It may be hard to believe but it’s been 15 years since the first HPV vaccine was approved in 2006.
Now, a new study shows the vaccine has not only resulted in a dramatic decline in human papillomavirus infections, but evidence shows it is also effective in reducing cervical pre-cancers, lesions that can become cervical cancers.
Cervical cancer is the most common cancer linked to HPV, the most common sexually transmitted infection in the United States. It is estimated that globally, a woman loses her life to cervical cancer every two minutes. Now data has emerged that shows the vaccine is effective in its long-term goal of reducing the incidence of invasive cervical cancer.
Ami P. Vaiyda, M.D., Division Chief of Gynecologic Oncology at Hackensack University Medical Center, says spreading the news of the importance of the HPV vaccine is more important than ever in the fight against cancer.
“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” says Vaiyda.
I had a chance to interview Dr. Vaiyda to learn more.
How common is HPV?
CDC estimates that there were 43 million HPV infections in 2018. In that same year, there were 13 million new infections. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don’t get the HPV vaccine. The most common health problems related to HPV include genital warts and cervical cancer.
Human papillomavirus infection is also associated with anogenital cancer (including cervical, vaginal, vulvar, penile, and anal) and oropharyngeal cancer (back of tongue, tonsil)
Of the more than 150 HPV genotypes, 13 genotypes have been shown to cause cervical cancer.
High-risk HPV types include types 16, 18, 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 70.
HIV types 6, 11 can cause genital warts
Why is it important for girls to get the vaccine whether or not they are sexually active?
I want to clarify: the HPV vaccine should be given in early adolescence to BOTH boys and girls. The vaccination is most effective before exposure to HPV through intimate contact. Human papillomavirus vaccines are among the most effective vaccines available worldwide, with unequivocal data demonstrating greater than 99% efficacy when administered to women who have not been exposed to that particular type of HPV.
The U.S. Food and Drug Administration has approved three vaccines that prevent HPV infection. These vaccines cover 2, 4, or 9 HPV serotypes, respectively. Bivalent and quadrivalent vaccines are approved for women and men aged 9–26 years, and the 9-valent vaccine is approved for women and men aged 9–45 years. Currently, the 9-valent vaccine is the only HPV vaccine available in the United States.
The 9-valent HPV vaccine protects against more than 99% of HPV disease related to genotypes 6, 11, 16, and 18 and up to 96.7% for HPV disease related to genotypes 31, 33, 45, 52, and 58
How does the vaccine work to help prevent cancer?
Like other immunizations that guard against viral infections, HPV vaccines stimulate the body to produce antibodies that, in future encounters with HPV, bind to the virus and prevent it from infecting cells.The current HPV vaccines are based on virus-like particles (VLPs) that are formed by HPV surface components. VLPs are not infectious because they lack the virus’s DNA. However, they closely resemble the natural virus, and antibodies against the VLPs also have activity against the natural virus. The VLPs have been found to be strongly immunogenic, which means that they induce high levels of antibody production by the body. This makes the vaccines highly effective.
It is important that as many people as possible in the recommended age group get vaccinated. Not only does vaccination protect vaccinated individuals against infection by the HPV types targeted by the respective vaccine, but also vaccination of a significant proportion of the population can reduce the prevalence of the vaccine-targeted HPV types in the population, thereby providing some protection for individuals who are not vaccinated (herd immunity).
How do you alleviate parents' concerns about the vaccine if they have any?
Discuss the pros/cons of vaccination. Reassure patients the safety of the vaccine, alleviate fears, and develop trust with parents.
If women haven't gotten the vaccine as a teen, can they still get it as an adult?
Yes, the targe age is 11-12 years, but can consider vaccination in low risk patients age 27-45 years (see below).
9-14yrs
The target age for HPV vaccination is 11–12 years. For immunocompetent girls and boys who receive their first dose of HPV vaccine before 15 years of age, only two doses are needed because the immune response that develops at this age provides antibody levels equivalent to those in patients who receive three doses at the age of 15 years or older. The timing of the two doses is 0 (baseline) and 6–12 months.
15-26yrs
If girls or boys receive their first dose at age 15 years or older, three doses are needed and given at 0 (baseline), 1–2 months after the first dose, and 6 months after the first dose
27-45yrs
The HPV vaccine is now licensed in the United States for women and men through age 45 years. Although administration of the HPV vaccine is safe in patients aged 27–45, and can prevent new infections in women not previously exposed to the HPV-type protection generated by the vaccine, most women in this age range will have been exposed to HPV already. The overall public health benefit of HPV vaccination in women aged 27–45 years is markedly diminished compared with use in the target age range.
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