Author: 
Carla Strom, Office of Cancer Health Equity, Wake Forest School of Medicine

What You Need to Know about the HPV Vaccine

What is HPV?

Human papilloma virus or HPV is a virus that causes the most common sexually transmitted infection in the United States.  There are more than 40 strands of HPV passed through sexual contact that can lead to serious health problems including genital warts and certain types of cancers.  HPV does not discriminate based on gender, infecting both men and women.  Additionally, at least  80 to 90 percent of sexually active women and men respectively will be infected with HPV at some point in their lives.  Most people do not know they have been exposed to HPV and in most instances, it goes away on its own without causing any problems.  However, that is not always the case.  There is no way to know who will develop problems and who will not.

HPV-Related Cancers

Cervical cancer is the most common HPV-associated cancer among women.  Given that men do not have a cervix, most HPV-associated cancers that arise in men are non-cervical cancers, such as those of the oropharynx and anus.  According to the National Cancer Institute, there are no formal screening programs for HPV-associated non-cervical cancers.  However, a clinical trial of Gardasil (an HPV vaccine) in men indicated that it can prevent anal cell changes caused by persistent HPV infection and genital warts.  You can protect yourself against many strains of HPV known to cause these cancers by getting vaccinated and encouraging those you know to get the vaccine. 

Importance of HPV Vaccinations

Vaccination is the approved public health intervention for reducing the risk of developing HPV-associated cancers at sites other than the cervix. The HPV vaccine provide maximum benefit if a person receives it before (s)he is sexually active.  Also, the vaccine guards against most cases of cervical cancer by protecting women against future HPV infection.  Thus, it is important to get the vaccine before you are exposed to the virus.  Even if you have been exposed to HPV, the vaccine may provide some residual benefit.  Although HPV vaccines have been found to be safe when given to people who are already infected with HPV, the vaccines do not treat the infection. If all young women and men were to get the vaccine, cervical cancer deaths around the world could potentially be reduced by as much as two-thirds.  Lastly, if a significant proportion of the population is vaccinated, we can enhance herd immunity, which provides protection to those who are not vaccinated.

Who should get the HPV vaccine?

The HPV vaccine is a safe and effective cancer-fighting vaccine that should be given before becoming sexually active.  Those who should receive the vaccine include:

  • Girls and boys ages 11 to 12; though they can receive the vaccine as early as age nine
  • Females ages 13 to 26 if the vaccine has not yet been started or all three shots completed
  • Males 13 to 21 years if the vaccine has not yet been started or all three shots completed
  • Gay and bisexual men under age 26

The vaccines are given as a series of three shots in the upper arm over a six month period.  In general, the side effects of the vaccine are mild and most commonly include soreness at the site of injection, headache, fainting or flu-like symptoms.

Routine vaccinations, including the HPV vaccine, are covered by most health insurance plans.  Children under 19 years of age who lack insurance coverage may be eligible to receive the vaccine through the Vaccines for Children program.  For more information on the program, visit the Centers for Disease Control and Prevention’s (CDC) website by clicking here.

Why should boys receive the HPV vaccinations?

Every year in the United States, around 11,000 men develop cancers caused by HPV infections.  Men, just like women, can get HPV by having sex with someone who is infected with HPV.  Cancers that may result from HPV exposure include anal, rectal, mouth/throat (oropharynx) and penal. HPV is thought to cause more than 90 percent of anal cancers and more than 50 percent of penile cancers.  Cancers of the head and neck are mostly due to tobacco use and alcohol consumption, however recent studies show about 60 percent to 70 percent of oropharyngeal cancers may be linked to HPV.  There are no screening tests for these cancers, they are often caught at a later stage when they are more difficult to treat.  Research is ongoing to better understand how and to what extent HPV causes these cancers.

It is important for both men and women to get the HPV vaccine so that they do not spread HPV to their partners or expose them to a higher risk of developing HPV-related cancers.  Many of the cancers caused by the HPV infection in both men and women could be prevented by HPV vaccination.

If you have received the HPV vaccination, do you still need pap tests?

Yes!  The vaccine is not intended to replace the pap test, a screening procedure to detect cancer of the cervix.  The current HPV vaccines do not protect against all types of HPV, so it is important that all women continue to be screened for cervical cancer.  Pap tests are an essential part of a woman’s routine health care.  The current guidelines for cervical cancer screening include:

  • First pap test at age 21
  • Pap test every three years from age 21 to 29
  • Pap test with HPV co-testing every five years from age 30 to 65
  • More frequent screening for women with risk factors including HIV or previous treatment for precancerous changes or cancer of the cervix
  • Women who have had a hysterectomy (not the result of cervical cancer) do not need cervical cancer screening