Skip to main content

The HPV Vaccine: Public Health or Profit?


As students go back to school and receive physicals and vaccines, parents may be asked if they want their child to receive the Human Papillomavirus (HPV) vaccination.  The HPV vaccination is recommended for boys and girls ages 11 or 12 but can be received by males or females from ages 9 to 26, according to healthychildren.org. The vaccine protects against certain strains of HPV, which can lead to cervical cancer, penile cancer, rectal cancer, and oropharyngeal cancer.

What Is HPV?
In order to make an informed decision about whether or not to vaccinate their children against HPV, parents need to know what HPV is.  HPV is a sexually transmitted infection.  It is transmitted through contact with the genitals or the rectum of an infected individual.  HPV is a virus, so it is easily transmitted on contact.  The Centers for Disease Control and Prevention (CDC) has indicated there is a prevalence rate of 45.2% of any type of HPV in men.  There is a prevalence rate of  39.9% of any type of HPV in women.  "Prevalence" means the number of people in the population that have a disease at any given time.  The above data was collected from 2013-2014. That means that in 2013-2104, nearly one out of two men and two out of five women ages 18-59 had some form of HPV during that year. During the same time frame, there was a prevalence rate of 25.1% of high risk HPV in men, and a 20.4% high risk HPV prevalence rate in women.  High risk HPV are the strains that may cause cancer.  This data means that in the 2013-2014 time frame, one out of four men were infected with the high risk form of HPV, and one in five women were infected with the high risk form of HPV.

How Does HPV Cause Cancer?
As mentioned above, not all strains of HPV cause cancer.  Some individuals may have HPV and never even know.  The virus may go away on its own.  Other times, the individual may have acquired high risk strains of HPV.  Two high risk types, 16 and 18, cause 70% of cancers from HPV. These high risk strains may cause genital warts and the more aggressive high risk strains may cause cancer. Someone may live with HPV for years and never even know they have the infection.  The strains cause cancer when the virus comes into contact with the epithelial cells in the cervix, the rectum, the mouth, and the penis.  The virus infects the cells and causes them to become precancerous or dysplastic. It is also called cervical intraepithelial neoplasia (CIN). This basically means the cells of the cervix have had a new abnormal growth.  This growth was caused by the HPV virus.  In Stage I cervical cancer, the cancer has spread to the cervix. In Stage II, the cancer has spread to the cervix and the uterus.  Pap smears test to determine the presence of CIN. Different treatments are available if CIN3 is found on the pap smear. Once CIN3 has developed, the individual is at greater risk for the cancer to spread to other parts of the body. Different treatment options include Loop electrosurgical excision procedure (LEEP), conization, and cryotherapy. For stage I cervical cancer, a hysterectomy may be a treatment option. Vaccines and pap smear screenings help to prevent cervical cancer.
Photo Courtesy of National Cancer Institute on GettyImages.com

How Much Does the HPV Vaccine Cost?
The vaccine costs between $130 and $150 per the Association of Reproductive Health Professionals. The vaccine requires a series of three shots, so the total cost of the vaccinations is between $390 and $450.  However, to put the cost comparison in perspective, a LEEP cure can cost the patient approximately $31,347.  The LEEP procedure also is considerably more painful and requires more recovery time than vaccinations. Conization may range in price from $2,500 to $8000 per treatment and cryotherapy could range from $500 to $800 per treatment. The latter two treatment costs do include follow-up visits and treatments ensuring a cure has occurred.  Hysterectomies used for treatment of stage I cervical cancer can cost between $31,000 and $51,000. Failure to prevent, screen or treat cervical cancer caused by HPV can cost the ultimate price, a human life.

Is the HPV Vaccine Just A Way To Make Money?
It is true that if parents choose to get the HPV vaccines for their children or if anyone at any age chooses to get the HPV vaccines, the pharmaceutical company will make money. It is also true that when someone visits a doctor or a hospital that the doctor or hospital will make money.  It is also true that the costs of treating cervical cancer that develops from HPV is far greater than the cost of the vaccine.  Thus, in the long term, the opportunity cost (that means money lost from not receiving a benefit, e.g. a vaccine)  for not having the vaccine is considerably higher than having the vaccine. Moreover, getting the HPV vaccine begins the process of herd immunity.  In herd immunity, when more people are vaccinated fewer people have a risk of acquiring the virus. Therefore, the benefits of getting the vaccine may far outweigh the risks (and cost savings) of not getting the vaccine.

Sources
Healthychildren.org. HPV (Human Papillomavirus) Vaccine: What You Need To Know (VIS). Found online at: https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/HPV-Gardasil-9-What-You-Need-to-Know.aspx?gclid=EAIaIQobChMIzeLTqt_c1QIV2LfACh0TwAsTEAAYASAAEgKJM_D_BwE
Centers for Disease Control and Prevention. Human Papillomavirus (HPV). Genital HPV Infection - Fact Sheet. Found online at: https://www.cdc.gov/std/hpv/stdfact-hpv.htm
Centers for Disease Control and Prevention. National Center for Health Statistics. Prevalence of HPV in Adults Aged 18-69: United States, 2011-2014. Found online at: https://www.cdc.gov/nchs/products/databriefs/db280.htm
Mayo Clinic. HPV Infection: How Does It Cause Cervical Cancer? Found online at: http://www.mayoclinic.org/diseases-conditions/cervical-cancer/expert-answers/cervical-cancer/faq-20057909
Johns Hopkins Medicine. Sidney Kimmel Cancer Center/Centers & Clinics. Cervical Dysplasia. Found online at: http://www.hopkinsmedicine.org/kimmel_cancer_center/centers/cervical_dysplasia/diagnosis_and_treatment/abnormal_pap_test.html
American Academy of Family Physicians (AAFP). CDC: HPV Infection Rates Remain High in Both Men, Women. Found online at: http://www.aafp.org/news/health-of-the-public/20170418hpvrates.html
familydoctor.org. Human Papillomavirus (HPV). Found online at: https://familydoctor.org/condition/human-papillomavirus-hpv/
ACOG. The American Congress of Obstetricians and Gynecologists. Abnormal Cervical Cancer Screening Test Results. Found online at: https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results
American Cancer Society. HPV and Cancer. Found online at: https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html
Amercian Cancer Society. Cervical Cancer Stages. Found online at: https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/staged.html
World Health Organization. Human Papillomavirus (HPV) and Cervical Cancer. Fact Sheet. Found online at: http://www.who.int/mediacentre/factsheets/fs380/en/
American Cancer Society. Treating Cervical Cancer.  Found online at: https://www.cancer.org/cancer/cervical-cancer/treating.html
Association of Reproductive Health Professionals. Health Matters Fact Sheet. Understanding HPV Vaccines. Found online at: http://www.arhp.org/Publications-and-Resources/Patient-Resources/Fact-Sheets/Understanding-HPV-Vaccine
Healthcare BlueBook. Cervical Cone Biopsy. Found online at: https://healthcarebluebook.com/page_ProcedureDetails.aspx?cftId=369&g=Cervical+Cone+Biopsy
E.L. K. Parviainen. Gynecological Cryosurgery Treatment & Management. Medscape. Jan. 26, 2015. Found online at: http://emedicine.medscape.com/article/269982-treatment#d14
K.N. Wright, G.M. Jonsdottir, S. Jorgensen, N. Shah, J.I. Einarsson. Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies. Journal of the Society of Laparoendoscopic Surgeons. Oct-Dec. 2012. Found online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558885/


Comments