HPV vaccine goes unused

BY ARIKIA MILLIKAN

Published October 30, 2006

Of the 40,000 students at the University, about half are women. Scientists say as many as 80 percent of them will contract the human papilloma virus at some point in their lives.

A preventative vaccination for HPV - a virus that can cause genital warts and certain types of cancer in women - has been available at University Health Services since Oct. 1.

But of the 16,000 women at the University that HPV is predicted to affect, as of Oct. 19 only about 45 had been vaccinated at UHS.

As low as this number may sound, it towers in comparison to Michigan State University's health clinic, which has only administered about two HPV vaccines so far, said Susan Ernst, chief of the UHS gynecology clinic.

Still, Ernst conceded that there has not been a great use of the HPV vaccine and that there is a great deal of educational work yet to be done.

"People don't know about this vaccine and its amazing effects," she said.

Transmitted sexually through skin-to-skin contact, HPV is screened by using the Pap smear technique, which detects cervical abnormalities.

About 10 to 12 percent of the Pap smears conducted at UHS show signs of HPV, Ernst said.

While most women clear the virus on their own and don't show further abnormalities, some HPV infections are persistent and require further examination, as well as the occasional removal of abnormal cells, to prevent those cells from becoming cervical cancer.

HPV is typically described as a sexually transmitted disease, although many experts in the medical field prefer to call it a sexually transmitted infection because of the negative connotation that the word disease carries.

Ernst said that because HPV is so common, it seems unfair to label it a disease.

"We try to reassure patients that it is so common, that they're not alone," she said.

HPV is not reserved to people who "sleep around," which is a common misconception among students, said Tom Morson, who provides counseling for students diagnosed with HPV through Counseling and Psychological Services.

HPV is not always sexually transmitted.

UHS Director Robert Winfield said it can be contracted non-sexually as well: non-sexual HPV is responsible for a variety of warts on the hands and feet, including plantar warts.

Chinyere Neale, a sexual health educator at UHS, said that because of HPV, sex is becoming correlated with cancer and death.

"The underlying theme of it is, you have sex, you die," she said.

Morson said that to most people, there's nothing more frightening than having a venereal disease.

"These kinds of words evoke all kinds of fear and terror," he said.

While most cases of HPV fail to produce a single symptom, HPV is the second biggest cause of female cancer mortality worldwide. Every year, an estimated 240,000 women die from cervical cancer associated with HPV, according to the World Health Organization.

Winfield said the new vaccine has the potential to lower this number dramatically.

The current vaccine available at UHS is tetravalent, meaning that it protects against four different strains of HPV. Among them are high-risk strains 16 and 18, which cause about 70 percent of the cases of cervical cancer. The vaccine also protects against strains 6 and 11, which almost never lead to cancer, but are responsible for 90 percent of the cases of genital warts.

Contrary to the belief of some men, HPV is not something that only affects women or that men don't have to worry about.

"I've seen plenty of guys with warts on their penises," Winfield said. "The problem is the guys without the visible warts."

HPV is just as prevalent in men as in women, but men often fail to show symptoms and unknowingly pass it between sexual partners without even realizing it.

The vaccination is not yet available to men, partly because the priority of the vaccine is in preventing cancer-related death in women.

Ernst said viral effects have also been more difficult to study in men because of the lack of symptoms they show and because of inconsistency of the HPV-DNA tests in men.

While the current vaccine is only available for women between the ages of 9 from 26, vaccines for men are in progress. Therapeutic agents to treat individuals already infected with HPV are also in the works.

Michigan may become the first state to require an HPV vaccine for sixth-grade girls. Two bills have passed the state Senate and are now waiting for the state House to reconvene next month.

Not everyone agrees that vaccinating children as young as 9 is appropriate.

Neale said she recognizes that while some parents are fearful the vaccination will make sex seem acceptable to young girls, many parents are willing to introduce the vaccine to their children by explaining that "this is going to protect you from cervical cancer."

Winfield advocated the vaccination at an early age because the time a person has to fully benefit from the vaccination is a "window of opportunity that can disappear."

If the vaccine is administered before a woman has sex, it is 100 percent effective in preventing the four most harmful strains of HPV infection.

"I think giving the vaccine is an acknowledgement, not an inducement to sexuality," he said.

Ernst said that during their college years, 40 to 60 percent of women will contract HPV, but the vaccine is expected to provide lifelong immunity.

One deterring aspect of the vaccination is the cost - many insurance providers have not yet included it on their lists of coverage. Some of the providers who immediately picked it up are MCARE and GradCARE, but if the cost is not covered, the vaccination will run about $570.

The vaccine is given in a series of three injections, each one costing $188.

Sheryl Kurze, a UHS physician, said it's extremely rare to be infected with all four strains at once, so the vaccine still almost always offers protection after infection.

"Even if you've (already) had an abnormal pap, you should get the vaccine," Kurze said.

The consensus of advice from health care professionals across campus is to get vaccinated.

"Here's something that is a terrible problem, that is now preventable," Neale said.