In 2007 the government introduced a free HPV vaccine, and new research into STIs in Australia seems to suggest it has had a big and positive effect on the population’s sexual health. According to the study, by the University of Sydney, patients reporting genital warts are down a huge 61 per cent.
A press release states that the study, which reviewed more than a million patient encounters between 2000 and 2012, showed a significant year-on-year reduction in the management rate of genital warts in women aged 15-27 years since the vaccination program started.
"The results show that the program has been a widespread success," said lead author of the study, Christopher Harrison.
Created by a research team led by Australian Professor Ian Frazer and approved in 2006, the HPV shot was hailed as a victory against a major killer of women.
About 40 strains of genital HPV circulate in the human population, but just two (6 and 11) are responsible for about 90 per cent of genital warts, and two more (16 and 18) for 70 per cent of cervical cancers (they’re also linked to many cases of vaginal, anal and throat cancer). Those four strains are targeted by Gardasil, the vaccine that’s offered in Australia. It’s prophylactic, meaning having it will protect you from further HPV infection. So it’s best to have it before you’ve ever had sex, as that’s the main way HPV is spread. Still, there is benefit in having it after you’re sexually active, to prevent further infection.
“It really is an amazing vaccine,” explains Dr Julia Brotherton, medical director of Australia’s National HPV Vaccination Program Register. “Not only does it essentially offer protection against cervical cancer for women – which, in itself, is a huge breakthrough – it can also protect against anal cancer (of which HPV 16 is a leading cause), which has no screening process.” In other words, you don’t know you have anal cancer until it’s too late.
Here’s the gist: the vaccine really works.
A recent study confirmed that young women who’ve received all three doses of the vaccine were 46 per cent less likely to develop pre-cancerous cells than those who didn’t. For Australian women aged 12 to 26, the incidence of HPV strains 6 and 11 has dropped 59 per cent.
What’s more, the vaccine’s having a follow-on effect, meaning that even those who haven’t been vaccinated are better protected. This can be seen in the overall decline in genital warts diagnoses, even though only 85 per cent of young women have been vaccinated.
So why is this preventive measure being bad-mouthed? You may have heard reports that women died after having the shot. You may have heard that one of the leading researchers on the vaccine raised concerns about it, questioning not only its safety but also its efficacy. And you may have heard that as long as you have regular Paps, you don’t need the vaccine.
“There is a lot of misinformation out there about HPV and the vaccine,” says Dr Brotherton. “I understand the confusion and fear, to some extent, as we all want to know that what we are putting in our bodies is safe.” However, recent research has proven, once and for all, that the HPV vaccine is not only safe, but that it’s working, too. “More than 50 million doses of the vaccine have been administered all over the world,” says Dr Brotherton. “And there haven’t been any major safety issues.”
Safety studies look for patterns of symptoms beyond what you would expect from random occurrence. And so far, nothing has turned up. In fact, a recent large-scaled study – published in 2013 in the British Medical Journal– found absolutely no risk of serious side effects. Yes, says Dr Brotherton, there have been reported reactions to the HPV vaccine. However, when you dig a little deeper, these are often as innocuous as headaches (20 per cent of the reported side effects) and skin reactions at the site of the injection (19.1 per cent). There have been just 16 reports of anaphylaxis following Gardasil injections in Australia, which means it’s pretty rare: you have a 2.6 chance in a million of it happening to you. And as for reports of a woman dying – you may have seen news about a segment on US TV presenter Katie Couric’s current affairs show about a girl who died after having the vaccine – there was no link found between the vaccination and her death
Still, “once those doubts are in someone’s mind,” says Dr Brotherton, “it’s really, really hard to get them out.” (In fact, research suggests nothing will change someone’s mind once it is set against vaccination).
It’s hard to read about the HPV vaccine without coming across Dr Diane Harper, who was involved in the clinical trials of Gardasil. In 2009 she spoke out against the vaccine, questioning whether it was actually worth having considering HPV often comes and goes over a lifetime and leads to cancer in only a small fraction of cases. Dr Harper made the speech at the National Vaccine Information Center, one of the oldest anti-vaccine groups in the US, so it’s pretty likely her agenda that day was skewed. In any case, she has since retracted her statements.
“On the one hand, Dr Harper is right,” says Dr Brotherton. “If you have a great screening process (such as Pap smears), you can detect cervical cancer early and treat it. But that’s a secondary form of prevention. The primary form should be vaccination.”
After all, treating pre-cancerous cells isn’t exactly a walk in the park – as Michele can attest. As well as being very uncomfortable, the treatment can lead to difficulty conceiving, pregnancy loss and even premature birth.
So far, doctors have administered more than 50 million doses of the HPV vaccine, and no serious side effects have been found. Major health crises, such as sudden, unexplained deaths, happen in the general population – even to people who are seemingly healthy, usually from pre-existing conditions that were not known. But when these tragedies occur after an immunisation, even by chance, the shot becomes the culprit.
That’s a terrible shame, because we are lucky enough to live in a world where Gardasil offers almost 100 per cent protection against cervical cancer. That should be the headline.
I’m already sexually active. Is it worth getting the vaccine?
At $150 a dose (and with three doses required), some women simply can’t afford Gardasil. If you can’t, ensure you have regular Pap tests.
If I get HPV, will I have it forever?
“While most people clear HPV infections within a year or two, we don’t know if that means the virus is completely gone or if it’s just dormant,” says Dr Jeffrey Klausner, an expert in infectious diseases. “Still, having HPV is much less likely to hurt you if you get regular cancer screenings.”
What are my odds of getting cervical cancer?
Really low once you know you have HPV. Thanks to regular Pap testing, cervical cancer has gone down more than 50 per cent in 30 years.
Can I still have sex if I have HPV?
Sure, unless you have genital warts, as they make you extra contagious. “Most of the population will get HPV,” says gynaecologist Dr Christina Chu. “Our concern is that it doesn’t turn into cancer.”
Can a virgin have HPV?
Yes, says Dr Chu. “HPV is transmitted via intercourse but also through skin-to-skin contact from intimate touching, rubbing, and even sex toys.”
Do condoms protect me?
Because HPV is spread through skin-to-skin contact, condoms don’t provide 100 per cent protection. But they do significantly lower your risk.
Does having HPV make other STIs more likely?
Cell changes caused by HPV break down tissue in the vagina and cervix, which could make you more vulnerable to HIV.
Will having anal or oral sex help me avoid HPV?
No. “Virtually all STIs can be transmitted during vaginal, oral, and anal sex,” says Dr Klausner. “However, because the same strains of HPV can cause cervical, oral and anal cancer, the vaccine helps protect you from all of them.”
Do I have to tell my guy?
Your call. He can’t get tested for HPV or be screened for HPV-related mouth and penile cancers. But he can spread HPV, so use condoms.