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Dr. Rajesh Patel, MD.
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Ask the Doctor!
June 2009
Q:
My daughter is 12 years old and I've have been considering the Gardasil vaccine for her. I am concerned about long term effects as well as why most insurance companies are not covering this vaccine. My insurance won't cover it and her pediatrician won't administer it until I pay first.
-- -- P. Ramirez, Chicago, IL
A:
Great question. Let’s just backtrack a bit for the sake of everyone. Gardasil is a vaccine directed towards four types of Human Papilloma Virus (HPV), two of which can lead to cervical cancer. It has just recently been cited by the World Health Organization as an effective way to fight cervical cancer, which is a major cause of cancer-related deaths among women. Because it targets some key types of HPV, this shot will reduce the risk of most cases of cervical cancer (and genital warts).
This vaccination is recommended in 11-12 year old girls. However, it can be taken anytime between the ages of 9 and 26, for only one course (3 shots over a 6-month period; no boosters are necessary). It’s safe to have other immunizations on the same day as well. There are some restrictions in regards to it‘s effectiveness. Since HPV is a sexually transmitted virus, the vaccine must be taken prior to becoming sexually active in life. Also, note that routine cervical cancer screening is still necessary, as the vaccine won’t protect against every single type of HPV. This vaccination should be avoided in individuals who have an ongoing moderate or severe illness, who suffer from serious yeast allergies, and who are pregnant. Therefore it’s crucial to tell the physician about any existing medical conditions and all current medications (including over-the-counter supplements).
The HPV vaccine has shown little to no adverse reactions in most people who receive it under the current guidelines. If symptoms do occur, most of them seem to be very mild and self-limiting. The person may experience temporary pain, redness, or itching at the injection site, bruising, mild fever, and headaches. Because there is a potential to become briefly faint, observation for 15 minutes after administration is recommended. With the HPV vaccine, the benefits of significant cancer prevention seem to greatly outweigh any foreseeable risk. The long term effects will be further evaluated as more information is collected over time. (This vaccine has been available for just a few years.)
Insurance coverage is indeed a complicated aspect to healthcare. State legislation will ultimately dictate school vaccination requirements as they provide funding. Once a state makes the vaccine mandatory, legislation will address whether insurance will cover HPV vaccination for girls ages 11-12 (as recommended by the advisory committee of immunization practices, ACIP). If appropriate insurance coverage or out-of-pocket cost is not feasible, consider the Vaccines for Children Program. This program exists in every state and assists those ages 9-18, who are either underinsured or uninsured. Your local health department can help locate a clinic that may offer the HPV vaccine at minimal cost. Additional programs may also be available, depending on federal, state, and private funding within your specific area. For those in college, many university health centers provide such services at a greatly reduced cost. There are multiple avenues for obtaining HPV vaccination for all appropriate age groups. With some exploration, you will find a suitable option to get this vaccine for your daughter right now.
For the most up-to-date information, please refer to your physician. Further immunization guidelines and information can also be obtained at www.cdc.gov.
Submit your questions to askthedoctor@nowoodennickels.org
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