The US mustn’t mess with the HPV vaccination drive: It saves lives

This message needs reinforcing in the US, where vaccination rates continue to lag behind pre-pandemic levels—which were already behind health officials’ targets for population-level coverage. Officials will now contend with a new administration that is stacking US public health agencies with leadership like Robert F. Kennedy Jr, who is well known for his scepticism of vaccines, including the HPV shot.

Also read: Single-dose HPV jab is enough to prevent cervical cancer, Indian study finds

In a letter published in JAMA, researchers narrowed in on cervical cancer deaths among women who were younger than 25 between 2016 and 2021—the first group with widespread uptake of the vaccine as adolescents following its approval in 2006. While cervical cancer deaths among young women had been steadily dropping for years, thanks to screening, researchers found a sharper decline among this group, leading to 26 fewer deaths over that period.

The number may sound small. But consider that the vaccine hasn’t been around long enough for researchers to comprehensively assess its long-term benefits. Most women are diagnosed with cervical cancer when they are older—typically in their mid-30s to mid-50s. That means we won’t see the larger impact of vaccination until five to 10 years from now, says Ashish Deshmukh, a professor at the Medical University of South Carolina who led the study.

Cervical cancer isn’t the only disease linked to HPV, and women aren’t the only ones affected. The virus is also implicated in oral, anal, vaginal, vulvar and penile cancers. Imagine if vaccination against HPV (eventually allowed the US to cut the 4,000 annual deaths from cervical cancer to zero —or dramatically reduce or even eliminate the nearly 38,000 HPV-related cancers diagnosed in the country each year.

Both are achievable goals, but it means propping up vaccination rates. Tweens are first eligible for the shots at age 9, yet recent data from the Centers for Disease Control and Prevention show the number of 13- to 17-year-olds who had completed the series of shots (two doses if initiated by age 14 or three doses if initiated at 15 or older) dipped to 61.4% in 2023 from 62.6% in 2022.

Health experts weren’t surprised that routine vaccination rates were affected by covid shutdowns, but getting HPV rates back to pre-pandemic levels— let alone to officials’ goal of 80% of adolescents vaccinated by 2030—has been a slog.

Also read: 1.5 mn: That’s how many years Indian women will lose to cervical cancer by 2025

Efforts have been focused on addressing disparities in coverage, such as improving access and uptake among people living in rural areas or without insurance, helping paediatricians make more effective pitches for vaccination, and clearing barriers to starting the shots during early adolescence when protection can be achieved with two rather than three doses.

Yet, there’s reason to worry all this work could be unravelled by President-elect Donald Trump’s picks to lead public health agencies. The HPV vaccine is among those aggressively targeted by Children’s Health Defense, a non-profit known for its anti-vaccine rhetoric and misinformation.

It was founded by Kennedy, Trump’s nominee to lead the Department of Health and Human Services. Kennedy has been involved in multiple lawsuits related to the HPV vaccine, including one filed in 2022, claiming Merck’s Gardasil has caused injuries to teens. Numerous studies have shown the side effects are mild

Meanwhile, Dave Weldon, Trump’s pick to head the Centers for Disease Control and Prevention, has been embraced by anti-vaccine groups. Most of the former representative’s problematic proposals while in Congress focused on the debunked link between MMR vaccination and autism.

But he did criticize the HPV vaccine as lacking long-term safety data. In fact, at the time of its approval, Gardasil had been tested in thousands of women. They were followed for up to four years, long past the time when a safety issue would likely emerge — something Weldon, a physician, should know.

The new leadership combo could undermine vaccine access and uptake (the number of people vaccinated with a certain dose in a certain time period). Beyond the reasonable worry that Kennedy might publicly question the benefits or safety of vaccines, the CDC also plays a significant role by providing recommendations on vax schedules, which influences insurance coverage.

Also read: We must break the silence on the silent killer that cervical cancer is

The HPV vaccine prevents unnecessary suffering and deaths from HPV-related cancers. What a colossal shame it would be to go backward—at the cost of women’s lives. ©Bloomberg