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Thursday, December 14, 2017

Decision about new two-dose HPV vaccination starts early

hpv-2dose

At my 10-year-old daughter’s last doctor’s visit, I was given all the routine information: height and weight compared to her peers, plus recommendations for healthier eating and better sleeping habits. Pretty run-of-the-mill stuff.

But then the doctor pivoted to medical advice I wasn’t expecting. He recommended Victoria get her first HPV vaccination at her next appointment — just after she turned 11.

A flood of questions ran through my mind about timing, safety, reliability and more. Why so young? What are the side effects?  How many of her friends had already gotten the shot? What exactly is HPV, and how should I explain it to my daughter?

Not being quite prepared in that moment to discuss sexually transmitted diseases with Tori, I did what any good parent does when confronted with a lack of information: I jumped online. Then I consulted a doctor.

The human papillomavirus is a group of about 150 viruses that make up the most common sexually transmitted infections in teens and young adults. The Centers for Disease Control estimates that about one in four Americans are infected with HPV.  About 14 million new infections occur every year in the United States, where HPV causes 30,700 cancers in men and women annually — most of which are preventable with the vaccine. Although most HPV infections clear up completely on their own, with or without symptoms, there is no cure for HPV.

Most people who are infected with HPV do not show any symptoms, but certain strains can lead to cancer and genital warts. The types of HPV that cause warts are not the types that cause cancer.

“All forms of the vaccine prevent HPV types 16 and 18, the two types that cause 70 percent of cervical cancer,” says Dr. Zachary Castle, a family-medicine physician at Mountain Vista Medical Center in Mesa, who teaches sexual-health classes for families. “And (it prevents) types 6 and 11, the two types that cause 90 percent of genital warts.”

In October, the CDC changed its recommendation of three HPV vaccinations for all 11- and 12-year-olds to two over the course of six months to a year. The reason: More kids and teens will be protected against cervical cancer and genital warts due to the more convenient vaccination schedule.

“The studies show that the two-dose series is equally as effective as the three-dose series,” Castle says. “It’s much more convenient and will improve compliance with the series.”

“It can be an uncomfortable subject for parents to have to think about regarding their kids,” Castle acknowledges. “I think there are a lot of misconceptions out there about the vaccine, its side effects and its effects on teen sex practices. There is no evidence that getting the shot leads to more promiscuous behavior. This was outlined in a study published in 2012 in (the medical journal) ‘Pediatrics’ and supported by the American Academy of Pediatrics, which did not show significant changes in pregnancy rates, sexually transmitted infections or contraceptive counseling for up to three years after vaccination in girls.”

Although the CDC recommends that all children ages 11 and 12 get an HPV vaccination, the shot can be given as early as age 9 and is approved for boys through age 21 and girls through age 26. So even if a teen has become sexually active without being vaccinated, he or she can get the HPV vaccination, administered in three shots given over six months.
The reason for getting kids vaccinated before their teen years is old-fashioned prevention.

“For the HPV vaccine to be the most effective, it must be administered prior to any exposure to HPV,” Castle says. “Therefore, there’s no reason to wait until teens start having sex to give the vaccine.”

The risks associated with getting the HPV vaccine are minimal and can include pain, redness or swelling at the injection site, fever, headache, fatigue, nausea and joint pain.

“The vaccine does not cause HPV infection or cancer,’ Castle says. “It uses a small protein of the virus to allow your body to defend against it if it were to come in contact with the virus, but there is no risk of infection coming from the vaccine. And there is no scientific evidence suggesting that the HPV vaccine causes problems regarding future fertility in women. In fact, the prevention of cancer and HPV infection helps women have healthy babies.”

After poring over a mountain of information, listening to parent testimonies, reading doctor recommendations and plain old asking friends and family for advice, I scheduled Tori’s HPV vaccination.

I put aside all reservations about having an embarrassing conversation with my daughter and decided to view this vaccination just as I would any other childhood shot for measles, mumps or tuberculosis — as a necessary and pre-emptive measure to safeguard my child against the very real risk of contracting a potentially deadly virus.

To learn more about the HPV vaccine visit cdc.gov/hpv/parents/vaccine.html.

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Dani Horn

Staff writer Dani Horn is the mother of Victoria (11) and Remy (7).

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