The HPV vaccine is an impressive health multitasker. The vaccine, which targets the human papillomavirus, can help protect your kids from developing six types of cancer in adulthood. It’s also highly effective in keeping them from having to deal with recurrent genital warts.
Oropharyngeal cancer, or cancer of the back of the mouth and throat, is one of the cancers caused by HPV. Also called oropharynx cancer, it often requires intensive treatment. Recovery is challenging.
Below, experts in head and neck cancers, as well as HPV, explain why parents do kids a lifelong favor by having them vaccinated as recommended.
What Parents Should Know About HPV Vaccine
“HPV vaccine is cancer prevention” is a Centers for Disease Control and Prevention motto. The CDC and American Cancer Society offer these pointers:
— HPV is a common infection in women and men.
— The HPV vaccination prevents infection caused by HPV that can lead to some cancers.
— Oropharyngeal cancer, or cancer of the back of the throat, can be caused by HPV in men and women.
— Cancer of the cervix, vagina, vulva and anus can occur in women infected by HPV.
— Cancer of the penis and anus can occur in men infected by HPV.
— HPV also causes genital warts and other conditions besides cancer.
— The HPV vaccination is effective.
— HPV vaccination is safe.
— Studies show HPV vaccination is decreasing the number of infections and precancers in young people.
— HPV vaccination is given for boys and girls starting at age 11 or 12 and can be started as young as 9.
— Having the HPV vaccine at a young age protects children before they’re exposed to the virus.
— The CDC recommends a two-dose series for most younger adolescents, given at least six months apart.
— Older adolescents and some vulnerable younger kids need a three-dose series, according to the CDC.
— For some young people not vaccinated earlier, catch-up vaccines are recommended up through age 26.
— As with any vaccination, side effects can include pain, swelling or redness at the injection site.
— Some kids faint after receiving shots (of any type), which can lead to injuries from falls.
— To prevent faintness, kids should stay seated for a short period after receiving the HPV vaccination.
— Getting the HPV vaccine does not make kids more likely to have sex, studies show.
Oropharyngeal Cancers and HPV
The oropharynx includes the back of your throat, the base of your tongue and your tonsils. Smoking, heavy drinking and a previous history of head and neck cancer are common risk factors for oropharyngeal cancer.
Infection with HPV also poses significant risk. Cases of oropharyngeal cancer caused by HPV, particularly the strain called HPV-16, are on the rise, according to the National Cancer Institute.
The HPV virus is transmitted though vaginal, anal or oral sex with someone who gets the virus. The infected person may not have any signs or symptoms. The HPV virus often clears on its own without causing any ill effects. However, if the virus doesn’t clear, the various types can cause either genital warts or cancer, sometimes years after the exposure.
Although most people infected by HPV don’t develop oropharyngeal cancer, when it does occur, about 70% of cases are caused by HPV, says Debbie Saslow, managing director of HPV and GYN cancers at the American Cancer Society.
At Johns Hopkins Hospital, a pathology exam is done on all surgically removed oropharynx cancers to see whether they’re HPV-related. “The overwhelming majority are HPV-positive,” says head and neck surgeon Dr. Carole Fakhry, an associate professor at Johns Hopkins University. Most people with HPV-positive orophayneal cancers do well, she says, with about 80% surviving at the three-year mark.
While the disease is treatable, oropharyngeal cancer and its aftermath take a heavy toll. Some patients require a feeding tube after undergoing chemotherapy, surgery or radiation in various combinations.
“People who are getting radiation-based therapy generally have trouble swallowing during radiation,” Fakhry says, adding that rehabilitation helps preserve long-term swallowing ability. “But it’s not an easy treatment to get through. It’s pretty rigorous for most patients. And then it takes time to recover and find a new baseline.”
Surgery can be complex. “In general, if we’re going to do surgery, we remove the tumor from the back of the tongue or the tonsil, and then we remove lymph nodes from the neck,” Fakhry says. “Then, after (patients) heal up from surgery, within four to six weeks they usually get radiation.”
Appearance may change for a minority of patients with oropharyngeal cancer, particularly for those who have surgery called neck dissection to remove lymph nodes from the neck, Fakhry says. In addition to a scar from the incision, one side of the neck can be thinner, among other side effects.
With all this, having the HPV vaccine seems like a clear investment in future health. “The most important message for people to know is the vaccine is safe and that it prevents cancers,” Fakhry says. “And just like it prevents cervical and anal cancers, and precancers, it likely also prevents oropharynx cancers. So, there’s really no reason not to get it.”
The Food and Drug Administration approved the original version of the HPV vaccine, called Gardasil, in 2006. Gardasil 9, which covers nine types of HPV, is the current FDA-approved drug to prevent some HPV-related cancers, as well as precancerous or abnormal growths. Gardasil 9 also protects against genital warts caused by two types of HPV.
HPV vaccination is indicated for boys and girls alike, according to the FDA. It can be given in girls and women, men and boys from 9 to 45 years old. However, vaccination provides the most protection when given at a young age. Older adolescents and young adults are increasingly likely to already have been exposed to HPV.
Genital wart cases have been dropping dramatically since HPV vaccination began in 2006, Saslow says. “We know that the vaccine is extremely effective against HPV types 6 and 11, making genital warts all but disappear in countries with high vaccination rates,” she says.
Cervical precancers are decreasing with HPV vaccination, and a proportional drop in cervical cancer rates is expected. Similarly, rates of oropharyngeal cancer in adulthood are expected to significantly drop as more kids receive HPV vaccination.
Another, noncancerous condition is providing additional evidence in support of the vaccine, Saslow says. Recurrent respiratory papillomatosis, a “rare but dreadful” condition, involves papillomas, which are similar to warts, developing in the back of the throat. Some patients must go through multiple surgeries every year to remove these papillomas, which keep coming back. Early studies show that with HPV vaccination, RRP rates are coming down, Saslow says.
A Safe Vaccine
HPV vaccine safety is well-established through international studies conducted in at least six countries, with nearly 200 safety studies conducted in well over 2 million people, Saslow says. “All of those have shown no serious side effects, other than the same serious side effects that you would see with any vaccine.” As with any vaccine (whether or not for HPV), an anaphylactic reaction is possible if somebody is allergic, she notes.
Although the HPV vaccine is approved for men and women up to 45 years old, it’s not recommended after age 26, according to the ACS. Eligible older adults interested in having the vaccine should have a discussion with their providers. Decision factors might include whether you’re closer to 27 or 45, or if you’re dating and having varied relationships versus being married or monogamous, Saslow says.
However, the bottom line is that younger is better for receiving HPV protection. “The vaccine only works before you get HPV,” Saslow emphasizes. “So it’s highly, strongly recommended and highly, strongly effective when you get it at the young age. And then the older you get, the less effective it becomes. Even at age 18, there’s a very low effectiveness against cancer.”
Rhode Island, Virginia and the District of Columbia are the three U.S. jurisdictions that require HPV vaccines for school attendance, according to the most recent update from the National Conference of State Legislatures. Legislation to require or fund the vaccine, or promote HPV and vaccine awareness, is pending in at least 42 states. For kids who qualify, the HPV vaccine is available through the federal Vaccines for Children program throughout the country.
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