Expanded Use for HPV Vaccine
Monday November 3, 2008
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The Centers for Disease Control and Prevention estimates 6.2 million Americans become infected with genital HPV yearly, and over half of all sexually active men and women will become infected during their lifetime. Fortunately, for most infected women, the body’s immune system clears the virus and prevents progression to cancerous lesion development.
The expanded indication was prompted by the results of a two-year study of 15,000 participants of which approximately half had received Gardasil. Study data revealed that 10 unvaccinated individuals developed precancerous vaginal lesions; none of the vaccinated individuals developed lesions due to HPV types 16 or 18.
Available as an injectable vaccine delivered into in the upper arm or thigh, Gardasil is a three-dose series given to females ages 9 to 26 years. The vaccine series may begin at any time. The second dose is given two months later and the third six months after the first dose is administered.
Adverse reactions: Side effects are mainly associated with injection site pain and tenderness. Some women developed fever. More serious, but less common, adverse allergic-type reactions include hives, difficulty breathing, and swelling of the face or lips. Before administration, ask about yeast allergies because they are a contraindication to vaccination.
Patient teaching: Remind women that HPV vaccination doesn’t replace the need for routine Pap screening to detect pre-cancerous changes. It is not a treatment for active HPV infections, and it provides no protection against other sexually transmitted diseases. Women desiring vaccination should clearly be advised that the vaccine does not replace the need for safer sex practices.
Caution: Review current drug information before administering and monitoring medications.
Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, CRRN, who maintains a private practice in Plantation, Fla., and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.
