HPV infection has been declining in the decade since the vaccine was approved

The medical community had high hopes for a human papillomavirus (HPV) vaccine, believing that it could significantly reduce the inflammation responsible for nearly all cervical cancers. Now, there is more data to support these beliefs. A new study published in the March issue of Pediatrics, the medical journal, found that the prevalence of HPV infection among girls ages 14 to 19 has fallen from 11.5 percent to 4.3 percent since the vaccine was first recommended 10 years ago. The prevalence of HPV infection among women aged 20 to 24 also decreased, from 18.5 to 12.1 percent.

Experts say the study results suggest that the vaccine could live up to expectations. “The real impact, and it will take years before we know, is when we see fewer people dying of cervical cancer from this vaccine,” said Justin Chura, MD, chief of surgery and director of gynecological oncology and robotic surgery at our hospital. in Philadelphia.

How common is HPV?

HPV is common in both men and women, infecting about 14 million Americans each year, according to the Centers for Disease Control and Prevention (CDC). Up to 80 percent of sexually active women and 90 percent of sexually active men will be infected with HPV in their lifetime. Having the virus does not necessarily mean that you will develop cancer. The National Cancer Institute estimates that most cases of high-risk HPV infection do not cause any symptoms and go away on their own without causing cancer. In fact, most people who contract the virus may not know it. In these cases, the body’s immune system attacks and kills the virus before it can cause permanent damage. Other times, high-risk strains are persistent, allowing the virus to survive long enough to alter cell composition.

In addition to cervical cancer, HPV is associated with most cancers of the vagina and vulva and more than half of all penile cancers. The virus is also associated with 90 percent of anal cancers and 72 percent of oropharyngeal cancers. It develops in the throat, tongue, or tonsils, according to the CDC. The CDC estimates that, on average, a new case of HPV-related cancer is diagnosed every 20 minutes, which is more than 27,000 cases a year.

Although a pelvic exam and subsequent Pap and HPV tests can help detect damaged cells before cervical cancer develops, there are no routine tests for other HPV-related cancers. Given the high cost of the virus to public health, the discovery of the HPV vaccines, now offered under the brand names Gardasil®, Gardasil 9® and Ceravix®, has been enthusiastically welcomed throughout the medical world.

The U.S. Food and Drug Administration approved the vaccine in 2006 for girls ages 11 to 12 and women up to age 26 who had not previously been vaccinated. Five years later, the agency expanded the recommendation to include children.

Advance, but the way to go

The Pediatrics study showed some promising trends. It found, for example, that 2.1 percent of sexually active women ages 14 to 24 have been infected with vaccine-targeted strains of HPV, compared to 19.9 percent of unvaccinated women. While the results are encouraging, the vaccination rate is still very low, says Dr. Chora. In 2013, only 57 percent of teenage girls and 35 percent of boys started the vaccination process. The number of teens who got the three recommended doses was just 38 percent of girls and 14 percent of boys.

“Partially, we still have to overcome some vaccine resistance in general. There have been flawed studies that have attempted to link vaccines to autism. And I think the stigma still exists,” Dr. Shura says, adding that it does exist. There is no medical reason for parents to prevent their children from receiving a vaccination, unless they have a known allergy to a component of the vaccine. “Part of the problem is that most people in the United States don’t know someone who has died of cervical cancer. I’ve seen women die of cervical cancer, and I know there’s a way to prevent that from happening. It’s powerful.”