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HPV Vaccine Age Limit Change: My Daughter Got Protection, but What About Me?

There was big news that came from the FDA a few days ago- extended approval for HPV vaccination for ages 27-45. Previously this vaccine which prevents certain types of cervical cancer and genital warts was only offered to patients ages 9-26.

The goal with the HPV vaccine is to prevent HPV virus related outcomes and therefore, it has traditionally been offered to patients who were thought most likely to benefit- those who had yet to have exposure through sexual contact.
Almost all adults will have exposure to at least one strain of HPV during their lifetime. This is a prevalent and often silent infection, as most people have no idea they were exposed to HPV until picked up on a pap smear or HPV test. The vaccine protects against 9 strains of HPV.

Although a large percentage of current vaccinations are occurring in the pediatrician’s office, as this is the best chance to catch patients in the right time frame, I have still had many visits with patients to catch up on this vaccination if It was missed earlier. Some of my teenage patients would be accompanied by their mothers (who were also my patients). These mothers would often ask, “what about me, can I get the vaccine too”? Unfortunately, this wasn’t really an option previously as the original studies about the vaccine efficacy and safety was tested and demonstrated in studies in the younger population.

While most Ob/gyns already understood that more people of older age were likely to benefit from this vaccine we did not yet have FDA approval or insurance coverage for this age group. As mentioned, even if an adult had been exposed to one strain of HPV earlier in their lifetime, the vaccine could potentially protect against 8 other strains they could be exposed to in the future.

There is a large group of people who never had the chance to receive the vaccine, as they were “too old” to get it before. Some of these people have never had sexual contact, or perhaps are recently divorced or out of a monogamous relationship. They would like to make an effort to protect themselves and we can finally offer this.

Interestingly, some Ob/Gyn’s in this age group who never had the chance to get vaccinated before will be taking advantage now. The reason may surprise you. As physicians, we actually have risk of exposure to the HPV virus through treating our patients with HPV related diseases. Smoke plumes from the LEEP procedure to remove HPV lesions have been documented to carry the virus. In addition, surgical smoke from removal of genital warts with lasers has been a documented source of transmission of HPV. This means that the doctor performing the procedure could be exposed.

However, we are still in the beginning stages. The FDA has approved the vaccine for use in this age group, but that doesn’t mean insurance will cover it yet.
We are still waiting on a statement/recommendation from the Centers for Disease Control (CDC). That will likely determine if insurers will cover the cost moving forward. So, while you may be able to get the vaccine now at your doctor’s office, if you want the cost covered by insurance you may need to wait a little longer.

Click to access Laryngeal%20Papillomatosis%20With%20Human%20Papillomavirus%20DNA%20Contracted%20By%20A%20Laser%20Surgeon.pdf

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