Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Gardasil9® is the only HPV vaccines on the market. It helps prevent cervical cancer and genital warts in boys and girls.
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Table of Contents for HPV (Human Papillomavirus)
How do you get HPV?
How many people get HPV every year?
What are the symptoms of HPV?
How soon do symptoms appear?
What are complications of HP?
Is HPV disease contagious?
How is HPV treated?
How effective is the HPV vaccine?
What is the immunization schedule for HPV?
What are HPV vaccine names?
Human papillomavirus (HPV) is a common sexually transmitted infection. It is so common that nearly all men and women who are sexually active will get at least one type of HPV. Some types of HPV cause health problems like genital warts or cervical cancer.
HPV is a virus that spreads through contact with infected skin, usually during sexual intercourse. Sometimes pregnant women also spread HPV to their baby during vaginal delivery.
The most common way people get HPV is by having oral, vaginal, or anal sex with someone who has HPV. Even people who do not have any symptoms can spread HPV to other people. The symptoms may not appear for years after you have sex with someone who has HPV.
Every year, around 14 million people are newly infected with HPV in the United States, around 360,000 get genital warts, and around 11,000 women get cervical cancer. There are currently around 79 million Americans who have HPV.
HPV usually goes away on its own and does not cause any symptoms, but some types of HPV cause genital warts and cancer in the cervix, vulva, anus, or penis.
The symptoms of genital warts may appear within weeks or months of having sex with an infected person, or not at all. The symptoms of genital warts may include:
- Small bump or a group of bumps in the genital area
- Warts may be big or small, raised or flat
- Cluster of warts shaped like cauliflower
- Warts on the vagina, anus, cervix, penis, scrotum, groin, or thigh
The type of HPV that causes genital warts is not the same one that causes cancer. However, there are many types of HPV that do cause cancer.
HPV frequently causes cervical cancer in women, but it can also cause cancers of the vulva, vagina, penis, or anus. HPV can also cause a cancer called oropharyngeal cancer in the back of the throat and the base of the tongue and tonsils. These cancers may not cause symptoms for years or even decades after infection with HPV.
The symptoms of cervical cancer may include:
- Irregular menstrual bleeding
- Bleeding after sexual intercourse
- Pain in the back, leg, or pelvis
- Weight loss
- Vaginal discomfort or odorous discharge
- Leg swelling
Most people do not know they are infected with HPV because they never develop symptoms. Some people only learn they are HPV-positive when they develop genital warts. Women are often diagnosed after they get an abnormal Pap test during cervical cancer screening.
HPV causes cancer in approximately 17,600 women and 9,300 men every year. High-risk types of HPV cause the following cancers:
- Cervical cancer (almost 100%)
- Anal cancer (95%)
- Oropharyngeal cancer (70%)
- Vaginal cancer (65%)
- Vulvar cancer (50%)
- Penis cancer (35%)
Yes. If you are sexually active, you can lower your chances of getting HPV by using latex condoms, but HPV can infect areas that are not covered by a condom. You can also reduce your risk of getting HPV by only having sex in a mutually monogamous relationship.
There is no cure for HPV infection, although the immune system usually eliminates the virus from the body on its own. Approximately 90% of women who are infected with HPV will be HPV-negative within two years without any specific treatment. However, a small percentage of people develop persistent infections for many years.
The first HPV vaccine is Gardasil® manufactured by Merck & Co. and it was approved in the United States in 2006. Gardasil protects against four types of HPV (16, 18, 6, and 11). These types are associated with more than 90% of cases of genital warts and 80% of cervical cancers.
Gardasil was approved for males in 2009, the same year a second HPV vaccine called Cervarix® (GlaxoSmithKline) was approved for use in females in the United States against HPV types 16 and 18. Cervarix was pulled off the market in the U.S. in October 2016 due to lack of demand.
Gardasil is no also no longer sold in the United States. It was replaced by a third HPV vaccine called Gardasil 9® that was licensed in 2014. It protects against the same 4 types of HPV as the original Gardasil, plus 5 more cancer-causing types of HPV (31, 33, 45, 52 and 58). These additional 5 types cause 11% of all HPV-associated cancer.
The vaccine is an inactivated (not live) vaccine, which means it has parts of the HPV virus that can’t cause disease-like symptoms or HPV.
All three HPV vaccines are nearly 100% effective at preventing cervical cancer for more than 10 years after vaccination. For girls, the vaccine prevents pre-cancerous cervical cell changes caused by HPV.
For boys, Gardasil is 89% effective at preventing genital warts and 78% effective at preventing pre-cancerous changes of the anus.
The CDC recommends routine HPV vaccination of boys and girls at the age of 11 or 12 years old. The immunization schedule depends on the age when the first dose of the vaccine was given.
For people who got their 1st dose before they were 15 years old, the immunization schedule is 2 doses, separated by 6-12 months.
For people who got their 1st dose after they were 15 years old, the immunization schedule is 3 doses. The 2nd dose is given 1-2 months after the 1st dose. The 3rd dose is given 6 months after the 1st dose and at least 12 weeks after the 2nd dose.
- Gardasil – no longer marketed in the U.S.
- Gardasil 9
- Cervarix – no longer marketed in the U.S. (October 2016)
Yes. HPV vaccines are relatively new and they are being monitored for serious or unusual side effects.
The most common side effects of the HPV vaccine are mild problems like pain, redness, swelling, and itching where the shot was injected. These side effects usually go away in a few days without treatment.
HPV vaccines can cause a severe allergic reaction known as anaphylaxis within a few minutes or hours. Symptoms may include hives, throat swelling, skin rash, nausea, vomiting, difficulty breathing, and shock.
There is also a risk of Shoulder Injury Related to Vaccine Administration (SIRVA) if the vaccine needle punctures the bursa or ligaments in the shoulder. SIRVA can cause chronic pain and shoulder weakness.
Other serious side effects like Guillain-Barre Syndrome and deaths have been reported, but studies have not detected a pattern that suggests an association with the HPV vaccine.