Why do pre-teens need the HPV vaccine?

The HPV (Human Papillomavirus) vaccine protects against a virus that is far more common than any other germ we vaccinate against. As many as 80% of all adults get infected with this virus. Around 44,000 of them develop cancer each year due to these infections.

Yet many parents are skeptical of their child’s need for protection against HPV. “We’d rather go the route of them not being exposed to it.” However, knowing the life cycle our children will inevitably go through, and as common as this virus is, avoiding life-time exposure is unrealistic.

We give this shot starting at age 9, and hope to have it completed by the time kids are wrapping up their “7th grade shots.” Parents have a lot of questions about this vaccine because of misinformation they have heard from lay people. Below are answers to the most common ones I hear.

Do you give this vaccine to your children?

Yes I do, to both my boys and my girls. After much study, I consider it a safe and effective way to prevent one kind of cancer, for the reasons below. (And, by the way, I am a “traditional values” kind of parent which lets you know where I’m coming from, and I still whole-heartedly support the HPV vaccine.)

What is HPV and why is it a problem?

HPV stands for Human Papillomavirus. It is a family of viruses that infect skin and genital areas which causes warts, growths and cancers.

A female’s cervix is like a magnet for HPV. Years after it has infected the cells of the cervix, it can cause them to start multiplying abnormally, leading to cancer. This cancer doesn’t cause any symptoms until it is very advanced. Moms know all too well that women ages 21+ get screened for these changes every few years as adults through “pap smears”. If there are precancerous changes on a pap smear, those areas may need to be treated or removed to keep the cancer from spreading. Certainly it would be more ideal to prevent those changes from happening in the first place. HPV can lead to problems with fertility and child-bearing. (By the way, moms will be interested to know that HPV vaccine was recently approved for women up to age 46 though it may be less effective at a higher age.)

In addition to the cervix, HPV can cause cancer in any part of the body it comes in contact with, including mouth, throat, penis, vagina or anus. It can also cause warts in those areas. Around 30,000 people develop cancer in those areas due to HPV every year.

If HPV is spread through sex, don’t you have to have multiple sexual partners to get it?

Actually, no. It is spread through sex, but it can also be spread through skin to skin contact. Is is so common that between 60-80% of people are infected with HPV by the time they are young adults. Most of these people will be asymptomatic and not know they are infected. For the future grown up that is your child now, even if they had only one lifetime partner, they would still have a 60-80% chance of being infected with HPV. Furthermore, while we may have some influence over our children’s behavior, we can’t predict the choices they will make, and we certainly don’t have any control over their future partners’ behavior.

Do kids really need protection against HPV even if they’re not sexually active? Why do doctors give it so young?

Kids need to get the vaccine before they’re sexually active. They will still have very good long term immunity after getting it young. In fact, their immune response is better when they are young compared to when they are older. The shot needs to be given before they are exposed to HPV in order to work. Most people are infected without knowing it by the time they are young adults. Kids require fewer doses when they’re young to get the same level of immunity (2 doses before 15 years compared to 3 doses after).

Does it work?

Yes, extremely well. We’ve seen HPV infections decrease between 70-85% in young adults since we’ve started giving the HPV vaccine. The incidence of HPV-related cancers has decreased as well.

Why would boys need protection against HPV?

HPV is not just a woman’s disease. Boys can get oral and pharyngeal cancers as well as genital warts and penile and anal cancers. We don’t chose our boys’ sexual orientation, and men who have sex with men are at higher risk for HPV infection. Giving your son the HPV shot could mean your future daughter-in-law will be less likely to have HPV-related cancer, protecting her reproductive health to make sure you have grandkids to enjoy. It’s a selfless act for your son to take a shot for the benefit of his future partner or spouse.

I’ve heard of a lot of controversy around this vaccine. Is it safe? Is it tested?

It is much more extensively tested and safe than most medications, and safer than some on Facebook would have you believe. Before HPV vaccine was approved and licensed for use in 2006, it underwent clinical trials in several different phases. These trials included around 30,000 individuals, first to assess safety, and then to assess efficacy. There were no higher rates of significant adverse reactions in those that got the vaccine compared to those who didn’t.

Since then, ongoing studies continue to be done, the same as with all vaccines, to monitor for any further side effects.

To understand this process, here’s a little primer on vaccine safety monitoring. When a vaccine is put into use, there is something called the VAERS system (Vaccine Adverse Event Reporting System) that doctors, nurses, parents, patients -literally anyone- can use to report a potential vaccine reaction. If we took all VAERS reports in this database at face value however, we would conclude that vaccines have literally turned kids into Spider-Man or the Hulk, because there are actual reports of this happening. So the next step is for independent academic researchers (who are not part of vaccine manufacturing corporations) to compare groups of children who got the vaccine with group of children who didn’t. If a vaccine really does cause a reaction reported in VAERS, that reaction should be seen more often in the vaccinated group.

These studies have revealed a very reassuring safety record for HPV. There’s no evidence of reproductive problems, blood clots or other severe adverse reactions occurring more often in vaccinated kids. After more than 120 million of doses of HPV vaccine have been given over the last 14 years, the only side effects detected are local pain, redness and swelling at the injection site, and occasional headache, muscle aches and fatigue. Teens have been known to faint after getting the HPV vaccine, but not any more than after getting any other immunization or similar medical procedure.

Despite this, HPV has been the target of a lot of anti-vaccine smearing. It’s one of the newer shots on the schedule (even after more than a decade) so it makes sense for those with a certain agenda to target it, which they have done from the very beginning. Parents may have been slow to give the HPV vaccine because they are uncomfortable thinking about their children having sex or getting a sexually transmitted infection. So in a way, buying in to what lay people say about HPV vaccine allows parents to dismiss those concerns and avoid that discomfort. But the reality is that our children will become adults (sooner than we think) and have sex, and many will even have sex as teens (but not just because they got a vaccine!)

Does it cause reproductive problems?

There is no evidence that HPV vaccines cause any reproductive problems. Results from these studies is available for parents to read here. On the contrary, cervical cancer can lead to problems with childbearing that could have been prevented through getting this vaccine.

Does it make teens more likely to have sex?

Research supports that teens are not more likely to have sex just because they got the HPV vaccine. Teens don’t choose to have sex or not have sex because of some vaccine at the doctor’s office. By giving them the HPV shot, you are not giving your pre-teen a green light to have sex, you are teaching them responsibility for the care of their body and care for their future loved one.

Parents may feel that HPV is an adult concern encroaching into their kids’ childhood, sexualizing their pre-teen years. But conversations about sex are best when started early and done incrementally based on what’s developmentally appropriate. Giving them the HPV shot can be an occasion to start having conversations about the bodily changes that will be starting soon, and help set the stage for them to be informed about their health and develop responsibility for it.

Learn more about HPV and preventing it through immunization at the Utah Cancer Control Program