If you’re a little too old to have received the HPV vaccine in school, should you still get it?
Probably, says the Society of Obstetricians and Gynaecologists of Canada.
Most provinces vaccinate children against HPV (human papillomavirus) in late elementary or middle school. Some provinces, like B.C., also provide it for free to women who were born in 1994 or later but didn’t get their shot at school. In some circumstances, the vaccine is also provided to men.
But even if you don’t fit those categories, you should still consider getting the shot to protect against cervical cancer, says Dr. Jennifer Blake, CEO of the Society of Obstetricians and Gynaecologists of Canada. “We certainly recommend that all young people should be vaccinated,” she said. “For women up to the age of 45 and beyond, it becomes an individual discussion that really depends on your circumstances.”
“But there really isn’t any downside to being vaccinated, except you have to go through some shots and there is a cost attached.”
A study published Monday in the medical journal Lancet Child & Adolescent Health found that the vaccine is still effective at protecting against cervical cancer caused by HPV in women who don’t get the shot until they’re between 15 and 20 years old.
The vaccine is approved for women aged nine to 45 based on clinical trial evidence, said Dr. Leah Smith, senior manager of surveillance at the Canadian Cancer Society.
It might be effective even longer than that but there is no research to support this, said Blake. “We don’t have any reason to believe that you’re not going to have some benefit, but we just don’t know what that benefit will be, what’s the likelihood that it would reduce the risk.”
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The Canadian Cancer Society recommends that all women under 45 get vaccinated.
“Individuals older than the recommended ages who are interested in getting the vaccine should speak with their healthcare provider about whether the vaccine is right for them,” said Smith.
More effective for young people
It’s still better to get vaccinated when you’re young, though. “We have data that starts with children from nine years of age, and we know that if you’re vaccinated as a nine-year-old your immune response is much stronger and you only need two doses of the vaccine to get full protection,” said Blake.
Once you turn 14, you will need three doses to be protected, though the vaccine still works.
Plus, when you’re young you haven’t been exposed to HPV yet so you’re preventing a potentially bad infection. But even older women who have previously been exposed to HPV can still benefit, said Blake.
“We’ve also got data showing that even for women who’ve had an abnormal pap smear … if they’re vaccinated at that late stage, it still reduces the risk of their having that come back or having to have further procedures done on the cervix.”
The vaccine isn’t free, though, and if you’re older, you may be on the hook to pay for it yourself, though some private insurance plans do cover it. The Canadian Cancer Society estimates that it costs around $600 for three doses of the Gardasil-9 vaccine, one of the common HPV vaccines, though this will vary somewhat between pharmacies and provinces.
Vaccinations for men
The HPV vaccine isn’t just for women either, said Blake. While boys are being vaccinated in school in many provinces, men in their twenties might want to consider getting the shot if they haven’t already, she said.
Vaccination can prevent some kinds of genital warts and throat cancers in men and can help to protect their partners, too. The Canadian Cancer Society recommends that men between the ages of nine and 26 get vaccinated against HPV — again, based on clinical trial evidence showing its effectiveness. Clinical trial data is only available on men aged 26 and younger, said Smith.
Man or woman, if you’re not in a long-term monogamous relationship, you should definitely think about getting the vaccine, said Blake. Even if you are in a relationship, you might still want to consider it, she said. “Most people think they know their partners but sometimes you don’t.”
If you’re interested in getting vaccinated, you should talk to your health care provider to discuss whether it’s appropriate for you.
Blake believes that Canada could actually eliminate cervical cancer with enough vaccination and screening programs.
“It really is possible for us to protect people against cervical cancer, and it is a disease worth protecting yourself from.”
“From where I sit, I treat women who have had cervical cancer. I look after the aftermath of this disease. I have a very decided bias, and my bias is I don’t want to have to see women suffer with this disease who don’t need to.”
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