HPV Vaccine FAQs

Children’s Community Pediatrics (CCP) strives to protect your children against the threat of disease at any stage of their lives. That’s why we promote HPV vaccination for all of our young adolescent patients.

The HPV vaccination is a cancer prevention drug – for the disease is identified in 99% of cervical cancer cases and in many male-specific cancers as well. By scheduling your son or daughter’s HPV vaccination series, you are helping to protect him or her from cancer later on in life.

Depending on your child’s age, the CDC makes different recommendations. If your child is between the age of 11 and 12, he or she will receive a two-dose series. If your child is over age 15, it will be a three-shot series. Below you will find some frequently asked questions about the HPV vaccine. For more information, talk with your child’s pediatrician.

What is HPV (Human Papillomavirus)?

  • HPV is a group of viruses that cause warts.
  • Warts caused by HPV can sometimes become precancerous or even cancer-causing lesions.
  • HPV has been linked to cancer of the mouth and throat.
  • Most HPV infections are transient and are cleared by the body. 
  • Some types of HPV (the ones covered by the HPV vaccine) are harder for the body to clear and may lead to precancerous and cancerous lesions.

How common is HPV?

  • An estimated 20 million people in the US currently have an HPV infection.
  • People who become sexually active have greater than a 50% risk of getting HPV.
  • An estimated 80% of sexually active women will have contracted HPV by the time they are 50.
  • Even in women with only one lifetime partner – some studies suggest that there is still a 20% risk of HPV infection. This is likely attributed to the sexual history of her partner.8

What cancers are linked to HPV?

Cervical Cancer

HPV is identified in 99 percent of cervical cancer cases. The HPV-9 vaccine covers strains of HPV that are responsible for 90% of cervical cancer cases. (75% are HPV types 16 and 18. 15% are HPV types 18, 31, 33, 45, 52, and 58.)

  • In 2009 in the United States, 11,270 women were diagnosed with cervical cancer and 4,070 women died of the disease.
  • According to the National Cancer Institute, a woman's lifetime risk of being diagnosed with cervical cancer is 1 in 145.

Anal and Penile Cancers

Vaginal and Vulvar Cancers

Oropharyngeal (Mouth and Throat) Cancers

HPV has long been suspected of playing a role in cancers of the mouth and throat. New studies are now firmly establishing the role that this virus plays in the development of these cancers.7

What is the history of the HPV vaccine?

  • 2006: FDA licenses HPV vaccine for use in females ages 9 to 26 years old to prevent cervical cancer, vaginal and vulvar cancers, and anogenital warts. The Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP) votes unanimously to recommend that all girls ages 11 and 12 receive the vaccine.
  • 2009: Licensed by the FDA for use in males to prevent genital warts.
  • 2010: FDA license extended for the prevention of anal cancer in males and females.
  • 2011: ACIP expands HPV vaccine recommendations to include routine immunization in males.
  • 2014: A 9-valent human papillomavirus (HPV) vaccine (Gardasil 9, Merck & Co., Inc) was licensed for use in females and males in the United States. (CDC Website)
  • 2016: The CDC made a formal recommendation for a two-dose, or two-shot, series of HPV vaccine for children starting the series prior to their 15th birthday. Those starting after their 15th birthday still require 3 shots. This recommendation comes from data showing a stronger immune response for vaccine series initiated prior to age 15, preferably at age 11-12.

What types of HPV does the HPV vaccine protect against?

  • The Gardasil HPV vaccine is directed against 9 strains of HPV (types 6, 11, 16,18, 31, 33, 45, 52, and 58).
  • HPV 6 and 11 are associated with 90% of anogenital warts.
  • HPV 16 and 18 are account for 75 percent of all cases of cervical cancer.
  • HPV 18, 31, 33, 45, 52, and 58 account for about 15% of cervical cancers.

Why should boys receive the HPV vaccine?

  • Boys are at risk for cancers caused by HPV also.
  • HPV-associated cancers in males include anal, penile, and oropharyngeal (mouth and throat) cancers.
  • An estimated 22,000 annual cases of HPV16- and HPV18-associated cancers occur in the US each year. Of these, 7,000 occur in males.3

Who should not receive the HPV vaccine?

