Your Sexual Health Update

The Cervical Cancer Vaccine

The health community cheered in June 2006 when the FDA approved a vaccine that could eliminate HPV altogether. But there's a catch: Gardasil, which protects against the four HPV types that cause at least 70 percent of cervical cancer cases and 90 percent of genital warts cases, was approved for women under age 27 only. The theory was that older women were likely to have been exposed to the virus, rendering the vaccine less effective, says Eva Chalas, MD, chief of gynecologic oncology at Winthrop-University Hospital in Smithtown, New York. Then last year, Gardasil's maker, Merck, submitted new research to the FDA showing that the vaccine -- which can also ward off some vaginal, vulvar, and oral cancers -- provides protection for 91 percent of women up to age 45. Revised FDA approval is pending. (GlaxoSmithKline's similar vaccine, Cervarix, which at press time was awaiting approval for use in the U.S., is already widely available in 49 countries.)

Should you get the vaccine? If you're under 27, definitely, according to the Centers for Disease Control and Prevention. (Your insurance will likely pay for it.) Women 27 and older should talk to their doctors about whether their sexual history makes them good candidates for the series of three shots, which costs $500 to $800. For each sexual partner she's had, a woman has a 5 to 10 percent increased chance that she's been exposed to one of the four HPV types covered by the vaccine. Previous exposure leading to an infection means Gardasil "won't do anything but give her a pain in the arm," says Dr. Einstein.

Because researchers are still studying the vaccine, no one knows how long immunity lasts, so don't think of it as a license to slack off on using protection or to skip your ob-gyn visits.