Posted By: joe1441 HPV vaccine to prevent Oral Cancer - 04-19-2012 11:28 PM
Hello,
I am new new to this forum, and I am looking for some opinions/recommendations regarding one of the HPV vaccines, specifically in the prevention of oral cancer. My situation is somewhat unique. My wife and I are both dentists and are concerned about possible infection from our patients. I am a prosthodontist, and occationally see OC patients who require prosthetics for obturation post surgically. Quite ironically, the ENT in my town who focuses on cancer removal and refers patients to me for this, requently was diagnosed with a squamous cell carcinoma at the base of the tongue, which tested positive for HPV. It is hypothesized that the HPV virus was possibly contracted from aresol resulting from laser ablasion of papiloma lesions (as this is a commen ENT practice). I had a discussion with a radiation oncologist, and she feels that every one in the dental field is at high risk of occupational transmission of HPV, and this certainly makes sense. I asked her if I should be vaccinated even though I am 31, she responded �nobody knows yet.� I asked a pathologist that I know the same thing. His response was �the vaccine is not thought to be effective past age 26.� Does anyone have any thoughts about this? Should I (we) get the vaccine or not? Is anyone aware of any recent studies that support vaciination past age 26? Thanks for your time! Joe
Posted By: Brian Hill Re: HPV vaccine to prevent Oral Cancer - 04-20-2012 05:53 AM
There is another thread running right now related to post age 26 vaccination ( just search for HPV16 and look at the results by date) so I won't go into that agin on your thread. I would be happy to talk to you on the phone if you would like, as there is much to consider. The foundation's phone number is on the main site and you can just ask for me there.

Given that the HPV virus family is one of the most common in the US, (the CDC says that somewhere between 50 and 80% of the entire US population will have the infection at some point in their lives) and documentation of infection through things such as aerosol dispersion completely unproven and undocumented, I would speculate that that would not be a likely risk. Especially given difficulty for an episomal viral dna to initiate a new infection, the likelihood that a medical or dental professional would be more at risk than the already high rate that the general population is, seems like over thinking it. I am not dismissing this, I just feel that even in monogamous relationships, and the unknown of whether this virus has a decades long latency period, the likely hood that a person over 30 for instance not to have been exposed through conventional means (and had their immune systems respond to it) seems unlikely. Anyway, the likelihood that the ENT came in contact with the virus through the same mechanisms that everyone else does, seems more likely than though gloved and masked contact with an infected patient.

Having said all that there are more thing that we do not know about this virus than we do. We do not even yet know the entire life history of the virus and only 3 years ago were we able to culture it outside the body in a petri dish, if that gives you any perspective about how far behind the cure we are on knowledge.

Please give me a call after you read the article in the other thread about vaccinations for already exposed individuals, and for those of us that have already had a malignancy develop from it. Just remember that in the general population 99.1% of all Americans will have an immune system that recognizes HPV16 as a threat, and will get infected and clear the infection - never knowing that it took place, and never developing malignancy as a result of the infection.

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