By Melinda Young
The most common sexually transmitted infection, human papillomavirus (HPV), also leads to a range of cancers in 10% of people infected with the virus. The most effective preventive measure is the HPV vaccine, which protects against seven high-risk, cancer-causing types, according to research.1 Cancers caused by HPV include cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers.1
Healthcare professional groups recommend providers discuss and encourage vaccination with everyone who is age eligible. The World Health Organization called for global action to achieve a 2030 target of fully vaccinating 90% of girls by the age of 15 years.2
The HPV vaccine was approved in 2006. It is available for prevention of genital warts and six types of cancer. Still, the United States has not reached the desired vaccination rate of 80%.1,2
“The HPV vaccine has never reached optimal levels [of vaccination] in the U.S. since the day it was approved,” says Ellen M. Daley, PhD, MPH, professor and senior associate dean for research and practice at the College of Public Health, University of South Florida in Tampa. “It never hit an 80% coverage rate in adolescents, which is the rate that would get to herd immunity,” she says. “With COVID, unfortunately, we took a bigger hit because there was so much mistrust and misunderstanding about vaccines.”
Plus, the pandemic led to people not taking their children to doctor visits for a long time, so all vaccination rates declined. “The whole issue about the HPV vaccine is there are continual barriers and continual factors that make it difficult to vaccinate as many adolescents as we hope to vaccinate,” Daley says.
The chief motivation to encouraging pre-teens and young people to be vaccinated is to reduce cancer rates. “Cancer prevention is the focus we always wanted to take,” Daley says.
“The way HPV is transmitted is another factor,” she adds. “You look at what the transmission is — in this case sexually transmitted.”
Marketing this message is a challenge because HPV is a sexually transmitted infection (STI), and public health officials and providers are asking parents to have their children, as young as 9 years of age, vaccinated against an STI. “It’s harder to talk to parents about it, and often physicians are uncomfortable because you are talking about adolescents and sexuality,” Daley explains. “So, we always wanted to make sure the focus is on cancer prevention, and this is a huge component.”
Any changes to how the HPV vaccine is distributed, including insurance coverage, public health messaging, and public perception, will have an effect on HPV-related cancer rates decades in the future, says Morgan Richardson Cayama, MPH, a graduate research assistant and PhD candidate in the College of Public Health at the University of South Florida in Tampa.
The United States could improve its HPV vaccination rate by adding it to the school schedule of required vaccines or offering free vaccines in school. Australia very quickly reduced HPV infection among young women by 77% and precancerous abnormalities by 34% among people 20 to 24 years of age.3 Australia’s success is the result of the nation’s free HPV immunization program and its program of providing vaccines to students in schools. Parents fill out a vaccination consent form, and the child is vaccinated.3-5
It is possible the United States will backslide in its limited success with the HPV vaccine if public policy no longer promotes vaccines or the HPV vaccine, specifically. For example, if the current presidential administration chooses to stop Medicaid coverage of HPV vaccination or if educational information, including what is posted on the website of the Centers for Disease Control and Prevention, is erased, these actions could greatly reduce the number of adolescents who receive the vaccine.
“The choices parents make today or if they are restricted from [having a choice] because of the current administration, will have impacts that we will see years down the road,” she says. Even those who are not vaccinated as adolescents can ask for the vaccine when they are adults — through age 45 years, she notes.
Current barriers to HPV vaccination include parents’ perceptions of acceptability and need. “If they don’t feel like their children are at risk or they don’t like to imagine their children getting an STI, then they won’t vaccinate,” Richardson Cayama explains. “One thing research has shown, and which we talk about in our current study, is there’s this disconnect between HPV and these other types of cancers.”
For instance, the HPV vaccine was originally marketed for cervical cancer prevention, but now there is evidence that it is connected to oropharyngeal cancer. That cancer can strike anyone, but it is more common in men. HPV also can lead to anal cancer and other types of cancer.
“There’s this lag in public understanding of all these different cancers, and a lot of our research has been looking at getting providers involved in this conversation,” Richardson Cayama says. “What are other avenues to having conversations with parents about the vaccine and what are other opportunities to get the vaccine?”
When asked about where parents would prefer their children receive the HPV vaccine, the top answer was the pediatrician’s office and family practice clinic. Other options were school health offices, public health departments, and dental offices. They rated dentists as low on the scale of convenience, she adds.
From a public health perspective, dental offices would be a convenient place for adolescents to be vaccinated because most families have their children visit the dentist once or twice a year. Dentists should learn more about oropharyngeal cancer since they can check patients for signs of oral cancer on the lips, tongue, cheek, floor of the mouth, and hard and soft palate, according to the Cleveland Clinic.6
This also makes it a good fit for dentists to help patients prevent oral cancer caused by HPV. They can be reimbursed by insurance for administering the vaccine. “It’s such an opportunity, but people are not making the connection,” Daley says.
“Dentists should be educating their patients and themselves about HPV,” Daley says. “Dentists should be discussing this with their patients in states where dentists can give the vaccine.”
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1. Owens H, Daley EM, Richardson Cayama M, et al. Missed opportunities for adolescent HPV vaccination in the United States: Parents’ perceptions of a range of healthcare providers and settings. J Cancer Educ. 2025; Jan 31:10.1007/s13187-025-02572-8. [Online ahead of print].
2. Desch J, Thompson E, Beckstead J, et al. Improving United States HPV vaccination rates: Factors predictive of parental attitudes towards middle school entry requirements. Human Vaccin Immunother. 2024;20(1):2390231.
3. Australian Government, Department of Health and Aged Care. School based vaccinations for teens. Feb. 4, 2020. https://www.health.gov.au/news/school-based-vaccinations-for-teens
4. Healthdirect. How the HPV vaccine is eliminating cervical cancer in Australia. Feb. 13, 2023. https://www.healthdirect.gov.au/blog/cervical-cancer-could-be-eradicated-within-40-years
5. Canfell K. An Australian success story: The HPV vaccine. Cancer Council NSW. Jan. 9, 2017. https://www.cancercouncil.com.au/news/australian-success-story-hpv-vaccine/
6. Cleveland Clinic. Can your dentist screen for oral cancer? Cleveland Clinic, Health Essentials. April 12, 2022. https://health.clevelandclinic.org/does-your-dentist-screen-for-oral-cancer-why-its-a-good-idea
The most common sexually transmitted infection, human papillomavirus (HPV), also leads to a range of cancers in 10% of people infected with the virus. The most effective preventive measure is the HPV vaccine.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content