In my practice, I ask every patient younger than 42 years old if they were vaccinated against the HPV vaccination at some point in their lives. I would say that most of my patients at least know what I am talking about, twenty-five percent believe that they were too old to get it when the vaccine was first available, and less than ten percent have no clue what I am talking about. Of those who know about the existence of the HPV vaccine, over fifty percent are unsure if they received it or completed all the recommended doses. Many patients also don’t know how to find out if they have received the HPV vaccine. So, why do I bother asking this question, when I know my chances of getting the simple answer that I am looking for is only about fifty percent? Because it’s important, and it is my job to make sure that my patients receive the best care, even if that means spending some extra time discussing important information they may not have heard in the past.
As you have learned, I have had lots of experiences giving this talk to my patients, so here are my key discussion points.
- HPV vaccination is aimed at reducing risk of HPV-related cancers like cervical cancer, not at preventing all future HPV infections. In addition to cervical cancer, HPV can cause cancer of the vagina, vulva, anus and the back of the throat.
Human papillomavirus (HPV) is the most common virus of the reproductive tract that can lead to precancerous lesions that may progress to cancer. There are over 200 types of HPV strains, but only a little over a dozen of them have been associated with cancer. HPV types 16 and 18 are responsible for over 70 percent of cervical cancer cases, and the remaining 7 types in the current Gardasil vaccine are found in 19 percent of cervical cancers. Therefore, while the vaccine won’t keep you from ever having a strain of HPV, it will dramatically reduce your risk of getting cervical or other HPV related cancers.
- The Gardasil vaccine was initially approved for people aged 9 to 26, however more recently has been FDA approved for people up to the age of 45. It is recommended that children get vaccinated against HPV at ages 11 and 12 for maximum protection. Because HPV is typically transmitted through sexual contact, it is best to be vaccinated prior to becoming sexually active in any way. Anyone from ages 13 to 26 who have not completed the vaccine series should start or complete the series regardless of prior sexual activity. For people from 27 to 45, there are no firm guidelines as to who should get vaccinated, but doctors and patients should discuss if getting vaccinated is appropriate. I typically recommend that my patients get vaccinated if their insurance covers it.
- When vaccinated before 15 years old you need two doses of the vaccine, after age 15 you need 3 doses.
- The vaccine has been extensively studied and over 135 million doses have been administered in the US alone. The most common side effects are pain at the injection site, fever, fainting, nausea, muscle and joint pains, which are temporary. The vaccine has not been shown to cause infertility.
- Over 80 percent of people will get an HPV infection in their lifetime as it is transmitted by skin to skin contact and it is not a sign of sexual promoscuity. Infection with HPV does not typically cause symptoms, except genital warts, which are not caused by the cancer causing strains of HPV. Thankfully, most people will clear HPV infection after 1-2 years, however persistent infection can lead to HPV-related cancers.
- Getting vaccinated against HPV can reduce a person’s risk of an HPV-related cancer, such as cervical cancer, by as much as 88 percent.
- The Gardasil vaccine can also prevent most cases of genital warts.
- Getting vaccinated against HPV does not mean that you don’t need to get cervical cancer screening when recommended, as it does not protect against every strain of HPV.
Here’s the bottom line, getting vaccinated against HPV, in addition to other available screening tests such as pap smears, can prevent you from getting cancer. So it is worth it to find your childhood vaccination cards, ask your parents or contact your pediatrician to confirm that you have been fully vaccinated.
Sources
https://www.cdc.gov/hpv/index.html
https://www.who.int/publications/i/item/who-wer9219-241-268