Or: How a Shot in the Arm Quietly Started Erasing an Entire Disease While America Was Busy Arguing About It on Facebook
Welcome to “Remember When Kids Just Died?” A daily two-part tour through every vaccine-preventable disease, starting with polio on September 1, 2026. Each disease gets two posts: the pre-vaccine era, when parents enjoyed the character-building experience of burying their children, and the post-vaccine era, when we ruined everything by making childhood survivable. Cramming both into one post felt disrespectful, to the corpses and the Nobel Prizes.
Welcome back to the HPV chronicles. Last time we toured the pre-vaccine era, when America hosted 79 million uninvited viral houseguests and paid billions of dollars a year for the privilege. Today: what happened after we invented an actual, functional, boring in the best possible way vaccine.
Spoiler: it worked. Alarmingly well. So well that if HPV had a LinkedIn, it would currently be posting one of those “open to opportunities” banners.
The Numbers That Should Have Made Front Page News (But Didn’t)
Within about 12 years of the HPV vaccine being introduced in 2006, infections with the four HPV types Gardasil targets dropped by 88% among teen girls ages 14–19 and 81% among young women ages 20–24 (CDC, HPV Vaccine Safety and Effectiveness Data). Let me translate that from CDC-speak: we took the most common sexually transmitted infection in the country, aimed a vaccine at it, and nearly wiped out its most dangerous strains in an entire generation of American women.
If any other product performed at 88% effectiveness, we would name a stadium after it. Instead, the HPV vaccine got a lukewarm nod from public health and a decade of internet conspiracy theories from people whose medical training consists of watching autoplay videos at 2 a.m.
Cervical Precancers: Suddenly Much Less Popular
Remember the pre vaccine Pap smear industrial complex? The 3 million abnormal Paps a year, the colposcopies, the biopsies, the LEEPs, the multi-billion-dollar screening tab? After the vaccine rolled out, cervical precancer rates fell 50% in screened women ages 18–20 and 36% in women ages 21–24, comparing 2014–2015 to 2008–2009 (CDC, HPV Vaccine Safety and Effectiveness Data). And among vaccinated women specifically, the share of cervical lesions caused by the vaccine-targeted HPV types dropped by 40%.
Translation: the vaccine didn’t just prevent infections in theory. It walked into gynecology offices across America and started deleting abnormal Paps in real time. Colposcopy schedulers everywhere had to invent new hobbies.
The Great Wart Recession
The pre-vaccine era gave us 340,000+ genital wart cases a year. After the vaccine? Anogenital wart prevalence dropped 61% in girls ages 15–19 and 44% in women ages 20–24 between 2006 and 2014 (CDC, HPV Vaccine Safety and Effectiveness Data). Even better: rates in young men started falling after 2009, before boys were even routinely recommended for the vaccine in 2011. That’s herd immunity, baby. The girls got vaccinated and the boys got a free ride, which is possibly the first time in human history that arrangement has worked out in men’s favor.
The cryotherapy tanks are lonely. The electrocautery pens weep quietly in their drawers. An entire generation of dermatology residents has to learn about genital warts from textbooks the way I had to learn about smallpox: as a historical curiosity.
Scotland Just Casually Cured Cervical Cancer (In One Cohort)
If you want the single most jaw dropping data point in modern vaccine history, sit down. In January 2024, Public Health Scotland reported that zero cases of invasive cervical cancer have been detected in women who received the HPV vaccine at ages 12–13 since Scotland’s national program launched in 2008 (Public Health Scotland, 2024). Zero. As in none. As in the number of times I have voluntarily watched a golf tournament in the rain. An entire cohort of women who used to statistically show up in cervical cancer registries just… didn’t.
A cancer that has killed women since ancient Egypt has, in one country, been essentially switched off in the vaccinated group. That is not a “promising signal.” That is a public-health mic drop.
Meanwhile, in America: We’re Doing Okay, I Guess
So how is the U.S. doing with vaccine uptake? According to the CDC’s National Immunization Survey Teen for 2023, 76.8% of 13–17 year olds have received at least one HPV vaccine dose, and 61.4% are up to date (CDC MMWR, 2024). The bad news: for the second year in a row, HPV vaccination coverage in American adolescents did not increase. It plateaued. We looked at a vaccine that prevents cancer, watched Scotland put up a big goose egg in the cervical cancer column, and collectively decided, “You know what, 61% seems fine, let’s not push it.”Meanwhile, we still line up around the block for exfoliating serums that promise “up to 12% brighter skin” if you use them every night for six weeks. But an actual cancer-preventing shot? Meh. Maybe next well-visit. Or the one after. Or never because Aunt Karen saw a TikTok.
For context: measles vaccination coverage in kindergartners is around 93%. HPV vaccine, a shot that prevents six kinds of cancer, is stuck at 61% up to date. We are, as a nation, more scared of the vaccine than of the cancers.
The Future: What Happens if We Actually Try
Here’s what the burden of HPV disease could look like a few decades from now if the world keeps vaccinating, and especially if the U.S. finally gets off its 61% plateau. Cervical cancer becomes a rare disease. The World Health Organization has a formal elimination target: fewer than 4 cases per 100,000 women per year, globally. Countries with strong vaccine programs (Australia, Scotland, Sweden, the UK) are on track to hit that within a couple of decades. In vaccinated cohorts specifically, we may be looking at cervical cancer rates that approach zero, as Scotland has already demonstrated in real humans, not models.
Genital warts become a medical trivia question. Dermatology board exams will still ask about them, the way they still ask about leprosy. Actual clinic volume will collapse. Cryotherapy will primarily be used for skin tags and questionable ideas.
Oropharyngeal cancer in men finally starts falling. This one is the sleeper. HPV linked throat cancer has been quietly rising in American men for decades, and it’s the one HPV related cancer that has not yet started declining, because the men currently getting it were infected long before the vaccine existed. But the boys vaccinated starting in 2011? Their throat cancer numbers, 30 years from now, should look dramatically better than their fathers’ generation. We’re playing the long game, and the long game is winnable.
Anal, vulvar, vaginal, and penile cancers all drop. Not to zero, the vaccine doesn’t cover every HPV type, but substantially. Entire sub-specialties of oncology will have fewer patients. This is the rare medical scenario where “putting oncologists out of work” is the goal.
The multi billion dollar HPV screening and treatment economy shrinks. Fewer abnormal Paps. Fewer colposcopies. Fewer LEEPs. Fewer cancer treatments. Fewer bereaved families. Screening will still exist, it has to, because the vaccine doesn’t cover 100% of oncogenic types, but the volume and intensity of the whole cervical disease industrial complex should keep contracting.
The Punchline
We invented a vaccine that prevents cancer. Actual cancer. Multiple cancers, actually. It works so well that an entire country has documented zero cervical cancer cases in the women who got it as young teens. It’s safe, it’s boring, it’s been given more than 135 million times in the U.S. alone, and after 12+ years of follow-up, protection hasn’t budged (CDC, Impact of the HPV Vaccine). And we’re sitting at 61% coverage while collectively arguing about it on social media.The future burden of HPV disease in the United States will be exactly as low as we decide to let it be. The vaccine has done its job.
The virus is on the ropes. The only remaining variable is whether we, the humans, can get out of our own way long enough to finish the fight.
Sources:
CDC, HPV Vaccine Safety and Effectiveness Data
Public Health Scotland, No cervical cancer cases detected in vaccinated women (2024)
CDC MMWR, National Vaccination Coverage Among Adolescents Aged 13–17 Years, 2023