What is human papillomavirus (HPV) infection?
HPV is the most common sexually transmitted infection (STI) in the United States. About 79 million people in the U.S. have HPV infection and another 14 million get HPV each year. Nearly half of these new infections occur among teens and young adults aged 15 to 24. HPV infection can cause genital warts and can lead to cancer many years later, making the need for early prevention that much more important.
Who gets HPV infection?
- Anyone can get HPV once they become sexually active.
- Most people are infected around the time they first become sexually active.
- Most sexually active people get HPV infection at some time in their lives, even if they only have one lifetime sexual partner.
How is HPV spread?
- HPV is spread through direct contact with an infected person, most often from vaginal or anal sex but also from oral sex or genital-to-genital contact.
- HPV can be spread even when the person has no symptoms.
Are there symptoms of HPV infection?
- Most people have no symptoms of HPV infection.
- Some people with HPV may develop genital warts. (About 360,000 people get genital warts each year.)
- HPV infections that cause cancer may not become apparent until many years later and may not show symptoms until the cancer is advanced.
What types of cancer are caused by HPV infection?
- Each year, there are approximately 27,000 cancers caused by HPV in the U.S. – about 17,600 in women and 9,300 in men.
- Cervical cancer is the most common HPV-associated cancer among women. Each year, about 12,000 women are diagnosed in the U.S., and about 4,000 die from the disease.
- HPV infection in women can also lead to anal, oropharyngeal, vulvar and vaginal cancer.
- Among men, HPV-associated cancers include anal and oropharyngeal (back of the throat, including the base of the tongue and tonsils) cancer, which are the most common, as well as penile cancer.
How is HPV infection treated?
There is no treatment for the virus itself. Although the body’s immune system clears HPV on its own within two years in about 90% of infections, it is impossible to know which infections will persist and go on to cause health problems.
There are treatments for the diseases that HPV can cause:
- Genital warts can be removed by prescribed medications applied by the patient him or herself or by a health care professional. Some warts can also disappear on their own.
- HPV-related cancers are most treatable when they are diagnosed and treated early. Women should have routine cervical Pap testing. Certain people at higher risk for anal cancer may need routine anal Pap tests. Talk with your primary care provider about your risk and whether you should get tested.
How can HPV infection be prevented?
The best way to prevent HPV is with a vaccine. Pre-teens, teens, and young adults should get the vaccine before they become sexually active. The vaccine works best on those who have not yet been exposed to HPV.
There are two licensed HPV vaccines, Cervarix® and Gardasil®, which can be used to protect girls and women against the HPV types that cause most cervical cancers. Gardasil is also licensed for use in boys and men and protects against most genital warts and anal cancers in both women and men.
If you chose to be sexually active, condoms also help prevent the spread of HPV. However, HPV can infect areas that are not covered by a condom – so condoms may not completely protect against HPV.
Who should receive the HPV vaccine?
The vaccine is recommended for all girls and boys between the ages of 11 and 12. It is important to vaccinate your child now, before he or she is old enough to be exposed to HPV. The vaccine may be given to pre-teens as young as 9.
Females aged 13 through 26 and males aged 13 through 21 should be vaccinated if they have not previously received the vaccine. High-risk males aged 22 through 26 should also receive the HPV vaccine (see below).
While the vaccine works best when it is given before having any kind of sexual exposure, teens and young adults can still benefit from it, even if they are sexually active, since they may not have been infected by the types of HPV the vaccine protects against.
Both vaccines are given as three shots over six months. Girls and boys should receive all three shots to be fully protected.
Can the HPV vaccine be given with other vaccines?
Yes. Your child’s visit to receive the Tdap vaccine, which is required for 6th grade entry, or the meningococcal vaccine is a good time to vaccinate your child against HPV. Many children also see health care professionals for physicals before school or for participation in sports, camping events, travel and so on. These are all great opportunities for your preteen or teen to get the HPV vaccine.
Why should the vaccine be given at a young age?
