new HPV vaccine?

[dial-zero.livejournal.com]

Hi all,
I am considering getting the HPV vaccine, however, I'm now 27 so it's likely my insurance won't cover it.  (Still have to do some research on that, I have Harvard Pilgrim insurance currently).  I was wondering, though, if anyone knew of a newer HPV vaccine coming down the pike.  Googling "new hpv vaccine" only brought up Cervarix, which only protects against 2 of the strains that Gardasil protects against.

I know some of you keep up with this issue and may have heard of something that's currently in trials.  If there's the possibility of a new vaccine coming out in a few years (that protects against more strains than Gardasil) I may hold off until it comes out, especially if I'm paying out of pocket anyway.

(Also, I am really annoyed that there is an age cutoff for coverage.  What, women over 26 never have new sexual partners or risk getting exposed to different strains?)

Thanks!

Comments

[dial-zero.livejournal.com]

That makes sense... I just seems that, if my doctor thinks it's a good idea, my insurance shouldn't refuse to pay because of an extra year. Oh well.

[queensugar.livejournal.com]

Another issue complicating the age thing, and perhaps one of the reasons why there's not tons of movement on it, is that the studies have shown quite a reduced efficacy against cervical abnormalities in older women and after the onset of sexual activity, likely due to how quickly people are exposed to the vaccine-type HPV strains -- in one study, adolescent girls had 31% and 20% exposure to the two vaccine-type high-risk strains within 2.2, with the median sexual partners of only two. In the FUTURE II trials where 93% of subjects were sexually active, the vaccine showed no efficacy against the highest grade of abnormal cervical lesion, and another study in NEJM found the vaccine was not cost-effective (http://www.medicalnewstoday.com/articles/119018.php) in older age-groups.

Since you would be looking at paying out-of-pocket, I might recommend reading through some of that data so that you can know whether or not the unknown value would be worth the cost for you; this paper (http://content.nejm.org/cgi/content/full/356/19/1991) and this statement (http://caonline.amcancersoc.org/cgi/content/full/57/1/7?ijkey=53c484dda35708771ad91a065cdb70f01745d961) from the American Cancer Society (scan down to "Age to Vaccinate") have some data and dicussion on that issue.

[dial-zero.livejournal.com]

This is very helpful, thanks. Maybe my best course of action is to keep doing what I'm doing... limiting risk and getting paps.

[queensugar.livejournal.com]

Yeah, it's totally up to you, based on our own risk-cost assessment. I just like to mention it because I find that the media campaigns re: the HPV vaccine leave many adults who are already sexually active with an impression of a likely benefit that the data does not support.

The good news is that with regular pap testing and appropriate follow-up as necessary, one's risk of cervical cancer is incredibly low -- not even in the Top 30 of cancer risks in women, IIRC. Pap testing and follow-up regimens are incredibly effective against cervical cancer, more effective alone than the current vaccines alone could be under the most optimal conditions (vaccination before sexual activity, lifetime immunity).