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BERMUDA | RSS PODCAST

Who needs the HPV vaccine? Making the point for HPV jab

FILE - In this Aug. 27, 2010, file photo, nurse practitioner Susan Brown prepares a flu vaccination for a customer in Rockville, Md. Flu seasonís arrived with lots of hacking in the South and New York City thatís sure to spread to the rest of the country. The good news: Thereís still plenty of vaccine for procrastinators. But donít wait much longer: It takes about two weeks for the vaccineís protection to kick in. ¬ (AP Photo/Evan Vucci, File)

While it’s not considered one of the most common cancers in Bermuda, local women do get cervical cancer.In 2009, 2.7 percent of the reported cancers were cancer of the cervix. There could have been even fewer cases there is a vaccine that protects against the most common cause of this type of cancer.Human papilloma virus or HPV is extremely common. We all come into contact with it everyday. There are several different types broadly classified as high-risk and low-risk. The high-risk HPVs are so named because of their potential to cause cancer while the low-risk do not pose this threat.Researchers have isolated and named HPV 16 and 18 as the most common causes of cervical cancer. Doing this enabled them to also develop a vaccine. Gardasil and Cervarix are the two recommended for young girls.In Bermuda, the vaccines are available at the Health Department and from most paediatricians and family practitioners. Vaccines work by introducing a mild form of a pathogen to the body, after which the body develops its own antibodies to fight it. Once such antibodies are created, they remain in the system and patrol the body for the specific pathogen they attacked. This is the body’s natural efficient way of keeping us well; the antibodies quickly recognise the pathogen and launch an immediate attack, preventing the pathogen from having the time to do harm.In order for the vaccine to be effective, it needs to be administered before the body has been exposed to the pathogen. HPV 16 and 18 are most common in sexual contact and therefore the vaccine is most effective when used before a girl has engaged in sex.“It is recommended that the vaccine is given at 11 to 12 years, that is an age when parents can discuss the reason for protection with their children, and can continue the conversation about abstinence in teenage years, safer sexual practices and limiting numbers of lifetime sexual partners,” said Hilda Dunsmore, gynaecologist with the Department of Health.Parental consent is required for any minor to have the vaccine. That’s right, any minor. Research has proved that boys can benefit from Gardasil (not Cervarix which is specific to cervical cancer).“The Department of Health, paediatricians, family doctors and gynaecologists are all aware of and agreed on the benefits of immunising our youngsters against a virus which has the potential to cause cervical cancer in women,” said Dr Dunsmore.“There is also an increasing awareness that this virus is associated with cancers in other areas such as genital areas, anus in both men and women, and a rising incidence of oro-pharyngeal cancers (tonsil, tongue, pharynx) in young men,” she added.Dr Dunsmore, who was involved in HPV research in the UK, explained why girls were the focus when the vaccine was first released.“Initially many countries have opted to vaccinate the girls only, as 90 percent of HPV-related cancers in women are cervical cancers. It was hoped that if there was a good uptake of the vaccine (over 80 percent of girls immunised) that the boys would be protected by herd immunity,” she said.“However in light of the rising incidence of HPV-related cancers in men, and the recognition that herd immunity in the female population will not halt the spread of HPV in homosexual men, the recommendation now is that immunisation should be offered to both sexes.”Her department has had enquiries from parents about vaccinating their sons, Dr Dunsmore said.While she could not say how many HPV vaccines have been administered to boys or girls locally, she explained why parents should now also seriously consider protecting their sons.“Parents cannot predict the sexual orientation or sexual practices of their children whether their children will have multiple partners or oral sex and so all boys should be offered protection,” she said.Cost of the vaccine may vary between doctors in private practice but at the Department of Health each Cervarix shot costs $35 and each Gardasil shot costs $60. In each case, three shots are required over six months.“This timing will give the recipient optimal immune response,” said Dr Dunsmore.Bermuda Cancer and Health Centre and the Department of Health are distributing written information about the vaccines to parents and young women who are eligible for immunisation.