In a press release issued last month announcing that the HPV-vaccine, Gardasil 9, can now be safely given to adults ages 27-45, the U.S. Food and Drug Administration reminded everyone why pediatricians, internists, family physicians, and surgeons take human papillomavirus infections so seriously:

According to the CDC, every year about 14 million Americans become infected with HPV; about 12,000 women are diagnosed with and about 4,000 women die from cervical cancer caused by certain HPV viruses. Additionally, HPV viruses are associated with several other forms of cancer affecting men and women.


As parents of tweens and teens know very well, Gardasil 9 is recommended for all children 11-12 years old as a two-shot series (three shots if given after the 15th birthday). The highly safe and demonstrably effective HPV vaccine has been available for adults up to the age of 26. But not all people get infected in their teen and early adult years. Jamie Ducharme says extending the age to 45 will potentially reduce the number of HPV-associated sexually transmitted cancers:

“Today’s approval represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” Dr. Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, said in a statement. ”The Centers for Disease Control and Prevention has stated that HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90% of these cancers,” — including cervical, oral, penile and colorectal disease — “or 31,200 cases every year, from ever developing.”

The FDA opted to expand the age range after testing the first iteration of the HPV vaccine, which was approved in 2006, in more than 3,000 women between the ages of 27 and 45. Over an average of 3.5 years of follow-up, the vaccine proved to be 88% effective in preventing persistent HPV infection, as well as genital warts, precancerous legions and cervical cancers associated with the virus.


Last year, we looked at a study examining the prevalence of genital HPV infections in adult men and women. The results were stunning:

The study, published last month in JAMA Oncology, estimates that nearly half of American men (45.2%) ages 18-59 have genital infections due to HPV. Moreover, half of this group of infected men (or 25.1% of men in the U.S.) are infected with one of the high-risk strains associated with causing cancer. Infection rates in vaccine-eligible men were lower, indicating that immunizing young men with the older 4-valent (HPV-4) or newer 9-valent (HPV-9) vaccines are effective in preventing HPV infection and associated cancers. It’s especially important to note that the vaccine rate in the 1,868 men who entered the study was very low — 10.7%.


Hopefully, expanding the use of HPV vaccines might really ease the burden of sexually transmitted cancers on an older demographic living with what seems at the moment to be a ticking public health time bomb. As we have said before, it’s not too early — nor, with the FDA’s recent announcement, too late — for parents to get onboard with HPV vaccination:

Parents should also be able to explain to their children how human papillomavirus infection is acquired, what the consequences are of those infections on their future health, and how a 2-shot series of vaccines (3-shots after 15 years old) can prevent those consequences. This discussion should occur before the 11-year well-child checkup when the first HPV vaccine will be given along with other vaccines (Tdap and meningitis B). There is no need to delay the start of the HPV vaccine series. Parents who remain hesitant should not hesitate to discuss this honestly with the pediatrician they trust.



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