In recent weeks, parents have helped their kids prepare for school with their annual checklist of necessary school supplies. In addition, students’ health considerations, such as making sure those who have allergies have their updated EpiPens, physicals for sports teams are completed, and immunizations are up to date. As kids get older and are of middle school and high school age, the immunizations are usually done and are no longer a concern to families.
However, one more vaccine—if not done already—should be added to the list for all students in these age-groups: the human papillomavirus (HPV) vaccine. This vaccine, which has been FDA approved since 2006, prevents HPV and the possible later development of certain cancers.
The Centers for Disease Control and Prevention (CDC)’s recommendation is for all children to get the HPV vaccine, with the optimal ages being 11 to 12 years. However, indications for the vaccine are for everyone aged 9 to 45 years, with different dosing instructions for teens and adults.
Why Get the Vaccine?
The CDC reports approximately 14 million people become infected with HPV every year. Although HPV resolves on its own in many cases, for those people who remain infected with HPV, they are vulnerable to certain cancers. These cancers include cervical, vaginal, vulvar, anal, and throat cancers in females, and anal, throat, and penile cancers in males.
Overall, there are 32,500 reported patients with cancer caused by HPV annually. The HPV vaccination can prevent most of these cancers (approximately 30,000) from ever developing, explains the CDC.
The Vaccines and the Dosing Schedules
There are 3 vaccines right now with varying protections. The pharmaceutical company GlaxoSmithKline manufactures the vaccine, Cervarix, which protects against infection from HPV types 16 and 18, which cause approximately 70% of cervical cancer cases.
Merck and Co, Inc. first developed the Gardasil vaccine that protects against HPV types 6, 11, 16, and 18. The company later developed the Gardasil-9 vaccine, which protects against the aforementioned HPV types as well as types 31, 33, 45, 52, and 58. These other types are responsible for 20% of cervical cancers. This vaccine is now the company’s standard that is used by healthcare providers in the United States.
In terms of the amount of shots and the dosing schedules, they vary depending on age. “For the ages of 9-14, kids only need two doses to be completely immunized for HPV, and the minimum interval for those two doses is six months,” explains Rodney Finalle, MD, Medical Director, Global Vaccines Medical Affairs, Merck & Co, Inc. “The dosing schedule changes at the age of 15, and kids are required to have 3 doses of the vaccine. The second dose is given at 2 months and the third dose is at 6 months.”
Looking at Cancer Prevention
In one study published in the American Journal of Preventive Medicine, cervical cancer rates among females significantly decreased after the introduction of the HPV vaccine in 2006. “The 4-year average annual incidence rates for cervical cancer in 2011-2014 were 29% lower than that in 2003-2006 among females aged 15-24 years, and 13.0% lower among females aged 25-34 years.”1
“The (Gardasil-9) vaccine that is available in the U.S. is a nine-valent vaccine, meaning it protects against 9 different types of HPV. Each of those cause disease, and 7 of those cause cancer,” states Finalle. “You need to be protected before you are exposed to those types.”
Not Just for Females
The HPV vaccine was once only thought applicable to girls and young women. Boys and young men are also indicated for the vaccine. “HPV does not discriminate between boys and girls,” says Finalle. “Boys and girls can benefit from vaccination.”
And for parents of older students, there is a benefit to getting the vaccine. “There is [vaccine] protections that can be given to high school and college students,” says Finalle.
Counseling children on the importance of cancer prevention should be part of the talking points for families, especially if they feel they are beyond immunizations. Before his current position at Merck, Finalle was a longtime pediatrician, most recently at The Children’s Hospital of Philadelphia.
“From a clinical point of view, there are concerns about safety with anything you do― from medicines to vaccines,” says Finalle. “I immunized my own children, and I believe the vaccine is safe.”
- Guo F, Cofie LE, Berenson AB. Cervical cancer incidence in young U.S. females after human papillomavirus vaccine introduction. Am J Prev Med. 2018;55(2):197-204.