal of American association (JAMA) study indicated that about 12, 424 individuals reported having experienced the side effects of the vaccine where 772 of them reported severe effects i.e. 6.2% while the rest (11,652) i.e. 93% reported mild ones (FDA pr10). Another study conducted by Villa et al. in 2006 indicated that a sum of 552 women aged sixteen to twenty three were vaccinated at the first, second and sixth months. After three years they were examined gyenacologically and underwent various HPV tests including a biopsy. A subset of 241 cases was subjected to a further two years follow-up study. It was noted that the HPV types targeted by the vaccine declined by 96% in the recipients. Besides, no HPV type targeted by the virus was noted to cause infection in the recipients. The efficacy was noted to be 100 percent. Therefore, from this study, the vaccine Gardasil is effective for prevention of the noted infections and cancers hence the study advocates for vaccination of young women (Villa et al. pr. 1).
A different study published in the Multiple Sclerosis Journal, also was noted that although vaccination was regarded as safe in individuals with Multiple Sclerosis, a five patients study indicated ‘multifocal or atypical demyelinating syndromes’ twenty one days after vaccination with Gardasil. These demyelinating cases could be linked to immune-stimulatory characteristics of HPV virus-like substances in the vaccine, although the study was inconclusive (Sutton et al. pr. 1).
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