Cervical Cancer Vaccine- Things to know

Cervical cancer is an cancer which develops in a woman’s cervix (the entrance to the womb through the vagina). It is leading cause of cancer deaths among women in Bangladesh. It can be detected at an early stage by Pap smear and a more sensitive test called VIA. Cervical cancer is one of the few terminal illnesses that when detected at early stages can be treated and cured.
In taking a Pap smear, a speculum is used to open the vaginal canal and allow the collection of cells from the outer opening of the cervix and the endocervix. The cells are examined under a microscope to look for abnormalities.
VIA, or Visual Inspection with Acetic acid, a simple procedure where vinegar, i.e. acetic acid, is swabbed on the cervix and the areas are seen for color change. Normal cervical tissue remains unaffected by the acetic acid, but damaged tissue — such as that found in precancerous or cancerous lesions — turns white.
Lately, the cervical cancer vaccine has created quite a hype, especially with all the celebrities branding the vaccine and raising awareness. Although it does prevent cervical cancer, but there are few factors you should know before deciding on the vaccine.
Cervarix, the vaccine by GlaxoSmithkline, is approved for use in females between 9-25 years of age. The vaccine prevents the following diseases caused by oncogenic(cancerous) Human Papillomavirus(HPV) type 16 and 18:
cervical cancer( reason behind 70% of all cervical cancer)
cervical intraepithelial neoplasia(CIN) grade 2 or worse and adenocarcinoma
cervical intraepithelial neoplasia(CIN) grade 1
However, it does not give protection from other types of HPV, of which there are 30 to 40 varieties and 20 are cancerous. It was not found to provide protection against disease from vaccine and non-vaccine HPV types to which a woman has previously been exposed through sexual activity. Experts continue to recommend routine cervicalPap smears even for women who have been vaccinated. Vaccination alone, without continued screening, would prevent fewer cervical cancers than regular screening alone. Cervarix was shown to be effective 6.4 years after vaccination and Gradasil for 5 years.
The vaccine is given in 3 doses intramuscularly at 0 month, 1 month and 6 month. Some side effects of the vaccine include pain, redness, and swelling at the injection site, fatigue, headache, muscle pain, upset stomach, and joint pain. Few serious complications have been reported following vaccination but it was not related to the vaccine.
CERVARIX has not been evaluated for its carcinogenic or mutagenic potential. Vaccination of female rats with CERVARIX, at doses shown to be significantly immunogenic in the rat, had no effect on fertility.
HPV vaccine cannot be given to pregnant women. It has not been tested during pregnancy but an increased rate of miscarriages has been reported if the vaccine was received in first trimester. The immunity may be passed to the baby but, it may at times result in warts in the baby’s throat resulting in breathing difficulty. If you wish to take HPV vaccine, it is better to wait after delivery. Lactating mothers can take the vaccine as it does not pass in breast milk.
70 percent of all HPV infections resolve themselves without treatment within a year and that within two years that number climbs to 90 percent. Of the remaining 10 percent, only half will develop into cervical cancer, resulting in “little need for the vaccine.”
So do women/young girls need this vaccine?
The choice is your own but it is important to have all the information before making that decision. Screening programmes are considered just as effective as a vaccination programme which allows doctors to detect abnormal cells at very early stages. In addition, it is recommended that women undergo full physical checkups for breast, uterus and cervical tumors from adolescent stages and onward irrespective of getting vaccinated or not. Talk to your doctor on cervical cancer vaccine and its effects on your body.
Dr Kazi Mashfia Fardeen
Medical Specialist
Photo taken from irishtimes.com
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