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HPV Vaccine

Sep 04, 2013

Has your child been vaccinated against HPV?

It’s a question that comes up often among parents of adolescents. Vaccines for HPV (human papillomavirus) have not been around for long. The first, Merck’s Gardasil, was approved by the U.S. Food and Drug Administration (FDA) in 2006. Three years later, GlaxoSmithKline’s Cervarix came on the scene.

The vaccines are not quite the same, but are generally designed to provide some protection from certain (but not all) strains of HPV, one of the most common sexually-transmitted infections in the United States.

HPV is actually an umbrella term for over 100 types of viruses. Over 40 of them are transmitted through sexual contact. And most of the time, people don’t know they’re infected. Usually, the infection goes away on its own with no treatment.

But not always. Some persistent, long-lasting types of HPV are linked to cervical, vaginal, and vulvar cancers in women and penile cancer in men. Both sexes can develop anal, oral (in the mouth), and oropharyngeal (involving the throat) cancers as well as genital warts.

Vaccination Rates

It would seem that a vaccine that could help prevent cancer and genital warts would be on a parent’s list of planned immunizations for their child. However, vaccination rates do not reflect this.

In July 2013, the CDC published a report on HPV vaccination rates among girls based on the National Immunization Survey – Teen (NIS-Teen). To understand the results, it helps to know that HPV vaccines are given in three doses. To be fully protected, a child must have all three before his or her first sexual encounter.

For 2012, researchers estimated the following rates for girls:

          One dose or more            53.8%

          Two doses or more          43.4%

          Three doses                    33.4%

Why are rates of full coverage so low?

Reasons for Not Vaccinating

A March 2013 study published in Pediatrics, the journal of the American Academy of Pediatrics, looked at this question. Researchers examined the reasons parents gave for not vaccinating. They found that the number of parents with safety concerns had increased over the years. Many parents thought that the vaccines weren’t needed at all or weren’t necessary because their daughters weren’t sexually active.

Let’s take a closer look at these reasons.

“HPV vaccines aren’t safe.”

Both federal agencies and vaccine manufacturers evaluate the safety of vaccines. Between June 2006 and May 2013, over 56 million doses of HPV vaccine were administered in the U.S. About 99% of these doses were HPV4 (Gardasil, which protects against 4 types of HPV).

The CDC examined the safety data for HPV4 and found 21,194 reported problems – less than one percent of all doses. Of that number, 92% were classified as “nonserious.” These included incidents of fainting, dizziness, nausea, headache, fever, and hives. Some girls had pain at the injection site, redness, and swelling.

The remaining 8% of reported problems, labeled “serious,” most commonly involved headache, nausea, vomiting, fatigue, dizziness, fainting, and generalized weakness.

HPV vaccines are generally considered safe. But parents are encouraged to talk to their child’s pediatrician, who can address any concerns.

“HPV vaccines aren’t necessary.”

As explained above, HPV infection is one of the most common sexually-transmitted infections in the United States. The CDC estimates that 79 million people in the U.S. are currently infected with HPV and 14 million are estimated to become infected each year. While most infections clear on their own, some do not. So, the extra protection is considered worthwhile.

“My child isn’t sexually active.”

HPV vaccinations are usually recommended for girls at age 11 or 12, although a young women can be vaccinated up until her mid-twenties. Many parents wonder why the vaccine is targeted to such a young age.

It’s best to vaccinate before any HPV exposure. HPV can be transmitted the very first time someone engages in sexual activity, including oral sex.

If a person is already infected with one type of HPV, the vaccine is less effective toward that type. It can still protect against another type, however.

What About Boys?

Most of the news and research about HPV vaccines have been about girls. But what about boys? HPV infection affects males, too.

In February 2012, the American Academy of Pediatrics (AAP) recommended that both girls and boys be vaccinated against HPV at age 11 or 12. However, only Gardasil, not Cervarix, has been approved for males. (Clickhere to read more about the AAP recommendation.)

What Can Parents and Guardians Do?

Navigating the sea of information on HPV vaccines isn’t easy. How can parents and guardians learn more and make the best decision?

First, and most important, talk to your pediatrician. He or she should be able to answer all of your questions about any vaccine you consider for your child.

Second, educate yourself about HPV and the vaccines. But be careful about where the information comes from. Consider the source. Is the information based on solid research? Does it come from a doctor? From a celebrity? (For tips on finding reliable sexual health information on the internet, click here.)

Finally, talk to other parents. What decisions have they made? What have their experiences been? Finding support among others who have been through the decision-making process might help you come up with other questions to ask your pediatrician.

Resources

American Academy of Pediatrics

“AAP Recommends HPV Vaccines For Both Males and Females”

(Press release. February 27, 2012)

http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Recommends-HPV-Vaccines-For-Both-Males-and-Females.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

HealthDay

Norton, Amy

“Parents' Worries About HPV Vaccine on the Rise: Study”

(March 18, 2013)

http://consumer.healthday.com/mental-health-information-25/behavior-health-news-56/parents-worries-about-hpv-vaccine-on-the-rise-study-674474.html

Pediatrics

Darden, Paul M., et al.

“Reasons for Not Vaccinating Adolescents: National Immunization Survey of Teens, 2008 – 2010)

(Full-text. First published online: March 18, 2013)

http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2384.full.pdf+html

Sexual Medicine Society of North America

“HPV Vaccines in the News”

(October 12, 2011)

http://www.sexhealthmatters.org/sex-health-blog/hpv-vaccines-in-the-news

Slate

Ohlheiser, Abby

“Why Are Parents Increasingly Fearful of the HPV Vaccine Even Though It's Safe?”

(March 18, 2013)

http://www.slate.com/blogs/the_slatest/2013/03/18/hpv_vaccine_side_effects_pediatrics_study_finds_increasing_number_of_parents.html

U.S. Centers for Disease Control and Prevention

“Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007–2012, and Postlicensure Vaccine Safety Monitoring, 2006–2013 — United States”

(Morbidity and Mortality Weekly Report. July 26, 2013)

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6229a4.htm?s_cid=mm6229a4_w