STYLETHREAD -- LET'S TALK SHOP!

scarlett · Marc Jacobs

HPV vaccine

relrel · Marc Jacobs

Okay, here are my thoughts...

1. No offense meant, but at 29, chances are you've already been infected and it won't do you a lick of good. Have you been tested? I would get yourself tested first, and then think about it. The vaccine protects againt four different types (two which cause the most cancers and two that cause the most genital warts) and while chances are that you haven't been infected with all four it's still a good idea to be tested anyway.

Actually, this is something that every woman should ask her doctor to do along with her annual PAP smear. Because there are around thirty HPV strains that are sexually transmitted (and around seventy more that are transmitted by other forms of contact or are asymptomatic or cause warts on other parts of the body and therefore not necessarily something to worry about) and because HPV infections generally go away on thier own without adverse affects at all, usually within two years, it is important to be tested every year.

However, there are no good, easy, cheap tests for HPV at this point. Most HPV infections are diagnosed on visual genital warts, and the rest are based off of abnormal PAP smears. Once a woman has a abnormal PAP, a doctor can perform a scraping from the walls of the cervix (or whereever lesions are spotted) and then have the scraping tested for HPV DNA. That's it. So, testing isn't always as easy as it could be. However, if a woman has had multiple partners or past abnormal PAP's she should definitly be talking with her doctor about HPV. There are no blood tests or any other sort of diagnostic tool available. AND there are no tests whatsoever for men other than visible genital warts and males can carry HPV without having warts!

2. The FDA hasn't approved the vaccine for someone of your age, therefore you doctor can't/shouldn't be even suggesting giving you the vaccine. I don't really know the legalities of this but I wouldn't be too excited about taking something that the FDA hasn't approved, even if the approval is only based on testing parameters.

My final thoughts....younger women (teens and very very very early twenties who haven't been sexually active) should get the vaccine, older women should just be diligent about thier annual PAP smears. Also, there are different types of PAP smears...some are better than others. If anybody is of a higher genetic risk for cancer or especially worried or whatever should look into Thin Prep PAPs because this test is significantly better at detecting abnormalities. If anybody wants to talk about this, just pm me...I've done heavy research about HPV for final papers and have had "issues" with abnormal PAPs and I have/had HPV.

scarlett · Marc Jacobs

I've actually done a lot of research on this too, both because I had HPV at one point and many of my friends have. Yes, it's a very common thing. And yes, all women should get screened for HPV in their annual pap smears. I should have made clear in my original posting that people should get screened before getting a vaccine, but I assumed people would do that anyway. The only people who don't need to worry about screening for HPV are those in a relationship where both entered as virgins. As soon as you sleep with more than one person, you can get HPV.

My intention with posting this was not to tell people to run out and get the vaccine, but to float the idea of discussing it with their gynecologist just in case readers here didn't know about it. I trust my doctor and that's why I talked about it with her. From her point of view, a difference of four years (between my age and the age of the people tested) makes no difference. She wasn't pressuring me to get it.

Relrel, I have to say the way you started out by saying that at my age I probably already had it felt like you were making some kind of judgement remark on my personal habits. I don't know if that was your intention, but it was a little hurtful.

-- Edited by scarlett at 22:31, 2006-06-29

relrel · Marc Jacobs

scarlett wrote:

Relrel, I have to say the way you started out by saying that at my age I probably already had it felt like you were making some kind of judgement remark on my personal habits. I don't know if that was your intention, but it was a little hurtful. -- Edited by scarlett at 22:31, 2006-06-29

Oh my goodness...no, that was totally not how I meant that to be taken. Hell, I'm 27 (or will be in a month/half)! It's just that by mid-twenties most people aren't virgins anymore and hence have probably been exposed to HPV at least once. That's all. Not a judgement call at all. And I was sorta writing to everybody, not just you. Again, I apoligize. No way would I want to intentionally hurt you or to make some sort of negative comment so I'm sorry it came out that way.

My post was meant as more of an informational thing for everyone, not just you. I actually think that there are a lot of women who 1. don't know anything about HPV 2. heard there was a vaccine to prevent cervical cancer and then 3. ran to thier doctors without knowing anything. Most women don't get tested for HPV, it's not a regular screening type thing, and well, I just don't trust a lot of doctors not to fully discuss the vaccine with thier patients before shooting them in the arm full of this stuff.

cc · Marc Jacobs

Thanks for reminding me about this. I need to schedule an appointment for my annual exam and have been meaning to look into this and the more advanced PAP smears.

scarlett, I don't blame you for being a bit offended. My gyno mistakenly diagnosed me with warts at my last appointment (which is actually the reason I've been putting off scheduling my appointment - I'm debating switching docs because I really didn't like the way she dealt with me and I think she was really jumping the gun with her diagnosis) and while I was totally freaked out for a week I was also a bit offended, though it was mainly because it didn't seem like she took my sexual history into account at all and was just going by my age. Anyway, she did do some kind of HPV test on me but I don't know if she was just going off my standard PAP or if she did something in addition to that. Whatever test she did came back negative but I should probably find out exactly what kind of test she did and how conclusive it was etc. I think this time I'm going with the "new improved" PAP smear because my mom has chronic "could be cancer" reproductive problems and I think for the peace of both our minds I should probably start shelling out the extra money for the better test.

relrel - I'm not an expert on this but I do know that once the FDA approves a drug doctors can prescribe it for whatever reason they see fit. There was a study recently that revealed that something like 1 in every 5 prescriptions is actually a drug being prescribed for an off-label use. So I assume (perhaps incorrectly) that if doctors are given the freedom to prescribe drugs for completely different problems they are also able to use their judgment in this kind of situation and can prescribe it to women who fall outside that age range. And if that's actually not possible I did read that Merck's rival Glaxo is currently working on a vaccine for women over 26.

