Preventing Cancer with Two Injections, A Clinical Review of the HPV Vaccination
Human Papilloma Virus (HPV) has become a major public health concern in the United States. HPV has high subclinical infection rates and is a major cause of preventable cancers (cervical, vaginal, vulvar, anal, penile, and oropharyngeal).1,2 Despite availability of an effective vaccine against several common and carcinogenic strains of HPV, it remains the most common STI.2 Gardasil 9 is a widely available vaccine that protects against nine strains of HPV. Seven of those strains are known to cause a wide range of cancer, and the other two strains are the most common cause of condylomas (genital warts).3 Yet, patients are not completing this vaccination series. There are a constellation of reasons for this, including failure of the provider to offer it to patients and patient refusal.4 Either way this easy public health intervention is significantly underutilized. This review explores the infection process of HPV; its link to cancer; a comparison of vaccines offered in the past, such as Cervarix and Gardasil 4, compared to the currently offered Gardasil 9; and finally, an exploration of the beliefs and views around vaccination of the STI and cancer by looking at patient/physician stances against the vaccine tied with the ways to help patient compliance.