Jab: In Bermuda it is recommended girls aged 12 have the GARDASIL vaccine. *iStock photo
Jab: In Bermuda it is recommended girls aged 12 have the GARDASIL vaccine. *iStock photo

FRIDAY, OCT. 5: At the age of 12 you may not think your child needs protection against cancer or an STD, but a simple vaccination now will protect them through their adult years.

GARDASIL is a Human Papillomavirus (HPV) Quadrivalent vaccine, and is the only one to protect against four different strains of HPV.

HPV, the human papillomavirus, can cause cervical, penile and anal cancer, as well as genital warts.

However, it presents no symptoms and you can remain infectious for years without knowing it.

There are more than 200 strains of HPV and although most benign strains clear up naturally, some can develop into cancer or genital warts. Up to 40 can cause an infection of the genital tract.

By the age of 50, studies in the US have shown that up to 80 per cent of people are infected by HPV.

But in nine out of 10 cases, the infection clears up by itself, due to the body’s immune system.

In 10 per cent of cases, it leads to genital warts, pre-cancerous lesions or cancer.

The GARDASIL vaccine protects against the two types of HPV (16 and 18) which cause 70 per cent of cervical cancer cases, and types six and 11 which cause 90 per cent of genital warts.

It can protect girls and young women against 70 per cent of vaginal cancer cases and 50 per cent of vulvar cancer cases.

However, it needs to be administered before someone is sexually active to provide the best protection.


In the US the vaccine is recommended for both boys and girls at the age of 11. In Bermuda it is recommended for girls when they reach 12-years-old, and boys aged 12.

The vaccine, however, is licensed for anyone aged nine to 26.

Dr Ryan Bates, consultant paediatrician at Wee Care, said: “In order for it to be effective the vaccination should be given to a sexually-naïve population.

“It will still work on older individuals but not as well. In many cases, they will have been infected with one of the vaccine strains in their first few sexual encounters.

“The vaccine will still protect these individuals against the strains they are not infected with, but not any previously contracted infections.

“The vaccine is recommended for women up to 26-years-old and men up to the age of 22.

“For MSM men (men who have sex with other men) or those with immune compromise (HIV or cancer, for example), it is recommended up to the age of 26.”

“In October 2011, the ACIP (Advisory Committee on Immunization Practices) in the US began recommending the vaccine for all 12-year-old boys.

“Some parents will say, ‘Why am I going to give my 11 or 12 year old a vaccine for STDs?’, or ‘My child doesn’t need this as they won’t be exposed to an STD’.

But your child doesn’t have to be sexually active or promiscuous to contract HPV. Even if they have just one partner, it could still be passed on to them.

“To me this vaccination makes a lot of sense — why not protect your child against cancer and genital warts?

“GARDASIL is 99 per cent effective in preventing infection by 70 per cent of the cervical cancer-causing strains, and 90 per cent of the genital wart-causing strains.

“It is a very safe vaccine. The most common side-effects are mild pain at the site of the injection, headache and occasional fainting.

“Fever is rare and any serious side-effects with this vaccine appear to be lower than most other vaccines.

“In Bermuda, most private physicians administer GARDASIL, and it is also given at the public health clinic.

“Insurers are keen on preventing the diseases which HPV causes, and so cover the costs of the vaccine for both men and women.”

Dr Bates said: “Cervical cancer is the second-most common type of cancer among women.

About 99 per cent of all cervical cancer is caused by the HPV virus, which is contracted sexually.

“But it doesn’t have to be through intercourse, it can be orally transmitted as well.

“The vast majority of people catch HPV in the first two or three years of being sexually active, and there isn’t a treatment like there is for other infections such as chlamydia or gonorrhea.

“HPV is difficult to control as the vast majority of people don’t know they have it.

“There are no symptoms and so you can easily pass it on to other people.

“In 10 per cent of cases it will progress into a chronic condition.

“This can be cervical or anal cancer for women, and penile or anal cancer for men. Both sexes can also get throat cancer or genital warts.

“As there is no cure for HPV, genital warts are a big problem, with long-term consequences.

“Studies estimate that one per cent of the sexually-active population in the US is infected with genital warts.

“Most people get no symptoms and there is no cure. Treatments are for outbreaks and include surgical options and chemical ablative procedures, with podophyllin or cryotherapy.

“As HPV infection is silent in most cases, if people do not develop genital warts they only usually know they have been infected many years after the fact, when they start to have abnormal Pap smear results.

“It can take nine to 15 years from an initial HPV infection for cervical cancer to develop.”

Since its introduction in the US six years ago, Dr Bates said more than 40 million doses of GARDASIL have been administered.

However, after receiving the vaccine it is still important for women to have Pap smears, as GARDASIL does not prevent all types of cervical cancer.


Dr Bates said when his patients reach 11 he usually gives them a “heads-up” on the GARDASIL vaccine and some information to take home to discuss with their parents.

“A lot of the time parents may have known someone with cervical cancer and they know what they went through, so most people can see the benefits of this vaccine,” he said.

“The uptake in Bermuda has been quite good.

“I think it’s an amazing thing, to have a vaccine which prevents cancer, especially such a safe product.”

GARDASIL, manufactured by Merck & Co, is administered as a course of three injections over six months.

People with severe allergies to yeast should avoid the vaccine.

• For more information contact Wee Care Pediatrics at 7 Elliott Street, Hamilton, tel. 296-3032, or see www.gardasil.com