Public Health Campaigns Need Greater Emphasis on Complementary Role of Condoms and Vaccination to Prevent HPV among Gay Men - DrexelNow - Drexel Now

Public Health Campaigns Need Greater Emphasis on Complementary Role of Condoms and Vaccination to Prevent HPV among Gay Men - DrexelNow - Drexel Now
Gardasil Vaccine Reduces Cancer Risk/HPV Rates — So Why Aren’t Kids Getting It? - Parentology
'Housewives' actress says HPV caused her anal cancer, husband's throat cancer - Boston 25 News

Posted: 30 May 2019 12:00 AM PDT

Health

Public Health Campaigns Need Greater Emphasis on Complementary Role of Condoms and Vaccination to Prevent HPV among Gay Men

Public health efforts must emphasize condom use and vaccination together to reduce human papillomavirus (HPV) cases among young sexually active gay men, according to researchers at Drexel University's Dornsife School of Public Health published today in the journal Vaccine. The work builds on other studies demonstrating success of these methods by modeling how many HPV cases can be prevented by increasing the number of people vaccinated. This study contrasted vaccination scale-up with other STI prevention strategies, such as condoms and selecting sexual partners based on HIV status, in the reduction of HPV.

Currently, YMSM are at higher risk of HPV, yet only about 15 percent of YMSM have received the HPV vaccine, compared to roughly half of United States adolescents as a whole. This is well short of the U.S. Healthy People 2020 – a set of 10-year national health objectives -- goal of 80 percent of eligible adolescents vaccinated. There are roughly 79 million Americans infected with HPV, including more than 43 percent of adults. The team simulated a population of 5,329 young men who have sex with men (YMSM) aged 18-26, reflecting the population in Philadelphia, for up to 10 years after they received the FDA-approved HPV vaccine. The researchers recorded anal and oral transmission of the nine types of HPV most likely to cause cancer and genital warts that the vaccine helps prevent.

Vaccination was scaled-up at varying levels in the simulation population, reflecting the goal of public health efforts to increase immunization rates. This scale up of vaccination led to consistent declines in anal and oral HPV. Anal HPV declined by 9 percent, 27 percent, 46 percent and 58 percent at vaccination levels of 25 percent, 50 percent, 80 percent and 100 percent, respectively. Similarly, oral HPV declined by 11 percent, 33 percent, 57 percent, and 71 percent across the same levels of increased vaccine use.

Comparing the prevention strategies, condoms blocked the greatest number of anal transmissions when vaccination was at or below present-day levels. For oral transmission, vaccination was more effective than condom use at all levels of vaccination.

"Education surrounding HPV risk still has a long way to go to protect public health," said lead author Neal Goldstein, PhD, an assistant research professor in the Dornsife School of Public Health and epidemiologist at Christiana Care Health System. "Young gay men tend to be less likely to share intimate details about their sexual health with a medical professional, so public health efforts must put a greater emphasis on what we know works in this particularly at-risk population."

The vaccine is typically a series of two shots, taken six to 12 months apart; although those receiving the shot after age 15 and those with HIV need three shots. The CDC currently recommends that all boys and girls receive their first HPV vaccine shot by ages 11 or 12, up to age 21 for men and 26 for women. HPV can cause warts on hands and feet and lead to anal or cervical cancer.

"Although public health efforts have focused many efforts on genital HPV, we found the vaccine to be especially impactful in preventing oral infection, which is also just as important," said Goldstein. "It's a simple message — vaccination before becoming sexually active is key, along with regular condom use — which protects against many other sexually transmitted infections." This research was supported by a grant from Merck Sharp & Dohme Corp.

In addition to Goldstein, additional authors on this research include Michael T. LeVasseur, Nguyen K. Tran, Jonathan Purtle, and Seth L. Welles, from Drexel, and Stephen C. Eppes from Christiana Health Care System.

Read the full study here: (https://doi.org/10.1016/j.vaccine.2019.05.047).

Gardasil Vaccine Reduces Cancer Risk/HPV Rates — So Why Aren’t Kids Getting It? - Parentology

Posted: 19 Jun 2019 12:37 PM PDT

What if, with a single vaccine, you could protect your child (or yourself) from many different types of painful, potentially fatal, cancers?

It's not a "what if" situation: the HPV vaccine, Gardasil, is an actual cancer vaccine. It's pretty revolutionary, it's been available for over 10 years, and it's essentially a "silver bullet" for cancer.

What is HPV?

HPV is the human papillomavirus. It's technically a sexually transmitted virus, although when it's active it's very easy to catch (no intercourse required, although it helps). The first thing it causes are genital warts, which can be removed. The initial symptoms of many HPV infections clear up and disappear.

But the havoc HPV can cause later down the line is the real worry.

