We strongly support this landmark decision, which builds on the CDC’s 2006 recommendation to immunize all girls against HPV.
The vaccines, which protect against either two or four HPV strains, could prevent about 60 percent of mouth and throat cancers, 76 percent of cervical cancer, 87 percent of anal cancer, 31 percent of penile cancer and 44 to 56 percent of vulvar and vaginal cancers. Yet some parents are skeptical of vaccination’s value in cancer prevention or reluctant to immunize their sons and daughters against a sexually transmitted disease.
HPV is the No. 1 STD in the United States. About 6 million Americans are infected each year. Up to 80 percent of adults are infected with this virus during their lifetimes, with half becoming infected within four years of sexual debut. If you have two sexual partners in your lifetime, you have a 70 percent chance of being infected with one of the four common strains covered by the HPV vaccines.
Fortunately, most people’s bodies get rid of HPV infection spontaneously. However, the oncogenic types of HPV, those that cause cancer, are more likely to persist.
To offer the best protection against cancer, the CDC and medical community recommend that the HPV vaccine be given at age 11 to 12, before the onset of sexual activity. According to the 2009 national Youth Risk Behavior Survey, more than one out of every 20 high school students reported they had sex before the age of 13, and 32 percent of high school ninth-graders reported they had had sexual intercourse.
The HPV vaccine is a safe and extremely effective vaccine against certain types of HPV, especially the types most likely to cause cancer. More than 35 million doses of the vaccine have been given in the United States. The only major confirmed side effect after continuous surveillance is pain and some risk of fainting within 15-30 minutes after injection.
Two vaccines are available — the quadrivalent one protects against four types of HPV virus (6,11, 16 and 18) and the other protects against two types (16 and 18). Both protect against types 16 and 18, the cancer-causing types of the virus. The quadrivalent vaccine is the only vaccine currently licensed for use in the United States for boys, but either vaccine can be used in girls. There are approximately 160 types of HPV virus.
As adolescent medicine specialists, we want parents who are struggling with the decision to vaccinate their sons and daughters to understand that the vaccine is very low-risk and the protection it confers against several life-threatening cancers is substantial. Parents who are reluctant to think about their children’s future sexual behavior should consider that even young people who are sexually abstinent until marriage are still vulnerable to infection after marriage from a spouse who had been previously infected. In addition, as adolescent medicine physicians, we often see young patients who have become sexually active without their parents’ knowledge.
The HPV vaccine is the first vaccine that has the potential to prevent more than one type of cancer. We strongly support protecting both boys and girls against these cancers by immunizing them before they become sexually active.
Golden, MD, is a professor of pediatrics and chief of the Division of Adolescent Medicine at Lucile Packard Children’s Hospital. Yen,MD, MPH, is president of the Northern California Society for Adolescent Health and Medicine and a clinical instructor in adolescent medicine at Stanford and Packard Children’s. Both Golden and Yen are board-certified in pediatrics and in adolescent medicine.
This perspective piece was originally published Dec. 5 in the San Jose Mercury News.