Do women who have been vaccinated still need to have Pap tests?

Yes. Because these vaccines do not protect against all HPV types that can cause cancer, Pap tests continue to be essential to detect cervical cancers and precancerous changes. In addition, Pap tests are critically important for women who have not been vaccinated or who are already infected with HPV. There could be future changes in screening recommendations for vaccinated women.

How much do these vaccines cost, and will insurance pay for it?

The retail price of the HPV vaccines is approximately $130 per dose.18 However, the actual cost for vaccination may be determined by the clinic that provides the service. Clinics may charge for staff time and the vaccination equipment, for example, or they may have sliding-scale fees that set the cost according to a person’s level of income or insurance coverage.


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The best way to know how much vaccination will cost is to contact the insurance plan or the clinic. Individual or group insurance plans are subject to state laws. These laws generally establish whether insurers should cover the cost of vaccination based on recommendations from the ACIP.

Medicaid covers HPV vaccination in accordance with the ACIP recommendations, and immunizations are a mandatory service under Medicaid for eligible individuals under age 21. Medicaid also includes the Vaccines for Children Program, which provides immunization services for children 18 and under who are Medicaid eligible, uninsured, underinsured, receiving immunizations through a Federally Qualified Health Center or Rural Health Clinic, or are Native American or Alaska Native.

The vaccine manufacturers also offer help for people who cannot afford HPV vaccination. GSK has the Vaccines Access Program Exit Disclaimer, which provides Cervarix free of charge to women who do not have insurance and who have a low income, and who are ages 19 to 25 and therefore too old for the Medicaid Vaccines for Children Program. More information is available by telephone at 1–877–822–2911.

Merck offers the Merck Vaccine Patient Assistance Program Exit Disclaimer, which provides Gardasil for free to people over the age of 19 who do not have health insurance or cannot afford to pay for the vaccine. More information is available by telephone at 1–800–293–3881.

What research is being done on HPV?

Researchers at NCI and elsewhere are studying how high-risk HPV types cause precancerous changes in normal cells and how these changes can be prevented or managed most efficiently. Most of this research has focused on cervical cells in women, but researchers are now investigating these questions in other tissues in which HPV may cause cancer, such as the oropharynx and anus.

NCI is conducting a community-based clinical trial of Cervarix in Costa Rica, where cervical cancer rates are high. This study is designed to obtain information about the vaccine’s longer-term safety, the extent and duration of protection, the immune mechanisms of protection, and the natural history of infection with HPV types other than the types included in the vaccine.

NCI is also collaborating with other researchers on second-generation preventive vaccines and on therapeutic HPV vaccines, which would prevent the development of cancer among women previously infected with HPV. The ideal vaccine strategy would combine a preventive and therapeutic vaccine.

Another prevention strategy that is being explored is topical microbicides. Carrageenan, a compound that is extracted from a type of seaweed and used widely in foods and other products, has been found to inhibit HPV infection in laboratory studies. Clinical trials are under way to test whether a topical microbicide that contains carrageenan can prevent genital HPV infection.

Laboratory research has indicated that HPVs produce proteins known as E5, E6, and E7. These proteins interfere with the cell functions that normally prevent excessive growth. A better understanding of how these proteins interact may help researchers develop ways to interrupt the process by which HPV infection can lead to the growth of abnormal cells.

The FDA-approved tests for HPV infection in women detect viral DNA in cervical cells that are collected during a Pap test. Researchers are trying to find other ways to test for HPV infection that may be faster, more accurate, and less expensive. These new tests may be especially useful in developing countries and medically underserved populations.

Researchers at NCI and elsewhere are also studying what people know and understand about HPV and cancer, the best way to communicate to the public the latest research results, and how doctors are talking with their patients about HPV. This research will help to ensure that the public receives accurate information about HPV that is easily understood and will help people get access to the appropriate tests.

How can people learn more about HPV infection?

The following federal agencies can provide more information about HPV infection:

National Institute of Allergy and Infectious Diseases
Office of Communications and Government Relations
6610 Rockledge Drive, MSC 6612
Bethesda, MD 20892–6612
301–496–5717
1–866–284–4107
1–800–877–8339 (TTY)
http://www.niaid.nih.gov

Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333
1–800–CDC–INFO (1–800–232–4636)
8:00 a.m. to 8:00 p.m. Eastern Time, Monday to Friday
1–888–232–6348 (TTY)
http://www.cdc.gov/std
http://www.cdc.gov/hpv/
[email protected]


Source: National Cancer Institute


Selected References

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