HPV Can Be Prevented - Here's How
The HPV vaccine has been proven safe and effective in preventing transmission of the human papillomavirus (HPV) and the cancers it can cause (the disease is considered responsible for over 26,000 new cases of cancer each year).
And yet, the Centers for Disease Control (CDC) reported earlier this month that U.S. children are still not getting the HPV vaccine at the rates hoped for by public health officials.
In order to encourage parents of young girls and boys to have their children vaccinated, doctors across the country, including Virtua gynecologic oncologist Randolph Deger, MD, and Virtua pediatrician Jeff Fendrick, MD, are speaking out.
Decoding the Decision
No one knows for sure why more parents aren’t opting to have their children vaccinated, but “when it first came out, there were some states that immediately tried to mandate it,” says Dr. Deger. “That approach may have felt too heavy-handed for some.”
Dr. Fendrick, who has already vaccinated two of his three children, finds that only around 20 percent of the parents of his patients ask or even know about this important vaccine, “and even then, they often want to ‘think about it’ before they decide to vaccinate their child.”
Both doctors have heard that some parents fear the vaccine is equal to a “license for promiscuity;” an idea Dr. Deger finds perplexing when comparing the vaccine to others that have long been mandated for all U.S. children.
“For example, almost all babies are vaccinated at birth against hepatitis B, which is a sexually-transmitted disease, or spread by sharing needles or getting tattoos with an unsterilized needle.”
Dr. Fendrick reminds parents, “the vaccine doesn’t create sexually promiscuous kids, but it does protect them from their very first sexual experience, which is usually when HPV is transmitted, and on. It’s still important to talk with your kids about safe sex and abstinence.”
Dr. Deger adds, “You don’t know who your child’s future sexual partner or partners will be,” although you can be certain that, unless they’ve received the HPV vaccine, they’ll likely become infected with HPV. With the vaccine, “you’ll at least be giving them a chance of avoiding some very serious medical consequences down the road.”
Your Child’s Future
HPV is the most common sexually transmitted disease; so common that today, according to the CDC, “nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”
Almost all cervical cancer can be traced back to an HPV infection, and new studies are starting to show links between HPV and several other types of cancer, including that of the head, neck, and anus.
“In my practice, I see women in their 40s and 50s who are dealing with cervical cancer, and whether or not to vaccinate their children is a non-issue,” says Dr. Deger. “They’re absolutely getting them vaccinated; my child is vaccinated.”
Cancer risks aside, the other medical issues that can arise from HPV are well-worth considering. Genital warts take a heavy emotional toll on young women. “Imagine you’re 17 years old, you’ve decided to have sex, and a few months later you could be faced with cauliflower-like growths on your vulva or around and inside your vagina,” says Dr. Deger. “You’re going to have to deal with the social stigma, you’re going to have to come back to the doctor to have a procedure, possibly multiple procedures, to have them frozen or lasered off. That’s a lot to go through at the very start of your life as a sexually-active young woman.”
If your child is vaccinated, it’s very likely they’ll never have to deal with this scenario.
For Girls and Boys
The first vaccine available for HPV, Gardasil, is now recommended for all pre-teen boys and young men as well as all girls and young women (there is another vaccine called Cervarix, which is only indicated for female patients).
“Getting boys vaccinated is an important part of the public health equation, as they can be carriers even if they never develop symptoms,” says Dr. Deger.
There’s a term in public health called herd immunity: It means we need a significant portion of the population to become immune to a disease before we start to see major health benefits for our society as a whole; for this to happen with HPV, we can only afford a small number of children to remain unvaccinated (for example, those with severe allergies or immune disorders often cannot tolerate vaccines).
“This is what makes it important to vaccinate boys as well as girls,” says Dr. Deger. “It wouldn’t make sense in the long term to only vaccinate half of the population.”
All told, “There really are no downsides,” says Dr. Fendrick. “This is a safe vaccine, and it’s already proven itself significantly effective. As a doctor and as a parent, I can’t think of a reason against this vaccine.”
Where to Begin?
An appointment with your pediatrician can get the vaccination process started. Cervarix and Gardasil are the two options recommended by the CDC for all 11- and 12-year-old girls. If not vaccinated in that window, girls and young women ages 13 through 26 should still get the vaccine.
The CDC also recommends the Gardasil vaccine for all 11- and 12-year-old boys, although, similarly, if not vaccinated in that window, boys and young men ages 13 through 21 (and possibly 26 – talk about this with your doctor) should still get the vaccine.
Side effects are rare and the most common are similar to the side effects of almost all vaccines: pain at the injection site, fever, headache, nausea and, rarely, fainting. Almost all major health insurance plans cover the cost of administering the vaccine, and Medicaid-eligible and uninsured children should be able to receive the vaccine at little to no cost through the federally funded Vaccines for Children (VFC) program.
The HPV vaccine is given in three doses over a period of six months. The CDC recommends the second dose be given 1-2 months after the first, and the third 6 months after the first. To ensure you follow the schedule, Dr. Fendrick recommends making appointments for the follow-up doses when you make the first appointment. The vaccine should be given long before any sexual activity with another person is expected in order for it to be most effective in preventing infection.
Updated June 6, 2016