HPV vaccine: America’s most effective and underused tool in fight against cancer

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You can help eliminate cervical cancer – off the face of the planet.

Scientists have developed a vaccine that, when given to non-sexually active males and females, can prevent the HPV virus from causing an infection. It is, says Dr. Jennifer Young Pierce, “a magic bullet.”

But, it is also a vaccine, a word that sends parents into a tizzy and conspiracy theorists fingers blazing in late night online chat rooms.

“People put this in a special category and think it is new and that it has something different about it, but it really is one of the safest vaccines on the market,” Pierce said.

The HPV Vaccine has not only passed muster, it has outperformed nearly every other type of vaccine in existence.

Now Pierce, a senior staff physician, gynecologic oncology and professor of interdisciplinary clinical oncology at USA Mitchell Cancer Institute, is on a mission to convince every parent to vaccinate their children.

Pierce sits on the National HPV Roundtable as the representative for the Society of Gynecologic Oncologists and has become a champion for HPV vaccinations across the state. As the leader of Cancer Control and Prevention at MCI, Pierce has a vested interested in reducing cancer rates any way she can. The HPV vaccine is her sword.

“I say to parents, if you are only going to get one vaccine, get this one,” Pierce says. “There are more HPV-related cancers in the U.S. than any other vaccine preventable illness.”

What is HPV

Human Papillomavirus (HPV) is one of the most common infectious disease in our society. It is as common as the common cold. While some HPV strains can cause warts, others lead to cancer of the mouth, throat and cervix, among others.

Roughly 80 percent of all people will be exposed to HPV at some point in their life. While most HPV infections clear up or may never display symptoms, many people carry a cancer-causing strain.

A recent study by the Centers for Disease Control and Prevention looked at the number of people carrying cancer causing HPV in the U.S. Among men ages 18 – 59 the rate was one in four, among women of the same age the rate is one in five.

Pierce says some of the pushback against the vaccine is the belief that HPV is not common and that cervical cancer is rare.

While rates of cervical cancer among women are lower than that of breast cancer, rates of pre-cancerous cervical cells in women are not. Doctors currently use pap smears to help find those cells when they are in a pre-cancerous state.

“And then those pre-cancer cells are frozen, burned or cut off of a young woman’s cervix which can have long-term implications for their fertility,” Pierce said.

How does the vaccine work?

Like other vaccines the HPV vaccine contains a protein coat that helps identify the virus. When that protein enters your body through the vaccination needle your body begins to make antibodies modeled to fight that type of protein coat.

This gives the body time to stash an armory full of antibodies it can unleash when it recognizes the protein again, and therefore the virus, when and if it enters the body. When a vaccinated person is exposed to HPV the antibodies rush to destroy the virus and keep it from causing an infection.

Even though the vaccine has been on the market for over a decade parents cite safety concerns as a common reason for not vaccinating children against HPV.

Pierce addresses some of the myths associated with the vaccine.

First, there is no actual viral DNA in the vaccine. It cannot give you HPV.

Second, 280 million doses have been given worldwide. That wide distribution means any patterns, potential hazards or life threatening reactions would have become obvious by now.

Third, the most common adverse effects reported are typical vaccination side effects: pain at the injection site, redness and swelling. The CDC consistently monitors for more serious adverse reactions and has found no cause for safety concerns.

The other interesting fact about the vaccine is that it has a higher level of personal protection. For other illnesses herd immunity is important because the vaccine might not work for everyone. Therefore, even if your child was given, for example, an MMR vaccine, the vaccine might not be as effective in their body. That child would rely on the rest of his classmates to also be inoculated and not carry the disease to the vaccine-resistant student.

The HPV vaccine, on the other hand, immediately protects those who have received it, regardless of how many others did as well.

“For the person who receives the vaccine before any exposure it is 99 percent effective,” Pierce said.

Who should be vaccinated?

HPV is spread amongst sexually active individuals and can be passed from an infected person who has no symptoms. Pierce said part of the pushback among parents is that talking with adolescents about sex can be uncomfortable.

“What I say to parents is if you want grandkids you want this vaccine,” Pierce said. “And to a teenager I think you say, I want you to be fully protected and I don’t want you to have sex until you are ready or married or whatever your family values are.

“I think it is a nice time to bring up what your family values are instead of having radio silence,” she said. “Teens respond to parents being explicit in their family values, whether it is in regards to alcohol, tobacco or sex. Hearing from you what your family values are is an important part of sending a kid off to college. And, I think this vaccine is an important part of preparing a kid for college.”

Beginning the vaccine earlier than the teen years is recommended and may help parents complete the three shot series. The CDC recommends the vaccine to be given on time at age 11 and 12 as part of a routine adolescent vaccine visit, along with a TDaP booster and meningitis vaccine. However, a recent study showed that children who began the vaccination series at age 9 had a higher rate of completing the vaccine series by age 13. Only two shots are needed (6-12 months apart) if the series is initiated before the 15th birthday and 3 shots are needed if a teen starts after 15. The shot creates a better immune response if given earlier, hence the difference.

“To a 9-year-old you simply say, this is a cancer shot, the end. There is no need for discussion about HPV. They are relatively immature at that age for those conversations,” Pierce said.

The vaccine is not just for girls. Cases of oropharynx cancer among men are on the rise, and in fact, have doubled since 2008. In Alabama the number of HPV related throat cancer cases in men outnumbered cervical cancer cases in women. Boys need to be protected from HPV-related cancers as much as girls.

While adults can safely receive the vaccine up to age 26, the effectiveness drops off if they’ve already been exposed to the virus.

The vaccine can be given by a doctor as well as at a local pharmacy with a doctor’s prescription. The vaccine is covered by every health insurance carrier in Alabama. (not certain of this but will defer to your research)

How well does it work?

So well that doctors believe that we can rid the planet of HPV-related cancers.

In Australia 90 percent of boys and girls have been vaccinated since 2007 and that nation is already seeing a reduction in the rates of HPV-related disease. In a 2018 study of the original vaccine trial participants in Scandinavia 20 years later, researchers found that in the group of women who were unvaccinated there were 10 instances of cervical cancer. Among the vaccinated group there were none.

Across Alabama, and in Baldwin County, vaccination rates are below the national U.S. average.

The Alabama Department of Public Health reported in 2018 of adolescents 11-15, 31% had received 1 dose of the HPV vaccine, and only 14% had completed the series.

Statewide a CDC report from the 2015 National Immunization Survey (NIS) for Teens showed Alabama girls' completion rate of three HPV doses went up to 41 percent from 35 percent, while Alabama boys' completion rate went to 23 percent from 9 percent.

As an advocate and cancer researcher, Pierce not just educates she follows her own advice. She got the vaccine herself at age 30 when it first appeared on the market and plans to have her own daughters vaccinated as soon as they are old enough.

“Save yourself the heartache of a future cancer battle,” she said. “You want this vaccine.”