Since its introduction in 2006, the vaccine against human papillomavirus (HPV) seems to be working to reduce the prevalence of the virus in young women. But, has anyone noticed?
A study published in Journal of Adolescent Health in September 2019 looked at HPV infection rates in participants of the National Health and Nutrition Examination Survey (NHANES) both before the vaccine was introduced in 2006 and after. The researchers found an 86 percent decrease in HPV in girls age 14 to 19. It also shows a 71 percent decrease in women age 20 to 24.
There was also an association between declines and the rate at which young women get the vaccine. Vaccine coverage was higher across ethnic lines in the 14 to 19 age group at more than one in two:
- 59.5 percent among Mexican-Americans
- 58.1 percent in non-Hispanic African-Americans
- 52.6 percent in non-Hispanic Caucasians
Compare that to the lower rate of decrease and the lower rate of coverage in women aged 20 to 24:
- 58.8 percent in non-Hispanic whites
- 45 percent in non-Hispanic blacks
- 33.1 percent in Mexican-Americans
Why the HPV Vaccine Is Important
HPV is the most common sexually transmitted disease in the US. It’s also responsible for about 90 percent of cervical cancer cases. HPV is associated with five other cancers, and actually causes more cases of oropharynx (back of the throat) cancer than cervical cancer.
Overall, the six cancers—with penile, anal, vaginal and vulvar rounding out the list—strike about 44,000 Americans per year. HPV is probably responsible for almost 35,000 of them—that’s about four out of five. Overall these cancers affect women more than men (about 21,000 versus 14,000). The Centers for Disease Control and Prevention that the HPV vaccine can cut the number of these cancers by 90 percent.
Cancer might be the scariest consequence of HPV, but it’s not the only one. HPV also causes warts:
- Genital warts
- Plantar (bottom of the foot) warts
- Common warts
- Flat warts
The CDC recommends that all 11- and 12-year-olds get two doses of the vaccine. Teens and young adults who start after 15 should have three doses, and everyone up to age 26 should get catchup doses if they’ve never been vaccinated.
Good News from Up North
It’s not just American girls and women who are benefitting from the HPV vaccine. Canadian girls are seeing fewer cervical abnormalities thanks to the vaccine, according to an October 2019 study published in The Journal of Infectious Diseases.
The Canadian province of British Columbia in 2008 implemented an HPV vaccine program for sixth-grade girls and boys. This year, the first group of women entered the Cervix Screening Program, which aims to provide free or low-cost Pap tests to BC women aged 26 to 65 every three years.
The researchers compared Cervix Screening Program records to immunological records and were able to look at Pap test results from women who were vaccinated and women who were not. They found that vaccinated women had pre-cancerous cells (cervical dysplasia) at a rate of 57 percent less than unvaccinated women.
Cervical dysplasia does not necessarily mean you’ll get cancer, but it might need to be treated to make sure you don’t. This can involve:
- Cryotherapy—freezing the abnormal cells to destroy them
- Surgical excision—cutting the abnormal cells away with a scalpel or laser
- LEEP—Loop electrosurgical excision procedure, burning the abnormal cells away with an electrified wire
That vaccinated women have a 57 percent lower chance of needing one of these treatments should make the HPV vaccine a no-brainer, but—at least in America—that’s far from a given.
Resoundingly Underwhelmed
Back south of the (Canadian) border, Americans remain either unaware of the dangers of HPV, or don’t particularly care. A research team publishing in JAMA Pediatrics found that about 70 percent of US adults—including 80 percent of men and 75 percent of women age 18 to 26, the target demographic of catchup shots—didn’t know that HPV causes oral, penile and anal cancers. Only two-thirds of women and one-third of men age 18 to 26 knew that HPV causes cervical cancer.
Meanwhile, the HPV vaccine continues to do its job and do it well. So well, in fact, that it benefits even the unvaccinated through herd immunity. A systematic review and meta-analysis in The Lancet looked at 65 studies from 14 first-world countries. Collectively the studies’ data covered about 60 million people.
The review found that the prevalence of HPV infections in women dropped across the board, including in the age 25 to 29 cohort, even though most of those were unvaccinated. Incidences of anogenital warts in unvaccinated men and boys dropped too, suggesting that an increase in HPV vaccinations in women may protect men as well.
The bottom line is, the HPV vaccine is safe and effective. If you or your children are members of groups recommended to be vaccinated, get vaccinated.
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