Q: When do I need an HPV vaccine?

A: Human papillomavirus is a common viral infection that most often occurs via skin-to-skin contact during sexual activity. Many infected people never have any symptoms, and the virus often clears from the system on its own. In others, HPV will cause symptoms including genital warts or precancerous lesions in the genital area that may lead to cancer.

All of the available vaccines protect uninfected people against types 16 and 18 of the HPV virus, while Gardasil and Gardasil-9 protect against additional strains. Remember, the vaccines are not a cure for people who already have been infected with certain strains. For women, the vaccines were approved for people under the age of 26 years old, primarily because younger people have a higher risk of being infected with HPV.

There is not an equivalent HPV screening test for men; if men are concerned about HPV or genital warts, they can speak with a health care provider for more information about risk and transmission. Being too old to receive the HPV vaccine does not mean that you are more likely to get HPV; it might just prompt another conversation with a healthcare provider.

Q: When does a fetus become conscious?

A: As you can imagine, this is a sensitive question and makes for a very lengthy response! Consciousness can be generally defined as a sensory awareness of the body, the self, and the world.

According to researchers Hugo Lagercrantz and Jean-Pierre Changeux, “the fetus may be aware of the body, for example by perceiving pain. It reacts to touch, smell, and sound, and shows facial expressions responding to external stimuli. However, these reactions are probably preprogrammed and have a subcortical non-conscious origin. Furthermore, the fetus is almost continuously asleep and unconscious partially due to endogenous sedation.”

A pre-term infant removed from the womb through ex utero intrapartum treatment may open its eyes, establish minimal eye contact and shows reactions to uncomfortable stimuli. Many connections are not fully established, so the pre-term infant can only reach a minimal level of consciousness. A newborn infant can be awake, show sensory awareness, differentiate between self and non-self touch, display some emotions and feelings; however, they make little reference to the concept of themselves.

Newborn infants display features of basic consciousness, but still have to undergo considerable growth to reach the level of adult consciousness. To put a specific number on this question, researchers J.A. Burgess and S.A.Tawia conclude tentatively that “a fetus becomes conscious at about 30 to 35 weeks after conception, an answer based on careful analysis of EEG (electroencephalogram) readings at various stages of cortical development.”

If you are interested in a month-by-month breakdown of fetal development, you can check out Planned Parenthood’s pregnancy guide.

Thanks to scholars.org and loveisrespect.org for assistance in answering these questions.