STD Awareness: Is There a Vaccine for Syphilis?

Before antibiotics, syphilis was the most feared sexually transmitted disease (STD) out there. It was easy to get, quack cures were ineffective and often unpleasant, and it could lead to blindness, disfigurement, dementia, and even death. Syphilis rates were highest during World War II, and plummeted when penicillin became widely available later in the 1940s. By 2000, syphilis rates hit an all-time low, and many scientists thought the United States was at the dawn of the complete elimination of syphilis.

What a difference an antibiotic makes. Image: CDC

Unfortunately, it soon became apparent that syphilis wasn’t ready to go out without a fight. Since 2000, syphilis rates have nearly quadrupled, climbing from 2.1 to 7.5 per 100,000 people by 2015 — the highest they have been since 1994. If you look at the above graph, you might think syphilis rates have been pretty stable over the past 20 years — but if you zoom in, the fact that we’re in the midst of an epidemic becomes more clear.

After hitting an all-time low in 2000, syphilis rates have been increasing nearly every year since.

The epidemic is disproportionately affecting men who have sex with men (MSM), with Arizona seeing a higher-than-average syphilis rate in this group. Additionally, syphilis rates are climbing among women, who have seen a 27 percent bump between 2014 and 2015. And, since women can carry both syphilis and pregnancies, a rise in syphilis in this population also means a rise congenital syphilis (the transmission of syphilis from mother to fetus), which causes miscarriages, stillbirths, preterm births, neonatal death, and birth defects. Ocular syphilis — that is, syphilis infections that spread to the eyes and can lead to blindness — is also on the rise.

Men, women, babies — no one is immune to the grasp of syphilis. Continue reading

Why Do Newborns Need the Hepatitis B Vaccine?

The first vaccine a baby receives — within hours or days of birth — protects them from hepatitis B virus (HBV). In a lot of people’s minds, HBV is associated with drug use and sexual activity — which stigmatizes people who have been infected with HBV or are carriers of the virus. Unfortunately, this stigma causes a lot of people to question why babies even need to be vaccinated against it, often pointing to “Big Pharma” conspiracy theories. A lot of other people are put off by the misconception that the HBV vaccine is made with human blood (it’s not).


May is Hepatitis Awareness Month, a time to learn about a childhood vaccine that’s saved millions of lives.


There are perfectly good reasons to vaccinate babies against HBV, mainly that HBV is the leading cause of liver cancer, itself one of the Top 10 types of cancer worldwide. Nine out of 10 infants born to a mother who is an HBV carrier will develop chronic infections and become carriers themselves — and a quarter of them will die prematurely of liver disease. Babies who develop chronic HBV infections are 63 times more likely to develop liver cancer than non-carriers, a connection that is 2 to 3 times stronger than the link between smoking and lung cancer.

When it comes to HBV, age at infection matters. Most people with chronic HBV infections are exposed at birth or in early childhood, when they are most likely to develop chronic, lifelong infections — whereas only 2 to 6 percent of infected adults will develop chronic infections, with only 15 percent of them eventually dying from liver disease. The fact that chronic infection risk is inversely correlated with age at infection means that birth is the time when a child is the most vulnerable to this virus — hence the importance of vaccinating as early as possible. Continue reading

STD Awareness: Human Papillomavirus Grabs Headlines

Human papillomavirus, or HPV, is the most common STD out there — a fact made even more aggravating by the absence of a good test for it. Sure, Pap testing can detect cellular abnormalities triggered by HPV, and the HPV DNA test can find evidence of infection. But it’s not a definitive test — a negative Pap/HPV DNA co-test doesn’t rule out the possibility that you carry the virus. Ditto for the anal Pap test — which most people haven’t even heard of anyway!


There are more compelling reasons to vaccinate boys against HPV — and not-as-compelling reasons to think Gardasil could protect against skin cancer.


The lack of a good diagnostic test makes the HPV vaccine an even more valuable asset. If we can drive the virus to extinction through aggressive vaccination campaigns, our limited diagnostic abilities become a moot point. And recent headlines have given us reasons to love the HPV vaccine even more.

HPV and Men

Many people think of HPV as a women’s issue, as the virus causes cervical cancer, and for a long time, boys and men weren’t even targeted for vaccination. But HPV is everyone’s issue — genital warts don’t care what gender you are, and cancer-causing strains of HPV cause most cases of anal cancer, penile cancer, and oropharyngeal cancer. Recently, a large, first-of-its kind study published in JAMA Oncology analyzed penile swabs provided by 1,757 men to figure out how common HPV is in this population. (While there is no FDA-approved test for diagnosing male patients with HPV, scientists can still collect swabs for research purposes.)

The results: 45.2 percent of American men ages 18 to 59 carry genital HPV — for a total of nearly 35 million adult males. HPV carriers can transmit the virus to sexual partners through vaginal, anal, or oral sex — or even just rubbing genitals together, as the virus is spread by skin-to-skin contact. Furthermore, a quarter of men are infected with cancer-causing strains of HPV. And, while the female population sees a peak in HPV infections in their early 20s, men’s HPV prevalence increases with age. While 28.9 percent of men 18 to 22 years of age carried HPV, 50.8 percent of them carried it by the time they were 28 to 32 years of age, and 59.7 percent of 58- and 59-year-olds were carriers. Continue reading

STD Awareness: Two Out of Three Ain’t Bad

For the past decade, human papillomavirus, better known as HPV, has been a pretty consistent headline grabber. Formerly a little-discussed virus, HPV was catapulted into the public consciousness in 2006, when suddenly people were all aflutter about this cancer-causing sexually transmitted pathogen, as well as Gardasil, the three-shot vaccination series the Centers for Disease Control and Prevention was recommending to preteen girls as protection from cervical cancer.


