Snooki’s Cancer Diagnosis Has Women Asking: Is It Too Late to Get the HPV Vaccine?

When Nicole “Snooki” Polizzi, 38, recently shared her stage 1 cervical cancer diagnosis on social media, women across the country started asking an important question: Could the HPV vaccine still help reduce my cancer risk in midlife? The answer might surprise you—and empower you to take action.

Here’s what you need to know: “More than 99% of cervical cancers are attributable to persistent infection with high-risk HPV types,” says Steven Goldberg, MD, MBA, clinician and Chief Medical Officer of HealthTrackRx. And unlike many cancers, where prevention feels out of reach, there’s a powerful tool available—an FDA-approved HPV vaccine called Gardasil, which is typically administered to pre-teens through adults in their early 20s. But what if you missed out on the vaccine when you were younger? Can (and should) you still get it now? We asked doctors to help you make the best decision for your health.

What is cervical cancer and how is HPV involved?

“Cervical cancer is a cancer that develops in the lower part of the uterus, called the uterine cervix,” explains Jaclyn Wall, MD, a gynecologic oncologist at VCU Massey Comprehensive Cancer Center. “This is the part of the uterus, or womb, that dilates during childbirth.”

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HPV is the most common cause. “It’s a group of more than 200 related viruses and is the most common sexually transmitted infection in the United States,” says Dr. Goldberg. “It spreads primarily through skin-to-skin sexual contact. In fact, the CDC estimates that nearly all sexually active individuals will acquire HPV at some point in their lives.”

Outside of HPV, which most of the time clears on its own, Dr. Goldberg says other contributing risk factors for cervical cancer include:

• A weakened immune system, perhaps due to immunodeficiency conditions or HIV
• Smoking, which hinders the immune system’s ability to clear HPV
• Not receiving regular Pap smears
• A history of other sexually transmitted infections 
• Having multiple sexual partners

Dr. Wall says that treatment for cervical cancer varies based on when it was diagnosed. “An early stage cervical cancer (stage 1) may be treated with an excisional procedure called a LEEP or a cone in certain patients who still desire to maintain their ability to carry a pregnancy,” says Dr. Wall. “A hysterectomy is a common treatment for stage 1 cervical cancer, and in certain situations, a type of hysterectomy that removes additional tissue may be performed.”

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How the HPV vaccine works to protect against cervical cancer

“The HPV vaccine, currently Gardasil 9 in the US, is a preventive vaccine that protects against the nine most cancer-causing and wart-causing strains of HPV (6, 11, 16, 18, 31, 33, 45, 52 and 58), including types 16 and 18,” says Dr. Goldberg. 

“It works by introducing virus-like particles (not live virus) into the body that train the immune system to produce antibodies that will recognize and neutralize HPV before it can establish itself in the body,” explains Dr. Goldberg. 

The vaccine is typically administered in two to three doses for children between 11 and 12, though those as young as 9 can be vaccinated. Ideally, you’d want to get vaccinated before you’re sexually active and potentially exposed to HPV. The CDC recommends the vaccine for adults up to age 26, though in 2018, the FDA expanded that upper age limit to 45.   

Can you get the HPV vaccine after 40?

In short, it depends on your personal health history and risk factors. According to Dr. Goldberg, the CDC’s Advisory Committee on Immunization Practices bases its HPV vaccine recommendations on age and individual risk.

• Children ages nine through 12 are the primary target group for the HPV vaccine because younger adolescents produce higher antibody levels and are typically vaccinated before any potential exposure to various types of HPV, which provides stronger and longer-lasting protection.
• Teens and young adults through age 26 are routinely recommended to receive the HPV vaccine, regardless of sexual activity history, to reduce the risk of cancers caused by HPV.
• Adults ages 27 through 45 should speak to their doctor about whether vaccination makes sense for them. Because many people in this group may have already been exposed to some HPV strains, the overall population-wide benefit is smaller. However, individuals can still gain protection against HPV strains they may not have encountered.

For women 40 through 45, Dr. Goldberg says the HPV vaccine is a personalized decision best made with your doctor—and it can offer meaningful protection depending on your individual circumstances. Dr. Goldberg notes that women who have had limited sexual partners, who have been in long-term monogamous relationships or who are entering new relationships may still benefit from protection against HPV strains they haven’t been exposed to. A doctor can help assess your individual risk history and determine whether vaccination is appropriate.

The HPV vaccine is currently FDA-approved for people ages nine through 45 and is not recommended after age 45.

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Who may need to skip the vaccine?

“Overall, very few people need to skip the HPV vaccine,” says Dr. Goldberg. “The vaccine has an excellent safety profile, with more than 135 million doses of [the] HPV vaccine distributed in the United States through 2021, and more than 280 million doses delivered worldwide.”

That said, Dr. Goldberg explains that people who are pregnant, have a severe allergy to vaccine ingredients such as yeast or aluminum, are acutely ill or fall outside the FDA-approved age range of nine to 45 should discuss vaccination carefully with their doctor. 

Additionally, Dr. Goldberg and Dr. Wall both say the decision to get the HPV vaccine after a previous cervical cancer diagnosis is a personalized decision that should be worked through with a patient and physician. Dr. Goldberg adds that the vaccine does not treat an existing HPV infection or undo a previous cancer diagnosis. However, for someone who is still within the approved age range and has not been vaccinated, it may still protect against other high-risk HPV types they have not previously been exposed to. 

The bottom line on the HPV vaccine in midlife

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Ultimately, you and your doctor can best determine whether the HPV vaccine Gardasil is a good fit for you based on your personal health history. And if it is, it can help put the power of cancer prevention back into your hands.

“Cervical cancer is almost entirely preventable,” says Dr. Wall. “The way to achieve this is through HPV vaccination. It is amazing that we have this tool to eliminate cancer that has caused a great deal of suffering worldwide, particularly in very vulnerable populations and those without consistent access to health care resources. Aside from that, if detected early, cervical cancer is treatable and curable.” 

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