The HPV vaccine given to US preteens and young adults is designed to head off six different cancers, not one. Cervical cancer is the best known.
But throat cancer caused by the same virus has quietly overtaken cervical cancer as the most common HPV-linked cancer in the country. It is showing up most often in men.
Gardasil 9 is the only HPV vaccine now used in the United States, according to the American Cancer Society.
It targets nine strains of the human papillomavirus, the family of viruses behind cancers of the cervix, anus, penis, vulva, vagina, and the back of the throat.
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What the vaccine actually blocks
The Centers for Disease Control and Prevention estimates that HPV vaccination prevents more than 90 percent of HPV-attributable cancers when given on time. That claim rests on years of real-world tracking, not just clinical trials.
Among vaccinated women, the share of cervical precancers caused by the HPV types the shot targets has dropped by about 40 percent. Cervical precancer rates in screened 20 to 24 year olds, the group most likely to have been vaccinated, have fallen sharply since the vaccine rolled out.
HPV types 16 and 18 alone drive roughly 70 percent of cervical cancers, and five other high-risk types included in Gardasil 9 (31, 33, 45, 52 and 58) add another 20 percent. Two low-risk types in the vaccine, 6 and 11, cause most genital warts.
The cancer most people do not associate with HPV
Cervical cancer is what most people picture when they hear "HPV." But oropharyngeal cancer, which affects the back of the throat, base of the tongue and tonsils, has surpassed cervical cancer as the most common HPV-related malignancy in the United States.
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More than 21,000 HPV-associated oropharyngeal cases are reported in the US yearly, compared with about 12,000 cervical cancer cases. It shows up in men about four times as often as in women.
There is no routine screening test for throat cancer the way there is for cervical cancer. That is part of why prevention through vaccination matters, especially for boys and men who were never offered the shot as adolescents.
Who is eligible, and at what dose
CDC guidance depends on the age at which vaccination begins.
Age at first dose Also read: Never being married may raise your cancer risk more than most people realize | Recommendation | Doses |
|---|---|---|
9-14 | Routine Also read: What should your VO2 max be? The healthy range sorted by age and sex | 2 doses, 6-12 months apart |
15-26 | Catch-up | 3 doses over 6 months Also read: Sugar-free soft drinks may reduce cravings for sweets, new study finds |
27-45 | Shared decision with a clinician | 3 doses |
For people with weakened immune systems, including those with HIV, the CDC recommends three doses regardless of age at the start of the series. The Food and Drug Administration has approved Gardasil 9 for use up to age 45.
Above 26, benefits are smaller because many people have already been exposed to some HPV types. The CDC advises adults 27 through 45 to discuss the decision with their doctor rather than routinely vaccinating.
The US target that is still out of reach
The American Cancer Society's Mission: HPV Cancer Free campaign set a goal of vaccinating 80 percent of 13 year olds in the United States by 2026. Coverage is still short of that mark.
In the CDC's 2024 National Immunization Survey-Teen, 78.2 percent of adolescents aged 13 to 17 had received at least one dose, and 62.9 percent were up to date with the full series. Both figures are roughly the same as the year before and well below the 80 percent up-to-date target.
Coverage also varies sharply by geography. Adolescents in rural areas trail those in metropolitan principal cities by about 11 percentage points on both first-dose and up-to-date coverage.
What to do if you are not sure you are protected
Ask your primary care clinician or pediatrician to look up your immunization record. Many states also let residents check their own status online through the state immunization information system.
If you started the series but never finished, you do not need to restart. Additional doses count toward the same schedule. Adults up to age 45 who are considering the shot can raise it at a routine visit and go through the decision with their doctor.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.