The HPV Vaccine Protects Against More Than Just Cervical Cancer, Experts Say

Only one-third of Americans know that human papillomavirus (HPV)—a common sexually transmitted infection—is linked to throat cancer, according to a new study.

Throat (oropharyngeal) cancer leads to more than 20,000 new cases a year in the United States. It is one of the most common HPV-related cancers, with 70% of cases estimated to be caused by HPV.

HPV can be transmitted through oral sex, and individuals can acquire a new infection with each new sexual partner. While HPV often clears on its own, persistent infections can lead to cancer over time, highlighting the importance of vaccination.

“The public is missing crucial information about the link between throat cancer and HPV, as well as the fact that vaccines may prevent HPV-related throat cancer,” said Daniel Kwon, MD, a head and neck surgeon at Keck Medicine at the University of Southern California (USC) and senior author of the study.

Only 6.5% of eligible adults said they’ve completed the full series of the HPV vaccine, according to another new survey study by researchers at USC’s Head and Neck Center.

Murky Guidance on HPV Vaccination

The low rate may be due to vague guidance on HPV vaccination for adults. The HPV vaccine, introduced in the U.S. in 2006, was initially recommended for girls and women ages 9 to 26. In 2009, the recommendation expanded to include boys and men in the same age range. By 2018, the vaccine’s use was extended to adults ages 27 to 45.

However, while there are clear recommendations for younger people from the Centers for Disease Control and Prevention (CDC), the guidance for adults 27 to 45 is less definitive. For this group, the CDC’s Advisory Committee on Immunization Practices (ACIP) advises “shared clinical decision-making,” meaning individuals should consult their healthcare provider to decide whether vaccination is appropriate.

A lack of public awareness about the link between HPV and cancer may have also contributed to the low HPV vaccination rate, said Niels Kokot, MD, a head and neck surgeon at Keck Medicine USC and the senior author of the survey study. He noted fewer public service campaigns promoting the HPV vaccine compared to the more widely publicized campaigns for the COVID-19 vaccines and flu shots.

Additionally, growing vaccine hesitancy in the U.S. may have also reduced the uptake of the HPV vaccine, Kokot said.

The CDC says that while the HPV vaccine may provide some benefit for adults over 26 years old, it’s less effective than for children and young adults not yet sexually active, as most adults have already been exposed to HPV through sexual activity.

However, researchers note that individuals can acquire a new HPV infection with each new sexual partner, increasing their risk for several cancers, including cancers of the anus, penis, vulva, vagina, and throat.

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HPV Vaccination Guidance May Get an Update Soon

Better guidance for adults about the HPV vaccine is now under discussion. In June, ACIP convened an HPV Vaccines Work Group to review several key issues, including whether to change the number of recommended vaccine doses.

The proposed changes would reduce the dose schedule from two to one for individuals ages 9 to 26 and from three to two for adults ages 27 to 45. The World Health Organization adopted similar changes in 2022 after studies showed the vaccine remains effective at lower doses.

“Reducing the number of doses needed, if advised, may take away one barrier for vaccination with the HPV vaccine,” said Oliver T. Brooks, MD, chair of the HPV Vaccines Work Group and chief of pediatrics at the Watts Healthcare Corporation in Los Angeles.

The work group is also reviewing the recommended age for routine HPV vaccination and clarifying guidance for adults in the “shared clinical decision-making” age group.

“When we have shared clinical decision-making for a vaccine, it can lead to less uptake. Doctors don’t often have the time to discuss the options,” Brooks said.

Kokot said he hopes the new study findings will help spur greater public education on the HPV vaccine. He also recommends that any eligible adult who has not yet been vaccinated for HPV talk to a healthcare provider about vaccinations.

“Every patient’s circumstances are different, and the subject is worth a discussion to see if an individual would benefit from the vaccine,” Kokot said.