8 Essential Facts About HPV Vaccines
Research shows that HPV vaccines are safe and can prevent some cancers and other problems. Here’s what you need to know if your children are due for their shots.
By Regina Boyle Wheeler
Medically Reviewed by Farrokh Sohrabi, MD
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It's been nearly a decade since the first vaccine to prevent some strains of human papillomavirus (HPV) infection was approved.
But vaccination rates in the United States remain low, even though health organizations like the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend the HPV vaccine for boys and girls when they're 11 or 12 years old to prevent HPV-related cancers and other health problems.
HPV is common and is spread through intimate skin-to-skin contact, with or without sexual intercourse, says Christine Nyquist, MD, medical director of infection prevention and control and occupational health at the Children’s Hospital Colorado in Aurora.
The infection usually clears on its own, but in some people it can persist. When that occurs, conditions such as genital warts and cervical and anal cancer can develop, as well as other female genital cancers, penile cancer, and cancers of the mouth and throat, according to the National Cancer Institute (NCI).
When children aren’t vaccinated at the recommended time, they're left vulnerable to getting cancer that could be prevented, says Dr. Nyquist. Here are eight essential facts about the HPV vaccine to help you decide whether to get your child vaccinated.
1. There is more than one vaccine.Three vaccines are now available, says , a research epidemiologist in the division of STD prevention at the CDC in Atlanta. All three vaccines guard against HPV 16 and 18, the strains that cause the majority of HPV-associated cancers, according to the CDC.
Gardasil 9 (human papillomavirus 9-valent vaccine) protects against nine strains of the virus implicated in genital warts and cancer. “Eventually, there will be a complete transition to Gardasil 9 in the U.S.,” Dr. Markowitz predicts.
Until that time, two other vaccines are also available: Gardasil (human papillomavirus quadrivalent), which protects against two strains of warts and the two top cancer-causing HPV types, and Cervarix (human papillomavirus bivalent), which doesn’t protect against genital warts and is only approved for use in girls. Cervarix isn’t commonly used in the United States, Markowitz says.
2. The HPV vaccine works.Despite low vaccination rates in the United States, HPV infections in teen girls dropped by more than 50 percent four years after the 2006 approval of the vaccine, according to a 2013 study led by Markowitz and published inThe Journal of Infectious Diseases. Australia, which has a high vaccination rate using Gardasil, has seen a dramatic decrease in the number of genital wart cases — an early consequence of infection, according to Markowitz.
3. The HPV vaccine is safe.As of March 2014, about 67 million doses of Gardasil had been distributed in the United States, and about 25,000 adverse events reported, notes the CDC. Most were not serious. Common side effects are injection site reactions, dizziness, fainting, nausea, and headache.
4. You shouldn’t wait to vaccinate.The HPV vaccine should be given in three doses when girls and boys are 11 to 12 years old, according to the latest recommendations from the CDC, published in 2015. It’s important to vaccinate well before there’s any exposure to the virus, because the vaccine prevents infection but doesn’t treat an existing one, Markowitz explains. If you miss that window, vaccinations can still be administered later.
Related: 10 Science-Based Facts About the Vaccine Debate
5. U.S. vaccination rates are slowly rising.In 2013, 35 percent of boys and 57 percent of girls ages 13 to 17 had started the HPV vaccine series, according to . Those numbers were up from 2011, when 8 percent of boys and 53 percent of girls were vaccinated. And while any increase is good, Markowitz says the trend isn't good enough. One problem, she says, is that some doctors aren’t recommending the vaccine.
6.TheHPV vaccine does not lead to promiscuity.A 2012 study published in the journal Pediatrics debunked the notion that the vaccine invites sexual activity. Researchers found that HPV vaccination of 11- and 12-year-old girls was not linked to increased rates of pregnancy, sexually transmitted infections, or contraceptive counseling for up to three years after vaccination.
“Parents ask children to put on seat belts to keep them safe in the event of an unexpected car accident," Nyquist says. "By putting on the seat belt, they aren’t inviting an accident. Vaccination keeps [children] safe for the future if they are exposed to HPV. It doesn’t invite sexual activity."
7. Vaccination doesn’t replace a Pap test.“The HPV vaccine protects against most HPV types that cause cervical cancer, but not all,” says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. So for now, she says, cervical cancer screening is necessary.
8. Protection against cervical cancer does not differ among blacks and whites.The HPV vaccine is equally effective at preventing cervical cancer in white and black women, Drs. Saslow and Markowitz say. But a study published in 2014 in the journal Cancer Causes & Control raised concerns that it might not work as well in black women. Researchers found that black women diagnosed with precancerous cervical changes were two times less likely to be infected with strains of vaccine-preventable HPV (16 and 18) than white women. Other strains of HPV not covered by the available vaccine were more common in black women in the study.
But, Markowitz explains, pre-cancers caused by strains other than 16 and 18 are less likely to actually progress to cancer. In addition, Gardasil 9 now protects against all but three of the strains that were more common in black women in the study.
Video: Essential vaccination for children and young adults
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