Human Papillomavirus (HPV): Misconceptions, Facts, and Prevention

Cancer—a heavy, scary, daunting diagnosis. Millions of Americans are affected by cancer every year, either themselves or someone they know. Technology is advancing at the speed of light, and for years now we have had access to a vaccine that prevents Human Papillomavirus (HPV), indirectly preventing many types of cancer, especially cervical cancer. It might sound strange to call the HPV vaccine an anti-cancer shot. However, when it prevents over 90% of HPV related cancers, it’s hard to explain it any other way. National Women’s Health Week (May 12th-18th) is a pivotal time to spotlight the significance of the HPV vaccine in safeguarding women’s health. By emphasizing the HPV vaccine in our newsletter during this month, we underscore the critical role it plays in preventing cervical cancer and promoting overall well-being among women. That being said, providers can dispel misconceptions, provide facts, and promote prevention of HPV.

Misconceptions

  • Misconception: The HPV vaccine causes infertility. Fact: The vaccine does not cause fertility problems, but HPV related cancers may result in fertility issues.
  • Misconception: Getting the HPV vaccine makes children think it is okay have sex. Fact: Numerous studies have shown no correlation between vaccine administration and onset of sexual activity.
  • Misconception: Males don’t need the HPV vaccine. Fact: Males can contract and spread HPV just like females, and should be vaccinated to prevent HPV infection and related cancers.
  • Misconception: Eleven years old is too young to receive the HPV vaccine. Fact: Early protection from the vaccine provides a better chance of prevention before the onset of sexual activity and exposure to the virus.

Facts

HPV is very common virus—the most common sexually transmitted infection (STI) in the US. In fact, about 13 million Americans become infected each year. It is spread via intimate activities skin-to-skin. Transmission occurs vaginally, anally, and via oral sex. While the majority of these infections clear on their own (about 90%), some don’t and can lead to genital warts and cancer. HPV infects both females and males, and can cause cancers of the cervix, vagina, vulva, penis, anus, and back of the throat. Genders combined, about 36,000 cases of HPV per year lead to cancer. More specifically, over 90% of cervical cancers are due to HPV and the vaccine has been shown to prevent nearly all cervical cancers. However, each year, 4000 women die from cervical cancer. Additionally HPV related cancers occur in men 40% of the time.

Signs and symptoms of HPV are often absent, making the spread easy and unrecognizable. Genital warts may cause pain or itching, but also could present without discomfort. Some types of warts can turn into cancer, but mostly are the low-risk type. Despite the limited signs and symptoms, the effects of HPV can be fatal if it does not clear.

Prevention

Because HPV can infect both men and women, vaccination is recommended for children, regardless of male or female, between the ages of 11-12. Why vaccinate at such an early age? Protection depends on prevention prior to encountering the virus. Getting the vaccine on board early before any risks of virus exposure ensures the best chance at protection. In fact, the series can be started as early as age 9. Starting early actually means less doses. If the series is started before the age of 15, only two doses are required. Starting on or after the age of 15 requires three doses six months apart. The vaccine is recommended to everyone through age 26 (unless pregnant or has a history of a life-threatening reaction to any component of a HPV vaccine). After age 26, shared decision making should be used to determine the need for the vaccine. At this point, many adults have already been exposed and the vaccine would provide less benefit.

The proof is in the data. Since HPV vaccine administration began, rates of most HPV cancer and genital warts have dropped in young adult women and teen girls by 81% and 88% respectively. They are safe. More than 135 million doses have been given in the US to date. The first licensed HPV vaccine was Gardasil in 2006 which protected against 4 types of HPV. Today Gardasil 9 is administered and covers nine HPV types. This vaccine is inactivated, meaning it is not a live vaccine. It is administered via injection of the deltoid muscle. Side effects can occurred but are typically mild: pain, redness, swelling, and itchy at the injection site. Fainting has also occurred. Of course monitoring for serious side effects is important, but generally speaking, the vaccine is well-tolerated.

Scripting can be helpful when discussing the vaccine with patients, especially with parents of the targeted age group. Misconceptions can be the driving factor for HPV vaccine hesitancy, so here are some helpful tips when recommending the HPV vaccine:

  • Recommend the vaccine in the same way and at the same time you recommend the other vaccines the child is due for.
  • Ensure follow-ups for the next dose are schedule prior to leaving the office
  • Take time to listen and respond empathetically to parental concerns.

Ensuring parents and patients have the right information to make a decision is the best chance at success for administering the HPV vaccine. After all, no parent wants their child to get cancer. Empower parents with a tool to prevent cancer and watch HPV related cancers continue to decline.  For more information please check out the resources below.

Resources:

Talking to Parents About Infant Vaccines and HPV Vaccines-July 2019 (cdc.gov)

HowIRecommend Vaccination Video Series | CDC

Human Papillomavirus (HPV): Infection and Vaccination | ACOG

HPV (Human Papillomavirus) | Immunize.org

infographic-hpv-screening-508.pdf (cdc.gov)

Top 10 Tips for HPV Vaccination Success (cdc.gov)

Posters to Promote Vaccination of Preteens and Teens | CDC

References

American College of Obstetrics and Gynecology (ACOG). (2023). Human Papillomavirus (HPV): Infection and Vaccination. ACOG. Human Papillomavirus (HPV): Infection and Vaccination | ACOG

Centers for Disease Control and Prevention (CDC). (2024). HPV Infection. CDC. HPV Infection | Human Papillomavirus (HPV) | CDC

Centers for Disease Control and Prevention (CDC). (2023). HPV Vaccine. CDC. HPV Vaccine | Human Papillomavirus (HPV) | CDC

Centers for Disease Control and Prevention (CDC). (2022). Cancers Caused By HPV. CDC Cancers Caused by HPV | Human Papillomavirus (HPV) | CDC

Centers for Disease Control and Prevention (CDC). (2021). Answering Parents’ Questions about HPV Vaccination. CDC. Answering Parents Questions about HPV Vaccine | CDC

Immunize.org (2023). HPV (Human Papillomavirus). HPV (Human Papillomavirus) | Immunize.org