There are over 40 different strains of the HPV virus, and about ten of them have been very definitively linked to a bunch of very nasty cancers.

According to current medical research, here are some of the cancers that are linked to HPV:

The CDC estimates that HPV is responsible for about 5% of cancers internationally, and that about 79 million Americans are infected. Of those people, about 49,000 are diagnosed with a cancer causally linked to their HPV infection. That's a lot of people, and a lot of cancer.

And, if you've really checked out that list above, you'll see some cancers on there really get you where you live. Anal cancer, for instance, is what actress and cultural icon Farrah Fawcett died from, and what the actress Marcia Cross ( Melrose Place; Desperate Housewives) is battling now. And while many of them seem gender specific, like cervical, vulvar, and penile, some are not. Everyone has an anus and a mouth (oropharyngeal); this can hit everyone.

The Latest on Gardasil

Since 2006, at least 42 states have introduced legislation requiring HPV vaccination, funding of the vaccine or educating the public and school children about the HPV vaccine. At least 25 states have enacted this legislation.

Gardasil was first introduced in 2006. It was initially viewed with suspicion, both because of unfounded vaccine related paranoia and because people associate HPV with sex. By now, though, it's been around and has a proven safety and success rate.

Gardasil is a series of shots, two and sometimes three, given when a child is about 11. The idea is to gain immunity against the cancer causing HPV strains before any sort of contact can happen. Remember: HPV is easier to catch than a standard STD.

According to the CDC, Gardasil is recommended through age 26 for women and through age 21 for men (although that's changing). If you didn't get vaccinated at around 11 or 12, the CDC recommends Gardasil for young adults who:

Have sex with men
Are transgender
Have weakened immune systems

In 2018, the FDA added on another layer: adults aged 27-45 were now eligible to get vaccinated. This is excellent news for adults who, perhaps, are emerging from a long term relationship and beginning to date once again. Because, after all, nothing is going to ruin your new dating life like catching HPV and all its associated problems.

Like any immunization, Gardasil can cause some minor, temporary side effects, like pain and swelling at the vaccination site, nausea, dizziness, and headaches.

There's Overwhelming Evidence of Safety

There's lots of vaccination paranoia worldwide, even though there's overwhelming evidence vaccines are safe for almost everyone (with exceptions for the immunosuppressed); the benefits of cancer protection far outweigh any other risks associated with Gardasil.

There have been plenty of studies that find no link between vaccines like Gardasil and other illnesses.

For instance, a very large 2017 study in Norway in Vaccine found no link between chronic fatigue syndrome/myalgic encephalomyelitis and Gardasil.

Another, even larger 2017 study in Vaccine was done in France with an enormous sample of two million girls. This study was looking for a link between the vaccine and autoimmune disease, but found none.

Going back in time further, a 2012 study in the Archive of Pediatric and Adolescent Medicine tracked 200,000 girls from initial immunization to two weeks after. The only thing they found were skin infections; other illnesses had been diagnosed prior to getting the shot.

One concern has been a supposed link between primary ovarian insufficiency (POI) and Gardasil. POI is a type of early menopause which causes early infertility. The CDC lists many reasons for this problem, from genetics to cancer treatments to smoking.

One thing the CDC hasn't found is a credible link to Gardasil.

"Between December 1, 2014 and Dec 31, 2017, when 29 million doses of Gardasil 9 had been distributed in the United States, VAERS received 3 reports of POI following Gardasil 9 vaccination. The 3 reports were determined to be hearsay reports, meaning there was not enough information to confirm a diagnosis of POI," the CDC website states.

Finally, one 2016 study focused just on the supposed link between vaccines generally and myelitis (inflammation of the spinal cord). The study, in Clinical Infectious Diseases, looked at 64 million vaccine doses. The decisive sentence in its conclusion read: "We found no association between TM and prior immunization."

Even With the Evidence, Immunization Rates are Low

So, Gardasil is safe. It protects against the most dangerous range of HPV critters. And, it's actually going to protect you and yours against developing a plethora of nasty cancers later in life.

Currently, the vaccination rate for Gardasil stands at about 50%, although the CDC estimates that, even with that rate, which is well below effective herd immunity thresholds, the shot has still reduced the dangerous HPV rates by 86%.

With such amazing results, why are the vaccination rates still low?

There's a variety of reasons.

One reason might be the same as for all vaccines: there are multiple shots. Sometimes, parents have difficulty making multiple appointments for vaccines. Maybe they move a lot, or are undocumented and unsure of where to get the shots. Maybe they don't have insurance and the cost is prohibitive.

Another reason, Planned Parenthood points out, probably stems from discomfort regarding connecting our children with sex. It states this on its website:

"One of the reasons the HPV vaccine is controversial is because it prevents a sexually transmitted infection, which leads some people to believe it's inappropriate for children. But, the thing is, the vaccine works best if you get it long before you have sex. So it's a good idea to get it when you're young so you won't have to worry about getting certain kinds of cancer later in life.

