The field of vaccines is changing with enhanced understanding of disease processes and new developments in vaccine research. New vaccine developments can protect those at risk for specific diseases from illness and its sequalae. As new vaccines are introduced, they must be approved by the Food and Drug Administration (FDA), recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the Centers for Disease Control and Prevention (CDC). For information on other vaccines please refer to the CDC.
Human Papillomavirus Vaccine (HPV)
Vaccinate Your Preteen or Teen: The Earlier the Better
The human papillomavirus (HPV) causes cancer, but there is a vaccine that prevents HPV infection that can cause six different types of cancer. The HPV vaccine is effective and safe. It has been widely used in the U.S. and around the world for over 10 years. The HPV vaccine is highly effective against the types of HPV that can cause most of the cervical and anal cancers, and genital warts. Serious side effects from HPV vaccine are rare. The most common side effects are soreness at the injection site, nausea and dizziness.
Answers to Common Questions regarding HPV
HPV is the most common sexually transmitted infection (STI). HPV is so common that nearly all sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers.
The best way to prevent HPV is with the HPV vaccine. Pre-teens, teens, and young adults should get the vaccine before they become sexually active. The vaccine works best on those who have not yet been exposed to HPV. There is evidence that the vaccine is most effective when given at younger ages. The HPV9 vaccine protects against nine cancer-causing HPV types and genital warts. It also protects from oropharyngeal and anal cancer. It also protects girls and women from the HPV types that cause cervical, vaginal and vulvar cancers and boys and men from penile cancers.
Condoms also help prevent the spread of HPV. However, HPV can infect areas that are not covered by a condom – so condoms may not completely protect against HPV.
Anyone can get HPV once they become sexually active. Most people are infected around the time they first become sexually active. Most sexually active people get HPV infection at some time in their lives, even if they only have one lifetime sexual partner. HPV is spread through direct contact with an infected person, most often from vaginal or anal sex but also from oral sex or genital-to-genital contact. HPV can be spread even when the person has no symptoms.
- Each year, there are approximately 27,000 cancers caused by HPV in the U.S. – about 17,600 in women and 9,300 in men.
- Cervical cancer is the most common HPV-associated cancer among women. Each year, about 12,000 women are diagnosed in the U.S., and about 4,000 die from the disease. The HPV vaccine has been shown to be 90% effective in preventing cervical cancer.
- Oropharyngeal (back of the throat, including the base of the tongue and tonsils) occurs in about 7,200 men and 1,800 women annually.
- HPV infection in women can also lead to vaginal and vulvar cancer, and in men HPV infection cause penile cancer.
- HPV infection also causes anal cancer in men and women.
- The vaccine is recommended for all girls and boys between the ages of 11 and 12. It is important to vaccinate your child well before he or she is exposed to HPV. The vaccine may be given to pre-teens as young as 9 years.
- When the HPV vaccine series is started before the fifteenth birthday, two doses are recommended six to 12 months apart. If the HPV vaccine series is started at 15 years or older or the person is immunocompromised, three doses are recommended over a six-month period.
- All females aged 13 through 26 and males aged 13 through 21 should be vaccinated if they have not previously received the vaccine. High-risk males aged 22 through 26 should also receive the HPV vaccine.
Before any vaccine is licensed, the Food and Drug Administration (FDA) must determine that it is both safe and effective. All HPV vaccines have been tested in tens of thousands of people in the United States and many other countries. Thus far, no serious side effects have been shown to be caused by the vaccines. The most common problems have been brief soreness and other local symptoms at the injection site. These problems are similar to those commonly experienced with other vaccines. The vaccines have not been sufficiently tested during pregnancy and, therefore, should not be used during pregnancy. HPV vaccines are highly effective in preventing infection when given before initial exposure to the virus, which means before individuals begin to engage in sexual activity. Evidence shows that protection is long-lasting.
The common side effects are usually mild and short-lived, such as soreness where the shot was given and fever, headache and nausea. The most common safety concern reported is a brief fainting spell, which is more common among adolescents following any vaccination. Reports that the HPV vaccine causes serious health problems, such as mental retardation or paralysis, are not true. Serious side effects, like severe allergic reactions are rare.
Anyone who has ever had a serious allergic reaction to any part of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine.
Pregnant women are not recommended to receive HPV vaccine. Although the HPV vaccine is not recommended for pregnant women, studies to date have not shown any safety concerns for pregnant women or their unborn children. Pregnancy testing is not needed before vaccination. If pregnancy is discovered after starting the vaccination series, the remainder of the series should be delayed until the end of the pregnancy. Women who are breastfeeding may get the vaccine.
People with a mild illness (low-grade fever, colds, ear infection, mild diarrhea) when a dose of HPV vaccine is planned can still be vaccinated. People with more severe illnesses should wait until they are better.
Most people have no symptoms of HPV infection. It is estimated that about 360,000 people may develop genital warts annually in the U.S. HPV infections that result in cancer may not become apparent until many years later and may not show symptoms until the cancer is advanced.
There is no treatment for the virus itself. Although the body’s immune system clears HPV on its own within two years in about 90% of infections, it is impossible to know which infections will persist and go on to cause health problems.
There are treatments for the diseases that HPV can cause:
- HPV-related cancers are most treatable when they are diagnosed and treated early. Women should have routine cervical Pap testing. Certain people at higher risk for anal cancer may need routine anal Pap tests. Talk with your primary care provider about your risk and whether you should get tested.
- Genital warts can be removed by prescribed medications applied by the patient or by a health care professional. Some warts can also disappear on their own.
Men who have sex with men are at greater risk for HPV infection, while people with weak immune systems (including those who have HIV/AIDS) are at higher risk for health problems resulting from HPV infection.
There are three different meningococcal vaccines available to help protect those at risk from the most common serogroups of meningococcal disease seen in the U.S. (serogroups B, C and Y), but they will not prevent all cases. Two of the vaccines protect against subgroups ACWY, while a different meningococcal vaccine protects against only subgroup B. Research is underway to develop a meningococcal vaccine that protects against all five subgroups, but it isn’t likely to be available soon.
The CDC has made general and risk/disease specific recommendations for meningococcal vaccines.