Can I Still Get the HPV Vaccine If I Am Older?

Can I still get the HPV vaccine if I am older?

Paul Offit: Hi, my name is Paul Offit. I am talking to you today from the Vaccine Education Center at the Children's Hospital of Philadelphia. And what I wanted to talk about was human papilloma virus, or HPV, the disease and the vaccine. So every year in the United States, about 30,000 people will develop cancer caused by HPV. Those cancers involve the head, neck, anal and genital region, and every year, 5,000 people die of HPV. The good news is there’s a vaccine to prevent it. That vaccine was first licensed in 2006, and initially, it was given to children between 11 and 13 years of age. More recently, that vaccine has been extended to include people between 27 and 45 years of age. So the question is: “Should older people also get this HPV vaccine?” And the current vaccine contains nine different serotypes of HPV that cause disease; it will protect against about 90% of the cancers that are out there. Should older people get this vaccine?

Now, the Centers for Disease Control and Prevention, or the CDC, has basically said that this decision should be a shared decision process with the clinician. In other words, they didn’t give it a full-throated recommendation, and there is a few reasons for this. I think one reason is that the best group to vaccinate are adolescents, meaning children around 11 to 13 years of age, because that’s before they have had sex and, therefore, it’s most likely to prevent then all the strains that are contained in that vaccine, whereas people who are older are more likely to have already been infected with one or more strains of HPV, so the impact, therefore, of the vaccine is less. Second, I think we have had trouble at some level of getting that vaccine into adolescents. Right now only about 55% of girls and 45% of boys get that vaccine, so we can do much better. It’s interesting that if you look at the adolescent group, about 80 to 90% will get the Tdap vaccine, tetanus, diphtheria, acellular pertussis, about 80 to 90% will get the meningococcus vaccine, whereas only about 50% get the HPV vaccine, and certainly HPV causes more suffering and more hospitalization and more death than all those other vaccines combined, so it doesn’t make a lot of sense.

The other thing is that of the countries in the world, about half those countries have HPV vaccine programs, and there is a limited supply. So I think the CDC is cognizant of that, and although there’s certainly plenty of vaccine to vaccinate America’s children, there isn’t a lot of vaccine to go around, so I think the CDC is sensitive to that. That’s why they didn’t give it a complete recommendation, but rather said it should be a shared decision-making process between the patient and the doctor.

Thank you for your attention.