NationMaster - Encyclopedia: HPV vaccine

Human papillomavirus (HPV) vaccine is a vaccine that targets certain sexually transmitted strains of human papillomavirus that are associated with the development of cervical cancer and genital warts. Two HPV vaccines are currently on the market; Gardasil and Cervarix^[1]. A vaccine is an antigenic preparation used to establish immunity to a disease. ... â€œHPVâ€ redirects here. ... Cervical cancer is a malignant cancer of the cervix. ... Genital warts or (or condyloma) is a very contagious sexually transmitted disease. ... Gardasil is a vaccine against certain types of the human papillomavirus (HPV), based on technology created by workers at University of Rochester. ... Cervarix is an investigational vaccine against certain sexually-transmitted human papillomavirus (HPV) types. ...

Introduction

Of the more than 200 known HPV types, 37 are known to be transmitted through sexual contact. Infection with sexually transmitted HPVs is very common in adult populations worldwide. Although a few HPVs, such as types 6 and 11, can cause genital warts, most genital HPV infections come and go without ever causing any symptoms. However, lingering infections with a subset of about 19 "high-risk" HPV types can lead to the development of cervical cancer or other genital/anal cancers, and some forms of HPV, particularly type 16, have been found to be associated with a form of throat cancer.^[2] Only a small percentage of women with HPV go on to develop cervical cancer.^[3] Cervical cancer is a malignant cancer of the cervix. ...

The latest generation of preventive HPV vaccines are based on hollow virus-like particles (VLPs) assembled from recombinant HPV coat proteins. The vaccines target the two most common high-risk HPVs, types 16 and 18. Together, these two HPV types currently cause about 70 percent of all cervical cancer. Gardasil also targets HPV types 6 and 11, which together currently cause about 90 percent of all cases of genital warts.^[3] Virus like particles (VLPs) consist of viral protein(s) derived from the structural proteins of a virus. ... Recombinant proteins are proteins that are produced by different genetically modified organisms following insertion of the relevant DNA into their genome. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Cervical cancer is a malignant cancer of the cervix. ... Genital warts or (or condyloma) is a very contagious sexually transmitted disease. ...

Gardasil and Cervarix are designed to elicit virus-neutralizing antibody responses that prevent initial infection with the HPV types represented in the vaccine. The vaccines have been shown to offer 100 percent protection against the development of cervical pre-cancers and genital warts caused by the HPV types in the vaccine, with few or no side effects. The protective effects of the vaccine are expected to last a minimum of 4.5 years after the initial vaccination.^[4] Each antibody binds to a specific antigen; an interaction similar to a lock and key. ...

While the study period was not long enough for cervical cancer to develop, the prevention of these cervical precancerous lesions (or dysplasias) is believed highly likely to result in the prevention of those cancers.^[5] Dysplasia (from Greek, roughly: bad form) is a term used in pathology to refer to an abnormality in maturation of cells within a tissue. ...

Although a 2006 study suggests that the vaccines may offer limited protection against a few HPV types that are closely related to HPVs 16 and 18, it is clear that other high-risk HPV types can circumvent the vaccines,^[4] and a 2006 study of HPV infection in female university students found that only 14 of 78 infections with high-risk types of HPV were by types 16 and 18, the remaining 64 infections being with 16 other high-risk types of HPV.^[6] Ongoing research is focused on the development of HPV vaccines that will offer protection against a broader range of HPV types. There is also substantial research interest in the development of therapeutic vaccines, which seek to elicit immune responses against established HPV infections and HPV-induced cancers.

Target populations

Gardasil and Cervarix are preventative (rather than therapeutic) vaccines, recommended for women who are 9 to 25 years old and have not contracted HPV. However, since it is unlikely that a woman will have already contracted all four viruses, and because HPV is primarily sexually transmitted, the US Centers for Disease Control and Prevention has recommended vaccination for women as old as 26. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...

