HPV/cervical cancer vaccines have great potential. The frequently asked questions below explain why these vaccines are so important and who can benefit from vaccination.

Why are HPV vaccines important?

• Most sexually active adults (ages 15 to 49) will acquire genital human papillomavirus (HPV), a common sexually transmitted infection, at some time in their lives and will never even know it. HPV usually has no symptoms and does not cause disease.
• Some types of HPV can infect a woman's cervix and cause the cells to change. Most of the time, HPV goes away on its own. When HPV is gone, the cervix cells go back to normal. But sometimes, HPV does not go away. Instead, it lingers (persists) and continues to change the cells on a woman's cervix. These cell changes can lead to cancer over time, if they are not treated.
• In 2006, 11,982 women were diagnosed with cervical cancer and 3,976 women died of the disease. The American Cancer Society estimates that the United States about 11,270 new cases of invasive cervical cancer will be diagnosed in 2009, and about 4,070 women will die from cervical cancer.
• Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds.

What HPV vaccines are available?

• Gardasil®. is vaccine available for both men and women. Developed by Merck, Gardasil® is close to 100% effective at preventing infection associated with HPV types 6 & 11 (types associated with 90% of all genital warts) and types 16 &18 (types associated with 70% of all cervical cancers, and many vulvar and vaginal cancers).
• Cervarix®, developed by GlaxoSmithKline (GSK) is a vaccine just for women. This vaccine is also close to 100% effective at preventing infection associated with HPV 16 & 18 (associated with 70% of all cervical cancers). Studies suggest Cervarix® also offers cross-protection against other "high risk" HPV types.
• In 2006 the Food and Drug Administration (FDA) licensed Gardasil® for use with females ages 9-26 for the prevention of cervical pre-cancers and cancers, vulvar and vaginal pre-cancers, and genital warts.
• In 2009 the FDA approved Gardasil® for the prevention of genital warts in males ages 9-26.
• The Advisory Committee on Immunization Practices (ACIP) - organized by the Centers for Disease Control and Prevention (CDC) to provide advice and guidance on the most effective means to prevent vaccine-preventable diseases - recommends routine use of Gardasil® for girls ages 11-12, with "catch up" immunization for women ages 13-26 who have not received the vaccine. Healthcare providers may give the vaccine to girls as young as age 9. ACIP recommends vaccination with Cervarix® for 11 and 12 year old girls, with “catch up” for those ages 13-25 who have not previously received the vaccine.
• ACIP recommends “permissive use” (at the healthcare provider’s discretion) of Gardasil® with males 9-26.
• Both vaccines are priced under $400 for the full three-dose regimen. However, individual provider's offices may charge additional fees (e.g., for administration). Individuals have reported costs as high as $600 for the full series in physician’s offices.
• Tested in thousands of people in many countries, both vaccines appear to be safe and well tolerated; the most common side effect has been soreness at the injection site.

Will states make HPV vaccines mandatory for school enrollment?

Each state decides whether or not to require vaccinations for enrollment in childcare or school attendance.

According to the National Conference for State Legislators (NCSL), Michigan was the first state to introduce legislation in 2006 to require the HPV vaccine for girls entering sixth grade, but the bill was not enacted. Ohio also considered legislation in 2006 to require the vaccine, which also failed. In 2007, at least 24 states and D.C.introduced legislation to specifically mandate the HPV vaccine for school.

As of February 2010, 17 states have proposed HPV related legislation or resolutions in 2009-2010. See the NCSL website for more information.

Can parents "opt out" of mandatory vaccine requirements?

According to the National Conference of State Legislatures, all fifty stays permit parents to exempt children from vaccine requirements for medical reasons. Forty-eight states have provisions that permit exemption from vaccination if it contradicts sincere religious beliefs. Twenty states permit exemptions for philosophical reasons. These include, but go beyond, religious reasons.

In Michigan, for example, parents can elect not to have girls receive the vaccine if they object for "medical, religious, or philosophic reasons."

Will insurance pay for the vaccine?

The vast majority of health insurance plans report including most or all of the ACIP recommended vaccines in their benefits for children adolescents and adults. Health insurers covering approximately 94% of those who have private insurance have decided to reimburse for Gardasil®.

For those that qualify, Gardasil® is also available through the federal Vaccines for Children (VFC) program. The VFC program creates a federal entitlement to immunization services for children aged 18 and under who are 1) Medicaid eligible; 2) uninsured; 3) underinsured and receiving immunizations through a Federally Qualified Health Center or Rural Health Clinic; or, 4) Native American or Alaska Native. In November 2006, Merck announced that Gardasil® had been added to the VFC contract.

Will HPV/cervical cancer vaccines to lead to increased or riskier sexual behavior among young people?

Some organizations have expressed concern about "behavioral disinhibition," the notion that HPV vaccines will convey a false sense of protection and result in risky sexual behavior among youth. CDC research shows it's not likely that vaccines will lead to disinhibition because sexual risk among young people is influenced by many factors and "fear of an STD is not a major motivation for abstinence."

What else do I need to know?

• The public needs more education about HPV. One study by the National Institutes of Health found only 40% of women ages 18-75 had ever heard of HPV.
• HPV vaccines will not eliminate all HPV or cervical cancer. The vaccines prevent the HPV types that cause 70% of cervical cancer cases. But there are other types of HPV (not covered in the vaccine) that could cause disease.
• HPV vaccines will not prevent infection with other STIs such as herpes (HSV) or HIV.
• HPV vaccines will not eliminate the need for cervical cancer screening, such as liquid-based Pap tests and/or HPV tests.

COMPARING VACCINES: A closer look at Gardasil® and Cervarix®