Prevent Cancer with the HPV Vaccine

It's back to school time and if you are the parent of a child just starting middle school, that means it's time for his or her middle school set of vaccinations. I have had some parents ask about the human papillomavirus (HPV) vaccine which isn't required for entrance to middle school, but is highly recommended. In my professional opinion, I feel that it should be required and it is my hope that after reading this post you will see why I feel strongly about this cancer-preventing vaccine.

Human papillomavirus is a virus that is most commonly acquired through sexual contact. In fact, it’s the most common sexually transmitted infection (STI). HPV infection is so common that almost everyone will be infected at some point in their life. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV and there are 14 million new cases each year. In many cases, fortunately, HPV will go away on its own and not cause any long-term health problems, but when it doesn’t, it can cause genital warts and cancer. The most common cancer caused by HPV infection is cervical cancer, but it can also cause cancers of the vagina and vulva in women, cancer of the penis in men, and cancers of the mouth, throat and anus in both men and women. The scary thing is most who are infected with HPV aren’t even aware they have it and it can take years for someone with it to develop cancer. Prior to the HPV vaccine, the only ways to prevent acquiring HPV and the health problems it can cause was to use protection such as latex condoms if sexually active, but even that can't offer full protection. Other means to prevent it are 1) to be in a mutually, monogomous relationship and, 2) to be screened for cervical cancer if female. Fortunately, now (well, actually for the past decade), we have another means of prevention and that's through the HPV vaccine.

There are over 100 different strains of HPV and while the  HPV vaccine doesn't protect against them all it can prevent infection from the more high-risk strains. The HPV vaccine can prevent cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58. It also can prevent precancerous lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; as well as genital warts caused by HPV Types 6 and 11. Now it is important to mention that not all cancers of the vulva, vagina and anus are caused by HPV and the HPV vaccine only protects against the strains aforementioned.

The HPV vaccine is approved by the food and drug administration (FDA) and is recommended by the CDC for females and males between the ages of 9 and 26 years of age, although it is routinely given at 11 or 12.  One of the questions I have received in clinic is, “Well, my child is only 11, and he isn't sexually active nor is he going to be anytime soon. Why does he need this vaccine now”. The answer is simple. The idea of vaccines is to protect your child long before they will exposed to the disease, – so in the case of HPV, long before he is ever sexually active. For example, we don't wait until your child is exposed to measles to protect him from it. This is the same idea with the HPV vaccine. In addition to that, preteens have a more vigorous immune response to HPV vaccine as compared to older teens. Your child will only need two doses if vaccinated before the age of 15 versus the three doses if vaccinated at 15 or older.

Another concern I have heard from parents is the idea that the HPV vaccine is  too “new” to the vaccine schedule. In all honesty, it's really not. Yes, it hasn't been around as some of the other routine vaccines, such as the Measles, Mumps and Rubella vaccine (MMR) and the H. influenzae type B vaccine (Hib), but it still has had years of clinical trials and post-marketing safety surveillance data to show it's safe and effective. The HPV vaccine was first developed in Australia over 20 years ago and filed for U.S. patent in 1994. In 2006, the FDA approved the first preventive HPV vaccine and by 2008, over 80 countries across the world had approved it. Since then —  about a decade now—  it has been approved in over 100 countries with over 100 millions doses given world-wide. You can also look at it this way, if your child is entering middle school, the vaccine is older than your child; it's really not that new.

Just like the other vaccines your child will be receiving at his middle school well-child check, the HPV vaccine is safe and effective. No serious side effects have been caused by the HPV vaccine, but as with any vaccine (or medication), there is always a risk for side effects, even serious ones, like allergic reactions, injury or death. The most common side effects associated with the HPV vaccine are just local site reactions like mild redness, swelling or pain at injection site. Some patients experience fever and others have complained of a headache, but overall, it is very well-tolerated and these symptoms should go away quickly. To date, the HPV vaccine has not been associated with any long-term or serious side effects. The benefits of this vaccine far outweigh the risks.

Moreso, the HPV vaccine is effective. In Australia, where they have a National HPV Vaccination program and have had better rates of vaccination against HPV, there has been a significant decrease in HPV-related infections in  young women. In fact, an October 2012 study in The Journal of Infectious Disease found that the prevalence of vaccine-preventable HPV types (6, 11, 16, and 18) in Papanicolaou test results of women aged 18-24 dropped significantly from 28.7% to 6.7% —  only four years after the National HPV Vaccination started. In addition, the vaccine is long-lasting and there is no evidence of waning immunity for at least 10 years. Now, as far as how long immunity lasts after inoculation, that is still unknown.

It is my hope this post has helped inform you regarding the HPV vaccine and allay some worries you may have had. I strongly believe in the importance of this cancer-preventing vaccine, why I'm talking about it here and why I recommend it to all my patients. What's more, we at ABC Pediatrics, believe that vaccinating your child may be the single most important health promoting intervention we perform as health-care providers and that you can do as parents and caregivers. As always, do not hesitate to contact us if you want any more information on the HPV vaccine or with any other questions or concerns. We are happy to help!

Information presented adapted from:
https://www.cdc.gov/std/hpv/stdfact-hpv.htm
https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html
https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/HPV-Gardasil-9-What-You-Need-to-Know.aspx
https://www.google.com/patents/US7476389
https://www.merckvaccines.com/Products/Gardasil9
https://www.ncbi.nlm.nih.gov/pubmed/23087430
https://web.archive.org/web/20130420211055/http://ncirs.edu.au/immunisation/fact-sheets/hpv-human-papillomavirus-fact-sheet.pdf