The Centers for Disease Control and
Prevention (CDC) suggests that boys
and girls start the HPV vaccine series
at age 11 or 12. It is recommended up
through age 26 for women and age 21
for most men. Certain men, including
cancer survivors, are advised to get
vaccinated up through age 26.
Getting vaccinated reduces the risk
of HPV-related cancers, which include
most cervical cancers, as well as some
anal, genital and throat cancers, says
Wendy Landier, a pediatric nurse practitioner and cancer researcher at the
University of Alabama at Birmingham
who co-led the study.
Based on surveys completed
from 2012 to 2015, Landier and her
colleagues found that 33 percent
of female and 14 percent of male
cancer survivors ages 13 through 17
reported having started the vaccine
series, compared to 52 percent of
female and 34 percent of male adolescents in the general population.
More than 80 percent of sexually
active people in the U.S. will be
infected with HPV at some point
in their lives, although the immune
system clears most HPV infections on
its own, and only some strains of HPV
U.S. protects against seven cancer-
causing strains, as well as two
strains that cause genital warts. The
Affordable Care Act mandates that
insurers cover the vaccine at no out-of-
pocket cost for recommended groups.
Cancer survivors may be at elevated
risk of developing persistent HPV infections because their immune systems
have been weakened by treatment. “It’s
just sad to see that there’s a population
that’s at risk that is being forgotten,”
says Lois Ramondetta, a gynecologic
oncologist at the University of Texas MD
Anderson Cancer Center in Houston
who was not involved in the study.
Ramondetta says that pediatric
cancer patients and survivors may
be skipping primary care appointments because they are already
seeing many specialists. Since the
vaccine is usually administered at
pediatricians’ offices, an oncologist
may not think to recommend it.
Pediatricians may be uncertain about
when to restart giving immunizations
to children who have completed cancer
treatment, adds Landier. Guidelines
developed by the CDC recommend that
live vaccines, such as those for chicken
pox or measles, mumps and rubella, not
be given to people who are immuno-
compromised. The HPV vaccine is not
a live vaccine and is considered safe.
Landier and other researchers are
currently investigating whether the
immunization is less effective when
given during or after cancer treatment,
when a patient’s immune system may
be unable to respond to the vaccine.
One group of cancer survivors,
women ages 18 through 26, did
have slightly higher rates of HPV
vaccination than their peers in the
general population. The study found
46 percent of survivors had been vac-
cinated compared to 38 percent of the
general population in this age range.
Landier’s study can’t pinpoint why,
but she speculates that young adult
female cancer survivors may be more
attuned to cancer prevention than
other women in their age group.
Vaccine initiation rates were low—
about 8 percent—for male young-adult
survivors and male young adults in
general. This may be related to the
fact that the HPV vaccine’s initial
approval in 2006 was for females only.
Vaccination was not recommended for
males until 2011.
Landier encourages all cancer survi-
vors 26 and under to ask their doctors
about getting the HPV vaccine. “I think
the answer that providers are going to
give is, ‘Yes they should,’” Landier says.
“Having one cancer stinks,” says
Ramondetta. “Surely you want to avoid
having a second, so go ahead and get
vaccinated.” —KATE YANDELL
STUDY FINDS LOW VACCINATION RATES AMONG
TEEN SURVIVORS
Young Survivors Are at Risk
for HPV-Related Cancers
Adolescent cancer survivors are less likely than their peers to have received the human papillomavirus (HPV) vaccine, according to a study
of 982 survivors published in the Nov. 1, 2017, Journal of
Clinical Oncology.