Although HPV types 6 and 11 do not cause cervical cancer, they can cause genital warts. "Warts cause considerable discomfort and psycho-social trauma, so this makes the vaccine more attractive and also provides a reason other than altruism for men to be immunized," explains John Schiller of the National Cancer Institute.^[7] From a public health point of view, vaccinating men as well as women is important because it decreases the vaccine pool within the population. HPV also causes anal and penile cancer. In the UK the drug is licensed for girls and boys aged 9 to 15 and for women aged 16 to 26. Thus, the drug has to be administered to adult men "off license".^[8] Genital warts or (or condyloma) is a very contagious sexually transmitted disease. ... The National Cancer Institute (NCI) is part of the United States Federal governments National Institutes of Health. ... Anal cancer is a distinct entity from the more common colorectal cancer. ... Penile cancer is a malignant growth found on the skin or in the tissues of the penis, usually originating in the glans and/or foreskin. ...

Implementation

In developed countries, the widespread use of good-quality cervical "Pap smear" screening programs has reduced the incidence of invasive cervical cancer, by 50% or more. The current generation of preventive vaccines offers protection against the two HPV types (16 & 18) that currently cause about 70% of cervical cancer cases. Therefore, experts recommend that women combine the benefits of both programs by seeking regular Pap smear screening, even after vaccination. The pap smear as we know it is an invention of Dr. Georgios Papanikolaou (1883-1962), an American of Greek birth, the father of cytopathology. ...

Pap smear screening is too expensive for routine use in developing countries and HPV-induced cervical cancer remains the fifth most common cancer in women worldwide.^[9] Thus HPV vaccines are most urgently needed in developing countries. With a cost of $360, Gardasil is the most expensive vaccine ever developed. The vaccine will be too expensive for initial use in developing countries unless substantial subsidies are offered. Merck has announced that it intends to support programs to offer Gardasil to disadvantaged women worldwide.^[10] The Bill & Melinda Gates Foundation has also expressed interest in helping make preventive HPV vaccines available to women in developing countries. Through the PATH organization, a nonprofit organization whose mission is to improve the health of people worldwide by advancing technologies, the Gates Foundation has donated $27.8 million to implement HPV vaccines. Starting in January 2007, women in India, Peru, Uganda and Vietnam will be receiving the vaccine. The Bill & Melinda Gates Foundation (B&MGF) is the largest transparently operated[2] charitable foundation in the world, founded by Bill and Melinda Gates in 2000 and doubled in size by Warren Buffett in 2006. ...

History

In work that was initiated in the mid 1980s, the vaccine was developed, in parallel, by researchers at Georgetown University Medical Center, the University of Rochester, the University of Queensland in Australia, and the U.S. National Cancer Institute ^[11] . In 2006, the U.S. Food and Drug Administration approved the first preventive HPV vaccine, marketed by Merck & Co. under the tradename Gardasil. This vaccine is now approved in over 70 coutries worldwide. Early in 2007, GlaxoSmithKline filed for approval in the United States for a similar preventive HPV vaccine, known as Cervarix. In the European Union, GlaxoSmithKline filed the application for approval in March 2006. In June 2007 this vaccine was licenced in Australia. Georgetown University is an elite private research university located in Georgetown, Washington, D.C., United States. ... The University of Rochester (UR) is a private, coeducational and nonsectarian research university located in Rochester, New York. ... The University of Queensland (UQ) is the longest-established university in the state of Queensland, Australia, and a member of Australias Group of Eight. ... The National Cancer Institute (NCI) is part of the United States Federal governments National Institutes of Health. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic - President George Walker Bush (R) - Vice President Dick Cheney (R) Independence from... hi â€œFDAâ€ redirects here. ... Merck & Co. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biologicals, and healthcare company. ... Cervarix is an investigational vaccine against certain sexually-transmitted human papillomavirus (HPV) types. ...

