HPV vaccine: What is it, who needs it and when?

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Dr. James Burke

It's thought that almost 80 million Americans are currently infected with human papillomavirus (HPV), a sexually transmitted virus that can cause genital warts and cancers of the cervix, vagina, vulva and penis, among others. Almost all men and women are exposed to it as some point in their lives.

Thankfully, the HPV vaccine can prevent most cancers from developing. Experts predict that about 30,000 of the 32,500 cancer cases that occur in the U.S. every year can be prevented with the vaccine.

Although most HPV infections never cause any symptoms or serious problems and will go away on their own within two years, it's important to take precautions with regular screenings and vaccinations.

• What is HPV and how does it spread? HPV is the most common sexually transmitted infection in the U.S. It includes more than 200 viruses, 40 of which are spread through direct sexual contact and 13 of which are high-risk strains that can cause cancer.

Some types of HPV cause warts or skin growths; some might never cause any problems. Certain strains are high-risk strains that can contribute to cancer. If you have sex with someone who has HPV, you can get it even if your partner doesn't have any symptoms.

• What is the HPV vaccine? The immunizations that protect against HPV encourage the body to make antibodies, which are proteins used by the immune system to fight viruses. If these antibodies are ever exposed to HPV, they bind to the virus and prevent it from invading the body's cells.

All of the vaccines protect to varying degrees against the HPV types associated with cervical cancer and other cancers, including anal, oropharyngeal, vulvar, vaginal and penile cancer.

Gardasil in particular protects against the HPV types related to genital warts, while Gardasil 9 protects against these cancers, genital warts and an additional five HPV strains, too.

In May 2017, Gardasil 9 became the sole HPV vaccine recommended in the U.S., while the other two are still used in other countries around the world.

• Who should get vaccinated - and when? HPV vaccine recommendations for the U.S. are as follows:

• Children ages 11 to 12 should receive two shots, 6 to 12 months apart

• If your teen hasn't gotten the vaccine yet, talk to his or her doctor or nurse about getting it as soon as possible

• After age 14, three shots are needed instead of two

• Females can be vaccinated up to age 26, males up to 21

There are some slight exceptions to those recommendations. The following adults should receive the HPV vaccine if they didn't receive it according to the general recommendations listed above:

• Young men through age 26 who are in sexual relationships with men

• Transgender men through age 26

• Young adults through age 26 with immunocompromising conditions like human immunodeficiency virus (HIV)

It's important for young people to remember that even if they missed their early dose of the vaccine, they should still consider getting vaccinated.

While the vaccine won't necessarily go back and reverse the course of the prior exposure, it can help prevent future exposures from other strains that they haven't been exposed to yet.

Dr. James Burke practices OB/GYN cancer care at Memorial Health University Physicians.

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