Introduction

Human papillomavirus (HPV) is an extremely common virus that affects everyone – both women and men – and can cause six types of cancer, including cervical, vaginal, vulvar, anal, penile, and oral/throat cancers. According to the Centers for Disease Control and Prevention (CDC), nearly 80 million Americans – one out of every four people – are infected with the virus. Of those millions, nearly 36,000 will be diagnosed with HPV cancers this year; more than 200,000 will be diagnosed with cervical pre-cancer.

Fortunately, an established, safe, and effective vaccine that provides long-lasting protection against HPV cancers is available, serving as a vital tool in broad cancer prevention. In fact, HPV vaccination is recommended for everyone aged 9 to 26 years and for some people aged 27 to 45 years. However, HPV vaccination coverage in the United States has been slow and lower than the national Healthy People 2030 goal of 80 percent. In addition, DNA research comparing pre-vaccine and post-vaccine era samples shows HPV infection rates have dropped in the United States since the vaccine’s introduction. What’s more, the COVID-19 pandemic has interrupted delivery of key health services for children and adolescents, including HPV vaccination for cancer prevention. 



Background

Experts began recommending HPV vaccination in 2006, representing a major milestone on the path to preventing cancer. To date, more than 270 million doses have been administered worldwide. But not enough people are receiving this life-saving cancer prevention method as uptake remains significantly lower than other recommended adolescent vaccinations in the United States.

This lag in vaccination coverage persists. In 2020, 59% of children aged 13-to17-years old in the United States had been vaccinated for HPV. Additionally, socioeconomic, geographic, racial, and other disparities may determine an individual’s likelihood of vaccination. For example, children living in rural areas are less likely to be vaccinated when compared to those living in urban areas, and vaccination rates vary state by state: Rhode Island leads vaccinations with 83% of children aged 13-to-17-years old up-to-date; Mississippi shows the lowest vaccination rates at only 32% uptake. States that rank low for vaccination rates are clustered in the American southeast and mountain west.

Variations and disparities in HPV vaccination coverage can largely be explained by one of several barriers to adoption:

Age at Which Vaccination is Recommended

Many parents and family decisionmakers are unaware that HPV vaccination provides the most protection when administered to children between the ages of 9-12. Ongoing studies continue to show the importance of on-time vaccination within this age range for HPV cancer prevention. 

Strong Provider Recommendation

Families, in making the decision on whether to have their children vaccinated against HPV, report relying heavily on their healthcare provider’s recommendation – but don’t always feel strongly enough encouraged to adopt it. Many providers also note feeling underprepared to discuss or properly recommend HPV vaccination.

Financial Coverage and Access

While the HPV vaccine is largely covered by private insurance in the United States, exact coverage varies by plan, by age, and by state, leading to inequities in access and availability. For children aged 18 and younger, HPV vaccination is available without financial access limitations, including through the Vaccines for Children Program (VFC) and state-based programs. However, for states that have not expanded Medicaid, wide-scale vaccination is not as robust, especially for adults.

Misperceptions of HPV

Due to its link to cervical cancer, a longstanding (mistaken) belief about HPV holds that it only or primarily affects women and girls; even when it’s understood that men and boys can be infected with HPV and can transmit HPV to others, many people think of HPV only as a sexually-transmitted infection that can be carried but does not impact the male’s health. In reality, HPV can cause cancers that affect everyone and is easily transmitted from skin-to-skin contact.

Misperception of Connection to Sexual Activity

Some families report hesitancy to vaccinate children against HPV (or even to discuss HPV) out of concern that doing so will inadvertently encourage sexual behavior or sexual promiscuity, despite many studies to the contrary.

Longstanding misinformation exists as a substantial barrier to increasing vaccination rates across the lifespan. Study results continue to show that parental concerns that steer young people away from HPV vaccination tend to focus on safety worries, lack of necessity, knowledge about HPV, and absence of physician recommendation.

What can individuals and families do to protect themselves?

  • Get vaccinated against HPV: If you or your child is in the recommended age range, get vaccinated.
  • Encourage others to get vaccinated: Normalize HPV vaccination as cancer prevention.
  • Share the facts: HPV vaccination is safe, effective, and durable. It prevents six types of cancer.

Call to Action

Urgent action is necessary to spread awareness of HPV vaccination and its effectiveness at preventing cancer. The St. Jude Children’s Research Hospital HPV Cancer Prevention Program recommends a coordinated and sustained approach that leverages the latest in public health findings to clearly articulate the dangers of HPV pre-cancers and cancers, in addition to the benefits of vaccination, to parents, the broader public, and healthcare practitioners, in order to:

  • Increase awareness and implementation of evidence-based interventions in community settings;
  • Improve implementation of best practices in clinical settings; and
  • Raise awareness of relevant policies and support vaccination advocacy efforts.

Combined, these efforts will help cultivate a landscape supportive of HPV vaccination as a tool for cancer prevention. By ensuring that key audiences and the public have the latest information and comprehensive resources, medical and public health practitioners, families, and individuals will be well equipped to have an open dialogue about the benefits of HPV vaccination as cancer prevention and empowered to make responsible decisions.

The Path to a Bright Future campaign calls on campaign partners to promote sound, relevant, and appropriate policies that encourage on-time HPV vaccination for 9–12-year-olds and support equitable administration of HPV vaccination for all people.

Ultimately, we aim to dramatically improve on-time HPV vaccination rates by the 13th birthday in order to reduce the threat of HPV cancers for everyone later in life – locally, regionally and nationally.


For More Information

For more information, please visit StJude.org/HPV or email PreventHPV@stjude.org.

The St. Jude HPV Cancer Prevention Program aims to reduce human papillomavirus (HPV)-associated cancer deaths locally and nationally by increasing HPV vaccination rates.

St. Jude Children's Research Hospital is leading the way the world understands, treats and cures childhood cancer and other life-threatening diseases. It is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. Treatments developed at St. Jude have helped push the overall childhood cancer survival rate from 20% to 80% since the hospital opened more than 50 years ago. St. Jude freely shares the breakthroughs it makes, and every child saved at St. Jude means doctors and scientists worldwide can use that knowledge to save thousands more children. Families never receive a bill from St. Jude for treatment, travel, housing and food — because all a family should worry about is helping their child live. To learn more, visit stjude.org or follow St. Jude on social media at @StJudeResearch.