It Might Not Be Too Late to Protect Yourself From Cervical Cancer
By Julia Craven,
If you’re over the age of 40 and have never been vaccinated for HPV, it’s not too late for you to protect yourself against the most commonly contracted STD in the country.
Initially approved solely for girls and young women aged 9 through 26, the Food and Drug Administration (FDA) first expanded the vaccine’s recommendation to include both women and men. Then in 2021, the vaccine was approved for people up to age 45 — but if you’re in your late 40s or older, getting vaccinated against Human Papillomavirus (HPV) could offer you similar health benefits.
“The odds that somebody has been exposed to all nine of the HPV types included in the vaccine are really, really, really small. In my whole practice, I've never seen that,” said Dr. Connie Trimble, a board-certified OB/GYN and professor of medicine at Johns Hopkins, who has dedicated most of her career to developing new ways to intercept and combat cancers caused by HPV.
We're exposed to HPV throughout our whole lives for a variety of reasons and at a variety of ages, explains Trimble — whether that be switching sex partners after a decade or two, or becoming sexually active later in life versus earlier. Research has found that even if someone has prior exposure to HPV, the vaccine has benefits. Participants in the HPV vaccine clinical trials who had precancerous cells on their cervix removed beforehand had a lower recurrence of the disease in the future, according to Trimble. The vaccine also boosts the immune response to the disease, which prevents HPV infections in the future.
HPV is the most frequently sexually transmitted infection in the U.S., and by the time people reach the age of 50, approximately 80 percent of us have been exposed to at least one strain of it. It's estimated that more than 42 million Americans are currently infected with HPV, and there are over 13 million new cases each year. HPV is unique among viruses due to its potential to cause various types of cancer — including cervical, vulvar, vaginal, penile, anal, and cancers affecting the back of the throat, the base of the tongue, and the tonsils. The virus can also cause genital warts.
Thankfully, our bodies' immune systems are efficient and robust, allowing most of these infections to clear without us ever knowing. But, in a minority of cases, the infection can progress to precancer or even full-blown cancer. For this reason, the HPV vaccine, which can prevent these severe cases from developing, has become an essential tool in the arsenal of modern healthcare.
In the 18 years since the vaccine became available, infections with the viral strains that cause most related cancers and genital warts have dropped 88 percent and 81 percent among teenage girls and young women, respectively. Vaccination has also led to lower cases of cervical precancers. This protection lasts; there’s zero evidence of effectiveness decreasing over time.
“Having any kind of cancer prevention technique that works as well as this kind of vaccine is pretty impressive,” said Dr. Colleen Denny, a board-certified OB/GYN and the director of family planning at NYU Langone-Brooklyn. “Generally, we think the vaccine is very safe for everybody, including people in their forties, fifties, and sixties.”
The only real drawback to getting the vaccine over 45 is dealing with insurance. “Because the vaccine isn't approved for people in the older age ranges, they can run into insurance issues and out-of-pocket costs,” said Denny. “That can be a big barrier or prohibitive, especially for people who aren't quite sure if they're actually getting anything out of this vaccine.”
Whether an insurance company has caught up with the fluctuating recommendations depends on the insurance provider, the doctor’s office, and the state — an annoying but familiar barrier when seeking healthcare.
Denny has seen some companies cover it at any age, while Trimble hasn’t seen a case where insurance covers it outside the initially recommended population of 9 to 26-year-olds. “I usually tell my patients that it's worth checking with their individual insurance company beforehand to get a sense of what their out-of-pocket costs might be if you really don't want that surprise,” said Denny. “Sometimes vaccines are surprisingly expensive.”
For example, people over 21 who receive Medicaid coverage are covered in 43 states and the District of Columbia as of fall 2022. Merck, the HPV vaccine manufacturer, offers a patient assistance program for uninsured folks between 19 and 45 who live below the federal poverty line.
As with other health concerns, it's crucial to have open conversations with your healthcare provider about your options. If you're considering the vaccine and you're over 45, discuss it with your doctor. They can provide you with the most accurate information based on your personal health history and circumstances. And while there may be a few insurance hurdles to clear, the potential health benefits are worth it.