For many of us, last-minute vacations, school supply shopping, and a visit to the pediatrician herald in the end of our kids' summer. It's also usually around this time when the emails and calls begin to pour in from friends asking whether or not their child should get the Human Papilloma Virus (HPV) vaccine. Sometimes, I can't believe that I am still asked this question, because to me, it's a no-brainer. Unless there is a contraindication, of course your child should get the HPV vaccine! Why wouldn't you protect your child from the most common sexually transmitted infection in the U.S. that causes genital warts as well as various cancers? Well, here are some of the excuses that I am given:
- Parents don't want to seem like they are condoning sexual activity
- Parents don't want to think about their kids being sexually active (otherwise known as "in denial")
- Their kids "aren't sexually active yet" (possibly also "in denial")
- Parents concerns about vaccine side effects
To really understand why this vaccine is so incredibly important for your child, let's review the facts about HPV:
- There are approximately 150 subtypes of the virus, with 40 of those affecting the genitals
- There are low risk, benign strains (genital warts) and high risk, cancer-causing strains (cervical, vulvar, vaginal, penile, anal, and head & neck cancers)
- Peak incidence of genital warts occurs between the ages of 20-24
- Although it is the most common way to become infected, you don't need to have penetrative vaginal or anal intercourse to acquire HPV. Oral sex, sharing sexual toys and skin-to-skin contact can also spread the virus.
- People with HPV often experience psychological distress and disruption of sexual relationships
- Women who have sex with women are also at risk for HPV
Here's why your child should get the HPV vaccine:
- The HPV vaccine can prevent infection with the types of HPV that most commonly cause genital warts and HPV-related cancers
- Kids are sexually active, often from a young age. It is ideal to get the full vaccine series before ANY type of sexual activity takes place (usually around age 11). However, even if sexual activity has already taken place, the vaccine should still be given.
- In a 2015 Youth Risk Behavior Survey, 41% of high school students reported that they had engaged in sexual intercourse
- 1 in 4 adolescent females has an STD (HPV is the most common)
- Most adolescents who are infected with the virus don't know that they have it
- By age 50, at least 4 out of every 5 women will have been infected with HPV at some point in their lives
- Most men are asymptomatic and are not tested for the virus
- HPV accounts for 70-80% of head & neck cancers in the North America and Europe and is occurring at younger ages, especially in men.
In general, females receive the vaccine between the ages of 9-26, while males can receive it between the ages of 9-21. When kids receive the vaccine before their 15th birthday, they only need 2 doses of the vaccine 6-12 months apart. After the age of 15, 3 doses are required. The vaccine is extremely effective, with data showing a 64% reduction in vaccine-type HPV infections among teen girls in the US since 2006. A study of Gardasil-9, the only HPV vaccine available in the U.S., showed that the vaccine was 97% effective in preventing high-grade precancerous cervical lesions or worse (cancer), in women who had never been exposed to the virus. Parents can also rest assured that the vaccine is safe. The clinical trials of the HPV vaccines, which included 44,000 subjects, did not identify any serious safety concerns. Thinking of our kids as sexual beings can be challenging for parents, but it is our job to protect them in all aspects of their lives, including their health. Make sure to talk to your child's healthcare provider about the HPV vaccine at their next visit.
Handsfield HH, Clinical presentation and natural course of anogenital warts. Am J Med 1997;102(5A):16-20
 Kann L, et al. MMWR Surveill Summ 2016;65(6):1-174