Should a 30-year-old woman who had carcinoma in situ (CIS) and a transvaginal hysterectomy (TVH) receive the human papillomavirus vaccine (HPV) (Gardasil)?
—Teresa Tullos, ARNP-C, Tallahassee, Fla.

Gardasil is currently approved for use in women aged 9-26 years. Neither safety nor efficacy has been studied in older women or in women who no longer have a cervix. While the CIS that led to this woman’s TVH in the past was, no doubt, due to one of the carcinogenic types of HPV, there is no evidence to suggest that vaccination now would protect her against future vaginal intraepithelial lesions from HPV.
—Sherril Sego, MSN, FNP (109-1)

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