The Pros and Cons of the HPV Vaccine

The human papillomavirus (or HPV) is the most common sexually transmitted infection in the United States. So common, in fact, that nearly all sexually active adults will get it at least once in their lifetime if they aren’t vaccinated against it. Roughly 14 million Americans are infected every year, and while the bulk of those cases will clear up on their own without any symptoms, some will lead to genital warts or cancer. 

Most new HPV infections happen in teens and young adults who have no idea they are infected, allowing them to pass the virus on to new partners without realizing it. With no cure, the best defense against cancer-causing HPV is vaccination. 

The Centers for Disease Control and Prevention recommends that everyone be vaccinated against HPV at age 11-12, though the vaccine can be given at any time up to age 45. While there are some risks to the HPV vaccine, these risks are mild and pale in comparison to the benefits of preventing six types of cancer later in life.

What Is the HPV Vaccine?

The HPV vaccine is one of four routinely recommended vaccines given at age 11-12, along with vaccines against bacterial meningitis, whooping cough, and influenza. It protects against nine strains of HPV, seven of which are the most common causes of HPV-linked cancers. 

So far, three HPV vaccines have been approved for use in the U.S., though only one is used today. 

  • Gardasil: Approved by the Food and Drug Administration in 2006. It protected against four strains of the virus: two most often linked to cervical cancer and two linked to genital warts. 
  • Cervarix: Approved in 2009. It protected two cancer-causing strains of the virus. 
  • Gardasil 9: Approved in 2014. It protects against nine strains of the virus, including seven strains that cause HPV-associated cancers and two that cause genital warts. Gardasil 9 is the only HPV vaccine currently available in the U.S.

HPV Vaccine Ingredients 

The HPV vaccine is made using a combination of tiny amounts of proteins, adjuvants, and stabilizers.

  • Proteins: Unlike other vaccines, which use whole viruses, the HPV vaccine doesn’t include any virus at all. Instead, it’s made using small proteins that look a lot like the outside of the human papillomavirus. Because it doesn’t contain the virus or even its DNA, the HPV vaccine cannot give someone HPV or cause an infection. 
  • Adjuvants: Adjuvants are ingredients added to vaccines to make them more effective. In the case of the HPV vaccine, aluminum salts are added to help stimulate the immune system, resulting in more protection from the virus. It should be noted that aluminum salts are not the same as raw aluminum or other aluminum compounds. Just like sodium and chloride can both be dangerous on their own but safe when combined together to make sodium chloride (table salt), aluminum salts are easily processed by the body. 
  • Stabilizers: Other ingredients included in the HPV vaccine—like water, salt, polysorbate 80 (an emulsifier that keeps the components from separating), L-histidine (an amino acid already found in the body), and sodium borate (regulates the pH of the vaccine)—are used to hold everything together and make it so that it can be injected safely. 

These ingredients have all been found to be safe in the minuscule amounts used. 

HPV Vaccine Schedule 

The Advisory Committee on Immunization Practices (ACIP) recommends all adolescents—both boys and girls—get vaccinated against HPV at age 11-12, though the vaccine can be given to anyone (men and women) ages 9-45 years. 

The number and timing of doses you need depend on when you get vaccinated: 

  • Ages 9-14: If you start the series before age 15 years, you only need two doses, spaced 6-12 months apart. 
  • Ages 15-45: If you get the first dose after age 15 years, then you should receive three doses over six months. 

Some research suggests that just one dose of the vaccine might be enough to protect against cervical cancer, but more studies are likely needed before the ACIP changes their recommendations. 

Who Shouldn’t Get the HPV Vaccine

While nearly everyone can safely receive the HPV vaccine, there are some who shouldn’t. You should not get the HPV vaccine if: 

  • You have had a severe allergic reaction to the HPV vaccine (or one of the components used to make it, like baker’s yeast). 
  • You’re moderately or severely sick—in which case, you should wait to be vaccinated until you recover.
  • You’re pregnant. This, however, is just a precaution. There’s no evidence that the vaccine will hurt a pregnant woman or a developing fetus, but because research is limited on the topic, women should postpone getting vaccinated until they are no longer pregnant. 

You can still get the HPV vaccine even if you’ve tested positive for HPV before because it will still likely offer you protection against other strains. 

Benefits of the HPV Vaccine 

The biggest pros to being vaccinated against HPV are that it can protect you from getting infected with a strain that causes cancer or genital warts, and that protection appears to last at least 10 years.  

