Human papillomavirus is a common infection—more than half of sexually active men and women are infected with HPV at some time in their lives. But HPV vaccines can help prevent infection from both high-risk HPV types that can lead to cervical cancer and low-risk types that cause genital warts.
In the U.S., HPV infections cause over 20,000 cancers in women, and over 13,000 cancers in men each year. HPV vaccines can help prevent HPV-related cancer. Maria Trent, MD, MPH, Associate Professor in Pediatrics at Johns Hopkins Bloomberg School of Public Health, knows the importance of vaccinating adolescents against human papillomavirus (HPV). She shares her experiences treating HPV disease and explains why vaccination is “a gift” for our children.
HPV vaccination is recommended for girls and boys ages 11-12. The vaccine produces a stronger immune response when taken during the preteen years. For this reason, up until age 14, only two doses are the vaccine are required. In late 2018 the FDA approved use of the Gardasil-9 HPV vaccine in males and females ages 27-45, expanding the previous indication that covered from ages 9-26. For those 15 and older, however, a full three-dose series is needed.
Rates of infection with strains of HPV covered by the vaccines have dropped significantly since the vaccine was introduced. Researchers comparing HPV infections rates among females ages 14-19 in years before (2003-2006) and after (2007-2010) the first HPV vaccine became available found a 56% drop in infection rates for the HPV types covered by the vaccine. As more young people receive the vaccine, these rates can continue to drop. As of 2017, almost half (49 percent) of adolescents were up to date on the HPV vaccine, and 66 percent of adolescents ages 13-17 years received the first dose to start the vaccine series).
- HPV is very common. Most sexually active people have HPV at some point in their lives. The infection is usually harmless and the body most often clears it in a short time.
- HPV can lead to cervical cancer. Some types of HPV can infect a woman’s cervix and cause the cells to change. Most of the time, HPV goes away on its own. When HPV is gone, the cervix cells go back to normal. But sometimes, HPV does not go away. In a few people, high-risk HPV and related cervical cell changes last for many years and can lead to cancer if they aren’t found. Being vaccinated against HPV can lower the chance a woman will develop cervical cancer.
- HPV can cause other types of cancer. Some types of HPV can cause cancers of the penis, anus, or oropharynx (back of the throat, including base of the tongue and tonsils).
- Low-risk types of HPV can cause genital warts.The types of HPV that can cause genital warts are not the same as the types that can cause cancer. Genital warts may cause problems during pregnancy.
Youth between ages 9 and 14 only need two doses of the HPV vaccine. The schedule calls for the second dose of the vaccine to be given 6-12 months following the first. Studies show the antibody response generated with the 2-dose regimen is not inferior to that observed with the three doses previously recommended for all age groups.
For older teens and adults who start the series later, aged 15 through 45, three doses are still required. In this case, the second shot should be given one to two months after the first, and the third shot should be given six months after the first. The goal is to get all three shots within six months.
Ideally, people should complete all doses of the vaccine before they become sexually active. However, those who are eligible and are sexually active should still get the vaccine.
As with any vaccine or medication, there is always a possible of a serious problem, such allergic reaction. However, such reactions are rare and HPV vaccine continue to be monitored for any safety concerns.
According to the National Conference for State Legislators (NCSL), legislators in at least 42 states and D.C. have introduced legislation to require the vaccine, fund or educate the public about the HPV vaccine since 2006, and at least 22 states have enacted legislation. Currently, only Virginia and the District of Columbia have requirements for HPV vaccination for school. However, parents can opt out of vaccination requirements.
See the NCSL website for up to date, state-specific information.
For those that qualify, HPV vaccines are also available through the federal Vaccines for Children (VFC) program. The VFC program provides free vaccinations for children aged 18 and under who meet at least one of the following criteria: 1) Medicaid eligible; 2) uninsured; 3) underinsured; or 4) Native American or Alaska Native. More information on the VFC program is available here.
In addition to regular Pap tests, women 30 and over can also request an HPV test along with their Pap. Unlike a Pap test, which only detects abnormal cell changes, an HPV test can be used to find one or more of the high-risk types of HPV that are most commonly found with cervical cancer. Most women under 30 with HPV will get rid of the virus, so the HPV test for younger women isn’t helpful.
For an additional resource check out ASHA’s brochure: HPV and Cervical Cancer Screening.