Friday, February 12, 2016

HPV vaccine: Why should my teen get it?

Paul Offit, M.D., the director of the vaccine education center at the Children's Hospital of Philadelphia, tells us more about the HPV vaccine and how it can protect against cervical cancer in females and cancer in the head and neck cancer in males.

HPV vaccine: Why should my teen get it?

HPV viruses are common types of sexually transmitted viruses. Although most cause no symptoms and go away on their own, genital HPV infection can cause cervical cancer, as well as other cancers and genital warts in both women and men. In June 2006, the FDA approved the HPV vaccine for girls and women aged 9 to 26, according to study background information, which noted that approval has since been expanded for males in that age group. (AP Photo)
HPV viruses are common types of sexually transmitted viruses. Although most cause no symptoms and go away on their own, genital HPV infection can cause cervical cancer, as well as other cancers and genital warts in both women and men. In June 2006, the FDA approved the HPV vaccine for girls and women aged 9 to 26, according to study background information, which noted that approval has since been expanded for males in that age group. (AP Photo) AP Photo

Despite the recommendation from experts, parents are increasing citing safety concerns as their reason to not vaccinate their teenage daughters against HPV, the virus that causes the most cases of cervical cancer, according to a recent study.

The study in the April issue of Pediatrics looked at vaccination rates among teens in the United States for several illnesses, including genital human papillomavirus. HPV, the most common sexually transmitted virus in the U.S., has been linked to cervical cancer, genital (anus, vagina, penis) cancers, and a type of head and neck cancer.

Researchers found a dramatic increase in the number of parents citing "Safety concerns/side effects" as their main reason for not vaccinating their daughters between 2008 and 2010. It jumped from 4.5 percent in 2008 to 16.4 percent in 2010.

The study did find a growing number of U.S. girls were vaccinated against HPV. The percentage of 13 to 17-year-olds who were not up-to-date on the vaccine fell from 84 percent to 75 percent. However, only 32 percent of girls from ages 13 to 17 were fully vaccinated against HPV in 2010. The three-shot vaccination hasn't been linked to any serious side effects.

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The researchers also cited other reasons parents decided not to vaccinate:

“The consistent 11 to 14 percent of parents who gave the main answer “Not sexually active” illustrates that parents mistakenly perceive this vaccine is related to and necessary only if there is current sexual activity. Another consistent response, given by 14 to 17 percent of parents across the 3 years studied, was that the HPV is “Not needed or not necessary” despite the high prevalence rates of HPV infection and of the infections dire consequences suffered later in life.”

We asked Paul A. Offit, MD, the chief of the division of infectious diseases and the director of the vaccine education center at the Children’s Hospital of Philadelphia, to tell us more about the HPV vaccine and address safety concerns parents may have about it. He specializes in infectious diseases and is an expert on vaccines, immunology, and virology.

Who should get the HPV vaccine and when?

It’s recommended for adolescent boys and girls, 11 to 13 years of age.

What does it protect against?

There are about 100 types of papillomaviruses. Some types of papillomaviruses cause warts on the skin, some types cause warts in the anal and genital areas, and some types cause cervical cancer.

Many different HPV types cause cervical cancer. Two types (16 and 18) are the most common, accounting for about 70 percent of all cases of cervical cancer. Similarly, many types of HPV cause anal and genital warts; but only two types (6 and 11) account for about 90 percent of cases. One vaccine, Gardasil, contains types 6, 11, 16 and 18. I recommend this vaccine since it protects against four strains. Another HPV vaccine, Cervarix, contains types 16 and 18 only.

Cervarix and Gardasil protect against cervical cancers in women. Gardasil also protects against genital warts and cancers of the anus, vagina and vulva. Both vaccines are available for females. Only Gardasil is available for males.

What many parents don’t know is that it’s also cancer preventing in males. It protects against cancer in the head area such as the throat, nose, and neck.

How is the vaccine made?

The vaccine is made using a protein that resides on the surface of the virus. The protein is grown in the lab in yeast cells. It will make a virus protein when the yeast cell reproduces itself, then the protein forms something called a virus-like particle. It looks like the virus under a microscope, but most importantly, it doesn’t contain HPV genetic material so it can’t reproduce itself like actual virus and cause illness.

Should I have any safety concerns about the vaccine?

Gardasil was tested in 30,000 people for seven years before Food and Drug Administration approval. Studies determined that the vaccine was 91 percent effective at preventing infections, 100 percent effective at preventing persistent infections, and 100 percent effective at preventing Pap smear changes that predict cervical cancer.

It was tested in another 190,000 women after FDA approval. The only problem that comes up in boys and girls is fainting during the shot. Sometimes it happens when the needle is unsheathed before the shot.

There have been concerns raised from bad information on the internet. There has been no causal relationship shown between the vaccine and adverse events such as blood clots, chronic fatigue syndrome, strokes or seizures. It’s now been given to tens of millions of people without any problems.

What are some side effects? Are they common?

The vaccine may cause pain, redness and tenderness at the site of injection. The vaccine may also cause a slight fever. It is a small price to pay to avoid cancer. It prevents the only known cause of cervical cancer.

Is the vaccine necessary for my child? Is it only for sexually active teens?

It only works as a preventative, not as a treatment. It needs to be given before a teen becomes sexually active in order for it to work. It is assumed that virtually all people will become sexually active at some point. Both of my children, who were adolescents at the time, were vaccinated when it came out about seven years ago.

Some parents falsely believe that vaccination will likely lead to their teen becoming promiscuous. A recent study that followed 11 to 12- year-old girls for three years found no difference between vaccinated and non vacinated girls with having taken a pregnancy test, been tested for sexually transmitted diseases, or been counseled for the use of contraceptives.

Every year, over 26,000 people in the U.S. are diagnosed with head, neck, or cervical cancers. The vaccine may have prevented these cases.

Read more from the Healthy Kids blog »

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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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