The Fight against the Human Papiloma Virus

My grandson has will soon turn 13 years old, and we were discussing his growth process. One of the things that came up was the question of getting vaccinated for HPV, Human Papillomavirus, a sexually transmitted disease. It is a relatively new vaccine, having been developed in 2006 and implemented widely in 2014. There is an international push to eradicate or at least control HPV, a group of 150 viruses that are linked to cancers in both women and men, but the types 16 and 18 are most likely to cause cancers, although other types may cause cancer as well.

Fifty-eight countries now include HPV as part of their regularly recommended vaccinations, with considerations for each population. In Peru, the cervical cancer is the reason for more deaths than any other cancer. According to Peru 21, “Virus del papiloma humano es responsable del 99.8% de casos de cáncer de cuello uterino, que causa la muerte de unas 2,500 peruanas al año.”

As I listened to my grandson, and read the pamphlet giving reasons why young people should be inoculated against this pervasive disease, several questions came to mind that were not answered readily in the glossy brochures and PSA’s that touted the importance of the vaccine.

HPV, or Human papillomavirus, is quite common among adults. There are wildly different estimates of what percentage of the adult population carry the disease, with some estimates as high as ‘everyone’ and others as low as 24%. The greatest risk factors are number of sexual partners over a lifetime (over three increases the chances of having HPV six-fold), age (people between the ages of 30-39 are more likely to have the virus) and Chlamydia seropositivity doubles the chances of infection. After the age of 39, for no reason that has yet been discovered, prevalence declines precipitously. One of the brochures from Peru identified several important co-factors for the disease, including smoking and multiple pregnancies. The disease can be acquired through oral sex, anal sex, and any other intimate contact. Starting sex early in life is also a risk factor.

The dangerous sexual visitor
The dangerous sexual visitor



It was of interest to me so see that different countries identified targets for the vaccine differently. In Australia, for example, the beginning age of the vaccine is 11, yet the vaccine is recommended for women to the age of 45. In the US, the vaccine is routinely given in two doses, (down from three) at 11 and 12, but not recommended for women over the age of 26 (although they can pay for a dosage of the vaccine, it is not covered by insurance, and the cost is close to $150 per dose in the US.

In Peru, the vaccine is started in girls at age nine, through the age of 45, with no mention of boys receiving the vaccine. The cost of the vaccine is closer to $2.16 per dose, but the hope is to get the dosage down to closer to .$50 per vaccine. (Reference)

There is deemed necessity to inoculate women in Peru, as many of them are developing cervical cancers. “Cada año se detectan de 5,000 a 5,500 nuevos casos y, de estos, unos 2,000 o 2,500 terminan en la muerte de la paciente, es decir unas 6 o 7 mujeres al día”, dijo Gilmar Grisson, cirujano oncólogo de la Liga Contra el Cáncer.

International studies have established that in 99.8% of cases the person responsible for cervical cancer is human papilomavirus (HPV), which can also cause cancer of the anus, penis or oral cavity, although they are rare.

Until recently, HPV occurred more frequently between the ages of 30 and 40, but is nowadays becoming more frequent in children under 18 years, due to the premature beginning of sexual intercourse, that is to say before five years after menarche.

Males, like my grandson, are being inoculated in the US. The charts from the CDC show which cancers are most prevalent, both in males and females.  The best way to avoid a problem with HPV is understanding, education, prevention and preparation.

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