  • Patients who have ever had a life-threatening allergic reaction to HPV vaccine or any of its components, including to yeast.
  • Although safe to administer to patients on chemotherapy or other immune-suppressing medicines, it may not create a full immune response in patients with a weakened immune system.

Is the HPV vaccine safe?

  • The HPV vaccine has been proven safe and effective and has been evaluated in numerous randomized control trials worldwide.
  • Organizations such the Centers for Disease Control and the National Vaccine Injury Compensation Program actively monitor the safety of the vaccine and investigate reports of adverse events.
  • Most reported adverse events are transient and mild, including injection site reactions, fever, and syncope (fainting). All of these reactions, especially fainting have also been noted with the administration of other adolescent immunizations.5
  • No causative link has been established between serious neurologic events (such as Guillain-Barré Syndrome and seizures) and HPV immunization.1,5,6

If my teenager gets the HPV vaccine, won’t that encourage them to have sex?

  • Multiple studies have shown that starting the HPV immunization series does not result in increased sexual activity.9,11
  • There are many social, ethical, and cultural factors that contribute to the sexual behavior of adolescents. Vaccination has not been shown to contribute to this behavior.
  • It is important to be vaccinated against HPV prior to sexual exposure. Remember, an estimated 80% of females will have been exposed to HPV by age 50. Therefore, it is important to take into account your child’s lifelong health beyond their pediatric years.
  • Vaccinating against HPV does not mean that you or your health care provider encourages sexually promiscuous behavior. It does create an opportunity to speak with your preteen/teen about risk taking and the importance of good decision-making.

Why should I get the HPV vaccine for my son or daughter as young as age 11?

  • The body will generate a much stronger immune response if HPV vaccination occurs before, rather than after, exposure to the HPV virus.
  • The HPV vaccine also reduces the incidence of abnormal PAP smears resulting in colposcopies.

Resources/ References

1 Wen, Xian et al. Human Papillomavirus Vaccine: Safe, Effective, Underused. Cleveland Clinic Journal of Medicine 2013. 80:1.
2 Siegel R, Naishadaham D, Jemal A. Cancer Statistics, 2012. CA Cancer J Clin 2012; 62:10-29.
3 CDC. Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males- Advisory Committee on Immunization Practices (ACIP), 2011. MMWR 2011; 60 (50); 1705-1708.
4 CDC. National and State Vaccination Coverage among Adolescents Aged 13-17 Years-United States, 2011. MMWR 2011; 61 (34); 671-677.
5 Gee J, Naleway A, Shui I, et al. Monitoring the safety of quadrivalent human papillomavirus vaccine: Findings from the Vaccine Safety Datalink. Vaccine 2011; 29; 8279–84.
6 Agorastos T, Chatzigeorgiou K, Brotherton JML, Garland SM. Safety of human papillomavirus (HPV) vaccines: A review of the international experience so far. Vaccine 2009; 52 (9): 7270-81.
7 Syrjänen, Stina DDS, Ph.D. Human Papillomavirus in Head and Neck Carcinoma. N Engl J Med 356; 19. May 10, 2007.
8 Broomall, Eileen M. et al. Epidemiology, Clinical Manifestations, and Recent Advances in Vaccination against Human Papillomavirus. Postgraduate Medicine, 122: 2. March 2010.
9 Bednarczyk, Robert A. et al. Sexual Activity Related Outcomes after Human Papillomavirus Vaccination of 11 to 12 year old. Pediatrics. October 15, 2012; DOI: 10.1542/peds.2012-1516.
10 Al Romaih WRR, Srinivas A, Shahtahmasebi S, Omar HA. No significant change in sexual behavior in association with human papillomavirus vaccination in young girls. Int J Child Adolesc Health 2011; 4:1–5.
11 Al Romaih WRR, Srinivas A, Shahtahmasebi S, Omar HA. No significant change in sexual behavior in association with human papillomavirus vaccination in young girls. Int J Child Adolesc Health 2011; 4:1–5.

Many thanks to Patrick Tate, MD of CCP – South Hills Pediatric Associates for his feedback in the development of these FAQs!