-- Edited by cc at 23:34, 2006-06-29

scarlett · Marc Jacobs

thanks for clarifying, relrel. this is obviously a sensitive issue for a lot of people so it's good to get things said as clearly as possible.

cc, that must have been so stressful. as if going to the gynecologist wasn't enough of a stress already! i always get nervous and a little tense before those visits. i'm glad it turned out that you didn't have warts, but i can imagine how upsetting it was to experience that misdiagnosis. the addition of your mom's history understandably makes it more nerve-wracking for you too. i'm happy to hear that she is okay, despite the scares.

-- Edited by scarlett at 01:19, 2006-06-30

relrel · Marc Jacobs

cc wrote:

relrel - I'm not an expert on this but I do know that once the FDA approves a drug doctors can prescribe it for whatever reason they see fit. There was a study recently that revealed that something like 1 in every 5 prescriptions is actually a drug being prescribed for an off-label use. So I assume (perhaps incorrectly) that if doctors are given the freedom to prescribe drugs for completely different problems they are also able to use their judgment in this kind of situation and can prescribe it to women who fall outside that age range. And if that's actually not possible I did read that Merck's rival Glaxo is currently working on a vaccine for women over 26. -- Edited by cc at 23:34, 2006-06-29

Yeah, I figure she's "allowed" to prescribe the vaccine, but it sorta gives me the heebie-jeebies when doctors go doing stuff that's not been put through FDA approval. Now, mind you, I am not a fan of the FDA and I think that they could do a much better job and that there are lots and lots of medicines that are okay as "off-label"...there is just something that bothers me. I guess it's my general distrust of doctors knowing what the hell they are doing and in general not thinking so highly of them. Who knows...? I think doctors tend to jump on bandwagon medicines just as much, if not more, than the general public so who's to say they've done thier research on what they're doing. I haven't had terrible experiences with doctors (except the hot med student on rotation that I was having dirty thoughts about during the exam but that's a different type of "terrible experience) so I am not really basing this negativity on anything concrete.

Scarlett: I'm glad you're cool with me clearing things up. It is a sensitive issue. STD's are such a dirty topic and are still attached to stigma of sorts still which totally sucks donkey balls, IMHO. Sometimes its hard to remember that HPV has that connection still. I remember being slightly embarrased to talk to my classmates about the paper I was doing...I didn't want to be the girl doing the paper on STD's because that, by default, would somehow make me a dirty whore with a personal stake in the paper's topic...ya know? Anyway, that was sort of a ramble there...the point was...no ill intentions meant.

asf · Kate Spade

relrel - a question, since you seem to know way more about this than i do. i thought that once you had hpv you always had it - i don't think it goes away. is that not right? for the record, i have/(had?) hpv...i've had a few abnormal paps but luckily things are okay now.

NCshopper · Hermes

asf wrote:

relrel - a question, since you seem to know way more about this than i do. i thought that once you had hpv you always had it - i don't think it goes away. is that not right? for the record, i have/(had?) hpv...i've had a few abnormal paps but luckily things are okay now.

I was under the same impression. I got HPV awhile ago, was treated for the warts (sorry if this is TMI!), had a biopsy of a suspicious looking area on my cervix, and then went back for PAP smears every 3 months, then every 8 months, and now I'm back to being on a yearly routine. It's always been my impression that once you've gotten it, you always have it and it's not really something that you can be "cured" of. Is that not correct?

Also, for what it's worth, I really hope some of the younger girls are reading this. HPV affects SO MANY women, and what really sucks is that unless guys have warts, they have no way of knowing that they have HPV, since there are no tests. This was something I was totally unaware of prior to getting it and I really hope that this "Tell Someone" education campaign that's on TV helps educate women about this. I'm really glad to see that they have come out with a vaccine and I hope that it helps with this huge problem. But I can't help but feel like the vaccine is too late for those of us with HPV though, which makes me kinda bummed, but I guess all we can do is keep an eye on things and get regular check ups, right?

joy0302 · Kate Spade

Scarlett and anyone else thinking about getting the vaccine-just to give you a heads up, ask your insurance company first if they will pay for it before your doctor gives you the vaccine. There is a chance that since the FDA has only approved it for people under 25 that the insurance company will fight you on putting up the money for it. Of course, for the piece of mind, it may be worth paying for the vaccine out of pocket if neccessary. I work for a company where we have to deal with both the FDA and the insurance companies and it is amazing how long they take to approve certain things and once you get the FDA to approve the insurance companies can still string you along forever.

relrel · Marc Jacobs

asf wrote:

relrel - a question, since you seem to know way more about this than i do. i thought that once you had hpv you always had it - i don't think it goes away. is that not right? for the record, i have/(had?) hpv...i've had a few abnormal paps but luckily things are okay now.

