HPV: Health Risks, Vaccine Efficacy, and Current Recommendations

Human papillomavirus (HPV) is the most common sexually transmitted infection. Over 200 genotypes; ~40 infect genital mucosa.

Oncogenic Potential

• High-risk (hrHPV): 16, 18, 31, 33, 45, 52, 58 cause ~90% cervical, 70% oropharyngeal, 90% anal, 75% vaginal, 70% vulvar, 60% penile cancers.
• Low-risk: 6, 11 cause 90% anogenital warts; recurrent respiratory papillomatosis.

Vaccination

9-valent (Gardasil 9): Covers 6, 11, 16, 18, 31, 33, 45, 52, 58.

• Routine: Ages 11–12 (can start at 9); 2-dose series if <15, 3-dose if ≥15 or immunocompromised.
• Catch-up: Through age 26 for all; shared decision-making 27–45.
• MSM and immunocompromised: Vaccinate through age 26 (or older per guidelines).

Safety & Impact

• >135 million doses distributed in US; safety profile excellent (syncope, injection-site reactions most common).
• Population-level data: >80% reduction in vaccine-type HPV prevalence, genital warts, and CIN2+ in vaccinated cohorts.

Screening Still Needed

Vaccine doesn’t cover all hrHPV; cervical screening (primary HPV test) remains essential per guidelines.