Journal of Vaccine Research, 2025, Vol.15, No.1, 23-33 http://medscipublisher.com/index.php/jvr 28 HPV-16/18, and these two viruses are the main "culprits" causing oral and oropharyngeal cancers (Kamolratanakul and Pitisuttithum, 2021). Now it seems that the vaccine can reduce the incidence of HPV infection in the mouth, which is a positive signal. However, whether it can effectively reduce the number of head and neck cancer cases and deaths caused by HPV still requires long-term research to draw a conclusion. However, from the existing data, it can be seen that the proportion of people who have been vaccinated and have oral HPV infections has decreased, which indicates that vaccines do have a certain role and possibility in preventing oral cancer (Kamolratanakul and Pitisuttithum, 2021). 5.3 Limitations of the current vaccination strategy Although the HPV vaccine is highly effective, the global vaccination situation is not optimistic. Only about 15% of the target population has completed the full vaccination. The main reasons are insufficient resources, unwillingness to get vaccinated, and many people failing to complete multiple doses as required (Bao et al., 2024). In addition, issues such as people's limited understanding of vaccines, differences in cultural concepts, high prices, and inconvenient vaccination have also led to the difficulty in popularizing vaccines in low-and middle-income regions (Schuchat, 2015; Nogueira-Rodrigues et al., 2022). There is a notable deficiency in the current vaccination schedule, with a particular focus on pre-adolescent girls. The protection available to boys and the elderly is relatively limited (Kamolratanakul and Pitisuttithum, 2021; Nogueira-Rodrigues et al., 2022). Moreover, even the nine-valent vaccine, which offers a wide range of protective types, cannot prevent all types of HPV that cause cancer. Although the effect of a single dose of the vaccine seems good, for this vaccination method to be widely used, more sufficient and reliable evidence is needed to confirm its effectiveness (Whitworth et al., 2019; Setiawan et al., 2023; Bao et al., 2024). 6 The Impact on Vaccination Strategies 6.1 Early vaccination for oral prevention To effectively prevent oral infection with HPV and related cancers, it is best to get vaccinated against HPV before starting sexual life. Research has found that people who have been vaccinated have a much lower probability of oral HPV infection than those who have not been vaccinated, with the infection rate reduced by 72% to 93% (Nielsen et al., 2021). Further analysis of the cases also found that people who have not been vaccinated are more likely to develop oropharyngeal cancer. Research shows that the possibility of unvaccinated people developing oropharyngeal cancer is 19 times higher than that of vaccinated people (Kaczmarczyk and Yusuf, 2021; Xu and Li, 2024). Multiple planning suggestions suggest that vaccinating children at the age of 9 can prevent various cancers caused by HPV, including oral cancer (Barsouk et al., 2023). Getting vaccinated early can protect people before they may be exposed to the virus, fully exerting the effect of the vaccine and significantly reducing the incidence of HPV-related oral cancer in the future (Wakim and Ramirez, 2020; Nielsen et al., 2021). 6.2 Expand the scope of vaccination Nowadays, most vaccination programs only focus on girls before puberty. However, to thoroughly carry out cancer prevention work, boys and people of other age groups must also be included in the vaccination scope. Actual data shows that the number of people suffering from oral cancer caused by HPV is increasing, with the number of male patients growing particularly significantly. Moreover, for both men and women, vaccination can reduce the risk of HPV infection and the probability of developing related cancers (Wakim and Ramirez, 2020; Nielsen et al., 2021; Barsouk et al., 2023). Vaccinating men not only directly protects them from infection but also helps build herd immunity, thereby reducing the spread of HPV among the population. In addition, vaccinating the elderly who missed the early vaccination can also provide certain protection, as people are at risk of HPV infection throughout their lives (Athanasiou et al., 2020). Some countries have recognized that this risk persists and understand that vaccinating a wider age group can prevent new infections and related cancers. Therefore, they now allow people under the age of 45 to be vaccinated (Harper and Gorin, 2020).
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