More than 11,000 women get cervical cancer every year in the United States, and slightly fewer than 4,000 die of it. Screening has made the cancer largely preventable in Western countries, but not everyone gets screened. Now it's possible to prevent even more cases with a series of shots. The Gardasil vaccine can protect women from the viruses that cause cervical cancer, precancerous cervical lesions and genital warts.
The Facts
Merck and Co. released Gardasil onto the U.S. market in 2006. It's meant to keep women from getting human papillomavirus (HPV) types 16 and 18, which cause the majority of cervical cancers along with certain other cancers, and types 6 and 11, which cause nonmalignant genital warts. The Centers for Disease Control and Prevention recommends that all girls be vaccinated at age 11 or 12. CDC recommends the HPV vaccine for all 11- and 12-year-old girls, but it can be given to females from from age 9 to age 26. It's administered in three injections over 6 months, at a cost of $360. It is covered by some insurance companies and not others.
Time Frame
A big unknown with the cervical cancer vaccine is how long the virus protection will last. Some vaccines require a booster at a certain point to remain effective. Gardasil is still so new that it's not clear whether a booster will be necessary. Gardasil lasts at least 5 years. To know what happens beyond that point, more research is needed.
Screening
Doctors screen women for cervical cancer using a Pap smear, where a sample of cells is taken from the cervix and tested in a lab to see if any are abnormal. You might think that once you are vaccinated, you could forgo annual screening. Unfortunately, that's not the case. Although the vaccine covers the HPV types that cause 70 percent of cervical cancer cases, it's still possible to contract a strain not covered. Additionally, especially if you have been sexually active, it's possible that you contracted an HPV strain before getting the vaccine, in which case the vaccine would not protect you from developing cervical cancer from that strain.
Males
Gardasil is not currently approved or recommended for use in males. But HPV types 16 and 18 have been linked to several cancers in men. They include penile and anal cancer. And HPV types 6 and 11 cause genital warts in men just as they do in women. As of 2009, Merck is requesting that the U.S. Food and Drug Administration approve Gardasil for administration to boys and men ages 9 to 26.
Controversy
Some researchers and health advocates have raised questions about the vaccine and whether Merck has exaggerated its benefits. Sheila and David Rothman, professors at Columbia University, in the August 2009 "Journal of the American Medical Association" criticized Merck for providing grant monies to medical organization that firmly back Gardasil. Girls and women are protected from cervical cancer by regular screening, and so Merck is "creating a market out of thin air" by telling mothers they should have their daughters injected with Gardasil, Rothman told "BusinessWeek" magazine in August 2009.
