MONDAY, July 9 (HealthDay News) — Even among unvaccinated girls
and young women, the human papillomavirus vaccine is reducing infections
of certain strains of the virus known to cause genital warts and cervical
cancer, new research finds.
The study is among the first to show signs that the human
papillomavirus (HPV) vaccine not only prevents infections, but it can also
promote herd protection — a decrease in infections among the unimmunized
thanks to lower rates of infections among other people in their community
who might otherwise be transmitting the disease.
HPV is the most common sexually transmitted infection in the United
States, and is thought to be the leading cause of cervical cancer. Certain
strains of the virus can cause other health problems as well, including
other genital cancers, anal cancer, head and neck cancers, and genital
warts, experts say.
The study involved two groups of women aged 13 to 26 who had already
had sexual contact and who were seen at two primary-care clinics in
Cincinnati, one of which was a teen health center.
One group was seen at the clinic in 2006 or 2007, before the HPV
vaccine, which protects against four strains of HPV, was widely available.
The second group was seen in 2009 or 2010, after the vaccines were widely
available.
About 60 percent of the latter group had received the vaccine.
Participants filled out a questionnaire with demographic information
and information about their sexual activity, and were tested for 37
strains of HPV. The vaccine protects against four common strains of HPV
that are known to cause warts or cancer. The strains include types 6 and
11, which cause almost all genital warts, and types 16 and 18, which cause
about 70 percent of cervical cancers and 90 percent of anal cancers, said
study author Dr. Jessica Kahn, associate professor of pediatrics at
Cincinnati Children’s Hospital Medical Center.
From 2006 to 2010, the prevalence of these four strains decreased by
about 60 percent, from about 32 percent to 13 percent.
Among the vaccinated, rates of HPV infection fell from 32 percent to 10
percent — a 70 percent drop. Perhaps even more dramatic, rates of
infection among the unvaccinated fell from 30 percent to 15 percent — a
50 percent drop.
“This is a first look at how the vaccine is working in a real-world
setting,” Kahn said. “We were very encouraged to find the rates of HPV
fell so dramatically, especially because the girls in the study already
had sexual contact, some had more than one sexual partner and some only
had one dose to be considered vaccinated.”
“That’s what you get in the real world,” she continued. “You get
vaccinated girls who have already had sex, who aren’t compliant with the
vaccine. It’s a messy sample, not the clean sample you get in a clinical
trial.”
Although encouraging, Kahn noted, the findings may not be applicable
nationally. Most participants in the study were low-income black women,
many with Medicaid insurance, and all were drawn from two primary-care
centers in the same city.
The study, funded by the U.S. National Institutes of Health, is
published online July 9 in the journal Pediatrics.
The U.S. Food and Drug administration has approved two HPV vaccines —
Gardasil and Cervarix. The girls in the study were given Gardasil, which
protects against four HPV strains; Cervarix prevents two HPV types.
“If girls are getting vaccinated, they are not spreading HPV to male
partners, who then don’t spread it to other female partners,” Kahn
explained.
Although the prevalence of the four main strains of HPV fell, the
overall rate of HPV infection remained “extremely high,” according to the
study. Infection by any strain actually increased from 61 percent to 76
percent during the study’s two time periods. Researchers said this
highlights the need for vaccines, some of which are under development,
that also protect from other strains of HPV.
Dr. Walter Orenstein, a member of the American Academy of Pediatrics’
committee on infectious diseases and associate director of the Emory
Vaccine Center in Atlanta, said the findings strongly suggest the
beginnings of herd immunity against HPV.
“It’s too early to be definitive, but there is a very strong suggestion
that this vaccine not only protects the [people who received the vaccine]
but protects the community as well,” Orenstein said.
The U.S. Advisory Committee on Immunization Practices recommends that
girls and boys get vaccines against HPV at age 11 or 12, before they’ve
had sexual contact, or up until age 26 if they missed that window. The
vaccine is given in three doses, each two months apart. Orenstein urged
parents to follow the recommend schedule.
“This is a vaccine that can protect against cancer. It’s important to
vaccinate at the recommended ages, before there is sexual debut,”
Orenstein said. “Not only can vaccines protect individuals, but the more
individuals who are vaccinated, the more likely the overall community is
protected as well.”
More information
The U.S. Centers for Disease Control and Prevention has more
on vaccination schedules.
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