HPV Awareness and Vaccine Gaps in the U.S.

The human papillomavirus (HPV) is a key cause of cancer, yet it can mostly be prevented through vaccination. Unfortunately, recent research reveals that many Americans lack knowledge about HPV and its associated health risks, not to mention the HPV vaccine itself.

Researchers from the Medical University of South Carolina analyzed survey data that represents the national population. They found that about a third of Americans are unaware that HPV exists. Among those who know about it, many are still unaware that it can lead to various cancers beyond cervical cancer. In particular, individuals in the Midwest and Southern states showed significantly lower awareness levels, which the researchers suggest could be a factor in the region’s low vaccination rates.

“Some of these states have the lowest HPV vaccine coverage in the nation, which could be a reason why we are observing these differences,” said Ashvita Garg, the lead author of the study.

There are over 200 types of HPV, spread mainly through skin contact, including sexual contact; it’s the most prevalent sexually transmitted infection worldwide. While some types lead to harmless warts, others can lead to serious cell changes that increase cancer risk.

HPV is the primary cause of cervical cancer, which makes up nearly all diagnosed cases. Additionally, high-risk HPV strains contribute to several other cancers, including vaginal and vulvar cancers in women, penile cancer in men, and oral cancer in both genders. Interestingly, or perhaps surprisingly, HPV-related oral cancers are more frequently diagnosed in men than in women, totaling approximately 40,000 cases linked to HPV occurring each year in the U.S.

Current vaccines can prevent up to nine different high-risk HPV strains, but vaccination rates remain disappointingly low, even in the U.S. The researchers aimed to explore public awareness regarding both the virus and the importance of vaccination.

The study utilized data from the Health Information National Trends Survey (HINTS), which assesses Americans’ understanding of health and cancer information. Ultimately, nearly 23,000 responses collected between 2017 and 2022 were analyzed.

According to the survey, around 34% of Americans did not know about HPV, and 37% were unaware of the HPV vaccine. Among those familiar with the virus, a large majority—71%—didn’t realize it could cause oral cancer, and 28% were unaware of its link to cervical cancer. Particularly high ignorance rates (over 40%) were found in states such as Kansas, Nebraska, and Illinois, as well as Mississippi, Arkansas, and Alabama. Notably, these states also rank among the lowest in HPV vaccination rates, correlating with the fact that about 62% of HPV-related cancers are found in the Southern and Midwestern regions.

“The gap in awareness that HPV causes oral cancer was strikingly larger than the awareness that it causes cervical cancer, underlining the lack of appreciation for the need for HPV vaccination in males,” Garg mentioned. The findings were published in JAMA Oncology.

Some countries are making significant strides in eradicating cervical and other HPV-related cancers via widespread vaccination, but the U.S. is still falling short. Just around 57% of American teenagers received the HPV vaccine as recommended in 2023, well below the 80% vaccination target set for 2030. Researchers emphasize that it is crucial to enhance public knowledge about HPV and its risks.

“Improving HPV awareness would necessitate a multifaceted approach, including public education campaigns, better communication between patients and providers, and outreach programs in communities and schools,” Garg noted.

Sadly, the federal government’s interest in HPV prevention seems to be dwindling. Robert F. Kennedy Jr., the current health secretary, has consistently shared misinformation about the HPV vaccine and even branded Merck’s Gardasil vaccine as “the most dangerous vaccine ever invented.”

Nonetheless, Garg and her team at MUSC remain committed to boosting HPV vaccine uptake in their area.

“We’re not just looking at the cancer burden related to HPV and mortality; we’re also exploring how to improve the uptake of prevention options and understand preventive behaviors across the U.S.,” she stated. “MUSC is actively involved in public health outreach, especially in South Carolina, where initiatives like the HPV Vaccination Van are helping to increase education and access to HPV vaccinations.”