HPV Vaccine Therapy in Interrupting Progression in Patients With High-Grade Vulvar or Anal Lesions

Inclusion Criteria: * Histologically confirmed diagnosis of initial or recurrent anal or vulvar high-grade squamous intraepithelial lesion (AIN2/3 or VIN2/3) diagnosed on or after 1/1/2014; study pathologist will use p16 staining as needed to rule out low-grade squamous intraepithelial lesion (LSIL) disease * \>= 2 months since last therapy for HSIL * No clinical evidence of HSIL on screening examination; if HSIL is suspected, a biopsy will be done to exclude HSIL; patients whose screening visit reveals HSIL on biopsy, may be re-screened \>= 2 months after therapy * Resident in the catchment area of the clinics and willing to attend up to 8 clinic visits for a 36-month period * Sexually active women of child-bearing potential must be willing to use effective contraception through month 7 of the study * If human immunodeficiency virus (HIV) positive, receipt of anti-retroviral therapy continuously for at least 6 months prior to enrollment * Ability to give informed consent * Willingness to sign medical records release form and tissue release form Exclusion Criteria: * Currently pregnant * Chemotherapy (current, within the last month, or anticipated in the next 7 months) * Prior history of invasive HPV-related anogenital cancer (cervical, vaginal, vulvar, penile, or anal cancer), or oropharyngeal cancer (base of tongue, tonsil); prior cancer at other sites (including most of oral cavity) or larynx are not exclusions * Unstable medical condition (e.g., another malignancy requiring treatment, malignant hypertension, poorly controlled diabetes, another cancer except for fully excised non-melanoma skin cancer) * Prior HPV vaccination * Known allergy or intolerance to lidocaine * Currently participating in an interventional research study related to HPV, except the Anal Cancer HSIL Outcomes Research (ANCHOR) study (NCT02135419) * Any other condition which, in the opinion of the investigator, may compromise the subject's ability to follow study procedures and safely complete the study