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HPV Vaccine Study Finds Zero Cases Of Cervical Cancer Among Women Vaccinated Before Age 14

A historic new study out of Scotland shows the real-world impact of vaccines against the human papillomavirus: The country has detected no cases of cervical cancer in women born between 1988-1996 who were fully vaccinated against HPV between the ages of 12 and 13.

Many previous studies have shown that HPV vaccines are extremely effective in preventing cervical cancer. But the study, published on Monday in the Journal of the National Cancer Institute, is the first to monitor a national cohort of women over such a long time period and find no occurrence of cervical cancer.

"The study is super exciting. It shows that the vaccine is extremely effective," said Kathleen Schmeler, a professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center, who was not involved in the research. "It's obviously early. We're just starting to see the first data of the impact of the vaccine because it takes so long from the time of the vaccine to the effects."

The results underscore the importance of working to increase uptake of the HPV vaccine in the U.S., said Schmeler. Scotland, for example, introduced routine immunization in schools in 2008, and close to 90% of students in their fourth year of secondary school (equivalent to 10th grade in the U.S.) in the 2022-2023 school year had received at least one dose of the vaccine. In the U.S., where HPV vaccines are not administered in school, uptake among adolescents ages 13 to 17 is a little over 60%.

The study also points to how crucial the timing of vaccination is. "The girls that didn't develop any cancer were vaccinated before becoming sexually active," said Schlemer. "So we should not wait to vaccinate folks and really do it, for the guidelines, prior to becoming sexually active."

The authors of the Scotland study monitored the records of all women born between 1988 and 1996 who were eligible for cancer screening, about 450,000 women. Of that group, 40,000 were vaccinated between the ages of 12 and 13, and 124,000 received the vaccines at or after 14 years of age. The remaining women, nearly 300,000, were not vaccinated.

No cases of cervical cancer were found among the women who were vaccinated before they turned 14, even if they had only received one or two doses of the vaccine rather than the full, three-dose protocol. Also noteworthy is that women who received the three-dose protocol between the ages of 14 and 22 also benefited significantly. While some cases of cervical cancer were recorded in this group, the incidence (3.2 cases per 100,000 women) was two and a half times lower than among unvaccinated women (8.4 cases per 100,000 women).

"I was very surprised that there were no cases" of cancer in the group who received vaccines before 14, said Tim Palmer, the former clinical lead for cervical screening in Scotland and an HPV immunization consultant at Public Health Scotland, who was a lead author of the study. "In that age group, I expected about 15 to 17 a year in Scotland — and we have had none."

The types of vaccine administered to the cohorts monitored in the study changed as newer ones became available, covering more types of HPV. Until 2012, the vaccine in use was the bivalent Cervarix, targeting HPV 16 and 18. Then the quadrivalent Gardasil was administered until 2023, when the nonavalent Gardasil 9 was introduced.

This is why it's still possible that cervical cancers may still arise even in vaccinated women, caused by the HPV strains not targeted by the earlier vaccines. "There are obviously other HPV types that cause cancer," Palmer said, noting that the current results don't mean cases of cervical cancers, caused by less high-risk strains of HPV, won't emerge in the analyzed cohort in the future.

The study's findings don't diminish the need for continued screenings for early detection of cervical cancers caused by HPV types that were not targeted in the original bivalent vaccine, said Palmer, but the vaccines effectively targeted the more aggressive strains of HPV (16 and 18).

The impact of the vaccination was also greater among women of lower socioeconomic status, who otherwise reported higher occurrences of cancer, said Palmer.

Ville Pimenoff, a senior researcher at the Karolinska Institutet and professor at the University of Oulu in Finland, published the results of a large cohort study in Finland in November 2023, which showed the effectiveness of cohort vaccination in creating herd immunity against HPV. He said the results from Scotland confirm his findings. "When you vaccinate in a cohort way, there seems to be very strong, protective immunity in those communities," said Pimenoff, who was not involved in the Scottish study.

HPV Vaccination: Know Why It Is Important For Adults Aged 35-45 Years To Remain Aware Of The Vaccine

Cervical cancer is one of the common types of cancer seen in women causing higher mortality and morbidity rates. The HPV vaccine is vital to prevent cervical cancer and even other cancers. There is a lack of awareness about the HPV vaccination in the general population. The vaccine is given from the age of 9 years or preferably before the age of first sexual activity and even adults aged 35-45 are eligible for the HPV vaccine. Both women and men need to discuss getting vaccinated without fail. By targeting the human papillomavirus, the vaccine significantly reduces the risk of developing potentially life-threatening conditions in recipients. However, it's not just about individual protection and widespread vaccination can lead to herd immunity, slowing down the spread of HPV within communities and ultimately reducing the incidence of related cancers. Debunking myths and emphasizing their safety and efficacy can encourage more people to get vaccinated. There are several reasons which prevent people from getting vaccinated.

