With increasing numbers of Virginians vaccinated for COVID-19 and social restrictions dropping, University of Virginia cancer experts are joining other health organizations in promoting vaccinations for another epidemic: the human papillomavirus.
An estimated 25% of all Americans are infected with the virus, known as HPV. Although it does not have the immediate health effects of the novel coronavirus, it causes cancers in tens of thousands people every year.
Experts are concerned that vaccinations for the virus dropped off during the pandemic, as did shots for most other ailments and most routine medical examinations and procedures.
“Things have gotten more complicated in the pandemic because people have been concerned about seeking preventive and primary care services like physicals and vaccinations,” said Emma McKim Mitchell, co-director of global initiatives at the UVa School of Nursing. “It’s led to a real decrease that we’ve seen in HPV vaccinations.”
In response, UVa is joining 70 other National Cancer Institute centers and partner organizations in promoting the vaccinations that can prevent a variety of cancers caused by nine different HPV genomes.
Most genomes and virus variants of HPV cause minor illnesses, such as warts and similar lesions. One form of HPV causes genital warts. Other variants can cause oral, vaginal, penile and anal cancers.
HPV is spread through skin-to-skin contact, including any form of sex with someone who has the virus. Infections are so common that nearly everyone will get a HPV infection at some point in their lives, according to the Centers for Disease Control and Prevention.
Although it doesn’t prevent all forms of HPV, the vaccine can thwart those that cause the most serious cancers, according to the CDC.
That’s good because nearly 80 million Americans are currently infected with HPV. Each year, another 14 million contract it. Most infections go away within a year or two, but others linger and create long-term trouble, including cancer.
“It is ubiquitous. We are probably all walking around with some genotype of HPV, but we know which ones are likely to cause cancer and we’re fortunate to have access to a vaccine that gives us protection against nine of those genotypes,” Mitchell said.
“I think the vaccine probably got a bad rap when it was introduced because of the association of it being a sexually transmitted infection,” she said. “But it causes everything from warts and plantar warts to genital warts and cancers. It just depends on the genotypes.”
Humans and the virus go way back. According to studies conducted under the auspices of the National Institutes of Health, we’ve been together since the beginning.
“All HPV types existed already when humans became a species,” a 2006 NIH study states. “Consequently, humans had always suffered from lesions like anogenital cancer, genital warts and common warts.”
The U.S. Food and Drug Administration has recommended routine HPV vaccination for females since 2006 and for males since 2011. Current recommendations are for routine vaccination at ages 11 or 12 or starting at age 9, with catch-up vaccination recommended through 26.
According to Johns Hopkins Medicine, worldwide studies show the vaccine is nearly 100% effective and safe. FDA findings show most side effects are minor but the benefits are major.
Medical professionals have strongly encouraged parents to vaccinate adolescents as soon as possible before they can contract the cancer-causing genomes.
UVa Health officials, citing CDC data, said HPV vaccination rates are well below other recommended adolescent vaccines, which has been the case since before the pandemic.
CDC data from 2019 shows 54% of adolescents were up to date on the HPV vaccine, while more than 90% were vaccinated against Hepatitis B, measles, mumps and rubella.
Those numbers plummeted during the pandemic when hospitals shut down for several months. Routine visits were either discouraged or put online through telemedicine portals. Early in the pandemic, HPV vaccination rates among adolescents fell by 75%.
“Tele-health has been a wonderful tool, but you can’t give someone a vaccination over tele-health,” Mitchell said. “We’ve seen a huge drop off in the vaccine but we’ve also seen an increase in the cancers. It’s going to take a long time to wrap our arms around the myriad of impacts we’ll see from [postponed preventive procedures during the pandemic]. It’s understandable, but it’s going to have a huge impact.”
The vaccine has been proven to be both safe and effective, Mitchell said.
“I’m hopeful as people feel more comfortable doing things like going to restaurants they’re also going to feel more comfortable accessing those primary care services that have gone by the wayside, services like vaccines,” she said.
“The vaccine is such a powerful tool that we want to encourage parents and families to have their children vaccinated before they are ever exposed to the virus,” she said.