March 24, 2021
Whenever I visit my family, without fail, dinner conversation turns medical as my husband (also an oncologist) and I answer a laundry list of medical questions from our loved ones. We welcome this firing squad of questions, as we hope to spread accurate information to those we care about most.
Recently, after the usual discussions of cholesterol (yes, Dad, you should be watching what you eat), a family friend with an eight-year-old daughter brought up the HPV vaccine. Like many parents, she had been scrutinizing all medical decisions that could affect her child. Her daughter is approaching the age for HPV vaccination and she asked if it was worth it? Is it safe? My (and oncologist husband’s) enthusiastic answer: YES!
What is HPV?
The Human Papillomavirus (HPV) is a common virus among people. It is sexually transmitted, and approximately 80% of people will be carriers of HPV at some point in their lives. There are numerous strains of HPV, some causing genital warts, others, precancerous or cancerous lesions of the cervix, anus, vulva, vagina, penis, tonsils and tongue.
HPV and Cervical Cancer
HPV is required to develop cervical cancer. Although it has become less common since widespread screening programs with the Pap test began in the 1950s, cervical cancer and its precursors remain a problem in the United States and abroad. It is important for women to have regular cervical cancer screenings with their gynecologist or other women's health provider beginning at age 21.
In the U.S., more than 12,000 women are diagnosed with cervical cancer each year; 4,000 will die, and more than 2 million will be diagnosed with cervical dysplasia—precursors to cervical cancer that lead to invasive testing, surgical procedures, and time away from work and family. Furthermore, cervical dysplasia and cancer can lead to difficulties with fertility and childbirth for young women.
Finding a Solution
Researchers recognized this problem and became dedicated to solving it, developing the HPV vaccine, which first became available in 2006. The third version of the HPV vaccine is now available, and protects against nine strains of the HPV virus--the most common to cause cervical dysplasia, cancer, and genital warts.
The most recent data from the 9-strain vaccine shows broad protection from HPV, and with wide-spread implementation, could prevent 90% of cervical cancer cases worldwide. The vaccine was 99% effective in reducing cervical dysplasia in the study group. The potential for lives saved and improved is great. The thought of beating a cancer before it even happens is exciting.
But Is It Safe?
To get back to the concerns of my family friend, the answer is a resounding YES. The vaccine was tested in a rigorous clinical trial—a randomized controlled trial. More than 14,000 girls age 16-26 were enrolled in the most recent trial to evaluate the 9-strain vaccine. Common reactions included swelling and redness at the injection site. Severe allergies were rare, occurring in less than .1% of patients. No deaths were attributed to the vaccine. Although the internet may spread stories of patients who were harmed by the HPV vaccine, follow-up studies of these girls showed no relationship to the HPV vaccine.
The bottom-line is that the HPV vaccine is safe and effective.
Who Should Be Vaccinated?
Girls and boys can be vaccinated between ages 9-26. Current vaccine protocols are a 3-shot series, the second shot 1-2 month after the first; and the third, 6 months after the first shot. Girls and boys vaccinated between 9-14 years of age may only require two shots, separated by 6-12 months. For adults ages 26-45, the vaccine may be beneficial and has been approved for this age group. The 9-strain vaccine or the previous versions of the vaccine are all acceptable. Your doctor can advise on what is best for each individual.
The vaccine can be given before or after first sexual contact. For those who missed the window to get the vaccine, the best way to protect yourself is by practicing safe sex with condoms and getting regular Pap tests.
It is an exciting time for cancer prevention: We have a vaccine that can prevent cancer! I encouraged my friend to talk with her pediatrician further about the vaccine, and I encourage you to do the same. This is an opportunity to protect our children or yourself from cancer.