Dr Sushruta Mokadam, consultant obstetrician at Motherhood Hospital, Kharadi, Pune said, "There is no knowledge about  HPV vaccination. Limited promotion and education campaigns focus on younger populations, and inadequate dissemination of expanded age guidelines contribute to lower awareness of HPV vaccination among older individuals. For adolescents and young adults, it protects potential exposure to HPV and prevents various HPV-related diseases. The vaccine is less effective in the age group 27-45, if already exposed to HPV but can still protect against new HPV types. It is not too late to get vaccinated at age 45. The vaccine may still provide some protection against HPV-related diseases, particularly for those not previously exposed to HPV." 

She also added, "The HPV vaccine has shown efficacy in preventing HPV infection and related diseases in older populations.  Men can receive the HPV vaccine later in life to protect against HPV-related diseases. Age and vaccination history determine the number of doses, ranging from two doses for individuals aged 9-14 to three doses for those aged 15 and older. HPV vaccination helps to safeguard from new HPV infections but is not effective in treating existing HPV infections or diseases. HPV vaccine gives good results when taken before any exposure to HPV. However, the HPV vaccine is not recommended for use during pregnancy. Women should take this vaccine during the adolescent age for better protection against cervical cancer and other infections. Remember to consult an expert for personalized advice on HPV vaccination based on individual circumstances."

ALSO READ: Cervical Cancer Awareness Month 2024: Alarming factors behind rising cases of the disease in younger women

Cervical Cancer Awareness Month: Benefits Of HPV Vaccine Other Than Cervical Cancer Prevention

Cervical cancer, primarily caused by the persistent human papillomavirus (HPV) infection, ranks among the leading causes of mortality in women. While cervical cancer is preventable, the focus often centres on the pivotal role of the HPV vaccine in averting this malignancy. However, the benefits extend far beyond cervical cancer prevention. Let's delve into the multifaceted advantages of the HPV vaccine that go beyond its primary objective, as per Dr. Uma Dangi, Consultant Medical Oncology, Fortis Hospital. 

Shielding Against Various Cancers

The HPV vaccine is not a one-dimensional defender; it acts as a robust shield against multiple cancers induced by high-risk HPV types. Beyond cervical cancer, it significantly reduces the risk of anal, penile, and oropharyngeal cancers, presenting a comprehensive protective measure against diverse malignancies.

Prevention of Genital Warts

Beyond the realm of cancer, the vaccine proves effective in curbing the incidence of genital warts. These warts, caused by low-risk HPV types, not only impact physical health but also contribute to improved overall sexual health when prevented by the vaccine.

Also Read:  Cervical Cancer Awareness Month: Here's Why HPV Vaccine Is Crucial For Men As Well

Transmission Prevention

The HPV vaccine's impact extends beyond the vaccinated individual, playing a crucial role in diminishing virus transmission within communities. Embracing the concept of herd immunity, it indirectly safeguards those who cannot be vaccinated, fostering a collective shield against HPV.

Reduced Pre-Cancerous Lesions

HPV infections can give rise to precancerous lesions in the cervix, vagina, and vulva. Unchecked, these lesions may progress to cancer over time. Vaccination significantly curtails the development of these pre-cancerous lesions, thwarting cancer at its nascent stages.

Herd Immunity at Work

A sufficiently vaccinated population creates a formidable barrier against HPV. This phenomenon, known as herd immunity, not only protects the majority but also extends benefits to individuals who cannot receive the vaccine due to medical reasons or age. It is a collective defence against HPV-related diseases.

Long-term Protection

The longevity of protection is a standout feature of HPV vaccines. Studies indicate immunity lasting at least two decades, if not more. By vaccinating at an early age, individuals can secure enduring protection throughout adulthood.

Also Read:  Cervical Cancer Awareness Month: Lifestyle Changes To Prevent Cervical Cancer In Women

Decreased Medical Costs

Beyond the realm of health, the HPV vaccine contributes to decreased medical costs associated with treating HPV-related cancers and conditions. These preventive measures translate into substantial savings at both individual and societal levels, easing the burden on healthcare expenses.

Bottomline

As we observe Cervical Cancer Awareness Month, it is crucial to recognize the holistic benefits that the HPV vaccine brings to the table. Beyond safeguarding against cervical cancer, it acts as a versatile shield, protecting against various cancers, minimizing transmission, and ensuring long-term immunity. Embracing the vaccine not only enhances individual well-being but also contributes to the collective health resilience of communities. Awareness, coupled with vaccination, becomes the cornerstone for a future where HPV-related diseases are increasingly preventable and manageable.

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