By Carol Berlin, MD
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States with nearly half of Americans ages 18 to 59 infected and about half of new infections occurring among those ages 15 to 24 years old. Usually, HPV infection clears on its own and causes no health problems. However, data from the National Health and Nutritional Examination Survey from 2013-2014 found that certain strains of the virus with the greatest cancer risks (high risk HPV) infected 25 percent of men and 20 percent of women. Those who develop a persistent high-risk HPV infection face a greater chance of developing certain cancers. Two vaccines (Gardasil and Gardasil 9) are currently available in the US for preventing HPV infection. The vaccines offer the greatest protection when given to girls and boys before sexual activity occurs. Young adults and parents of pre-teens and adolescents should consider vaccination for HPV to decrease the risk of certain cancers and genital warts.
Numerous studies have shown the HPV vaccine reduces the risk of women developing cervical cancer and reduces the risks for both genders of developing anal, reproductive tract and oral cancers. It has also been shown to decrease the incidence of genital warts among teenagers and young adults. The most recent data comparing Tompkins County HPV immunization rates to other areas of the state show 36 percent of girls ages 13 to 17 have had the recommended number of doses of the vaccine. No data is available on male vaccination rates. While the 2014 data from New York State’s Health Improvement Plan show the immunization rate in Tompkins County is about 20 percent higher than neighboring counties and upstate NY as a whole, the rate remains far lower than the state’s target goal of 50 percent by next year.
How is HPV transmitted?
Anyone who is sexually active can get HPV. HPV can be transmitted during any intimate sexual contact including oral, anal, and vaginal intercourse. A person can get HPV even if his or her partner has no signs or symptoms of a HPV infection. HPV infection can remain even if years have passed since any sexual contact with an infected person.
How serious is disease caused by HPV?
While HPV infection can resolve on its own, HPV is associated with cervical, vulvar, and vaginal cancer in females, penile cancer in males, and anal and oropharyngeal cancer in both sexes. About 31,000 new cancers each year were attributable to HPV during 2008 through 2012. Genital warts are also caused by HPV infection.
How do I know if I have HPV?
Most people with HPV do not know they are infected. For women 21 – 65 years old, routine cervical cancer screening is recommended to detect if HPV related changes are present. There is no recommended HPV screening test for men. The development of genital warts may indicate an HPV infection. Unfortunately, some people may discover an HPV infection only after they have developed a more serious illness, such as cancers.
Is there a treatment for HPV infection?
There is no treatment for HPV infection in itself. However, HPV associated lesions including genital warts, pre-cancers and cancers are treatable. Recommended treatments vary depending on the diagnosis, size and location of the lesion.
Who should get HPV vaccine?
The U.S. Centers for Disease Control and Prevention (CDC) recommends all children ages 11 to 12 receive the HPV vaccine. Prior to the age of 15, two doses of the vaccine are given 6-12 months apart. After turning 15, three doses of the vaccine are recommended. The vaccination series can be started as early as age 9. Catch up vaccinations can be done up to certain ages for both sexes. The goal is to vaccinate adolescents and pre-teens well before any sexual contact in order to prevent HPV infection and thereby decrease the risk of subsequent cancers and genital warts.
HPV vaccine is recommended for young women through age 26, and young men through age 21. HPV vaccine is also recommended for the following people, if they did not get vaccinated when they were younger:
- Young men who have sex with men, including young men who identify as gay or bisexual or who intend to have sex with men through age 26.
- Young adults who are transgender through age 26.
- Young adults with certain immunocompromising conditions, including HIV, through age 26.
After age 26, the benefit of getting the vaccine is lessened because the person has most likely been exposed to HPV infections and the immune response to the vaccine is not as robust.
Is the HPV vaccine safe?
The HPV vaccine has been administered since 2006 in the United States and even longer in other countries. Numerous studies have shown the vaccine is very safe. Common side effects include injection site tenderness or swelling, fever, headache, tiredness, nausea and muscle aches.
Is the HPV vaccine covered by insurance?
All private insurance plans regulated by New York State are required to cover the cost of HPV vaccinations for patients 18 and younger. For complete coverage details check with your insurance plan. For more information on HPV and the HPV vaccine visit the CDC website.
Dr. Berlin is a board-certified family medicine physician with Family Medicine Associates of Ithaca and on staff at Cayuga Medical Center. She received her medical degree from Jefferson Medical College of Thomas Jefferson University in Philadelphia. She can be reached at (607) 277-4341.