Thursday, July 30, 2015

Why I had my daughter vaccinated for HPV

As a pediatrician and a mom, I made sure my daughter always put on her helmet before she rode off on her bike, and I made sure she had an HPV vaccine by age 12 - not because I expected her to have sex at that tender age, but because I knew how important it was to protect her from HPV well before her first sexual experience.

Why I had my daughter vaccinated for HPV

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Gardiasil, one of two FDA-approved vaccines to prevent the human papilloma virus. (AP Photo / Charles Rex Arbogast)
Gardiasil, one of two FDA-approved vaccines to prevent the human papilloma virus. (AP Photo / Charles Rex Arbogast)

Today we have the first entry by Rima H. Himelstein, M.D., a pediatrician with Crozer-Keystone Health System. Board-certified in adolescent medicine, Dr. Himelstein treats boys and girls age 12 to 21. She has a special focus on adolescent gynecology and sexual health and she conducts research in youth development.

As a pediatrician and a mom, I made sure my daughter always put on her helmet before she rode off on her bike, and I made sure she had an HPV vaccine by age 12 — not because I expected her to have sex at that tender age, but because I knew how important it was to protect her from HPV well before her first sexual experience.

Yet many parents are skipping or delaying this important vaccine. According to one Centers for Disease Control and Prevention survey, just one in three teenage girls is fully vaccinated against human papilloma virus (HPV).  While vaccination rates are rising for some other teen and preteen vaccines, the HPV vaccine is lagging behind.

HPV is actually a group of more than 40 different viruses. Spread by sexual contact, HPV infections often cause no symptoms and usually go away without treatment. But HPV is also the most common STI, or sexually transmitted infection: About half of all sexually active males and females are infected with HPV, often within 48 months after their first sexual experience. I’m sorry to say that it’s all too common among 15- to 19-year-old girls.

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HPV is the main cause of cervical cancer. About 10,000 women get cervical cancer every year in the United States, and 3,700 die as a result. HPV can also cause other cancers in women and men, as well as genital warts. Condoms aren’t completely effective at preventing spread of the virus.

That’s the bad news. Now for the good news:

HPV vaccine protects against the viruses that cause more than 70 percent of cervical cancer and 90 percent of genital warts. That’s why the Centers for Disease Control and Prevention recommends that girls receive a three-dose HPV vaccine around the age of 11 or 12. The American Academy of Pediatrics (AAP), the American Academy of Family Physicians, and the Society for Adolescent Health and Medicine all support the recommendation. At that age, the vaccine produces the best immune response.

There are two FDA-approved HPV vaccines: Gardasil and Cervarix.  Both are effective at preventing HPV infections and related cancers. The HPV vaccine is given in three parts: an initial dose, a second dose one to two months later, and a third dose six months after the first.

If your child is over 12 and has not been vaccinated, don’t panic. The HPV vaccine still works and is also recommended for 13- to 26-year-olds who haven’t yet received it.  And if you are late for a dose, you don’t have to start over. (Wouldn’t it be great if everything in life was like this!)

Why delay? Most of my patients’ parents want their preteens to have the HPV vaccine. To them, it’s another routine childhood immunization, just like vaccines against flu, measles-mumps-rubella, chickenpox, hepatitis A and B, meningitis ... and the list goes on.

Some parents want to wait because they don’t “trust” the vaccine yet. But as the AAP points out, more than 35 million doses have been given since the HPV vaccine was introduced (it was approved in 2006), and it has an excellent safety record. Usually, side effects are mild: a little pain or swelling at the injection site, mild fever, etc. Like every vaccine, HPV vaccine has its rare risks. My own daughter (and both of my sons) had the HPV vaccine.

And some parents want to wait because they do not feel comfortable talking about sex with their 11-year-old. I understand how difficult this may seem.

My advice: Open the door to these kinds of talks. Let your children know that they can talk to you about any and all subjects, including sex. You should know that parents influence their kids more than anyone else. And your kids really are listening! Your car ride to the doctor’s office for the vaccine offers the perfect opportunity (they can’t escape and neither can you)!  Think of the vaccine as an invitation to talk — and one that you receive three times!

So, have your preteen kids received the HPV vaccine? And if not, why are you waiting? 

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About this blog
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. Division 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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