HPV vaccine: Get your questions answered

By Benjamin Matthews, MD, Geisinger obstetrician and gynecologist

The human papillomavirus (HPV) is the most common sexually transmitted infection, and most people will have exposure at some time in their lives.

HPV is the virus that causes genital warts, but some strains can lead to various types of cancer later in life, including cervical, vaginal, vulvar, penile, anal, mouth, and throat cancers.

The HPV vaccine is the safest and most effective way to protect against HPV infections — and their potential negative effects — and stop the spread. 

A misperception is that HPV only causes problems in females. In reality, both women and men can develop genital warts and HPV-related cancers. The vaccine helps the body develop immunity to the virus and prevents spread among people. Immunity is more likely before exposure to HPV, so vaccination in early adolescence is so important to keep preventable cancers from happening.

How is HPV spread?

HPV is spread through skin-to-skin contact. The strains of HPV that cause cancers in the cervix, penis, throat and anus are usually spread by sexual contact.

The problem is, most people infected with HPV will not have symptoms. Even so, the virus is still in their system and could be causing damage. Not to mention, people with HPV can pass the infection to others without knowing it.

No treatment for HPV is available. Fortunately, a healthy immune system can detect and suppress HPV in most cases. However, when it doesn’t and the virus remains in the body for long periods, the infected cells can progress into pre-cancer and then cancer. 

What is the HPV vaccine?

Gardasil 9, approved by the U.S. Food and Drug Administration in 2014, is the most often recommended HPV vaccine. This HPV vaccine helps protect against 9 of the highest-risk HPV strains that cause genital warts and cancers. 

The vaccine works by stimulating the body’s immune system to produce antibodies that can fight off the HPV virus. This response helps the body recognize and destroy the virus if encountered in the future. It’s not a live vaccine.

If you’ve already been exposed to a particular strain of HPV, the vaccine doesn’t treat the infection. The vaccine is meant to protect against a new HPV infection, so the vaccine may not be as effective once a person has HPV.

Who should get the HPV vaccine series?

The CDC recommends the HPV vaccine series for males and females starting at the age of 11 or 12, but it can be safely administered as early as age 9.

At this young age, a child’s immune system is especially strong and provides the greatest immune response — and the best protection against HPV infection. Plus, the HPV vaccine series is most effective when given before a child is sexually active and potentially exposed to the virus.

Many parents have concerns that giving their child the HPV vaccine might encourage sexual activity at a younger age. But as a provider caring for women with potentially deadly cervical and vulvar cancers, I encourage parents to focus on the opportunity to prevent their child from developing an avoidable cancer. Also, research shows that receiving the vaccine at a young age isn’t linked to an earlier start of sexual activity.

The CDC also recommends the HPV vaccine series for older adolescents who aren’t yet vaccinated.

Is there anyone who shouldn’t get the HPV vaccine?

A person shouldn’t receive the HPV vaccine:

• If they’re pregnant
• If they had an allergic reaction after the first HPV shot or have severe, life-threatening allergies
• If they’re sick with a mild illness at the time

When can you get the HPV vaccine?

The HPV vaccine is a series of shots, with the number depending on the age at the first dose, and can be safely given at the same time as other vaccines.

The CDC recommends the following HPV vaccine schedule:

• Kids ages 9 to 14 should receive 2 doses of the vaccine, with the second dose administered 6 to 12 months after the first.
• Teens and young adults ages 15 to 26 should receive 3 doses, with the second dose given about 2 months after the first and the third dose given 6 months after the initial one. 

Kids who didn’t start or complete the HPV vaccine series during the recommended age can still catch up on their vaccination up to age 45.

However, the HPV vaccine after age 26 should be individualized, as the vaccination provides less benefit because more people in this age group have already been exposed to HPV. But everyone’s situation is different, so talk to your primary care provider or OB-GYN about whether the HPV vaccine is right for you. You might still benefit from the vaccine by protecting you against HPV strains you don’t already have.

Is the HPV vaccine effective?

Earlier forms of the HPV vaccine were only made available less than 20 years ago, but the impact of vaccination is already clear. A recent study in the Journal of the American Medical Association showed that cervical cancer deaths among young women dropped by more than half in the last decade.

Gardasil 9 has been extensively studied and is close to 100 percent effective at preventing precancerous lesions and genital warts that are caused by the strains included in the vaccine for people who are vaccinated before onset of sexual activity. It’s proven to offer long-lasting protection and doesn’t require a booster shot after the initial series.

However, the HPV vaccine doesn’t protect against all strains of HPV. So, it’s still important to practice safe sex and get regular screenings for cervical cancer starting at age 21.

What are the HPV vaccine side effects and risks?

Like any vaccine, the HPV vaccine may have side effects and potential risks, but these are generally mild and temporary. Most people don’t have any trouble with the HPV vaccine.

HPV vaccine side effects can include:

• Pain, redness or swelling at the injection site
• Fever
• Dizziness or fainting (remain seated for 15 minutes after the shot to lower the risk)
• Headache
• Fatigue
• Nausea
• Muscle or joint pain

These symptoms usually resolve within a few days and can be managed with over-the-counter pain relievers, if necessary.

In rare cases, more serious side effects like an allergic reaction can occur. If you or your child have difficulty breathing, hives or swelling of the face, lips or tongue, seek medical attention immediately.

The benefits of the HPV vaccine far outweigh its risks. It’s a proactive step in protecting your family’s health. By getting your kids vaccinated, you can reduce their risk of developing potentially life-threatening conditions as an adult.

For more health and wellness topics, visit Geisinger.org/balance.