Whenever I have talked about the HPV vaccine as an anti-cancer vaccine, I am usually met with at least a modicum of skepticism. For so long, we have associated vaccines as agents to protect us from Acute infectious diseases—small pox, polio, diphtheria, tetanus, measles, among others. Our lifelong experience with vaccines has not allowed us to get our heads around the concept that, for the first time in history, a vaccine has been developed whose primary objective is to stave off cancer. The most recent iteration of the HPV vaccine will likely prevent at least 90 percent of cervical cancers. It is hoped that the current vaccine will prevent the majority of the HPV associated head and neck cancers. It is therefore imperative that boys and girls be vaccinated if they are to be protected from these potentially lethal cancers.
People have generally been confused as to why the vaccine is called the HPV vaccine if its goal is to prevent cancer. This is where the story becomes a bit confusing so please bear with me. The vaccine is actually a vaccine against a virus; the HPV or human pappilloma virus. In this way it is similar to all other vaccines with which we are familiar. However, unlike almost all other viruses and bacteria which we are vaccinated against, HPV does not cause an acute illness. In fact, in the vast majority of people, the virus will never cause any problems during a lifetime. However, in a very small minority of people, the virus produces a smoldering inflammation without producing symptoms. Then, after a decade or longer, this chronic inflammation, will finally reveal itself; typically as a bump on the cervix or tongue. In the case of the cervix, this is usually detected with a PAP smear and, if treated in its early stages, can arrest the inflammation before full blown cancer develops. In the case of the mouth and throat, the bump usually indicates cancer. In short, the vaccines goal is to prevent acquisition of HPV, a sneaky virus capable of damaging out tissues without us being aware, until emerging decades later as cancer.
The HPV virus is ubiquitous. It is estimated that 70 million Americans have contracted the virus. However, as I mentioned earlier, in only a small minority is it actively damaging tissue. These 70 million people are therefore unaware that they harbor HPV and are unwitting transmitters of the virus. The virus is generally acquired through sexual contact. Therefore, it is recommended that the vaccine be given to boys and girls before they become sexually active. The immune response to the vaccine is most robust around age 11 or 12 and therefore the vaccine should be administered at this age. Although less effective with advancing age, the vaccine can be given into the early 20s.
As a physician approaching the twilight of my career, I continue to be awed by the incredible advances being made in virtually every arena of science. When I began my career in 1979, I never would have imagined that a shot could protect us from cancer. It is simply amazing. It is no less amazing than the Salk vaccine against polio; a vaccine which interestingly enough was slow to gain acceptance in the United States due to fear and misunderstanding. Thousands of people succumbed to polio at a time when it was eminently preventable. Hopefully, in the case of HPV, history will not repeat itself.
I encourage all parents to vaccinate their children and protect them from cervical and mouth and throat cancer. For those wishing to learn more about the HPV vaccine, as well as the other childhood vaccines, I encourage you to attend the vaccine forum that will be held at Falmouth High School September 16 at 7 PM. Experts in infectious disease, pediatrics, and cancer will be presenting current information as well as answering questions you may have.
For more information about the forum contact Kelly Welch 508-566-3610
Dr. Fishbein is Director Community Outreach for Falmouth Hospital Cancer Committee