Preteens may soon have something to celebrate: Medical experts are discussing the possibility that one dose of a life-saving cancer vaccine, instead of two, may be enough to protect them.
uncertain
dose → have → them
U.S. vaccination recommendations have become splintered in the past year, with federal officials and doctors’ organizations disagreeing over guidance and even battling each other in court.
asserted
officials → become → court
But both sides have been exploring revisions in longstanding HPV vaccine recommendations.
asserted
sides → explore → recommendations
“This would be a significant shift in terms of what has been communicated for many years about the best way to protect adolescents against HPV,” said Jason Schwartz, a Yale University vaccine policy researcher.
asserted
Schwartz → communicate → HPV
Here’s a look at HPV shots, which debuted 20 years ago and may now be approaching a crossroads.
uncertain
which → ’ → crossroads
HPV is linked to thousands of cancer cases
HPV, human papillomavirus, is the most common sexually transmitted infection in the U.S.
More than 40 HPV types can infect the genital areas of men and women, plus the lining of the mouth and throat.
asserted
types → link → mouth
HPV also is a leading cause of the nearly 50,000 cancer cases diagnosed in the U.S. each year that affect those parts of the body.
asserted
that → lead → body
Indeed, about 90% of cervical cancer and anal cancers are attributed to HPV infections, according to the Centers for Disease Control and Prevention.
uncertain
% → attribute → Control
In 2006, federal health officials approved the first HPV vaccine, Merck & Co.‘s Gardasil.
asserted
officials → approve → vaccine
A second vaccine was approved in 2009, GlaxoSmithKline’s Cervarix.
asserted
vaccine → approve → 2009
Both vaccines are approved for use in males and females, available for kids as young as 9 to adults in their 20s.
asserted
vaccines → approve → 20s
But they were prioritized for 11- and 12-year-olds, because the shots work best if given before someone is sexually active.
asserted
someone → prioritize → olds
HPV vaccination recommendations have changed before
Initially, in 2006, HPV vaccinations were recommended only for girls and given as a series of three shots over six months.
asserted
vaccinations → change → months
Boys were added in 2011, a move largely intended to stop them from spreading a virus to girls that could cause cervical cancer.
uncertain
that → add → cancer
Ten years ago, the government changed the dosing recommendations.
asserted
government → change → recommendations
It dropped the number of recommended doses from three to two after studies showed that amount offered sufficient protection.
asserted
amount → drop → protection
Research also suggested two doses worked better when spaced six to 12 months apart, meaning they could be given at annual checkups.
uncertain
they → suggest → checkups
Since then, studies in multiple countries have shown dramatic decreases in infections, genital warts cases and precancerous cervical lesions.
asserted
studies → show → infections
In 2020, the American Cancer Society updated its guidelines for women, raising the age at which screenings should start to 25, from 21.
asserted
screenings → update → 21
The organization attributed the change to data indicating vaccinations had led to a drop in rates of cervical changes that are seen as precursors to cancer.
asserted
that → attribute → cancer
Evidence has continued to be favorable.
asserted
Evidence → continue → ?
The University of Minnesota’s Vaccine Integrity Project this year published a research review that found that HPV vaccines had lowered the risk of genital-area cancers in women.
asserted
vaccines → publish → women
And a study published in April in the journal JAMA Oncology found vaccinated males are nearly 50% less likely to develop cancers of the head and neck, esophagus, anus or penis.
asserted
males → publish → head
What’s more, “the duration of protection is long,” said Angela Ulrich, who led the Vaccine Integrity Project review.
asserted
who → ’ → review
“We have people who are 20, 30, 40 years old who are seeing protection from the HPV vaccine.”
asserted
who → have → vaccine
HPV vaccination rates are lower than for other vaccines
A recent CDC report found vaccination rates against HPV were lower than the rates for some other shots adolescents get, at least partly because most states don’t require HPV vaccinations as a condition of school attendance.
asserted
states → find → attendance
Still, the HPV vaccination rate has been flat for four years in a row, with about 63% of teenagers getting both doses.
It doesn’t help that HPV shots are known to have a sharper sting.
asserted
shots → get → sting
(Doctors have noted fainting is more common after HPV shots.)
asserted
fainting → note → shots
Questions about pain are common, said Dr. Scott Hadland, who works at a Boston clinic that treats adolescents and young adults.
asserted
that → say → adolescents
“Some of my patients tell me it hurts more than other vaccines they’ve received, but only for a moment,” he said.
asserted
he → tell → moment
Also not helping lately, perhaps, is the elevation of Robert F. Kennedy Jr. to U.S. health secretary
asserted
elevation → help → secretary
Before he was appointed to oversee federal health agencies last year, Kennedy was an attorney and consultant in lawsuits against Merck over the Gardasil vaccine, and falsely claimed the vaccine increases cervical cancer risk.
asserted
vaccine → appoint → risk
Research suggests one shot may be enough for girls
In January, Kennedy ordered the number of recommended HPV doses to be reduced to one, as part of a unilateral reduction of the childhood vaccination schedule.
uncertain
number → suggest → schedule
That change was blocked by a federal judge’s order, but it actually is something that medical experts had been considering for some time.
asserted
experts → block → time
The idea gained attention late last year with the publication of a study in Costa Rica that tracked more than 20,000 girls over five years.
asserted
that → gain → years
It found a single HPV shot provided about 97% protection against cervical cancer, similar to two doses.
asserted
shot → find → doses
A year earlier, in 2024, research developments prompted a CDC advisory committee to form a work group to explore the possibility of a revised recommendation.
asserted
developments → prompt → recommendation
That work was interrupted when Kennedy dismissed the members of the committee.
asserted
Kennedy → interrupt → committee
The American Academy of Pediatrics — one of the medical groups that sued Kennedy — makes its own vaccination recommendations.
asserted
that → sue → recommendations
It has been considering a guidance change, exploring questions such as whether one dose is sufficient for at least some people and at what age vaccination should begin, said Dr. James Campbell, chair of the organization’s committee on infectious diseases.
asserted
Campbell → consider → diseases
…and 8 more, not listed.
The Aporia
