HPV vaccine expanded to include those 27 to 45

For years, Dr. Zane Saul had heard tales of people who wanted to protect themselves from a sexually transmitted disease linked to several deadly cancers — but were told it was too late.

Gardasil and its successor, Gardasil 9, were vaccines approved to prevent most types of the STD human papillomavirus, commonly called HPV.

The vaccines, however, were only approved for use in those aged 9 to 26, which means insurance wouldn’t cover the shots for people outside that age range, said Saul, chief of infectious disease at Bridgeport Hospital.

“We had patients in their late 20s and early 30s coming in, wanting to play catch-up, but they couldn’t get a payment source,” for the vaccine, he said.

Soon, though, such patients may be able to get the vaccine.

On Oct. 5, the Food and Drug Administration announced it was expanding the approved use of the vaccine to include those ages 27 to 45. The vaccine helps prevent certain cancers and disease caused by the nine HPV types covered by the medication.

Saul said while the Centers for Disease Control and Prevention hasn’t officially changed age recommendations on the vaccine — which would clear the way for insurance companies to cover the shot — “I can’t imagine they would turn it down.”

Saul and others said the expansion is a great thing, and should prevent more people from getting certain kinds of cancers.

“We know that HPV is the causative virus to many vaginal, penile, rectal and oral cancers,” said Dr. Michael Kessler, an obstetrician-gynecologist affiliated with Griffin Hospital in Derby. “(Expanding the age range) made clinical sense.”

According to the CDC, about 14 million Americans become infected with HPV annually, and nearly 80 million Americans have the infection, making it the most common sexually transmitted disease. It can be contracted by oral, anal or vaginal sex with an infected person.

The CDC reports about 20,260 cancers in women and 13,477 cancers in men every year likely are linked to HPV. These include cancer of the cervix (roughly 90 percent of which is probably caused by HPV), as well as cancer of the vagina, penis, anus, vulva and oropharynx, which is part of the throat.

In Connecticut, the CDC reports, about 11.7 people in 100,000 were diagnosed with HPV-associated cancers between 2011 and 2015.

Gardasil was approved by the FDA in 2006 to prevent four types of HPV. It is no longer used in the U.S. Instead, in 2014, the FDA approved Gardasil 9, which added protection against five more HPV types.

CDC research has shown the HPV vaccine prevented 90 percent of cancers linked to the illness — which equated to roughly 31,200 cases every year — in people 9 to 26.

The FDA states it partly based the decision to expand the age range on a study that followed about 3,200 women from 27 to 45 years old for 31⁄2 years. The study found Gardasil was 88 percent effective in preventing “a combined endpoint of persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions and cervical cancer related to HPV types covered by the vaccine.”

Kessler said he is not sure why age 45 was the cutoff for the expansion, but the vaccine could be less effective as people age.

“It may just be that the immunogenic response is not as valid” in older people, he said.

Both Kessler and Saul said there have been problems getting people vaccinated against HPV.

“A lot of parents didn’t want to give it to their kids, because they thought it was condoning premarital sex,” Saul said.

Kessler echoed that statement, adding the parents weren’t the only obstacle.

“We have practices that are not even distributing or offering the vaccine,” he said.

But, generally, the expansion should be helpful in protecting more people against cancers, Saul said.

“The link is very, very clear that getting vaccinated decreases the chance of getting these cancers,” he said.