Controversy

More than eighteen U.S. states and the District of Columbia are considering making HPV vaccination mandatory for young girls entering middle or high schools.^[12] New Hampshire has adopted a voluntary program, in which it supplies the vaccine free of charge on a triage basis.^[13]

Texas Governor Rick Perry, without legislative approval, issued an executive order on 2 February 2007 mandating Gardasil be given to all school girls entering sixth grade, beginning September 2008. It being a patent-protected vaccine, Merck is the sole producer of Gardasil. On April 25, 2007, the Texas legislature overruled Governor Perry's order, forbidding mandatory vaccination until at least 2011.^[14] Official language(s) No official language See languages of Texas Capital Austin Largest city Houston Largest metro area Dallasâ€“Fort Worth Metroplex Area Ranked 2nd - Total 261,797 sq mi (678,051 kmÂ²) - Width 773 miles (1,244 km) - Length 790 miles (1,270 km) - % water 2. ... For other uses, see Governor (disambiguation). ... James Richard Rick Perry (b. ... is the 33rd day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Merck & Co. ... is the 115th day of the year (116th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ...

Several conservative groups in the U.S. have publicly opposed the concept of making HPV vaccination mandatory for pre-adolescent girls, asserting that making the vaccine mandatory is a violation of parental rights. Both the Family Research Council and the group Focus on the Family expressed concerns about this.^[15]^[16] The Family Research Council (FRC) is a Christian conservative non-profit lobbying organization, formed in the United States by James Dobson in 1981 and incorporated 1983. ... The graphic identity of Focus on the Family is intended to recall old time traditional values. ...

Many women's rights organizations disagree. Dr. Christine Peterson, director of the University of Virginia's Gynecology Clinic, said "The presence of seat belts in cars doesn't cause people to drive less safely. The presence of a vaccine in a person's body doesn't cause them to engage in risk-taking behavior they would not otherwise engage in." ^[17]

Some individuals and groups have raised similar objections to the HPV vaccine that have been raised to other vaccines (see vaccine controversy).Dr. Joseph De Soto M.D.,Ph.D.,F.A.I.C formally of the National Institutes of Health argues against the mandating of the HPV vaccine based on medical ethics. He states, " Medical Ethics require that patients have autonomy in their medical decisions , with informed consent. They have the right to know what they have , what the prognosis i, what the proposed treatment is, what the alternatives are, and what the possible side effects are prior to any treatment. Indeed, a patient has a right to say no, even if by refusing treatment they may die. I as a medical professional cannot overrule their decision" It has been suggested that Anti-vaccinationist be merged into this article or section. ...

Possible adverse reactions after vaccination

As of May 11, 2007, 1,637 adverse reactions to Gardasil vaccination have been reported to the Food and Drug Administration.^[18] Most appear minor, but there have been three reports of deaths following HPV vaccination. A child, a 12-year-old girl, and a nineteen-year-old woman died of heart problems and/or blood clotting after receiving Gardasil.^[19] Other reported adverse events are "neurological symptoms including syncopal episodes and seizures, arthralgia and joint pain, Guillian-Barre Syndrome, and other immunological reactions."^[20] Full details are not available and it is not known if these are related to the vaccine. These reports are from the Vaccine Adverse Event Reporting System database: "When evaluating data from VAERS, it is important to note that for any reported event, no cause and effect relationship has been established... VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine." ^[21] Gardasil is a vaccine against certain types of the human papillomavirus (HPV), based on technology created by workers at University of Rochester. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... The Vaccine Adverse Event Reporting System is a United States program for vaccine safety, co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). ...

In the Gardasil clinical trials, 1,115 pregnant women received the HPV vaccine. Overall, the proportions of pregnancies with an adverse outcome were comparable in subjects who received GARDASIL and subjects who received placebo ^[22]. However, the clinical trials had a relatively small sample size. Currently the vaccine is not recommended for pregnant women.^[23]

Therapeutic HPV vaccines

In addition to preventive vaccines, such as Gardasil and Cervarix, laboratory research and several human clinical trials are focused on the development of therapeutic HPV vaccines. In general these vaccines focus on the main HPV oncogenes, E6 and E7. Since expression of E6 and E7 is required for promoting the growth of cervical cancer cells (and cells within warts), it is hoped that immune responses against the two oncogenes might eradicate established tumors.^[24] An oncogene is a gene that can cause a cell to develop into a tumor cell, possibly resulting in cancer. ... Tumor or tumour literally means swelling, and is sometimes still used with that meaning. ...

