Human papilloma virus accounts for 42,000 new cancer cases in the United States each year.
The HPV vaccine has become the backbone of the battle against HPV-associated cancers. There have been many positive changes, and we learned more since the approval of the vaccine in 2006.
Early vaccine clinical trials focused primarily on the prevention of vulvar, vaginal and cervical cancer. As a result, the first HPV vaccine recommendation was for routine use in females. At the time, the public and most health providers were unaware of the role HPV plays in cancer. Initial marketing and educational efforts frequently labeled HPV a women’s issue.
Over time, recognition grew that HPV plays a major role in cancers of the rectum, anus, mouth and throat, and that men account for about 18,000 of the annual HPV-associated cancer cases. Clinical trials in males were completed resulting in a recommendation for routine use in young males in 2011. Due to HPV characterization as a women’s issue, vaccination rates of males dramatically lagged behind those of females. Many parents failed to vaccinate their sons, as they mistakenly believed that males aren’t at risk of HPV-related cancers. The good news is that the gender gap is narrowing with 69 percent of teen females and 63 percent of teen males starting the HPV vaccine series.
A welcome improvement came with the approval of Gardasil-9 in 2014. This “next-generation” vaccine provides protection against nine HPV types instead of just the two or four types that the first vaccines covered. In the case of cervical cancer, this expands protection from 70 percent to 90 percent against types accounting for cervical cancers.
The best news is that the HPV vaccines have proven themselves safe. Worldwide, more than a quarter billion doses of HPV vaccine have been given allowing for completion of very sensitive safety studies. Six governments including the U.S., have scrutinized the data and studies, finding no serious adverse effects with HPV vaccination. Specifically, there’s not any association between the vaccine and miscarriages, birth defects, premature ovarian insufficiency (“premature menopause”), Guillain-Barré syndrome, postural orthostatic tachycardia syndrome, complex regional pain syndrome or chronic fatigue syndrome. Additionally, there is no evidence suggesting any link between the vaccines and unexpected deaths.
Australia illustrates what’s possible. It was one of the first countries to have a highly effective national HPV vaccination program. They’ve seen a 77 percent reduction in the two types of HPV most responsible for cervical cancer. A recent study indicates that if Australia continues its current practices of vaccination and cervical screening, they will effectively eliminate cervical cancer in their country by 2028.
Columnist’s note: Look to upcoming Vaccine Smarts columns for recommendations on when to get the HPV and other vaccines.