Kids 14 and younger develop such a strong immune response to Gardasil that they only need two doses — not three!


Dialogue has evolved since then, as people have recognized that HPV causes more than just cervical cancer — including anal cancer, head-and-neck cancer, and penile cancer — meaning that all children should be vaccinated, not just girls. And fears that the vaccine will “encourage” promiscuity still abound, despite thorough scientific debunking. In fact, many experts believe that our skittishness surrounding sexuality — especially when it comes to teenagers — causes parents to turn a blind eye to the importance of vaccinating their children against HPV. (Unvaccinated children might not appreciate their parents’ choice, if, say, a few years down the line they find a smattering of genital warts below their belts.)

Ongoing scientific research into Gardasil and the virus it protects against provides continuous fodder for journalists covering medical and scientific advances. Here are just a few of the most recent headlines featuring HPV:

Continue reading

Hepatitis B Vaccine: The Importance of the Birth Dose

babiesDid you know that Saturday kicked off National Infant Immunization Week, which is part of a worldwide observance that shines the spotlight on the importance of vaccination? Most of us think of infant immunization as a tool to protect babies from childhood illnesses like chickenpox and whooping cough. But did you know that one infant immunization protects them from cancer later in life?

Globally, hepatitis B virus (HBV) is one of the top causes of cancer. Every year, it kills more than three-quarters of a million people worldwide. An HBV infection might be defeated by the immune system, but when it’s not, it can become a chronic infection. And chronic infections can lead to serious health outcomes, including cirrhosis and liver cancer. The younger you are, the less likely you’ll be able to fight off an HBV infection — 90 percent of infants infected with HBV will develop chronic infections, and 25 percent of them will go on to die prematurely after developing liver disease. Compare that to 2 to 6 percent of infected adults who will develop chronic infections.


Because infants are so vulnerable to developing chronic infections, vaccinating them against hepatitis B at birth makes sense.


Most people think of hepatitis as a bloodborne disease, and it is spread very efficiently when IV drug users share needles, during needle-stick accidents and other occupational injuries, or by using contaminated piercing needles, tattoo equipment, or acupuncture needles. Even sharing items like razors, toothbrushes, and nail clippers can do it, as the virus can survive outside of the human body for a week. HBV can also be spread by sexual contact, including vaginal and anal sex.

Lastly, babies and children can be at risk as the virus can be transmitted from mother to infant during birth, and during early childhood when risk of chronic infection is high. A significant number of people with chronic infections acquired them during early childhood, but we don’t know exactly how they got them, as their parents and other household contacts were negative for the virus or its antibodies. Since infants and children are at the highest risk for developing chronic infections, focusing on that population for prevention is very important.

Luckily, there’s a vaccine. Continue reading

STD Awareness: Which STDs Are Vaccine Preventable?

scientistWouldn’t it be great if we could wipe sexually transmitted diseases off the face of the earth? If vaccinologists have a big “to-do” list out there, probably every single infectious disease is on it, including every STD. But some STDs have a higher priority than others, while other pathogens, unfortunately, don’t yield to our efforts quite as easily as other vaccine-preventable diseases.

Celebrate National Immunization Awareness Month by taking a look at a vaccinologist’s hypothetical “to-do” list below. While we already have a couple of STDs checked off that list, there is still more progress to be made!

check boxHuman papillomavirus: Gardasil, the most widely used HPV vaccine, introduced a new-and-improved version earlier this year. Gardasil 9 protects against seven strains of HPV that collectively cause 90 percent of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90 percent of genital warts. Not only that, but vaccination against HPV will also reduce the frequency of “pre-cancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments. In fact, Australia is already seeing a huge nosedive in genital warts and pre-cancers — all thanks to their sky-high HPV vaccination rates.

check boxHepatitis A and B: Hepatitis, a disease of the liver, can be caused by several types of viruses, including hepatitis A virus and hepatitis B virus. Both can be transmitted sexually, but thanks to the vaccines, you can ask to be protected against them using a combination vaccine, meaning you’ll only have to get three shots over a six-month period rather than the five shots you’d receive if you were vaccinated for the two viruses separately. Continue reading

Teen Talk: Gardasil, a Shot of Prevention

pink vaccine cartoonOne of my least-favorite medical memories must have happened when I was 5 years old, give or take. All I remember is that I was very small, surrounded on all sides by my mom, my pediatrician, and a nurse, and shrinking into a corner as the nurse came at me with a needle. I was squirming and protesting and cringing, but she grabbed my arm and pierced it with a syringe, quick as lightning. Before I could howl in protest, it was over.


Arm yourself against genital warts with Gardasil!


But here’s the thing: It hurt. A lot. And for days afterward, I went about my business feeling as if I had been punched in the arm. When I complained to my mom about how sore I was, she said that my muscles were completely tensed up, and shots hurt more when your muscles are tense. That fact only compounded my annoyance — why had that mean old nurse pricked me at the height of my freakout? If someone had just explained it to me, maybe I could have calmed down enough to relax my muscles and minimize the pain.

That incident made a mark on me, and once I hit adulthood I saw no reason to continue inviting the painful sting of immunization if I didn’t have to. It wasn’t until vaccine-preventable diseases like pertussis and measles started making a comeback that I had to admit to myself that avoiding immunization wasn’t anything to be proud of, and I started getting all my booster shots and yearly influenza vaccinations. Continue reading