Even the Unvaccinated are Protected by HPV Vaccine
Jul 10, 2012

A new study published in Pediatrics is getting a lot of media attention today.  CBS News, HealthDay News, The Inquisitr and Examinir.com, are among the many news outlets that have been reporting about the human papillomavirus (HPV) vaccine.
The results of the study show that the HPV vaccine has been effective at reducing the number of infections that people are getting, while also protecting those people who haven’t been vaccinated.  The study abstract concludes that

“four years after licensing of the quadrivalent HPV vaccine, there was a substantial decrease in vaccine-type HPV prevalence and evidence of herd protection”.

The abstract specifically states that

“the prevalence rate for vaccine-type HPV decreased substantially from 31.7%–13.4% and the decrease in vaccine-type HPV not only occurred among vaccinated (31.8%–9.9%) but also among the unvaccinated (30.2%–15.4%)”.

Since vaccine critics often question the validity of “herd immunity”, it’s encouraging that this study was able to illustrate the reduction of disease, not only in the vaccinated population, but also among the unvaccinated.  The simple suggestion is that if we can protect a critical portion of the community from ever contracting these particular strains of HPV covered by the vaccine, than we can effectively reduce the overall transmission of these viruses and reduce the incidence of infection even among those who remain unvaccinated.  This is especially good news since the vaccine has had less than optimal uptake since it was first recommended to pre-teen girls several years ago.
In evaluating the disappointing vaccination rates, many believe that there have been a number of possible reasons.

• Some have claimed that parents may be less agreeable to vaccinating for HPV (as opposed to other diseases) because it requires genital contact for transmission.  The argument some parents make is that they are uncomfortable with vaccination their children because they believe than in doing so they are somehow communicating consent for their young children to engage in sexual behavior that they feel is inappropriate at their age.  Certainly the age recommendations, chosen to ensure that children receive the full series of three vaccines before their first sexual encounter, may be an obstacle for some parents.
• Additionally, some have criticized health care providers for not being more diligent in offering the vaccine to preteens and discussing the benefits fully with parents.
• Still others suggest that parents – concerned about the safety of the vaccine as a result of widely distributed, yet unsubstantiated claims of injury – are extremely emotional, nervous and less likely to agree to vaccinate their children.

Whatever the reasons that are impacting these parental decisions, public health officials continue to try to address parental concerns with solid scientific evidence, and this recent study simply helps to demonstrate the effectiveness of this vaccine.
The fact remains that approximately 20 million Americans are currently infected with HPV and about 6 million people becoming newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.  In the U.S. alone, this results in about 1% of sexually active adults getting genital warts, almost 12,000 women getting HPV-associated cervical cancer and thousands of other women getting HPV-associated vulvar and vaginal cancer.
And now, with the HPV vaccine recommendations recently extending to young males, there is a concentrated effort to also prevent thousands of men from eventually getting HPV-associated penile, anal and throat cancers. 
The study abstract concludes with an interesting note which explains that the nonvaccine-type HPV was noted to increase among the study participants from 60.7%–75.9% during the observation period.  While it is suggested that this information be further analyzed, I felt that it seemed to suggest that the vaccine was effective in reducing the vaccine-type HPV, while also demonstrating that  sexual relations will continue to spread those viruses that are not covered by the vaccine at this point in time. Perhaps this will not only help validate the effectiveness of the current HPV vaccine, but also encourage and support development of an even better vaccine that can effectively cover more viruses.
Until that day comes, we can be grateful that the current HPV vaccine covers the most common viruses and that those who do vaccinate will be helping to prevent further spread of this disease, even among those who choose not to be vaccinated.

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