Introduction
HPV is a prevalent sexually transmitted infection (STI), with transmission typically occurring shortly after the onset of sexual activity. Prolonged illnesses with high-risk HPV strains can cause cervical, anal, vaginal, penile, and oropharyngeal cancer, typically decades later. Adolescents and young adults account for the majority of newly diagnosed cases of HPV.
According to the National Cancer Institute (2023), three percent of all malignancies in women and two percent of all cancers in males in the United States are caused by high-risk HPVs. It is projected that HPV is responsible for 36,000 of the 45,000 new instances of cancer diagnosed each year in areas of the body where HPV is often prevalent (Centers for Disease Control and Prevention, 2021). Vaccination is strongly recommended for preventing HPV infections and associated diseases, as it will decrease the prevalence of cervical cancer and improve general public health outcomes.
Influence of the HPV Vaccine
Girls in high-income nations have access to HPV vaccination programs, and women in these countries also enjoy frequent screenings and effective treatment. Since HPV types 16 and 18 are responsible for at least 70% of cervical malignancies (World Health Organization, 2022), four vaccinations have been approved by the World Health Organization (WHO) for protection against these strains. WHO (2022) estimates that an extra 20% of cervical cancers are caused by five oncogenic HPV strains covered by the 9-valent vaccination. The anogenital wart-causing HPV strains 6 and 11 are also protected against by two vaccinations.
HPV vaccinations have been proven safe and efficient in preventing HPV infections and invasive malignancies via clinical studies and post-marketing monitoring. Vaccination against HPV is most effective if given before the virus is contracted. Therefore, the WHO recommends vaccinating girls between the ages of 9 and 14 against cervical cancer as they have not yet become sexually active.
Cervical cancer and other associated cancers are far less likely to occur due to vaccination. In the United States (US), HPV is responsible for an estimated 33,700 cancer cases annually (Meites et al., 2019). This includes 12,900 cases of oropharyngeal cancer in women and men and 10,800 cases of cervical cancer in women. Most of these malignancies might be avoided with the current HPV vaccination initiative for young people. While the average age of HPV infection that leads to cancer is unclear, it is believed that it occurs decades before cancer is detected (Meites et al., 2019).
According to Meites et al. (2019), the percentage of teenagers aged 13–17 years who received at least one dose of HPV vaccination in 2017 was 65.5%. Despite progress, the United States’ teenage population’s coverage with the required number of doses is still below the 80% Healthy People 2020 goal (Meites et al., 2019). The prevalence of vaccine-type HPV illnesses, genital warts, and cervical cancers has decreased dramatically as a direct consequence of the HPV vaccination campaign.
The vaccine has been shown to effectively prevent anogenital warts, reducing the burden of the illness and improving the quality of life for those affected. Genital warts may upset patients since they can take a long time to eradicate and frequently return despite therapy. Estimates made before the HPV vaccination program point to many hospitalizations, even though only a small percentage of genital warts need hospital care. For instance, the most significant global reduction in genital wart incidence has been achieved in Australia through the HPV immunization program, largely due to the comprehensive catch-up initiative (Patel et al., 2018). Heterosexual males who have not been vaccinated have shown a significant herd impact on genital warts due to the female vaccination scheme.
Effects of the HPV Vaccine
The HPV vaccination has significantly lowered the prevalence of HPV-related illnesses. An HPV infection, anogenital warts, and cervical intraepithelial neoplasia (CIN) are conditions for which these vaccines have been shown to protect in earlier research, including randomized controlled trials evaluating efficacy (Lei et al., 2020). The vaccination has been beneficial in reducing HPV transmission and consequently lowering the chance of acquiring cervical cancer by focusing on teenagers before they have their first sexual interactions. Quadrivalent HPV immunization was linked to a significantly lower incidence of invasive cervical cancer in the research on Swedish girls and women between the ages of 10 and 30 (Lei et al., 2020). Since immunization had no therapeutic impact against preexisting HPV infection, the results justify the suggestion to provide quadrivalent HPV immunization before being exposed to HPV infection to receive the most benefits.
Numerous studies have also confirmed the effectiveness of the HPV vaccine. According to research from the US, cervical cancer prevalence was considerably reduced among girls and women aged 15 to 34 after vaccination compared to before (Lei et al., 2020). According to Lei et al. (2020), if immunization coverage of girls and women in a society approaches 50%, unvaccinated people will indirectly gain from HPV vaccination. The Swedish population has experienced a herd response to the HPV vaccine against genital warts (Lei et al., 2020). Herd immunity minimizes the likelihood of the HPV virus spreading by creating an impediment that makes it more difficult for the virus to propagate, thereby protecting both those who have received the vaccine and those who have not.
