The Duke Endowment and HPV Vaccines
What is HPV?
HPV stands for human papillomavirus, a common virus with many different strains that are spread
through sexual contact. It produces no symptoms, but some types can cause cervical cancer. Other types
can cause genital warts.
How do you treat HPV?
In most people, HPV goes away on its own without any treatment and does not cause health problems.
Experts do not know why HPV goes away in some cases, but not in others.
How common is HPV?
HPV is the most common sexually transmitted infection in the United States, with about 20 million people
currently infected. Women have an 80 percent chance of getting HPV by the time they are 50. Every year
in the U.S., about 6.2 million people get a new HPV infection. HPV is most common in people in their late
teens and early 20s.
How common is cervical cancer?
The American Cancer Society estimates that in 2007, 11,000 women in the U.S. will be diagnosed, and
3,700 will die, from cervical cancer.
What is the HPV vaccine?
Known as Gardasil® and produced by Merck, the vaccine protects against four HPV strains, which
together cause 70 percent of cervical cancers and 90 percent of genital warts. It is given through a series
of three shots over a six-month period.
Who is the HPV vaccine for?
In 2006, the U.S. Food and Drug Administration licensed Gardasil® for use in girls and women from ages
9 to 26. It is most effective in girls and women who are not yet sexually active, and have therefore not yet
acquired any of the four HPV types covered by the vaccine.
Will it help girls and women who are sexually active?
Yes, unless they have already acquired all four HPV types covered by the vaccine. For others, the
vaccine can still help, but it is less effective in young women who have already been exposed to one of
the HPV types covered by the vaccine.
How much does it cost?
$120 per dose, or $360 for the full series.
Why is The Duke Endowment funding the vaccine?
Through its Health Care work, The Duke Endowment seeks to accomplish lasting change by investing in
early intervention, prevention and equitable care. We believe that educating parents on the vaccine’s
potential to prevent HPV and save lives is critical to their choice on whether to vaccinate their eligible
daughters. Once informed, we aim to reduce disparities of access within the community.
How did the Endowment choose the pilot sites?
In partnership with state officials, The Duke Endowment invited communities in North Carolina and South
Carolina to participate in the initiative based on their histories of effective mass immunization efforts and
health departments maintaining good relationships within the community. School districts were then
invited by the county health departments to participate in the initiative locally. While the Endowment
works to ensure healthcare is accessible to all people, poverty levels did not play a direct role in the
invitation to participate.
How can others get the vaccine?
Private health insurance may cover it for some. Federal health programs such as Vaccines for Children
will also cover the HPV vaccine for uninsured, Medicaid eligible, American Indian or Alaska Native
children and teens under 19 years of age.
Why is the Endowment providing the vaccine if it’s available through federal health programs?
While federal programs exist, they are not always accessible due to location and/or lack of transportation.
In some cases, those who qualify are not aware of their existence. Endowment-funded programs are
based in neighborhood schools, which are familiar and accessible.
Why has the HPV vaccine generated controversy nationally?
1. HPV is a sexually transmitted infection (STI), so some believe providing the vaccine eliminates a
consequence of (and therefore a disincentive for) sexual activity.
From the American Social Health Association briefing paper:
Some organizations have expressed concern about “behavioral disinhibition,” the notion that HPV
vaccines will convey a false sense of protection and result in risky sexual behavior among youth.
CDC research found that it is unlikely that vaccines will lead to disinhibition because sexual risk
among young people is influenced by many factors and “fear of an STD is not a major motivation for
abstinence.”
– Liddon, N.; data presented at the CDC Advisory Committee on Immunization Practices meeting,
February 2006.
2.
The HPV vaccine received fast-track approval from the FDA without long-term trials or conclusive
evidence that it will prevent cervical cancer five, 10 or more years hence.
3.
Merck & Co., the corporation that developed the vaccine, launched a multi-state legislative campaign
to make the vaccine mandatory for girls entering middle school, and an expensive, multi-pronged
public relations campaign to sell parents on its benefits.
Why has the HPV vaccine generated controversy in Spartanburg?
After receiving materials that promoted focus groups and informational meetings, a local parent
expressed her concerns in a local newspaper article. The principal of the school involved was also
interviewed for the story:
“Mary H. Wright [school] principal Pat Paul said although no parents showed up at the two
educational meetings about the vaccines, she has received calls. Some of the concerns include the
perception that minority students from low socio-economic backgrounds are implied to be more likely
to engage in risky sexual activity, Paul said.”
What is the Endowment’s position on this matter?
The Endowment works to ensure that equitable healthcare is accessible for all people regardless of sex,
age, race, religion, sexual preference, ethnic or socio-economic background. Neither race nor poverty
level was considered criteria for participation.
Will the Endowment expand funding for HPV vaccines?
Once education and access elements of the initiative are completed, an evaluation phase will commence.
Continued funding depends on success of current efforts.