Table 1.

Summary of nine myths and fake messages about human papillomavirus vaccination

Myth		Fact
#1: PAP smears are also effective: no need for a vaccination	X	The only screening available is for cervical cancer, not other cancers Five other cancers (affecting both women and men) are caused by HPV Screening is a secondary prevention method to detect pre-cancerous lesions or cancer early HPV vaccination is effective in the primary prevention of disease	✓
#2: HPV vaccines are new so there are no safety and efficacy data on long-term side effects	X	We have 25 years of experience with the vaccines We have 15 years of real-life experience with several hundred million doses distributed worldwide The possible side effects are well documented Vaccine safety has been confirmed by WHO, CDC, and many other authorities	✓
#3: HPV vaccination can cause ovarian failure	X	No connection between HPV vaccination and ovarian failure has been observed, following observation of 1 million females	✓
#4: Vaccines cause autoimmune diseases, neurological disease, and death	X	The incidence of autoimmune or neurological conditions and death is the same in HPV-vaccinated and unvaccinated populations	✓
#5: Children are not sexually active so there is no need to vaccinate them early	X	The earlier you vaccinate, the better the immune response Fewer doses are needed when individuals are vaccinated under the age of 15 years The earlier you vaccinate, the better the strength of the prevention	✓
#6: Boys and men do not get cervical cancer so they do not need a vaccine	X	HPV is linked to at least five malignancies other than cervical cancer: vulvar, vaginal, anal, penile, and oropharyngeal cancers Gender-neutral vaccination provides the best protection for all individuals regardless of gender and (future) sexual orientation	✓
#7: After the first sexual intercourse the vaccine does not work any longer	X	In clinical trials most young women were sexually active and the level of protection was >90% Efficacy data up to the age of 45 years are available Even after treatment for HPV-related disease, the vaccine potentially reduces the risk of subsequent disease	✓
#8: Natural HPV infection already creates a protective antibody response so there is no need for vaccination	X	Antibody response after natural HPV infection is low HPV vaccination provides a strong immune response and gives robust protection against disease	✓
#9: HPV vaccination increases risky sexual behavior and promiscuity	X	There is no evidence that HPV vaccination increases promiscuity or promotes risky sexual behavior	✓

CDC, Centers for Disease Control and Prevention; HPV, human papillomavirus; PAP, Papanicolaou; WHO, World Health Organization.