When the human papilloma virus (HPV) vaccine was first introduced in 2006, the primary purpose was to prevent cervical cancer caused by HPV in pre-teen girls and young women. Since then, the vaccine has proven to serve a broader community and recognized to prevent six types of cancer by the Center for Disease Control and Prevention (CDC).
Most recently, in June 2020, the U.S. Food & Drug Administration (FDA) approved the HPV vaccine, Gardasil 9, to prevent oropharyngeal and other head and neck cancers caused by HPV. Particularly as in-person care visits resume, providers have an opportunity to help patients catch up on preventative care measures they may have missed during the pandemic, including the HPV vaccine.
Head and Neck Cancers and HPV
Head and neck cancers encompass a range of cancers that affect the larynx, throat, lips, mouth, nose, and salivary glands. While studies suggest that at least 75% of head and neck cancers are caused by tobacco and alcohol use, HPV is also a known cause of head and neck cancers; in particular oropharyngeal cancers. More recent research from the CDC suggests HPV may be linked to about 70% of oropharyngeal cancers.
Though the HPV vaccine is largely associated with young women, the American Cancer Society reports that men are twice as likely to have head and neck cancers compared to women, and that these types of cancers are more often diagnosed among people 50 years of age and older. It’s estimated that each year there are 3,500 new cases of HPV-associated oropharyngeal cancers diagnosed in women and about 16,200 new diagnoses in men, as noted by the CDC.
The Impact for Providers and Patients
While the FDA’s recent approval of the HPV vaccine as a tool to prevent head and neck cancer is significant, it does not immediately change the Advisory Committee on Immunization Practices (ACIP) recommendations for the vaccine. However, there have been several changes to HPV vaccine recommendations over the past few years that include populations affected by head and neck cancers. The current guidelines are:
Girls and boys aged 11 or 12 years should receive two doses of the vaccine.
Adults up to age 26 years who have not received the vaccine or are not adequately vaccinated should be vaccinated with two or three doses depending on their age of initial vaccination.
Adults aged 27 through 45 years should work with their provider to determine if they should receive the vaccine.
Recent studies have proved the effectiveness of the vaccine; results from the National Health and Nutrition Examination Survey found that, “HPV infections decreased by 86% in female teens aged 14 to 19 years and 71% in women in their early 20s.” The approval of the HPV vaccine to protect against head and neck cancers is yet another way that it can protect the health of adolescent patients as they move later into adulthood.
Despite the benefits of the HPV vaccine, CDC data suggests that only 54% of adolescents have received both doses of the vaccine. Provider recommendations for the HPV vaccine can serve a powerful role in improving vaccine uptake and protecting patients against the negative effects of the human papilloma virus. The CDC’s annual National Immunization Survey found that if a provider recommended the HPV vaccine, patients were three times more likely to receive the vaccine.
HPV is estimated by the CDC to cause 35,000 cases of cancer in the U.S. each year, and the HPV vaccine is one of the best tools available to prevent these cases. By educating patients on the vaccine’s role in cancer prevention—of all kinds—providers can empower patients to take advantage of the resources available to set themselves up for a healthy future.