References

^ Glaxo cervical cancer shot approved in Australia Reuters (2007-05-21) Retrieved on 2007-05-25
^ D'Souza, Gypsyamber (May 10, 2007). "Case–Control Study of Human Papillomavirus and Oropharyngeal Cancer". New England Journal of Medicine 356: 1944-1956.
^ ^a ^b Prophylactic human papillomavirus vaccinesJournal of Clinical Investigation. 2006 May;116(5):1167-73.
^ ^a ^b Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trialLancet. 2006 Apr 15;367(9518):1247-55
^ FDA Licenses New Vaccine for Prevention of Cervical Cancer and Other Diseases in Females Caused by Human Papillomavirus. FDA (2006-06-08). Retrieved on 2007-02-04.
^
^ HPV vaccine moves into late stage trials, Nature Medicine 7, 388 (2001), accessed May 19, 2006
^ Gay men seek 'female cancer' jab. BBC (2007-02-23).
^ Cancer facts. World Health Organization (February 2006). Retrieved on 2007-04-05.
^ FDA Approves Merck's GARDASIL®, the World's First and Only Cervical Cancer Vaccine. Merck (2006-06-08). Retrieved on 2007-02-04.
^ Who Invented the VLP Cervical Cancer Vaccines? McNeil, C., Journal of the National Cancer Institute, 2006, 98(7): 433.
^ Wilson, Brenda (2007-02-05). States Consider Requiring HPV Vaccine for Girls. NPR. Retrieved on 2007-02-07.
^ Belluck, Pam. "In New Hampshire, Soft Sell Eases Vaccine Fears", New York Times, 2007-05-12. Retrieved on 2007-05-15.
^ Blumenthal, Ralph. "Texas Legislators Block Shots for Girls Against Cancer Virus", New York Times, 2007-04-26. Retrieved on 2007-04-26.
^ Sprigg, Peter (2006-07-15). Pro-Family, Pro-Vaccine — But Keep It Voluntary. The Washington Post. Retrieved on 2007-02-04.
^ Coyne, Brendan. "Cervical Cancer Vaccine Raises 'Promiscuity' Controversy", The New Standard, 2005-11-02. Retrieved on 2006-08-28.
^ "Lifesaving Politics." Ms. Magazine. pp 12-13. Spring 2007.
^ http://www.judicialwatch.org/archive/2007/GardasilVAERSReports.pdf
^ VAERS Line List Report. Vaccine Adverse Event Reporting System (11 May, 2007).
^ Human Papilloma Virus Vaccine Safety. National Vaccine Information Center. Retrieved on 27 July, 2007.
^ http://vaers.hhs.gov/info.htm
^ http://www.merckpregnancyregistries.com/gardisil.html
^ http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
^ Vaccination to prevent and treat cervical cancer Hum Pathol. 2004 Aug;35(8):971

