By Gail D’Souza

Human Papillomavirus (HPV). Yes, we have all heard of it. HPV is a common sexually transmitted disease that people can be exposed to as early as adolescence.¹ Currently, there are 79 million HPV-infected Americans, and an estimated 14 million new HPV infections recorded annually.² Most cases are detected in young adults in their late teens and early 20s.² Due to this early exposure, the Centers for Disease Control and Prevention highly recommends two doses of the HPV vaccine to children aged 11-12.³ Before discussing why children should get the HPV vaccine, let us take a look at what HPV is.

HPV is a group of more than 150 viruses that can be contracted by having vaginal, anal, or oral sex with someone who has HPV.^1,2 When contracted, HPV first attaches itself to the basement membrane of the skin by entering the body through a wound or micro-abrasion.⁴ Once the virus has attached to the basal cell, the virus injects its DNA into the cell nucleus.⁴ As the basal cell matures, the infected cell makes its way to the top of the skin layer.⁴ At this top layer, the cell begins proliferating, causing viral reproduction of the infected epithelial cell.⁴ Fortunately, for the majority of time, the human body can get rid of the infection completely; however, this is not always the case.⁴ The concern over HPV comes from the 13 high-risk HPV types correlated to the cause of cervical, vagina, vulva, anus, penis, and oropharynx cancers. ^1,2,4

In 2020, more than 35,000 cancer cases were attributed to HPV in the US.⁵ To prevent the incidence of HPV infections and HPV-related cancers, the Advisory Committee on Immunization Practices (ACIP) recommends the HPV vaccine to boys and girls beginning at age 11-12.⁶ This routine vaccination results in protection rates of almost 100% against cancers from infections with HPV cancer strains.⁶ Unfortunately, HPV vaccine completion rates are suboptimal with less than 50% of adolescents up to date with the HPV vaccine in 2017.⁷

The reason for the low uptake and completion rates of the HPV vaccine series may be due to missed clinical opportunities to recommend and administer HPV vaccines, low provider recommendation of the vaccine, and concerns surrounding the vaccine’s safety, efficacy, or necessity.⁸ Although HPV vaccines were introduced in the US back in 2006, not everyone is well-informed about the HPV vaccine due to misinformation from social media and other news outlets.⁹ The following reasons are aimed to clarify misunderstandings about the HPV vaccine and why children should be vaccinated against HPV.

Reason #1: HPV is very common

The human body is a complex organism that harbors multiple bacteria, viruses, and other microbes.¹⁰ Over 90% of the time, our immune system does a tremendous job of clearing HPV infections; however, that 10% of the time must be addressed.¹⁰ Additionally, some individuals may be unaware that they have HPV, as it is not always symptomatic.¹⁰  For this reason, it is important to get vaccinated to prevent the virus from spreading to others and ensure everybody is protected against HPV.¹⁰  By starting the HPV vaccine series at a young age, parents can help prevent the spread of HPV among children and furthermore stop the spread of HPV-related cancers in the future. ^1,2,10

Reason #2: HPV can cause multiple cancers

HPV is known for causing cervical cancer, but HPV can also cause other types of cancers like oropharyngeal, anal, vulvar, vaginal, and penile cancers.^10,11 Oropharyngeal cancer, a head and neck cancer formed in the tonsils, throat, and tongue is almost as common in men as cervical cancer is in women.¹¹It is estimated that about 75% of oropharyngeal cancers develop due to HPV infections.¹¹

Reason #3: The HPV vaccine is safe, highly effective, and lasts for a long time

The HPV vaccine was developed in 2006 and has been well-researched for 15 years.^10,11,12 All HPV vaccines (Gardasil® 9, Gardasil®, and Cervarix®) were carefully monitored and assessed under extensive safety testing before being approved by the U.S. Food and Drug Administration (FDA).¹² With over 120 million doses of the vaccine distributed in the US, the vaccine has been monitored continuously by the Centers for Disease Control (CDC) and the FDA, with any safety concerns reported to health officials.¹² Additionally, the HPV vaccine has been monitored in individuals who have received the vaccine for about 10 years and protection against the virus remains high.¹²

Reason #4: The HPV vaccine protects both boys and girls

90% of men and 80% of women who are sexually active will contract some form of HPV in their lives.^10,13 HPV can be transmitted to a partner without their knowledge and can be asymptomatic.^13,14 To prevent children from transmitting or contracting HPV, getting the HPV vaccine protects both boys and girls once the vaccine series is complete.

