Vaccines don't usually make it
into presidential debates; a few weeks ago, however, the Republican
presidential candidates got into a heated debate over the HPV vaccine and
whether it should be mandated for girls entering the 6th grade.
Personally, I'm not a fan of
political candidates' attempts to influence public health decisions, especially
when some of the "facts" thrown around during that debate have no
basis in science. However, the squabbling of those politicians did remind me
that we, as parents, need to be well informed and knowledgeable about the HPV
So, What is HPV?
HPV stands for "human papilloma
virus," which right now happens to be the most common sexually
transmitted disease in the U.S.
HPV is the main cause of cervical cancer
and genital warts. In other words, HPV is not a trivial infection--and it
can also cause cancer of the anus, vulva, back of the throat, and penis.
Most people who have it are unaware that
they have it. For more than 90 percent of the people who will acquire it
(and it only takes one sexual encounter to do so), their immune systems will
clear the virus within two years. But serious illness can result for those
whose bodies cannot clear the virus.
Over 40 types of this virus exist.
How Do You Prevent HPV?
Abstinence is 100 percent effective.
Abstinence, however, is not a realistic public-health strategy for cutting
down on the spread of HPV.
Condoms can help, but they must be
used with every sexual encounter, and the infection can still be acquired
in areas of the body not covered by the condom. And, as many studies of
teen sexual behavior have proven, few teens use condoms 100 percent of the
time, or use them correctly every time.
The HPV vaccine
So, What About the HPV Vaccine?
The HPV vaccine is in fact the
first vaccine ever introduced to help prevent cancer. Its primary goal is to
reduce the number of cases of cervical cancer in women.
There are currently two brands of
the vaccine licensed for use in the United States: Gardasil and Cervavix, which
were first introduced in 2006. Gardasil is, by far, the most frequently used
because it covers more strains of the HPV than does Cervavix, including the
most common types that cause cervical cancer and genital warts.
To date, over 35 million doses
have been administered, and these have had an excellent safety record. The
vaccine, which is given as three separate injections over si months, with the doses
spaced about two months apart, is most effective if all three doses are received
before the first-ever sexual contact.
Typical side effects are swelling
and redness at the site of injection. Another possible side effect might be
syncope (passing out); however, health officials don't know whether the vaccine
is the actual cause of this. One reason this debate is still going on is that
the main population receiving the vaccine--preteen and teen girls--might be
particularly prone to fainting when they are getting a shot. In any case,
patients must be observed for 15 minutes after the injection is administered
and again when they stand up.
Who Should Get the HPV Vaccine?
The American Academy of Pediatrics
recommends that girls start the vaccine when they have their checkups at ages
11 or 12 years. Why this young? As was mentioned above, to be most effective,
the vaccine's three doses must be given to girls before they ever have sex
and, sadly, a significant number of girls have had sex by age 15.
Besides 11- or 12-year-old girls,
other candidates for HPV include females ages 11 to 26. (The vaccine's
effectiveness--how well it works--is still being studied in women over 26 years
More recently, a third group was
approved for the vaccination: males ages 9 to 26 years. HPV vaccine can
prevent genital warts in males, and can help decrease the spread of HPV to
We Mustn't Let HPV's Associations with Sex Prevent Us From Using the Vaccine
I want to stress again that the
primary objective of the HPV vaccine is to reduce the number of cases of deadly
cervical cancer in women. For this reason, I don't want the crucial good
accomplished by the vaccine to be overshadowed by the fact that HPV is a
sexually transmitted disease.
I am a huge fan of sexual
abstinence in teenagers and encourage teens and parents to have ongoing discussions
about abstinence, especially at home. Studies have shown repeatedly that
talking to teens about safe sex does not increase their promiscuity or
risk-taking behaviors, but instead can help protect them. And, until we achieve
a 100-percent abstinence rate in teens, we need to do all we can to keep them
Again, we mustn't let the fact
that HPV is sexually transmitted distract us from its true worth, or prevent us
from giving this vaccine to our loved ones. If someone offered you a vaccine
that would prevent breast cancer from striking your child years later, wouldn't
you take advantage of it?