What vaccines are available for cancer prevention and treatment?

Cancer Prevention Vaccines: Current Options and Recommendations

Human Papillomavirus (HPV) and Hepatitis B vaccines are the only currently available vaccines for cancer prevention, with HPV vaccines protecting against multiple HPV-related cancers and Hepatitis B vaccine preventing liver cancer.

HPV Vaccines

Indications and Coverage

• HPV vaccination protects against HPV types 6,11,16,18,31,33,45,52, and 58, which together cause approximately 90% of cervical cancers and 90% of genital warts 1
• HPV is associated with multiple cancers including:
  • Cervical cancer
  • Anal cancer
  • Oropharyngeal cancer
  • Vulvar and vaginal cancers
  • Penile cancer 2, 1

Vaccination Recommendations

• Routine vaccination:

  • Recommended for all children ages 9-12 years 2, 1
  • The American Cancer Society specifically encourages starting at age 9-10 years to achieve higher on-time vaccination rates 2

• Dosing schedule:

  • Ages 9-14 years: 2-dose schedule with doses 6 months apart
  • Ages 15-26 years: 3-dose schedule (0,1-2, and 6 months) 2, 1
  • Immunocompromised individuals: 3-dose schedule regardless of age 2, 1

• Catch-up vaccination:

  • Recommended for all persons through age 26 years who are not adequately vaccinated 2
  • For individuals aged 22-26 years, providers should inform that vaccination at older ages is less effective in lowering cancer risk 2

• Adults aged 27-45 years:

  • The American Cancer Society does not recommend routine catch-up HPV vaccination for adults older than 26 years 2
  • The NCCN and ACIP suggest shared clinical decision-making for some adults aged 27-45 years, though effectiveness is limited due to prior HPV exposure 2, 1

Special Populations

• Immunocompromised individuals:

  • Recommended for all immunocompromised persons regardless of age 2, 1
  • 3-dose schedule required 2

• Men who have sex with men (MSM):

  • Recommended through age 26 years 2, 1
  • Higher risk of anal HPV infection and related cancers 2

• Other high-risk groups:

  • HIV-infected patients
  • Women with precancerous cervical lesions
  • Patients with inflammatory bowel disease
  • Transplant recipients 2

Important Considerations

• HPV vaccination does not treat existing HPV infections or HPV-related diseases 2
• Vaccinated individuals should continue cervical cancer screening according to guidelines 2, 1
• No pre-vaccination testing (Pap test, HPV DNA testing) is needed before vaccination 2, 1

Hepatitis B Vaccine

Cancer Prevention Benefits

• Recognized by the CDC as the first anti-cancer vaccine because it prevents hepatocellular carcinoma (primary liver cancer) 3
• Universal childhood immunization against hepatitis B has decreased the incidence of hepatocellular carcinoma among children 3
• Studies demonstrate decreased incidence and risk of developing hepatocellular carcinoma in vaccinated adult males 3

Recommendations

• Universal vaccination recommended from birth to age 18 years 3
• Screening of pregnant women for hepatitis B is recommended to prevent vertical transmission 3
• Particularly important for high-risk individuals with potential exposure to hepatitis B virus 3

Effectiveness and Safety

HPV Vaccine Effectiveness

• Nearly 100% effective in preventing HPV16/18-related cervical intraepithelial neoplasia in HPV-naive individuals 1
• 64% decrease in HPV type prevalence among girls 14-19 years since vaccine introduction 1
• High efficacy against anal HPV infection and anal intraepithelial neoplasia (77.5% efficacy observed) 2, 4
• Emerging evidence suggests effectiveness against oral HPV infections 4

Safety Profile

• HPV vaccines have demonstrated excellent safety profiles 1, 4
• Most common side effects are local injection site reactions and headache 1
• Syncope (fainting) has been reported; patients should be observed for 15 minutes after administration 1

Implementation Challenges

• Despite proven efficacy, vaccination rates remain suboptimal (approximately 49% of adolescents have completed the series) 1
• Access barriers in low- and middle-income countries where the burden of HPV-related diseases is highest 5
• Need for improved education of providers, policy-makers, parents, and adolescents about cancer prevention benefits 1

Future Directions

• Research on therapeutic HPV vaccines that could treat existing HPV infections and related diseases is ongoing 5, 6
• Single-dose HPV vaccination schedules are being studied and show promising early results 7
• Development of more affordable vaccine formulations to increase global access 6

Remember that while cancer prevention vaccines are highly effective, they must be administered before exposure to the virus for maximum benefit. Regular cancer screening according to guidelines remains essential even after vaccination.