The HPV vaccine works best if it is given before any sexual activity and possible exposure to HPV. It is important to vaccinate well before exposure to an infection, as is the case with measles and other recommended adolescent vaccines. Similarly, parents should vaccinate their children well before they are exposed to HPV.
Studies also show that younger adolescents have a higher immune response after vaccination compared to teens and young adults older than 15. Evidence shows that protection is long-lasting.
In addition, several studies show that teens vaccinated against HPV do not have sex at an earlier age and do not have more sexual partners than teens who are not vaccinated.
Are there populations at higher risk of HPV infection and related health problems?
Men who have sex with men are at greater risk for HPV infection, while people with weak immune systems (including those who have HIV/AIDS) are at higher risk for health problems resulting from HPV infection.
Is the HPV vaccine effective?
Studies before the vaccine was released suggested that among females, the HPV vaccine was up to 99% effective in preventing cervical, vaginal and vulvar abnormalities, which can develop into cancer if left untreated. The vaccine was also 89% to 99% effective in preventing genital warts in males and females. For more information about these studies, visit the Advisory Committee on Immunization Practices published recommendations on the Centers for Disease Control and Prevention’s (CDC) webpage.
While it is too early to look at the effect of HPV vaccination on cancer outcomes, recent studies indicate positive findings. Studies looking at data through 2010 found that in just four years of vaccine availability, there has already been a 56% reduction in the types of HPV the vaccine prevents. Studies have also shown a 38% reduction in genital warts among adolescent girls in the U.S., despite low vaccination coverage.
Countries like Australia and Denmark, which started national HPV vaccination programs for adolescent girls, have also seen a large impact. In Australia, data through 2011 shows there has been a 77% decrease in HPV (those types the vaccine prevents) among women ages 18-24 and a 93% decrease in genital warts among women under age 21. Denmark has also seen a 45% reduction in genital warts in girls aged 16 to 17.
Is the HPV vaccine safe?
Yes. Studies conducted as part of the Food and Drug Administration’s (FDA) approval process before the vaccine’s use indicate that the HPV vaccine is very safe.
Since the vaccine’s use, nearly 67 million doses have been given in the U.S. through March 2014, and studies provide continued evidence of the vaccine’s safety. For more details, visit CDC’s HPV vaccine safety webpage.
What are the side effects of the HPV vaccine?
The common side effects are usually mild and short-lived, such as soreness where the shot was given and fever, headache and nausea. The most common safety concern reported is a brief fainting spell, which is more common among adolescents following any vaccination.
Reports that the HPV vaccine causes serious health problems, such as mental retardation or paralysis, are not true. Serious side effects, like severe allergic reactions (see below), are rare.
Who should NOT receive HPV vaccine?
- Tell your doctor if the person getting vaccinated has any severe allergies, including an allergy to latex (for Cervarix) or yeast (for Gardasil). Anyone who has ever had a serious allergic reaction to any part of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine.
- People with a mild illness (low-grade fever, colds, ear infection, mild diarrhea) when a dose of HPV vaccine is planned can still be vaccinated. People with more severe illnesses should wait until they are better.
Should pregnant women receive the HPV vaccine?
- While the vaccine is not recommended for pregnant women, studies to date have not shown any safety concerns for pregnant women or their unborn children.
- Pregnancy testing is not needed before vaccination.
- If a woman is found to be pregnant after starting the vaccination series, the remainder of the three-dose series should be delayed until completion of pregnancy.
- Women who are breast feeding may get the vaccine.
Who recommends the HPV vaccine?
In addition to recommendations from the New York City Health Department, the CDC, and the World Health Organization (WHO), the vaccine is supported by the following medical experts: American Cancer Society, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American Academy of Family Physicians and Society for Adolescent Medicine.
If you need more information, call 311 for:
- Places where your child can be vaccinated
- Help finding a doctor for your child
- Help finding a doctor or clinic to do a Pap test
Free, confidential STD exams and treatment, including Pap testing, are available at Health Department clinics in all five boroughs of New York City. Health insurance, proof of citizenship, and parental consent are NOT required. View a list of clinics and hours or call 311.