Abstract: Approaches for cervical cancer prevention are changing. Screening still remains the most effective method for cervical cancer prevention. Guidelines are moving to an older group of women to be screened less frequently with combinations of technologies that include biomarkers and cytology. HPV vaccination is an appropriate option for this older group of women as well, should the woman not wish to make her decision about vaccination until 21 years of age, the age of screening. Parents making decisions about HPV vaccination for their young adolescent daughters need to be fully informed that only continued screening prevents cervical cancer. HPV vaccination reduces the possibility of their daughter having an abnormal Pap test by 10% if the vaccines have not waned by the time the young adolescent becomes sexually active. HPV vaccine efficacy must last at least 15 years to contribute to the prevention of cervical cancers. At this time, protection against cervical intraepithelial neoplasia grade 2/3 (CIN 2/3) is 5 years for Gardasil and 8.4 years for Cervarix. The value of the current protection HPV vaccines offer will be viewed differently by different women. Physicians' ethical duties are to provide full explanation of the risks and benefits of adding HPV vaccination to the ongoing screening programs, and to support women in their personal choice for cervical cancer prevention. ... Read more

Abstract: Infectious agents contribute to the environmental factors involved in the development of autoimmune diseases possibly through molecular mimicry mechanisms. Hence, it is feasible that vaccinations may also contribute to the mosaic of autoimmunity. Evidence for the association of vaccinations and the development of these diseases is presented in this review. Infrequently reported post-vaccination autoimmune diseases include systemic lupus erythematosus, rheumatoid arthritis, inflammatory myopathies, multiple sclerosis, Guillain-Barré syndrome, and vasculitis. In addition, we will discuss macrophagic myofasciitis, aluminum containing vaccines, and the recent evidence for autoimmunity following human papilloma virus vaccine. ... Read more

Abstract: Despite their much-heralded clinical potential, therapeutic cancer vaccines have thus far failed to achieve the necessary clinical benchmarks to allow their regulatory approval. In contrast, vaccination against infectious pathogens represents one of the biggest achievements of modern medicine, and in certain cases such as vaccines against the human papilloma virus or hepatitis B virus, vaccination may impact the development of cancer. To the extent that these two approaches differ as immunotherapy vs. immunoprevention, the challenge is to rethink the types of non-viral antigens that are currently being targeted in cancer vaccines. Immunological analysis suggests that the telomerase reverse transcriptase hTERT is a widely applicable target recognized by T lymphocytes and a prototype for a novel class of universal tumor antigens. Findings from initial clinical trials demonstrate that hTERT-specific immune responses can be safely induced in cancer patients. If the amplitude and duration of cellular immunity against hTERT can be optimized without toxicity in humans, then an opportunity exists to test hTERT vaccination as a way to reduce the risk of cancer recurrence in patients or even the risk of developing cancer in otherwise healthy individuals. ... Read more

Abstract: The clearly defined causation by papillomavirus (HPV) and precursor lesions of cervical cancer have made this cancer largely preventable through Pap screening programs, and now by vaccination with Gardasil. This represents an important public health success story and here the authors summarize the potential impact of preventive HPV vaccination and some of the outstanding questions. ... Read more

Cures or effective drug treatments for cancer have been elusive. Much of the obstacles lie in the lack of a specific cancer target and the fact that cancer cells mutate and change frequently. While no immediate relief is in sight despite the advent of genomics technologies, it seems logical to go after the cancers with a known cause: cancers caused by viruses.

This month, a vaccine for human papillomavirus developed by Merck showed a surprising efficacy in protecting recipients from the viral infections and the associated cervical cancer. While scientists and the pharmaceutical industry deserve credit for beginning to ... Read more

A new vaccine for human papillomavirus (HPV) has achieved 100% protection against the viral infection in young women, recently reported by a team led by Dr. Laura A. Koutsky of University of Washington, Seattle, WA and Dr. Kathrin U. Jansen of Merck Research Laboratories, Blue Bell, PA in the N. Engl. J. Med. (347:1645-1651, Nov. 21, 2002).

About 20% of adults are infected with HPV type 16 during their lifetimes. Approximately 90% of the infections resolve spontaneously and uneventfully. However some of the persistent viral infections eventually lead to cervical cancer (20 years later on average), which affects 470,000 women a ... Read more