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External links

Categories: American inventions | Australian inventions | Vaccines is the 199th day of the year (200th in leap years) in the Gregorian calendar. ... The New York Times is a daily newspaper published in New York City by Arthur Ochs Sulzberger Jr. ... (Clockwise from upper left) Time magazine covers from May 7, 1945; July 25, 1969; December 31, 1999; September 14, 2001; and April 21, 2003. ... is the 172nd day of the year (173rd in leap years) in the Gregorian calendar. ... Vaccination is the process of administering pathogens that cant reproduce (due to being weakened or dead) to a healthy person or animal, with the intent of conferring immunity against a targeted form of a related disease agent. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... A child being immunized against polio. ... Inoculation, originally Variolation, is a method of purposefully infecting a person with smallpox (Variola) in a controlled manner so as to minimise the severity of the infection and also to induce immunity against further infection. ... Vaccine topics 2000 Simpsonwood CDC conference AIDS vaccine Andrew Wakefield Edward Jenner Edward Yazbak Generation Rescue Genetics Immunization Immunology Inoculation MMR vaccine Safe Minds Timeline of vaccines Vaccination Vaccine Adverse Event Reporting System Vaccine controversy Vaccines and Fetal Tissue ... Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ... It is possible to model mathematically the progress of most infectious diseases to discover the likely outcome of an epidemic or to help manage them by vaccination. ... Timeline of vaccines This is a timeline of the development of prophylactic vaccines. ... A toxoid is a bacterial toxin whose toxicity as been weakened or supressed while other properties, typically immunogenicity, are maintained. ... I am an elf. ... The Advisory Committee on Immunization Practices (ACIP) consists of fifteen advisors to the Centers for Disease Control (CDC), selected by the Secretary of the United States Department of Health and Human Services, to provide advice and guidance on the most effective means to prevent diseases through nation-wide vaccination campaigns. ... The Global Alliance for Vaccines and Immunization is an alliance between various UN organizations, national governments, private foundations, NGOs and the pharmaceutical industry. ... The Vaccine Adverse Event Reporting System is a United States program for vaccine safety, co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). ... Over the past two decades, the recommended vaccination schedule in the United States and elsewhere has grown rapidly and become more complicated as many new vaccines have been developed and marketed. ... The Vaccine Safety Datalink Project (VSD) was established, in 1990, by the Centers for Disease Control (CDC) for the study of adverse side effects of vaccines. ... An apparatus (4-5 cm length, with nine short needles) used for BCG vaccination in Japan. ... The term cancer vaccine is often used to describe a process whereby a persons immune system is coaxed into recognizing and destroying malignant cells without harming normal cells. ... ... Model of Influenza Virus from NIH The flu vaccine is a vaccine to protect against the highly variable influenza virus. ... An HIV vaccine is a hypothetical vaccine against HIV, the etiological agent of AIDS. As there is no known cure for AIDS, the search for a vaccine has become part of the struggle against the disease. ... The MMR vaccine is a mixture of live attenuated viruses, administered via injection for immunization against measles, mumps and rubella. ... Pneumococcal polysaccharide vaccine (PPV), also known as Pneumovax, is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia. ... Two polio vaccines are used throughout the world to combat polio. ... The smallpox vaccine is the only effective preventive treatment for the deadly smallpox disease. ... It has been suggested that Anti-vaccinationist be merged into this article or section. ... Advocates for Childrens Health Affected by Mercury Poisoning (A-CHAMP), is a United States political activism group, founded by parents, which advocates on behalf of children who were injured by mercury in thimerosal-containing vaccines, and other toxins. ... Anti-vaccinationists are those who oppose the practice of vaccination. ... The National Childhood Vaccine Injury Act (NCVIA) of 1986 (42 U.S.C. Â§Â§ 300aa-1 to 300aa-34) was enacted in the United States to reduce the potential financial liability of vaccine makers due to vaccine injury claims. ... A pox party is a normal party for children organised by parents whose kids have the chicken pox. ... The Coalition for Safe Minds (Sensible Action For Ending Mercury-Induced Neurological Disorders) is a nonprofit organization dedicated to investigating the risks of exposure to mercury from medical products. ... The 2000 Simpsonwood CDC conference was a meeting convened in June, 2000, by the Centers for Disease Control, held at the isolated Simpsonwood Methodist retreat and conference center in Norcross, Georgia. ... Following US government action to evaluate levels of environmental toxins, including mercury, it has been claimed, particularly in the context of lawsuits, that thimerosal in childhood vaccines could contribute to, or cause, a range of neurodevelopmental disorders in children, most notably autism and related Pervasive Developmental Disorders (PDDs), or other... Vaccine injury is a term used in both medicine and law to designate alleged injuries sustained by individuals subsequent to having been vaccinated. ...

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