There's been all of this hype about HPV and an ongoing debate over whether or not to vaccinate against HPV, but what exactly is it? Should everyone be vaccinated against HPV?
To understand the significance, or rationale, behind the HPV vaccine, we need to first understand the virus and who it affects. The human papillomavirus, also known as HPV, is a DNA virus with over 150 strains. Each strain is labeled with a different number. HPV may be spread through sexual or non-sexual transmission. The virus is implicated in common warts, plantar warts, genital warts, as well as certain cancers including cancers of the cervix, oropharynx, anus, vulva, penis, and vagina. Nonetheless, it is important to note that not all HPV strains are oncogenic (cancer inducing) and that most people are exposed to the virus at some point in their lives. HPV is usually self-limiting, meaning that most people infected with the virus clear the infection on their own. HPV related cancer is believed to be associated with persistent HPV infections.
How common is HPV?
Very common! As stated above, most people will be exposed to some type of HPV at some point in their lives.
So if I've had a wart on my hand will I get cancer?
Not all HPV strains are associated with an increased risk of developing cancer. If you've had a wart on your hand, then yes, you've been exposed to HPV, but not the same HPV strains believed to cause certain cancers. As a general rule, the lower numbers are associated with warts on the feet, hands, chest, and arms. Additionally, 90% of genital warts are believed to be caused by HPV 6 or HPV 11. Higher numbers, by contrast, are implicated in cancer and are more commonly spread through sexual transmission. For example, HPV strains 16, 18, 31 and 45 are considered 'high risk' types as they may lead to certain cancers with HPV 16 specifically being associated with oropharyngeal cancer.
So what is the HPV vaccine?
Currently, three vaccines are available and approved by the FDA to prevent HPV infection (Gardasil, Gardasil 9 and Cervarix). Gardasil 9, which was approved by the FDA in 2014, prevents infection from nine strains (6, 11, 16, 18, 31, 33, 45, 52 and 58). Gardasil, which was approved in 2006 by the FDA, prevents against four strains (6, 11, 16 and 18). Cervarix prevents against two strains (16 and 18).
Who should get the vaccine?
The CDC recommends immunizing girls and boys before they become sexually active since HPV vaccines protect against sexually transmitted strains of HPV. Nonetheless, individuals who are sexually active who have not yet been exposed to the 'high risk' strains may also consider receiving the HPV vaccine.
If I had the vaccine do I still need regular exams and screenings?
Yes! Though the vaccine may effectively prevent infection from certain strains, it does not protect against all strains or other potential causes of cancer. Thus, it is still recommended that patients continue to regularly visit their healthcare providers for examinations.
Why are some people opposed to the vaccine?
Like everything in life, there are risks and benefits associated with receiving the vaccine. Some people are concerned that the vaccine is not safe, however, the risks associated with the vaccine are minimal.
Further reading
Haelle, Tara. "Gardasil 9 Effectively Stops 90% Of Cancers Caused By HPV In Girls and Boys." Forbes. Forbes Magazine, 22 June 2015. Web. 06 Oct. 2015. <http://www.forbes.com/sites/tarahaelle/2015/06/22/gardasil-9-effectively-stops-90-percent-of-cancers-caused-by-hpv-in-girls-and-boys/>.