Parents would do anything to protect their children and keep them safe and healthy, so when I’m asked about whether or not girls (and boys) should get the HPV (Human Papilloma Virus) vaccine, I don’t hesitate to say YES!! BY ALL MEANS!! Of all the things parents can do now to try and prevent cancer in the future, the HPV vaccine is probably the single most effective tool currently available.
In fact, the HPV vaccine and the Hepatitis B vaccine are the two only vaccines approved in the U.S. that can prevent cancer. Estimates of the number of people affected by Hepatitis B per the CDC ranges from 850,000-2.2 million (with many people unaware they are infected). The primary modes of transmission are through contact with blood or other infected body fluids, as can occur with sexual activity or IV drug use. It’s estimated that 50-60% of hepatocellular carcinoma (liver cancer) is related to chronic hepatitis B. Why am I telling you this? Because: resistance to Hepatitis B vaccination is uncommon, and starts at birth for most babies in the US since the 1990’s.
HPV, on the other hand, is estimated to affect almost everyone who is sexually active at some point during their life. Approximately 14 million new infections occur in the US every year, although about 90% of those infected will manage to clear the virus within two years (Centers for Disease Control). For those unable to clear the infection due to genetics, their immune system or other factors, HPV can lead to genital warts or cause abnormal Pap smears, cervical cancer, and other cancers of the head, neck, and genital tract. About 11,000 women are diagnosed with cervical cancer each year, and thanks to Pap smears, many are found at early stages with high rates of survival. Even so, it’s a terrible disease that requires surgery and often painful radiation treatments.
Generally, HPV-related cancers are slow growing (one of the reasons we can effectively screen for some of them), so the men and women getting diagnosed now were not likely to have been candidates for the HPV vaccine, which first became available in 2006. Initially, the HPV vaccine in widest use (Gardasil) protected against 4 of the most common subtypes (over 100 different varieties have been identified that infect humans), subtypes16/18 are highly associated with the development of cervical cancer and 6/11 are frequently the cause of genital warts. At the end of 2014, the Gardasil vaccine was improved to provide protection against infection from 5 additional HPV subtypes that are known to be highly associated with causing cancer. These 9 HPV subtypes account for roughly 90% of the most common HPV-related cancers.
HPV Vaccine Schedule
The recommended schedule for the HPV vaccine is for girls and boys ages 11 or 12 (although it can be started as early as age 9) to get their first dose during their regularly scheduled well-child visits. It consists of 3 injections, the second one is recommended two months after the 1st dose, and the last or 3rd injection should occur four months after the 2nd dose (or 6 months after the 1st one). However, if this ideal vaccination schedule is missed, it is recommended that children and young adults simply catch up at whatever point that can. Every dose counts and can help provide lasting immunity. It will take us decades to determine if adults will need a booster shot at some point, but we do know that protection will be much better if the series is started before sexual activity does.
And that’s where everything falls apart, at least here in the U.S. Parents know their 11 and 12-year-olds are not having sex, so why would they need a vaccination to protect them from a sexually transmitted infection? That’s precisely the point! They are not (yet) having sex, so this is the time to get them immunized and fully protected. The statistics show that the vaccine is up to 99% effective at preventing infections with those nine subtypes if fully immunized. There is also an erroneous idea that if children hear that they are being protected against a sexually transmitted infection that could affect them in the future, that will somehow induce sexual activity or “give them license” to engage in such activity.
Also, the immune response and antibody production in a young adolescent are many hundreds of times stronger (and hopefully longer lasting) than the response from an adult immune system, so that is another compelling reason to have the series completed during these years. Even so, the vaccine is indicated for anyone up until age 26, whether or not they have already been sexually active, and in some cases, older patients will discuss getting the vaccine with their provider, if they are at risk of acquiring the infection.
It’s a sad failure of the healthcare system here in the U.S that only one-third of all girls have been vaccinated against HPV. In Australia, where rates are around 80% for vaccination, the rates of some HPV-related diseases have plummeted to less than 1% (British Medical Journal 2013).
While I respect that some families have legitimate concerns about vaccinations in general or the HPV vaccination, in particular, I encourage them to discuss these with their healthcare provider. For the vast majority of young people, the HPV vaccine should be just another in a series of regularly scheduled injections that will help protect them from some devastating diseases, like hepatitis, measles, and meningitis.
I hope that anyone out there on the fence about getting their children vaccinated will strongly consider doing so. At least look at the facts and discuss them with your doctor, and if you’re already on board, I hope you’ll spread the word about doing something that can prevent cancer and disease for future generations. I’ll get down off my soapbox now; it’s not a place I come to very often, and I appreciate you sticking it out to the very end!