NEW YORK NURSE: June 2007
Q.: Can you give me an update of what the new Gardisil® vaccine is all about?
A.: Human papillomavirus (HPV) is transmitted through sexual contact and infection is very common. There are more than 100 strains of the virus; four are linked to the development of precancerous lesions on the cervix, vulva, or anus; genital warts in men and women; and cervical cancer. Methods to reduce the risk of infection or transmission include practicing abstinence, limiting sexual partners, and using condoms.
HPV is incurable; however, most individuals will clear the virus without treatment. For some women, HPV can cause cells in or around the cervix to become abnormal and possibly progress to a precancerous stage, which is detectable with an annual PAP smear. An additional cervical smear test called the HPV DNA test uses advanced technology to spot one or more of the cancer-causing HPV types.
The Food and Drug Administration recently approved a vaccine called Gardasil® aimed at preventing cervical cancer caused by HPV types 6, 11, 16, and 18. It is provided through a series of three shots over a six-month period and has been found to be almost 100% effective in preventing disease caused by the four types. This vaccine is licensed for use in girls and women from 9 to 26 years of age. The cost is $120 per dose and is covered under federal programs such as Vaccines for Children, which includes children under 19 who are uninsured, underinsured, Medicaid eligible, Native American, or Native Alaskan.
Recommendations for the vaccine’s use have been published by a number of agencies (see below). Gardasil® is most effective in females who have not yet been exposed to any of the four HPV types targeted by the vaccine – therefore, it is best administered before sexual activity begins. Many states have considered making the vaccine mandatory for young girls. Some groups, however, reject mandating a vaccine that protects against an infection resulting from sexual contact. The heated debate is ongoing; stay tuned to national news sources to follow its progress.
The New York State Education Department has added the vaccine to its list of immunizations that RNs may give with a non-patient-specific order. A non-patient-specific order is not individualized to a particular patient and can be utilized as a guideline for any patient who comes in to receive the immunization series. It is important to speak to a healthcare provider to determine the benefits and risks before receiving any vaccination.
For more information on HPV and the vaccine: