Is the HPV vaccination appropriate for children?

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Many parents have expressed concerns about the safety and effectiveness of the HPV vaccine. In particular, mothers of young daughters are questioning whether or not to have their child vaccinated. Thinking about a vaccine involving a virus that is transmitted through sexual activity when that time in your child’s life is far away in the future is difficult. As an obstetrician-gynecologist, I respond by asking the parent: “Would you give your daughter a vaccine that has the potential to prevent her from developing cancer in the future?” That is exactly what the HPV vaccine can accomplish.

HPV is the acronym for Human Papillomavirus. People pass it from person to person through skin-to-skin contact. There are many types of HPV (as many as hundreds), and about 30 of these affect the genital area. The types are identified by numbers, such as “HPV type 11.” It is primarily spread through sexual activities, not just intercourse. The virus can be spread by any intimate skin-to-skin contact.

Parents should be concerned about HPV because of the serious illness caused by the infection. HPV infection causes either genital warts or cervical cancer. Many do not realize that individual HPV types do not cause both, but just one or the other. Approximately 12 types cause genital warts, though two types — type 6 and type 11 — cause the majority of cases. About 15 types of HPV cause cancer of the cervix. They may also cause other types of cancer, including that of the sexual organs and the head and neck. Research indicates that types 16 and 18 cause most cases of cervical cancer.

Thinking that virus causes cancer is unsettling. Most of us think of cancer as a random event, not a response to a virus. In many cases, that is true, but in this situation the virus is responsible for the vast majority of cervical cancer cases. If HPV enters the cells covering the cervix, these infected cells may become abnormal or damaged and begin to grow differently. The abnormal cells can evolve into cancer, though it usually takes several years for cancer to develop. This is why pap smears are so important. Pap smears can identify abnormal cells before they become full-blown cancer.

What if there was something that prevented the HPV infection from the start? Enter the HPV vaccine, which provides immunity to some of those HPV viruses. Two vaccines are currently available: one vaccine contains protection against four types of HPV — type 6 and 11, the causes of most genital warts, and types 16 and 18, which cause most cases of cervical cancer. The other vaccine protects against two types of HPV — type 16 and 18. Remember that these vaccines contain only two to four types of the virus and there are more than thirty types that can affect the genital tract. The vaccine protects against the most common HPV types that cause genital warts and cervical cancer, but it will not protect against all types. Therefore, it is possible to get genital warts or have an abnormal pap smear.

The vaccines are nearly 100 percent effective in preventing genital warts and cervical cancer caused by the types in that vaccine. However, they only contain two to four types, depending on which vaccine is received. Both are recommended for girls and young women aged 9 years through 26 years of age, though the vaccine is most often administered between ages 11 and 13. The vaccine is most effective if it is given before a person is sexually active and already exposed to HPV. Note that boys can be given the vaccine as well. Three doses are given over a six-month period with the most common side effect being a sore arm. Rarely, a person can develop headache, fatigue, nausea or dizziness and fortunately these symptoms are generally mild and disappear quickly.

I suggest you review the Centers for Disease Control website at www.cdc.gov. It is not for me or any doctor to choose what is best for you or your children. Rather, I hope you will become informed enough to feel comfortable making a decision that is right for both of you. Consider asking your obstetrician-gynecologist or your child’s pediatrician about the HPV vaccine at your next visit.

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Kristia Patsavas, MD is a Park Ridge, Illinois-based physician specializing in obstetrics and gynecology. The advice contained in this article is for informational purposes only. Readers are advised to consult with their physician to evaluate any illness or medical condition. Patsavas may be contacted through her website at www.associatesinobgyn.com.