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Cervical cancer vaccine: Who needs it, how it works
Get answers about the cervical cancer vaccine, including how the vaccine works and who should be vaccinated.
By Mayo Clinic staff
A vaccine that offers protection from the virus responsible for most cases of cervical cancer is the latest addition to the official childhood immunization schedule. Here, Bobbie Gostout, M.D., an HPV infection expert and gynecologic surgeon at Mayo Clinic, Rochester, Minn., provides insight into this revolutionary cervical cancer vaccine.
What's the significance of the cervical cancer vaccine?
The cervical cancer vaccine (Gardasil) is the first vaccine approved by the Food and Drug Administration (FDA) designed to prevent a cancer. In the United States — where cervical cancer strikes about 10,000 women a year and causes nearly 4,000 deaths — the impact of the cervical cancer vaccine will be tremendous. Worldwide, the impact may be even greater. According to the World Health Organization, about 510,000 new cases of cervical cancer are reported each year.
The tragedy of cervical cancer is that it often strikes when a woman is still young. She may be trying to raise her family or maybe she hasn't had children yet. Cervical cancer treatment may make future fertility impossible.
What does the cervical cancer vaccine do?
Various strains of the human papillomavirus (HPV), which spreads through sexual contact, are responsible for most cases of cervical cancer. The cervical cancer vaccine specifically blocks two cancer-causing types of HPV — types 16 and 18 — to get at the root cause of the cancer. In essence, the cervical cancer vaccine stops cervical cancer before even the first step can begin.
The cervical cancer vaccine also blocks HPV types 6 and 11, which are not associated with cervical cancer but are associated with genital warts and mild Pap test abnormalities.
When should the cervical cancer vaccine be given?
The vaccine is recommended for girls ages 11 to 12, although it may be used in girls as young as age 9. This allows a girl's immune system to be activated before she's likely to encounter HPV. Vaccinating at this age also allows for the highest antibody levels. The higher the antibody levels, the greater the protection.
The vaccine is given as a series of three injections over a six-month period. The second dose is given two months after the first dose, followed four months later by the third dose.
Experts at the Centers for Disease Control and Prevention (CDC) recommend a catch-up immunization for girls and women ages 13 to 26 who haven't been vaccinated or who haven't completed the full vaccine series. By vaccinating this catch-up group, as well as the younger girls, we'll see the positive effects of the cervical cancer vaccine that much sooner.
Why are three doses of the cervical cancer vaccine needed?
We really don't know that three doses are necessary because we don't know what antibody levels provide adequate protection from HPV. In early clinical trials, researchers observed that the antibody levels in women continued to go up with each of the three doses of the vaccine. Since antibody levels inevitably fall once you stop getting a vaccine, it makes sense to start with high antibody levels to get the greatest HPV protection for the longest possible time — years or even decades.
Over time, we may find that three doses of the vaccine aren't necessary, or we may discover that a booster shot is needed years later. Those are details we just don't know right now.
Next page(1 of 2)
- Gostout BS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 10, 2009.
- Recommended immunization schedule for persons aged 7-18 years - United States. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2008/08_0-6yrs_schedule_bw_pss.pdf. Accessed Dec. 16, 2008.
- Detailed guide: Cervical cancer: What are the key statistics about cervical cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_cervical_cancer_8.asp. Accessed Dec. 16, 2008.
- Human papillomavirus infection and cervical cancer. World Health Organization. http://www.who.int/vaccine_research/diseases/hpv/en/. Accessed Dec. 16, 2008.
- Human papillomavirus vaccine: What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hpv.pdf. Accessed Dec. 16, 2008.
- Harper DM. Patient information: Human papillomavirus (HPV) vaccine. http://www.uptodate.com/home/index.html. Accessed Dec. 16, 2008.
- Garland SM, et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. New England Journal of Medicine. 2007;356:1928.
- Questions and answers about HPV vaccine safety. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccinesafety/concerns/hpv_faqs.htm. Accessed Dec 15, 2008.
- Detailed guide: Cervical cancer: What are the risk factors for cervical cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_cervical_cancer_8.asp?rnav=cri. Accessed Dec. 16, 2008.
- Information from CDC and FDA on the safety of Gardasil vaccine. U.S. Food and Drug Administration. http://www.fda.gov/CbER/safety/gardasil071408.htm. Accessed Jan. 12, 2009.