The Outcome of the HPV Vaccine
The prevalence of HPV infections has decreased in several nations that have carried out extensive vaccination programs. Action has been taken at the national and state levels to increase HPV vaccination uptake and potentially eliminate inequities in cancer prevention and cancer-related outcomes (Chido-Amajuoyi et al., 2021). In recent years, comprehensive cancer centers with National Cancer Institute (NCI) accreditation have approved extensive gender-neutral HPV immunization. The President’s Cancer Panel Report, released in 2014, noted the insufficient use of HPV vaccines as a public issue and suggested tackling these impediments (Chido-Amajuoyi et al., 2021). To do this, it was suggested that multi-level initiatives be used, including communication tactics to increase awareness of the HPV vaccine’s advantages, effectiveness, and safety.
Following the advent of HPV vaccines, nations like the United Kingdom (UK) experienced a decrease in anogenital warts. To prevent HPV primary infection, a vaccination campaign was initiated in the UK in 2008, and as of the time of writing, approximately 10.5 million doses have been provided to females (Rodrigues & Plotkin, 2020). After 10 years of use, a decrease in genital infections caused by serotypes 16 and 18 was noted. Nevertheless, more time will be required to detect a decrease in the risk of cervical cancer (Rodrigues & Plotkin, 2020).
However, among Scottish women older than 20 who received the bivalent HPV immunization when they were 12 to 13 years old, the prevalence of pre-invasive cervical illnesses has decreased by 79 to 89%, with findings suggesting herd protection (Palmer et al., 2019). The influence of HPV immunizations on neonatal morbidity and death, as well as the decrease in surgical procedures for cervical neoplasias and the associated preterm deliveries and problems, is another advantage. These favorable results demonstrate the vaccine’s effectiveness and positive impact on societal health.
Compared with other health interventions, HPV vaccination is both highly advantageous to the population and inexpensive. A vaccination program includes definite upfront expenses, such as the cost of vaccines, the infrastructure needed to conduct the program, and the costs of administrative and medical staff. Successful immunization programs have reduced morbidity and mortality through direct and indirect protection, thereby decreasing illness incidence, the need for treatment, and healthcare expenditures (Rodrigues & Plotkin, 2020). Due to the expenditures avoided by patients and parents, taking fewer medical tests, surgeries, and treatments, and less time off work, may result in economic growth.
Antibiotic resistance has been minimized with the use of the HPV vaccine. The use of antibiotics exposes the bacteria that make up the human microbiota to pressures that drive the emergence of antimicrobial resistance (AMR). As the host microbiota is often the source of invasive diseases such as urinary tract infections, meningitis, pneumonia, and abdominal infections, the risk of contracting difficult-to-treat or incurable diseases is increasing (Rodrigues & Plotkin, 2020). Vaccination is essential for minimizing this risk because it prevents people from getting bacterial and viral illnesses in the first place, thereby reducing the number of antibiotics their microbiota are exposed to.
Conclusion
HPV is a sexually transmitted infection that can result in cancer in both men and women. Clinical studies and real-world data have demonstrated that HPV vaccines prevent oropharyngeal and anogenital cancers. Herd immunity protects those who have been vaccinated and those who have not due to the widespread availability of vaccines. The introduction of the HPV vaccine has been a breakthrough in the fight against HPV infections; as a result, the population’s overall health has improved. Maximizing the HPV vaccine’s potential advantages and ensuring its long-term effect on public health will require ongoing research, training, and awareness initiatives.
References
Centers for Disease Control and Prevention (2021). STD Facts – Human papillomavirus (HPV). Centers for Disease Control and Prevention.
Chido-Amajuoyi, O. G., Jackson, I., Yu, R., & Shete, S. (2021). Declining awareness of HPV and HPV vaccine within the general US population. Human Vaccines & Immunotherapeutics, 17(2), 420-427.
Lei, J., Ploner, A., K. Miriam Elfström, Wang, J., Roth, A., Fang, F., Sundström, K., Dillner, J., & Pär Sparén. (2020). HPV vaccination and the risk of invasive cervical cancer. New England Journal of Medicine, 383(14), 1340–1348.
Meites, E., Szilagyi, P. G., Chesson, H. W., Unger, E. R., Romero, J. R., & Markowitz, L. E. (2019). Human papillomavirus vaccination for adults: Updated recommendations of the Advisory Committee on Immunization Practices. American Journal of Transplantation, 19(11), 3202-3206.
National Cancer Institute. (2023). HPV and Cancer; Cancer.gov.
Patel, C., Brotherton, J. M., Pillsbury, A., Jayasinghe, S., Donovan, B., Macartney, K., & Marshall, H. (2018). The impact of 10 years of human papillomavirus (HPV) vaccination in Australia: What additional disease burden will a nonavalent vaccine prevent?. Eurosurveillance, 23(41), 1700737.
Rodrigues, C. M., & Plotkin, S. A. (2020). Impact of vaccines; health, economic and social perspectives. Frontiers in Microbiology, 11, 1526.
World. (2022). Cervical cancer. Who.int; World Health Organization.