Do I Still Need a Pap Smear After the Gardasil Vaccine?

Regular pap tests for cervical cancer are still required

HPV vaccine
HPV vaccine. Getty Images/Peter Dazeley/Photographer's Choice

After being immunized with one of the HPV vaccines (Gardasil, Gardasil 9, and Cervarix), you may be wondering if you still need to have regular Pap smears. After all, the vaccines do protect against the human papillomavirus (HPV), the virus that causes cervical cancer. Shouldn't that eliminate the need for a Pap smear? While that may seem like logical thinking, it couldn't be further from the truth.

Regular cervical cancer screening is a necessity for all women, whether they have had the HPV vaccines or not. These vaccines are not intended to replace the Pap smear, but instead to help prevent HPV. However, the vaccines do not protect against all types of HPV that can cause cervical cancer, and several factors may influence the level of protection you receive from the vaccine.  

The HPV Vaccines Offer Protection From Many Cervical Cancers

Gardasil and Cervarix, the two HPV vaccines that were first available, protect against the two types of HPV that cause 70% of all cervical cancer cases, as well as genital warts. The vaccine will not protect you against the other cancer-causing strains. Those other strains are responsible for 30% of all cervical cancers, which is still a significant number. 

Gardasil 9, which became available in 2015, protects against nine types of HPV, including the two that original Gardasil protects against, offering immunity to 90% of cervical cancers while still protecting against genital warts.

 

But because even Gardasil 9 doesn't protect against 100% of cervical cancers, regular Pap smears are necessary. 

Other Reasons You Still Need Regular Pap Smears 

Not all women get the same amount of protection from the vaccines. Just like with other routine vaccines, some women may not be fully protected by the HPV vaccine, especially those with weakened immune systems.

You must have a well-functioning immune system to respond to a vaccine and produce antibodies to the virus.

Some women may not complete the vaccine series. Gardasil requires a series of three shots given over a six-month period. Some women may not finish the series or may get them at the wrong time, which may cause them not to be fully protected.

Some women may be infected prior to vaccination. It is possible for a woman to be unaware that she is/has been infected with HPV. Women with prior HPV infection may not receive the same level of protection from the vaccines as women who have never been infected with HPV.

The Best Defense Against Cervical Cancer

The HPV vaccine combined with regular cervical cancer screening is an effective defense against cervical cancer. Don't rely on just one part of this one-two punch.

The Pap smear is a highly effective screening tool for women. It can detect abnormal cervical changes long before they become cancerous. When combined with the HPV vaccine, women have excellent protection against developing cervical cancer.

How often a woman has a Pap smear depends on several factors, such as age, current HPV status, and the result of previous cervical exams. Current cervical cancer screening guidelines recommend that women begin having regular Pap smears at age 21.

 

Keep in mind that yearly pelvic exams are recommended, even if you do not get a Pap smear every year. Pelvic exams will detect many other medical conditions besides cervical cancer. They are an important part of women's health screening to maintain your reproductive health and detect problems early.

American Cancer Society. FDA Approves Gardasil 9 HPV Vaccine. Jan 8, 2015.

American Cancer Society. HPV Vaccines. July 12, 2016. 

"HPV Vaccine Information for Young Women," Centers for Disease Control and Prevention. March 26, 2015

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