Benefits and risks of the new HPV vaccine aren't fully known

Media coverage of the recently introduced human papillomavirus (HPV) vaccine - including talk of state-mandated vaccination programs - has brought considerable attention, if not always clarity, to this issue.

Although the vaccine represents a major medical breakthrough, there is reason to be cautious. The benefits and risks of the new HPV vaccine aren't fully known, reports the August 2007 issue of Harvard Women's Health Watch .

Gardasil, the new vaccine, has been shown to protect against four types of HPV that are sexually transmitted and thought to cause most cases of cervical cancer and genital warts. But it won't protect against the nearly one dozen other types of HPV associated with cervical cancer, and it won't protect against any type that a girl or young woman has encountered before vaccination. So women will still be at some risk even after they've been vaccinated, and they'll still need regular cervical cancer screening with Pap smear testing. Moreover, they will still need to take precautions against other sexually transmitted diseases.

The HPV vaccine is a medical achievement that could save thousands of lives annually worldwide, but it is not a perfect answer to cervical cancer. There are still questions about the vaccine's safety and effectiveness beyond five years, especially in girls ages 11 and 12—the age group targeted for vaccination by health officials.

The bottom line: Certainly the new HPV vaccine shows great promise. But given the many unanswered questions about its effectiveness and safety, the Harvard Women's Health Watch suggests its use should be more a matter of individual choice than government mandate.

Also in this issue:

• Hysterectomy and sexual function
• Simple steps to ease heel pain
• Concerns about the diabetes drug Avandia
• By the way, doctor: Can strontium help treat osteoporosis? How much should I limit my salt intake:

Harvard Women's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $24 per year. Subscribe at www.health.harvard.edu/women or by calling 1-877-649-9457 (toll free).