The HPV Vaccine Is Making History

October 8, 2018 Rene F. Najera

Once in a while, a vaccine comes along that is capable of saving millions of lives. There's no denying that Jenner's smallpox vaccine stopped smallpox from killing millions. In the United States alone, the number of cases of smallpox numbered in the tens of thousands until the widespread use of the vaccine put an end to the virus once and for all. Then there is the rotavirus vaccine prevents about half a million deaths from diarrhea in children, according to some estimates.

Another vaccine that is making history is the HPV vaccine. Not only does it prevent genital warts, it also prevents cancer. The way it does this is by preventing an HPV infection that causes changes at the cellular level in different kinds of tissues that the Human Papillomavirus infects. Those changes lead to the activation of what are called "oncogenes," genes that tell the cell to start multiplying out of control, leading to cancer.

Now comes news that the Food and Drug Administration (FDA) has expanded the use of Gardasil 9, a vaccine against Human Papillomavirus (HPV), to be given to people up to the age of 45. According to The New York Times:

"The approval was based on a study in women ages 27 to 45, showing that an earlier version of the vaccine was highly effective in preventing persistent HPV infection, genital warts, vulvar and vaginal precancers, cervical precancers and cervical cancers related to the virus types covered by the vaccine.

The vaccine’s effectiveness in men ages 27 to 45 is inferred from the data in women, from its efficacy in younger men and from evidence that it created immunity in a study of men 27 to 45-years-old.

The most common side effects of the vaccine include soreness at the injection site, swelling, redness and headaches."

This comes as no surprise as HPV is one of those viruses that comes with the human condition. That is, people are perfectly capable of having sex up until very late in life. And, since most people will be exposed to HPV in their lifetime, it only makes sense to use the vaccine as widely as possible to prevent more infections and the cancers related to those infections.

In other news related to the HPV vaccine, Australia is about to eliminate cervical cancer. How? Again, we turn to The New York Times:

"Cervical cancer could be eliminated in Australia within the next two decades because of a government program to vaccinate children against the cancer-causing human papillomavirus, according to a new report.

The study, published this week in The Lancet Public Health(https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930183-X/fulltext#%20), found that by 2028, fewer than four women in every 100,000 could be diagnosed with cervical cancer annually in Australia — effectively eliminating the disease as a public health problem. And by 2066, the researchers say, less than one woman per year could receive that diagnosis."

The study is a modelling study, kind of like a forecast, taking many different things into account. The scenario of getting rid of cervical cancer depends on many things going right, and they very well could. Still, this should all be taken with a grain of salt. It is going to require a lot of collaboration and hard work, but it's good to know that it is doable.

Finally, the World Health Organization (WHO) is reporting an increase in the use of the HPV vaccine in Ireland:

"Health authorities from Ireland’s Health Service Executive (HSE) have announced a provisional 15% increase in uptake for human papillomavirus (HPV) vaccination in just over a year to the current 65%...

Following a decrease in coverage in 2015–2016, the HSE launched a comprehensive response in collaboration with many partners and stakeholders, including the Irish Cancer Society.

The HSE formed a HPV Vaccination Alliance and organized a vaccine conference for school vaccination teams. Through social media and other channels, parents were offered and encouraged to seek the facts about the virus, the diseases it causes and the vaccines available to prevent them. With support from a range of organizations, policy-makers and individual advocates, the response has had an immediate positive outcome."

Who knows? Maybe HPV will be a thing of the past one day, like smallpox. Until then, the HPV vaccine will at the very least save women the worry of abnormal pap smears and the follow-up diagnostic tests that go with it. At the very best, it will save hundreds of thousands of lives.