HPV vaccine linked to dramatic drop in cervical cancer deaths, so why are vaccination rates low?

Woman getting HPV vaccine injection in her arm
Thanks, in part, to the HPV vaccine, cervical cancer rates dropped 65%, according to new report from the American Cancer Society. (Getty Images)

According to a new report from the American Cancer Society, rates of cervical cancer have dropped 65% among women in their 20s from 2012 to 2019. These women are part of the first cohort to get the HPV vaccine, which the Food and Drug Administration approved in 2006 to target human papillomavirus (HPV), a group of viruses that causes several different types of cancer.

Dr. Tracy Seo, clinical lead for Breast and Cervix Cancer Screening and Outreach for Kaiser Permanente in Northern California, tells Yahoo Life that the study shows the vaccine is “preventing cancer and saving lives. … We are seeing benefits.”

However, we still have a long way to go before HPV is eliminated. Although these cancers are now almost entirely preventable, HPV vaccine rates remain low.

What is HPV?

HPV is extremely common. About 13 million people, including teens, become infected with HPV each year, according to the Centers for Disease Control and Prevention (CDC). Seo notes that 80% of the population will become infected with HPV at some point in their lives.

Because HPV is so prevalent, Seo recommends that everyone who is eligible for the vaccine get vaccinated. In most cases, thanks to the immune system, HPV goes away on its own within two years without causing any health problems or symptoms. But in some cases, depending on the HPV strain, an infection cause genital warts or serious complications, including cancer, which may not occur until decades after the initial infection.

“The most well-known HPV-related cancer is cervical cancer,” Dr. Amy Banulis, an ob-gyn for Kaiser Permanente in Falls Church, Va., tells Yahoo Life. “However, the virus can also cause cancer of the vagina, vulva, anus, penis and the back of the throat.” Among those infected with HPV, more than 36,000 people a year will be diagnosed with an HPV-related cancer. Thousands of them will die.

Why are HPV vaccination rates low?

Dr. Ruchi Garg, enterprise chair of gynecologic oncology at Cancer Treatment Centers of America (CTCA), part of City of Hope, and a gynecologic oncologist at CTCA Atlanta, tells Yahoo Life that when the HPV vaccine was first introduced, many health care professionals hailed the vaccine as a “major advancement” in cancer prevention. Yet Garg explains that many of those who were eligible for the vaccine didn’t get it due to concerns about its safety and effectiveness, in addition to fears it would lead to “sexual promiscuity,” since HPV is often sexually transmitted.

According to Garg, continued misinformation on social media and concerns about the COVID-19 vaccine that have bled over into other vaccines have kept HPV vaccination rates low. Dr. Theofano Orfanelli, assistant professor in the department of obstetrics, gynecology and reproductive medicine at Stony Brook University Hospital, tells Yahoo Life that despite evidence that the vaccine is safe and effective, HPV vaccination rates in the U.S. remain “suboptimal.”

In 2020, only about half of adolescents in the U.S. were up to date with their HPV vaccines. This contrasts with other countries such as the United Kingdom and the Netherlands that have achieved much higher rates of vaccination, according to Orfanelli. This is significant because “there is evidence of herd immunity in populations with high vaccination rates,” says Banulis. “Scientists estimate that cervical cancer could be eliminated if 80% of people receive the vaccine and the recommended cervical cancer screening tests.”

How HPV affects people's health and fertility

Garg sees firsthand how preventable cancers related to HPV affect her patients’ lives. “As a gynecologic oncologist, I have seen a major impact on cervical cancer patients, mostly younger females who are at a reproductive age,” she says. “There can be life-changing impacts on these patients and their families, including infertility due to cancer treatment. The vaccine also prevents precancerous lesions and noncancerous lesions, leading to a significant social, health and economic impact.”

Orfanelli shares that “patients that have been diagnosed with cancer [related to] HPV infection tend to be more proactive … in getting their kids vaccinated against HPV" after experiencing the effects of HPV themselves.

This is true for Kate-Madonna Hindes. Shortly after the birth of her daughter in 2005, Hindes was diagnosed with cervical cancer and HPV. Hindes required multiple surgeries and invasive procedures to treat her cancer, including a radical hysterectomy. She has subsequently been diagnosed with several other types of cancer. “HPV has dotted my life with grief, medical trauma and immense pain,” Hindes tells Yahoo Life. “It cost me my ability to have another child and potentially a far different career.”

She adds: “I was a healthy adult, who happened to get HPV — leading to decades of cancer care. The toll of misinformation is far heavier than we realize.”

Because the HPV vaccine was not introduced until 2006, Hindes was not able to get vaccinated before her diagnosis. “Having the vaccination would have saved my fertility and completely changed my life,” she says. “I missed the window by only a few short years.”

However, Hindes is grateful that her older child is already fully vaccinated against HPV and says that her younger child will get the HPV vaccine as soon as he is eligible. “I believe the best choice we can make as parents is to be well informed and educated about risks and rewards. I chose vaccination because the risk of HPV-related cancer far outweighed a negative and very rare vaccination reaction,” she says.

Hindes was “elated” by the study's showing a drastic reduction in cervical cancer rates. “It signals hope is on the horizon,” she says, adding that more funding is still needed for HPV research and education to achieve even better results.

Garg shares Hindes’s hope that more people who are eligible for the vaccine will choose to get it and that more parents will get their children vaccinated.

When should you get the HPV vaccine?

Boys and girls should both get vaccinated between the ages of 9 and 26, most commonly with a two-dose series. However, “vaccinating preteens, 11- and 12-year-olds, before they become sexually active and exposed to HPV is key to making the vaccine ... as effective as possible,” explains Garg.

If you miss that window, however, it might not be too late. The HPV vaccine is approved for use in adults up to age 45, and Garg recommends that unvaccinated adults discuss with their doctor getting the HPV vaccine.

“There remains an urgent need in the U.S. for galvanized, coordinated advocacy efforts and public education campaigns by the health care ecosystem to promote the HPV vaccination through data, education, conversation and practice,” says Garg.

Over 130 million doses of the HPV vaccine administered over 15 years have “confirmed its safety,” Seo points out. She emphasizes that, although some parents fear the HPV vaccine will cause infertility or encourage their children to become sexually active sooner, there is no evidence to support that either is true. Moreover, Garg emphasizes that while there is no evidence that the HPV affects fertility, treatment for HPV-related cancers, including chemotherapy, can “limit the ability to have children.”

“I’m encouraged by the steady increase of vaccination. We are heading in the right direction,” says Seo, adding that she hopes the study showing the HPV vaccine’s effectiveness “will convince more people to get vaccinated.”

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