Reason #5: HPV vaccination aids in cancer prevention

The HPV vaccine protects against more than 32,000 cancer cases every year.¹⁵ Among all HPV-related cancers, cervical cancer can be tested through cervical cancer screening while the others (oropharyngeal, anal, vulvar, vaginal, and penile) cannot be detected through early screening. ^10,11,15 For this reason, getting the HPV vaccine allows individuals to protect themselves from developing cancer in the future, and prevents potential cancers, instead of waiting to treat them later in life.^1,2,10,15

For the above reasons and more, it is highly recommended to vaccinate children for HPV. It is important to remember that the HPV vaccine has been around for more than a decade and is deemed safe, highly effective, and long-lasting.^10,11,12 Additionally, HPV vaccination prevents the spread of HPV, thus reducing the incidence of cancer in the future. By getting the HPV vaccine, children can protect themselves and those around them.

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References:

1. STD Facts – Human papillomavirus (HPV). Cdc.gov. https://www.cdc.gov/std/hpv/stdfact-hpv.htm. Published 2021. Accessed June 10, 2021.

2. About HPV (Human Papillomavirus). Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/parents/about-hpv.html. Published 2021. Accessed June 1, 2021.

3. HPV Vaccination: What Everyone Should Know | CDC. Cdc.gov. https://www.cdc.gov/vaccines/vpd/hpv/public/index.html. Published 2021. Accessed June 1, 2021.

4. Tong Q, Zheng L, Zhao R et al. Human papillomavirus infection mechanism and vaccine of vulva carcinoma. Open Life Sciences. 2016;11(1):185-190. doi:10.1515/biol-2016-0024

5. HPV Vaccine for Preteens and Teens. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/parents/diseases/hpv.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fparents%2Fdiseases%2Fteen%2Fhpv.html. Published 2021. Accessed June 13, 2021.

6. ACIP HPV Vaccine Recommendations | CDC. Cdc.gov. https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hpv.html. Published 2021. Accessed June 10, 2021.

7. HPV Vaccination: Understanding HPV Coverage | CDC. Cdc.gov. https://www.cdc.gov/hpv/partners/outreach-hcp/hpv-coverage.html. Published 2021. Accessed June 13, 2021.

8. Committee N. Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee. Public Health Rep. 2015;130(6):573-595. doi:10.1177/003335491513000606

9. Sundstrom B, Cartmell K, White A, Well H, Pierce J, Brandt H. Correcting HPV Vaccination Misinformation Online: Evaluating the HPV Vaccination NOW Social Media Campaign. Vaccines (Basel). 2021;9(4):352. doi:10.3390/vaccines9040352

10. Bednarczyk R. Addressing HPV vaccine myths: practical information for healthcare providers. Hum Vaccin Immunother. 2019;15(7-8):1628-1638. doi:10.1080/21645515.2019.1565267

11. Heid M. HPV and cancer: The lesser-known risks. MD Anderson Cancer Center. https://www.mdanderson.org/publications/focused-on-health/FOH-hpv-cancer-risks.h10-1589835.html. Published 2021. Accessed June 14, 2021.

12. HPV Vaccine Safety. Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/parents/vaccinesafety.html. Published 2021. Accessed June 7, 2021.

13. Berkowitz D. HPV and cancer: 9 myths busted. MD Anderson Cancer Center. https://www.mdanderson.org/publications/focused-on-health/FOH-HPV-myths.h14-1589835.html. Published 2021. Accessed June 10, 2021.

14. UHS Health Topic – Genital Warts. Healthyhorns.utexas.edu. https://www.healthyhorns.utexas.edu/HT/HT_genitalwarts.html. Published 2021. Accessed June 15, 2021.

15. HPV Vaccine. Hopkinsallchildrens.org. https://www.hopkinsallchildrens.org/Services/Pediatric-and-Adolescent-Medicine/Adolescent-and-Young-Adult-Specialty-Clinic/HPV-Vaccine. Published 2021. Accessed June 14, 2021.