HPV (human papillomavirus) is the most common sexually transmitted infection – 79 million folks in the US currently have it, and 14 million become infected every year. Although there are a couple strains you should worry about (and we’ll discuss below), most cases of HPV are not considered high-risk and clear themselves out the body on their own. Some physicians compare HPV to the common cold and even the Center for Disease Control (CDC) states, “HPV is so common that nearly all sexually active people get it at some point in their lives”. So with that, let’s discuss the types and what you should know about important updates to the HPV vaccine.
While there are over 200 types of HPV strains, you will only be screened for the low and high-risk types. Low risk strains associated with warts in your genitals, feet, mouth or throat include: 6, 11, 40, 42, 43, 44, and 54. Higher risk strains include: 16, 18, 31, 33, 35, 39, 45, 51, 52, and 58. Specifically, 16 and 18 are the two main strains that can cause cancer in the penis, anus, vulva, vagina, and throat. These two high-risk strains occur in less than 1% of HPV cases.
While there is no cure for HPV, but you can mitigate potential issues by having warts removed, getting regular annual exams (make sure you ask your clinician for both a pap smear and HPV screening together), using barrier methods like condoms, and getting the HPV vaccine.
The 101 on the HPV vaccine
Depending on which HPV vaccine you get, you could be protected from not only types 16 and 18 – the cancer-causing types – but also 6 and 11 (these types cause 90% of genital warts), and another five which can also cause cancer. The Center for Disease Control (CDC) recommends
that kids 11-12 years old get two shots of the vaccine 6-12 months apart, three shots over six months for kids over 14, and in three shots for those ages 15 – 26. Ideally, people will receive the vaccine before they become sexually active, in order to protect them from getting HPV, although if you’re already sexually active, getting the vaccine can still give you some benefit, since it’s possible you haven’t been exposed to the HPV targeted by the vaccine.
Those who didn’t get vaccinated when they were younger, transgender folks, and those who have an immunocompromising condition (i.e. HIV, a transplant within the last 2 years), should get the vaccine through age 26, and men should get it through age 21. If you’re pregnant however, it is not recommended that you get the vaccine.
The new guidelines for Gardasil 9 HPV vaccine
Before October 2018, the HPV vaccine was not recommended for people over the age of 26. Per the new guidelines, Gardasil 9 (the newest version of Gardasil, originally approved by FDA in 2006 which protected you against four strains) can now be given to folks ages 11 to 45 – older folks will need three shots. The motivation for expanding the age range? Although more people are getting vaccinated, HPV related cancers are on the rise in the US, in particular, those that affect the throat.
Gardasil 9 protects you from nine different types of HPV, including the cancer-causing types. It’s approval was based on a study in which 3,200 women 27 through 45 who took Gardasil were followed for an average of 3.5 years, and during that time, the vaccine proved 88 percent effective in preventing not just recurring HPV infection, but the precancerous and cancerous lesions in the cervix, vagina and vulva.
Let’s review: If you’ve already been exposed to the strains of HPV targeted by the vaccine, getting it won’t make a difference. That’s why it’s recommended that you’re vaccinated before you become sexually active. These new guidelines won’t just help folks over 26 feel more protected, they actually can protect them from the most nefarious kinds of HPV. Even if you have been vaccinated, you should still get regular annual exams and specifically ask for both an HPV test and a pap smear test. Because they’re a means of screening for cervical cancer, when combined with the vaccine, this is truly effective in protecting your reproductive (and overall) health. Talk to your doctor if you have questions – remember, you are your own best advocate!