Studies show that the HPV vaccine doesn't lead to people having more sex or sex at a younger age. So giving kids the HPV vaccine doesn't encourage them to have sex. All it does is help protect them from genital warts and cancer in adulthood."

Dr. Dave Fuchs, both a doctor and a parent, understands the hesitance on the parents' part, but sees it as an issue of knowledge and education.

"I vaccinated my kids," Fuchs tells Parentology. "I see the HPV vaccine as high reward and low risk. But, many parents feel it's different because it's vaccinating against a sexually transmitted disease, and vaccinating their child who isn't yet sexually active. It's the parent's decision, and they should do their due diligence on the risks and benefits by looking up facts. The best source I know of is the CDC's vaccination statement. They do a really good job."

And Let's Not Forget the Boys

There tends to be a disconnect when it comes to Gardasil and immunizing boys. Perhaps it's because the warts (and cervical cancer) show up in the female population, so the male role in spreading HPV gets ignored.

The fact of the matter is, boys are carriers of HPV just as much as girls. They are often asymptomatic, but if they contract certain strains of HPV, they are very vulnerable to developing penile, anal, and oropharyngeal cancers, all of which are horrible.

According to the CDC, oropharyngeal cancer, or throat cancer, is thought to be responsible for about 70% of all throat cancers. It gets its start through oral HPV, caught through oral sexual contact, and it's estimated that 10% of men and 3.6% of women have oral HPV. Obviously, males seem more vulnerable to this risk.

Are there guarantees that Gardasil will protect you or your child from developing these cancers? Not yet, but the data is pretty compelling.

As the AMA Journal of Ethics put it:

"One of the best ways to combat this stigma is by teaching that HPV infection has a well-established link to various cancers, that it is preventable, and that primary prevention is needed to reduce its incidence. We need to standardize acceptance of the HPV vaccine so that one day the cancers associated with HPV infection will be a distant memory."

Sources:

CDC
Planned Parenthood
AMA Journal of Ethics
Skeptical Raptor
Vaccine
Pediatric and Adolescent Medicine
National Conference of State Legislatures: HPV Vaccine: State Legislation and Statutes

'Housewives' actress says HPV caused her anal cancer, husband's throat cancer - Boston 25 News

Posted: 09 Jun 2019 09:13 PM PDT

First it was her husband. Then it was herself.

But actress Marcia Cross is determined it won't be their daughters.

>> Read more trending news

The "Desperate Housewives" star is speaking out about the human papillomavirus, commonly known as HPV.

Cross' husband, actor Tom Mahoney, was diagnosed with throat cancer in 2009, and Cross found out a year and a half ago she had anal cancer.

But she's hoping to prevent the same fate for their 12-year-old twins.

"My girls don't know it, but they're up for their first shot at the end of the school year," the actress told "CBS This Morning" on Wednesday.

That shot will likely be of the HPV vaccine Gardasil 9, which was previously recommended for ages 9-26 but was expanded in October 2018 to include ages 27-45. According to cancer.gov, Gardasil 9 is the only HPV vaccine available for use in the United States.

Cross said Wednesday that doctors suspect her and her husband's cancers were caused by the same type of HPV.

About 79 million Americans are currently infected with HPV, according to the Centers for Disease Control and Prevention in Atlanta. About 14 million people become infected each year. HPV is so common that almost every person who is sexually active will get HPV at some time in their life if they don't get the vaccine.

The CDC recommends all kids ages 11 or 12 get vaccinated, with catch-up vaccines for boys and men through age 21 and for girls and women through age 26, if they did not get vaccinated when they were younger.

HPV vaccine is also recommended for the following people, if they did not get vaccinated when they were younger:

young men who have sex with men, including young men who identify as gay or bisexual or who intend to have sex with men through age 26;
young adults who are transgender through age 26; and
young adults with certain immunocompromising conditions (including HIV) through age 26.

There is currently no test to find out your HPV status. There is also no test to find the virus in the mouth or throat. That's likely why Cross was exposed to it by her husband.

The actress said she had no clue a routine visit to her gynecologist was going to end with a cancer diagnosis.

"I was so not thinking anything was wrong because I didn't have any symptoms, and she gave me an exam and came around and said, 'Well, I just want you to know, whatever it is it's curable,'" she said. "It was like 'What? What are you talking about?'"

Cross said she's also speaking out about her anal cancer in order to destigmatize it.

"I know that there are people who are ashamed," she told "CBS This Morning." "You have cancer. Should you then also feel like ashamed like you did something bad because it took up residence in your anus? I mean, come on, really? There's enough on your plate."

Cross said she and Mahoney are both in remission.

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