Gimme the Gardasil

Or, why I got myself vaccinated against HPV.

At first glance, there isn’t any huge reason for me to be vaccinated:

• I’ve been sexually active for nearly a decade, increasing the likelihood that I’ve already been exposed to HPV.
• I’m in a stable, long-term monogamous relationship.
• I would have to pay for it out of pocket.
• I’m at the end of the eligible age range.

On the other hand:

• I haven’t had a number of partners that makes me higher-risk for HPV exposure, and neither has my current partner. I’ve had full STD testing, but this doesn’t test for HPV. Even if I’ve been exposed to one HPV virus, there are numerous carcinogenic strains out of the hundreds known to exist. My HPV status is therefore a bit of a Schrodinger’s Cat situation – there’s no reason to assume either way.

• As much as I love my boyfriend, it’s not overwhelmingly likely that we’ll be together and monogamous for the rest of both our lives: it might be what we’re aiming for, but shit happens. He also happens to like me and want me around for a while: cervical cancer has a 33% mortality rate.
• I will likely be able to claim some of the cost back through my family’s health insurance and on my tax return. I’m also employed full-time now, though I wasn’t when I started the vaccination.
• The age range is mandated by the original studies, but studies on older people are ongoing.
• The major reason: a lower risk of cervical cancer, anal cancer (which you don’t have to have had anal sex to get), and some other rare cancers. If I can do something to lower my risk (of cervical cancer by nearly 3 times, according to U.K. data), whose only cost to me is financial– unlike too-frequent smear tests and their treatments– I will.

And a few other things which helped me make up my mind:

• The HPV vaccine still works even if you’ve been exposed to the relevant HPV strains – it just doesn’t work as well. It’s not totally useless just because you’re sexually active. This is something that many people– including some doctors, scarily enough– don’t know. I was lucky: I’m well-informed and my GP was supportive (even telling me where to get it at the lowest price), but other women may not be so lucky. We deserve the best, most up-to-date information available.

• I’ve seen friends go through the pain, worry and inconvenience of years of repeat tests and colposcopies after HPV infections led to pre-cancerous cervical lesions. I’ve also witnessed loved ones dealing with all kinds of cancer, including anal cancer. If I can avoid that, again, I’ll try.
• I have a normal but mildly capricious immune system. A few years ago, I noticed a wart developing on my hand. I thought nothing of it, assuming it’d go away after a while as they usually do. But a few months later, another developed, and then another, until within a year I had almost twenty warts on my hands and face. I tried cryotherapy and the other usual treatments several times, but nothing worked. My dermatologist said that for whatever reason, my immune system sucked at defending against that particular HPV virus. I was prescribed Aldara, which did work (thank you, science!), but there are no guarantees about what my immune system will do with the next wart virus it encounters. It could behave like a grown-up, or it could throw a tantrum and let the virus colonize like it did before.

  

• If that were to happen, I’d prefer it not happen to my genitals, hence why I shelled out the extra cash for Gardasil (protects against four varieties of HPV, including two wart viruses) instead of Cervarix (just two varieties).

I know that there’s no definite data yet on how long the protective effect of the vaccine lasts; I may need a booster series in the future. I will continue to be sexually responsible and get my scheduled smear tests, because the vaccine doesn’t protect against all known carcinogenic varieties of HPV. I also realise that given the same information and circumstances, someone else might make a different decision.

But the bottom line is: I’m a fan of evidence-based medicine, informed consent, and weighing the risks and benefits of any medical treatment. I’m not a fan of cancer.