The HPV Vaccine Is Really Effective at Preventing Cancer-Causing HPV 

From 2012-2016, about 44,000 HPV-associated cancers occur in the United States., including nearly all cases of cervical and anal cancers and most cases of cancers in the oropharynx (in the head and neck), penis, vagina, and vulva. 

While the vaccine doesn’t protect against all strains of HPV, it does protect against the strains most likely to cause cancer. According to the CDC, vaccination could prevent 92% of all HPV-caused cancers in the U.S., or roughly 32,100 cancers a year. 

That’s because the HPV vaccine is really effective at preventing infection from these cancer-causing strains. More than 99% of people who get the HPV vaccine develop protection from the HPV types included in the vaccine.  

Protection Appears to Last a Long Time 

The protection gained from HPV vaccination appears to last a long time. Because the vaccine was only first introduced in 2006, research is limited on how long protection from the vaccine lasts. But studies so far have shown the protection lasts at least 8-10 years with no evidence that it wanes over time

HPV Vaccine Side Effects 

Like any medical product, the HPV vaccine has some side effects, but they are temporary and almost always mild.  

The most common side effects from the HPV vaccine are similar to those you would expect from other vaccines given to the same age group. They include: 

  • Redness, swelling, or soreness where the vaccine was given in the arm 
  • Fever
  • Dizziness or fainting
  • Nausea
  • Headache 
  • Feeling tired 
  • Body aches

Serious Reactions Are Extremely Uncommon

Just like someone can be allergic to peanuts or penicillin, individuals can be allergic to components of the HPV vaccine, such as latex or yeast. If the allergy is severe, it’s possible for someone to go into anaphylaxis shortly after getting a dose of the HPV vaccine. This, however, is extremely rare and can typically be managed in a clinical setting. 

No other serious or long-term issues are linked to the HPV vaccine. Scientific studies and investigations on the safety of the vaccine have not found any evidence that it’s linked to things like infertility, Guillain-Barré syndrome, postural orthostatic tachycardia syndrome, chronic regional pain syndrome, chronic fatigue syndrome, or autoimmune disorders. 

While some deaths have been reported following HPV vaccination, further investigation into these deaths found that they were likely caused by other factors and not by the vaccine. 

What About the Vaccine Insert?

Vaccine package inserts are documents written by the vaccine manufacturer and included in each newly purchased box of vaccines. These inserts contain a lot of information, including how to use the vaccine, dosage levels, and precautions, but they shouldn’t be confused for a comprehensive summary of the safety of the vaccine. 

Vaccine inserts are legal documents created during the approval process and can sometimes include information for legal reasons, rather than medical ones. For example, the list of adverse (or negative, unwanted) events listed in the vaccine insert for Gardasil 9 includes automobile accidents—even though the crash wasn’t caused by the vaccine. 

How the HPV Vaccine Safety Is Tested and Monitored

The HPV vaccine undergoes extensive safety testing similar to other vaccines. Before they could be licensed in the U.S., all HPV vaccines were tested in 15,000+ people during clinical trials to verify that the vaccine was safe and effective enough to be used in the general public. 

Now that the HPV vaccine is on the market in the U.S., there are three primary monitoring systems to ensure it continues to be safe and effective. These systems include: 

  • Vaccine Adverse Event Reporting System (VAERS): A passive reporting system, where anyone can report any outcome into the system, even if they aren’t sure the vaccine was the cause. This system helps to guide further research but shouldn’t be used as proof that the vaccine causes a particular outcome.   
  • Vaccine Safety Datalink (VSD): A group of health care organizations that conducts studies to see if specific rare or serious side effects are linked to a particular vaccine. 
  • Clinical Immunization Safety Assessment (CISA) Network: A group of vaccine safety experts and organizations that study vaccine safety issues, such as whether certain things make a person more (or less) likely to experience side effects following vaccination. 

When these systems flag a potentially negative side effect of vaccination, the ACIP reviews the evidence and adjusts their recommendations, if needed. For example, after the HPV vaccine was released, reports of syncope (fainting) right after vaccination prompted the FDA and the ACIP to remind medical professionals to ask their patients to sit or lie down for 15 minutes after receiving the vaccine in order to prevent falls or injuries.  

A Word From Verywell 

The benefits of the HPV vaccine far outweigh the risks associated with vaccination. Research shows side effects of the HPV vaccine are mild and that the vaccine is very effective at protecting against cancer-causing HPV. 

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Article Sources

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