Human Papilloma Virus (HPV) Vaccination

Major breakthroughs in healthcare are few. It is rare that the paradigm shifts in such a manner that our whole way of thinking about how we should address a topic radically changes. It appears this will begin to happen much more frequently as scientific breakthroughs occur at an expanding and much more rapid pace.

The HPV Vaccine may be seen as a wonderous breakthrough in science as soon as a generation has past and recieved it purported benefits.

One such example of this phenomenon is the recent approval by the FDA (Food and Drug Administration) of a vaccine for the Human Papilloma Virus. Strong evidence suggests that this intervention may grow into something just short of a panacea for cervical cancer (we know the drug manufacturers hope so!). At the same time, medical history will likely look back at this occasion as the time that vaccines were introduced to protect us from things that we never even dreamed were possible.

In the beginning of my medical career, the thought of a vaccine for a cancer seemed preposterous. Now it is reality. Only time will tell. This concept of the self correcting nature and the non dogmatic objective review of pier reviewed literature will be reviewed in an upcoming article on Science – How and why it works. However, for now we are relegated to make informed desicions as best as we can on the evidence that we have. That body of work is very strong and becoming more reliable everyday.

For over four decades the scientific community and the clinical community of basic science community and the clinical community of Obstetricians and Gynecologists, and ancillary health care professionals learned that women who had certain subtypes of HPV, were at much higher risk for bad changes in the cervical cells, and those bad changes occasionally led to the horrendous disease, cervical cancer.

In the beginning of the 1960’s we watched about 1/45 women over a lifetime DIE from this heinous illness. The introduction of aggressive cytology through pap smears with the microscope (colposcopically directed) biopsies of those sick cells led to an enormous decrease (almost 1/3, absolutely extraordinary) in the incidence of the precursor disease and the full blown out illness of cervical cancer.

HPV sadly became one of the most prevalent sexually transmitted diseases. Before the onslaught of AIDS the barrier free sexuality of the 60s and 70s facilitated the transmition of hordes of STD’s which still continues today, in not quite the same tsunami of spread.

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Very soon depending on who you are, you must engage your health care provider with the discussion: it is appropriate for me? my daughter? my significant other, to receive the HPV vaccine. This will be a difficult question. Wow, extremely difficult. Just imagine! Some of our daughters will be 11. The thought of vaccinating an 11 year old against a sexually transmitted disease is intuitively abhorrent, however, the reality is, a generation from not we may come close to eradicating one of the primary gynecologic cancers in women – using a vaccine. A cancer that strikes and kills women in their prime, as opposed to the other illesses whcih tend to have a higher prevalance as the individual gets older. This is not to be taken as it is a better cancer, but I suspect we are saddenned greatly when more of a potential life is snuffed, a mother taken from her daughter when she needs her most. The potential to rid ourselves of this monstrosity, now that is astonishing, I recommend you do your reading and education, as this is a big one.