Human papillomavirus (HPV) is an infection that spreads from person to person, usually via contact with mucous membranes of the skin on the inside of the mouth and in the genital region. When it comes to prevention, not just the HPV shot is misconstrued, but also the disease itself.
“Generally people are wary and cautious about the safety of a vaccination,” says Dr. Peter Ye, MD, OB/GYN at Memorial Hermann Medical Group (MHMG) Kingwood Obstetrics & Gynecology. “But the HPV vaccine, Gardasil 9, is very safe, and it provides protection against HPV and its more serious consequences.”
HPV is considered a sexually transmitted infection, with the virus’ ailments ranging from warts to cancer. Dr. Ye explains whether common beliefs about HPV and its vaccine are true or false.
BELIEF: The only way to get the virus is through sexual contact such as penetrative intercourse.
TRUE: HPV is a contagious, sexually transmitted virus, and penetrative genital intercourse, oral sex and other forms of sex all pose a risk.
It’s highly unlikely nor is there strong evidence that suggests that HPV can be transmitted in other ways such as shared linens or surfaces.
BELIEF: HPV is a single virus.
FALSE: “Actually, there are more than 200 strains,” Dr. Ye says. Also, a person can be infected by more than one strain simultaneously.
The various strains are responsible for many types of conditions and can affect different parts of the body. Most concerning are the abnormal cells which eventually can turn into cancer. In fact, for women, HPV is the biggest cause of cervical cancer.
A persistent HPV infection can lead to warts or precancerous lesions. HPV also can cause anal genital cancers, pharyngeal throat cancers, and anal and genital warts.
“The HPV vaccine protects children from the nine most dangerous, virulent strains of HPV,” Dr. Ye says. “These include the number 16 and 18 strains that cause 70% of cervical cancers.”
There are also milder strains which may not be as consequential and may cause no symptoms.
Other strains are predominantly associated with warts on the skin, and some cause different patterns and in different areas.
Not all warts are HPV-related, but many kinds of anogenital warts can be caused by HPV. And HPV can affect both genders, depending on exposure.
BELIEF: You may have been exposed to HPV without even realizing it.
TRUE: “The virus itself is fairly common,” Dr. Ye says. “But with most people who are exposed, if they’re young and healthy, the immune system will clear the infection in six to 12 months.”
More than nine out of 10 cases resolve on their own within two years. Keep in mind that smoking and abusive drug and alcohol use can weaken your immunity. “Conditions involving immune system deficiencies, such as HIV/AIDS, also can put you at increased risk of recurrent and persistent HPV infections,” he says.
BELIEF: Having only a few partners protects you from HPV.
TRUE and FALSE: Limiting partners may help, but keep in mind that when you sleep with someone, in effect you’re also sleeping with their sexual history. They may be your first or constant partner, but that doesn’t mean they haven’t had many previous partners with unprotected sex.
“In terms of sexual history,” Dr. Ye says, “a partner who has engaged in more risky sexual behaviors may put you at greater risk.”
BELIEF: If my child gets the HPV vaccination, they’re more likely to have sex.
FALSE: Children who have received HPV vaccinations are no more likely to be sexually active than those who have not, Dr. Ye says. Yet a common misconception among parents is that the HPV vaccine will prompt a child’s entry into the sexual world.
Young people are always going to explore their developing bodies and their sexuality—sometimes in ways which might make parents uncomfortable. Studies consistently show that about half of teens will have become sexually active by age 19, and around 10% by age 15. And that is independent of vaccines.
An HPV vaccine can be a plus when it comes to your child’s awareness of sex in that you may find it easier to address risks of unsafe sex when a doctor is present—a doctor who has experience in having conversations teens about their sexuality can answer questions for you and your child.
Even so, besides having your doctor discuss the HPV vaccine with your child, having honest, accurate and age-appropriate sexual education within your home also is important.
BELIEF: The HPV vaccine could harm your child.
FALSE: “There can be minor, temporary discomfort at the vaccination site, as well as bruising or mild fever and other general vaccine responses,” Dr. Ye says. “But most people don’t have a bad reaction to the vaccine, and it’s very safe.”
BELIEF: Getting an HPV vaccine can only occur in a narrow window of age.
FALSE: HPV vaccines can be administered until age 45. However, most insurance only covers the vaccine between ages 9 and 26.
BELIEF: Once a child has been vaccinated, they won’t need to be vaccinated again.
FALSE: The vaccine can require two to three doses, depending on age.
Most pediatricians recommend getting vaccinated between ages 11 and 12, though vaccines can be given as early as age 9.
“It’s best to receive the vaccine when patients are younger and just entering puberty. That way they can get maximum protection before they become sexually active,” Dr. Ye says. “Also, younger patients tend to have more robust immunity and a better or more proactive response to receiving the vaccination.” Patients receiving the vaccine at age 14 or younger receive two doses six months apart.
Those age 15 and up will need three doses, with the second dose coming two months after the first and the third dose coming four months after that.
BELIEF: Older adults don’t need the vaccine.
FALSE: Studies support giving the vaccine even up to age 45, but that is on a case-by-case basis, depending on the individual.
Patients at that age are less likely to still be sexually naive, and if they’ve already been exposed to HPV by that age, their immune response is less robust, and the vaccine gives them decreased protection.
However, getting a vaccine at an older age can be a good idea, especially for those who have had a limited number of sexual partners but are still at risk of developing HPV. A 28-year-old not previously at risk might consider an HPV vaccine when having a new partner.
BELIEF: Not just women can get cancer from HPV.
TRUE: Head and neck cancers caused by HPV are two to three times more common in men than in women. But along with penile and anal cancers and genital warts, head and neck cancers are among the conditions against which men are protected by the HPV vaccine.
BELIEF: Among the younger generations, only girls need to be vaccinated.
FALSE: Both girls and boys should receive the vaccine, Dr. Ye says. “The burden of HPV is higher among girls and women because of cervical cancer, but boys can get genital warts, anal warts and certain throat, anal and genital cancers.”
“From a public health perspective, boys getting vaccinated can have a far-reaching effect,” he says.
BELIEF: Safe sex practices are still important.
TRUE: Whether vaccinated or not, people should use protection whenever they can and be cautious about engaging in high-risk sexual behaviors. HPV vaccines won’t protect from other virus such as HIV/AIDS.
BELIEF: Cervical, anal-rectal and head/neck cancer may have warning signs.
TRUE: And you should see your doctor before they become advanced. Head/neck cancer is apparent via growths in and around the throat and neck and can cause difficulty with swallowing or breathing. Treatment includes radiation therapy, surgery and chemotherapy.
Anal/rectal cancer causes changes in bowel function and leads to blood in the stool and development of masses in or around the anus. Anal genital warts caused by HPV can be treated with topical medications applied to the warts, or surgical means can be used to remove them.
Cervical cancer starts with abnormal cells on the cervix, which are most detected via routine pap smears—ideally before tumors and symptoms exist. But testing for HPV also can detect abnormalities before a pap smear is taken.
Cervical cancer signs can include pelvic pain, bleeding after intercourse, change in bowel or bladder function and unexplained weight loss. The most common symptom is abnormal vaginal bleeding.
“Treatment can vary depending on the severity of the abnormality of the pap smear,” Dr. Ye says. “There may be watchful waiting to see if the body clears the infection, or surgery may be recommended for severe abnormalities with a higher risk of developing cancer soon.”