While there is no cure for HPV, most strains are completely asymptomatic and will leave the body within two years. Your immune system will evantually fight the virus off without any ill health effects. Because there are so many strains however, there could always be some other form of the virus out there waiting for you. HPV is also particuraly (sp?) bad because condoms don't protect you from the STD because the virus just requires skin to skin contact.

Here is the website from the CDC for HPV: it has a ton of good stuff on it, especially since the vaccine came out (note...most of my research was done in the fall, prior to the vaccine's introduction) and the site here also has links to a bunch of other good sites.
http://www.cdc.gov/std/hpv/default.htm

cc · Marc Jacobs

For anyone who had HPV- the vaccine supposedly works on women who have been exposed in the past but it's not as effective. I think they explain this on the CDC site that relrel linked to.

relrel- I totally understand your distrust of doctors (after all mine seemed pretty convinced that what I said were a few irritated hair follicles from an at-home bikini wax were actually warts!) and I'd probably be nervous about a doctor prescribing me something that was actually designed and approved for a totally different illness but it seems like in this case the approved age range is just reflecting the age range used in the clinical trials and I can't really think of any reason why it can safely be used on a 24 year old but not a 29 year old. From what I've read there were no reported side effects so it doesn't seem like there's really a downside to getting it even if you're a bit older, other than the fact that insurance might not cover it.

Thanks for the sympathy, scarlett. I know that it's so common and everyone I talked to at the time kept saying that it wasn't a big deal but I was still a wreck and totally convinced myself that I had it even though looking back I don't know how my doctor could have made that diagnosis.

sephorablue · Marc Jacobs

I actually heard that women who's had HPV are advised not to get the vaccine--evidently it can raise your risk of getting a dangerous lesion later on. But I don't have an article to link to or anything, so I can't say for sure where I read it--but it's something to ask about if you've had the disease and are considering the vaccine.

halah · Kenneth Cole

Just wanted to bump this thread up and see if any of you have received the vaccine or more information?

I too have had an HPV and although I have had no symptoms of it for over 15 years. My thoughts now are if there are no adverse effects why NOT get the vaccine. I know it isn't foolproof (only 4 strains) but even if there is a small chance of it preventing a cancer or warts I think it's worth it.

Elle · Hermes

I think the vaccine is generally a good thing ...

HOWEVER,

The marketing they're using really pisses me off to no end. They use the phrase 'Cervical Cancer Vaccine' in their TV commercial, which is just wildly irresponsible and untrue. There are soooo many people out there that don't know they should be researching this stuff for themselves - my SIL was told by her doctor she should get this and that it prevents cervical cancer. That's it. No testing for previous exposure, no risks/warnings, and no further explanation that it doesn't lessen the chances of developing non-HPV related cervical cancer. How much more misleading can you be?!

IMO this is going to have a huge impact on the next generation though - I think it would be the most effective if they gave it routinely (but not absolutely required) in the same set with the rest of the pre-junior high shots.

I'm really glad that people here are researching and asking questions before getting the vaccine themselves. I'm still undecided whether to get it or not, myself.

blubirde · Chanel

A little off topic but here in Texas the governor just made an executive order that every girl entering 6th grade had to get the HPV vaccine. There are, of course, exceptions if it's against religion, etc., but I all in all, I think it's a great, progressive move by a guy who is best buds with W.

XtinaStyles · Marc Jacobs

ok this is slightly off topic and maybe ignorant.. but

how is it so common? arent people using condoms? can HPV be spread with condoms?

Elle · Hermes

XtinaStyles wrote:

ok this is slightly off topic and maybe ignorant.. but

how is it so common? arent people using condoms? can HPV be spread with condoms?

Many strains of HPV do not cause symtoms in men, so they can pass it without knowing. Many strains also do not cause symtoms in women, who can therefore spread it without knowing. It's also spread via skin-to-skin contact, aka areas condoms don't cover.

-- Edited by Elle at 14:54, 2007-02-08

-- Edited by Elle at 14:56, 2007-02-08

jacL · Coach

I just saw my general practitioner and she reccomended the vaccine to me. I am 25 years old and have already been infected with HPV and am in a mnonogamous relationship. We talked about it and mostly she said if my insurance will pay for it, why not get it as it may do some good (prevent any future infections of those four types of HPV) but will not do bad. I think I am going to get it.

Blubirde, I just read about that Texas order and think it is a great idea. I really hope not too many parents object.

Elle, I am also really annoyed by the marketing. I yelled at the TV the first time I saw the ad!

Aurora · Marc Jacobs

I am going next month for my annual visit and its definetly one of the things I'm going to ask about since I'm seeing a new doctor.