Cancer, Say Hello to My Little Friend: HPV Vaccine
By Elizabeth Kinsey Hawley
Wouldn’t it be amazing if there was a vaccine that could prevent cancer? Wait, there is!
Each year in the U.S. about 17,500 women and 9,300 men get cancer from a virus called the human papillomavirus (HPV) and these figures have been rising for the past decade. Many of these cancers are now preventable with the HPV vaccine (U.S. Department of Health and Human Services [HHS], 2020; Women’s Health Policy [WHP], 2018).
What is HPV and how does the HPV Vaccine work?
HPV is a group of around 200 related viruses that are transmitted by skin-to-skin or sexual contact (Healthline, 2005-2020; National Cancer Institute [NCI], 2019). They are so common that nearly all men and women get at least one HPV virus at some point in their lives (HHS, 2020). Of about 40 viruses which are primarily spread through sexual activity, roughly a dozen can cause cancers such as cervical, anal, mouth/throat, and penile cancer. Two of these strands (HPV types 16 and 18) are particularly high-risk viruses. Additionally, two types of HPV can cause gentile warts in men and women (types 6 and 11) (NCI, 2019).
The HPV vaccine, first introduced in 2006, initially protected against only these four previously mentioned types of virus, with an updated vaccination in 2014 that now protects against five additional cancer-causing types (HPV types 31, 33, 45, 52, and 58) (Davidson, 2017; NCI, 2019). With just two doses of vaccine spaced 6 months apart, antibodies produced by the HPV vaccine can eliminate medical complications for thousands of people and save lives (HHS, 2020).
Who is the HPV vaccine targeted toward?
The key to the HPV vaccine is to receive it before getting the virus. This means ideally vaccinating children before they become sexually active. It is recommended that boys and girls ages 11 or 12 years-old receive the vaccine for the best immune response, but the vaccine is routinely given to young people ages 9 to 26. After age 15, the prime window for inoculation has passed and three doses of HPV are needed (HHS, 2020). Additionally, research indicates that men have a naturally weaker immune response toward HPVs than women, therefore they highly benefit from the vaccine (Anic and Giuliano, 2012). The vaccine is not recommended for pregnant women (HHS, 2020).
Why isn’t everyone getting the HPV vaccine?
HPV and sex are interrelated. For many parents, is it difficult to think of their young children engaging in sexual activities. For this reason, they may choose to delay or avoid the vaccine. Additionally, at the time the vaccine came out, many parents did not know what HPV was. Initial public education and marketing caused confusion, and lead to the belief that HPV was a gendered disease – only affecting girls. Many parents felt that abstinence was sufficient protection against HPV (Hawley, 2020).
The anti-vaccination movement believes risks of vaccinations outweigh their benefits and promote relying on herd immunity to protect their children. Unfortunately, as parental resistance to vaccinating children increases, the herd is becoming less immune and infectious diseases are reemerging (Healthline, 2005-2020). Likewise, the HPV vaccine will only protect those who receive the vaccinations, because coverage in the U.S. is well below herd immunity levels for HPV viruses (WHP, 2018).
Regional differences affect the rate of vaccination. Estimated vaccine coverage in 2018 for teens in the U.S. showed the Northeast was significantly higher (59-78%) than the South (28.8-48.5%) (WHP, 2018). Providers’ recommendation of the HPV vaccine varies by region as well. For example, in Mississippi 59.5% of providers recommended the vaccine, while 90.7% did in Massachusetts (Walker et al., 2019). Research at the county level in Texas, where the vaccine is not widely utilized (28.8-39.9%), showed that cultural, socioeconomic, population density, religious and political differences were social influences in the utilization of the HPV vaccination. (Hawley, 2020; WHP, 2018).
What can be done to increase the use of the HPV vaccination?
Reasons that the HPV vaccine has not been embraced as a groundbreaking achievement are based on public attitude, and vary according to region and many other social factors. Thus, social policy and engagement promise to be effective tools for greater acceptance.
Education must undo confusion about HPV and teach that the viruses are not gendered, and that both boys and girls benefit from the vaccination. Culturally tailored community campaigns have been successful, as well as disseminating information about low- or no-cost vaccination programs for uninsured individuals, and should be expanded (Molokwu et al., 2019; Planned Parenthood, 2020). Anti-vaccination movement sentiments must be challenged. Many schools require health classes where teens should learn about HPV and the vaccine. Additionally, more states must require HPV vaccination for school entry.
The medical system must address providers’ attitudes and influence compliance for recommending the HPV vaccination along with all other vaccines. Providers must discuss the vaccine with young men and women who have not had the vaccination prior to turning 18 years-old, and allow them to make the decision to be vaccinated for themselves, as it is not too late.
Cancer kills. Wearing colored ribbons will not stop it, but HPV vaccinations will.
References
Anic, G. M., & Giuliano, A. R. (2012). Genital HPV Infection and Related Lesions in Men. Preventative Medicine, 53(1), S36-S41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495069/
Center for Disease Control and Prevention (CDC). (2016, December). Human Papillomavirus (HPV): HPV Vaccine Information for Young Women. U.S. Department of Health and Human Services. https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm
Davidson, T. (2017). Vaccines: History, Science, and Issues. ABC-CLIO, LLC. http://ebookcentral.proquest.com/lib/utxa/detail.action?docID=4865674
Hawley, J. K. (2020). Inoculation Hesitations: Efforts to Understand and Overcome the Pitfalls of HPV Politics. The University of Texas at Austin (Thesis), Tshepo Masango Chéry, Ph.D., University of Houston, Department of History, Supervising Professor
Healthline. (2005-2020). What Are the Pros and Cons of the HPV Vaccine? https://www.healthline.com/health/sexually-transmitted-diseases/hpv-vaccine-pros-and-cons#takeaway
Molokwu, J., Dwivedi, A., Mallawaarachchi, I., Hernandez, A., & Shokar, N. (2019). Tiempo de Vacunarte (time to get vaccinated): Outcomes of an intervention to improve HPV vaccination rates in a predominantly Hispanic community. Preventive Medicine, 121, 115–120. https://doi.org/10.1016/j.ypmed.2019.02.004
National Cancer Institute. (2019, September). Human Papillomavirus (HPV) Vaccines. National Institute of Health https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet
Planned Parenthood. (2020). Should I get the HPV vaccine? https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv/should-i-get-hpv-vaccine
U.S. Department of Health & Human Services. (2020, May) HPV (Human Papillomavirus) https://www.vaccines.gov/diseases/hpv
Walker, T. Y., Elam-Evans, L. D., Yankey, E., Markowitz, L. E., Williams, E. L., Fredua, B., Singleton, J. A., & Stokley, S. (2019). National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 – United States, 2018. Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. https://www.cdc.gov/mmwr/volumes/68/wr/mm6833a2.htm#T1_down
Women’s Health Policy. (2018). The HPV Vaccine: Access and use in the U.S. Kaiser Family Foundation. https://www.kff.org/womens-health-policy/fact-sheet/the-hpv-vaccine-access-and-use-in-the-u-s/