Parents: HPV Vaccine Is Not About Sex, It’s About Preventing Cancer

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A young woman receives one of three shots of the HPV vaccine.

Courtesy / CDC Public Image Gallery.

A young woman receives one of three shots of the HPV vaccine.

Most kids have warts at some point in their lives, usually on their hands or feet. They’re caused by human papilloma viruses (HPVs) and nearly every person will become infected at some point in their lives. But not all HPVs are created equal. There are more than 100 types and most cause no real harm. But there are nine HPV strains definitively linked to various cancers. Two of these strains, 16 and 18, are the most dangerous.

The good news? There’s a vaccine for that. Yes, there is a vaccine to prevent cancer and it’s been around since 2006. The first vaccine included four strains, including 16 and 18, which cause 70% of cervical cancer cases. The latest vaccine, released in 2015, protects against five additional strains.

Although 79 million Americans are currently living with HPV and 14 million new infections occur each year, only 34% of girls in the US aged 13-17 have been fully vaccinated. Only 18% of boys in the U.S. are protected. In San Antonio, only 31% of girls and 15% of boys have completed the vaccination series of three doses. That means the vast majority of our teenagers are at risk for HPV infection and developing cancer.

Most people infected don’t have any symptoms: they are silent carriers and can pass on the virus for years without knowing it. Since women typically do not develop cervical cancer until their 30s or 40s, it’s easy to dismiss the threat of HPV when you’re young. Dr. Lois Ramondetta, of MD Anderson Cancer Center, spoke last week at University Health System’s Robert B. Green Campus to more than 60 health care providers attending the Texas Pediatrics Society HPV Conference. As she shared stories of her cancer patients, ranging in age from early 20s to 50s, it was difficult to not be overcome with sorrow.

Dr. Lois Ramondetta, of the University of Texas MD Anderson Cancer Center and LBJ General Hospital, talks about her young patients with cervical cancer. Photo by Cherise Rohr-Allegrini

Dr. Lois Ramondetta, of the University of Texas MD Anderson Cancer Center and LBJ General Hospital, talks about her young patients with cervical cancer. Photo by Rachel Jew

Some of these young women, many with young kids, won’t live out the year. If you’re on social media, you’ve seen the heartbreaking story of country and bluegrass singer Joey Feek, 40, as she said “Goodbye” to her two-year-old daughter. Joey was diagnosed with cervical cancer in 2014. Though Joey was likely infected before the vaccine became available in 2006, nearly 80% of women are infected by the time they are 26. Many of Ramondetta’s patients are in that target age range for vaccination, nine-26, when the vaccine became available in 2006.

Most of the attention in the press has been focused on cervical cancer, but HPV infection can lead to vulvar, anal, vaginal, penile cancers, and most significantly, oropharyngeal cancer.

“Since 1995, there’s been a huge jump in the number of HPV-related cancers in men,” Ramondetta said.

HPV mostly affects men in their 40s and 50s. More than 15,000 new oral cancer cases were reported in the US in 2015 and 2,793 of these were in Texas.

“If there were a vaccine against cancer, wouldn’t you get it for your kids?” said Dr. Melinda Wharton, acting director for the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control.

Since the vaccine was introduced in 2006, there has been a significant reduction in HPV infection in girls and young women aged 14-19, and more recently in women aged 20-24. The vaccine is working, but not enough people are getting it.

The U.S. lags far behind much of the world in protecting our kids against HPV.

The U.S. lags far behind much of the world in protecting our kids against HPV.

In Rwanda, 99% of the at-risk population has been vaccinated. In the United Kingdom, 86% are protected. In the U.S., less than 40% are vaccinated. Why do we lag so far behind other countries?

Understandably, people worry about anything that is new.

“They wonder if it’s safe,” said Dr. Ryan van Ramhorst, a pediatrician with University Health System. Most of the families he sees at the UHS Southeast Clinic have concerns.

However, the HPV vaccine has been available for 10 years. It’s been studied in tens of thousands of people and is continually monitored by the Centers for Disease Control. The worst reaction is a sore arm. While there has been some concern with teenaged girls fainting, all studies have shown this is not linked to any component of the vaccine.

But my kid is not sexually active, some parents might say.

We worry our teenagers might get in a car accident, but do we stop them from driving cars? No, we teach them how to drive cautiously, responsibly. We require them to take a course, to pass a test. We give them the tools to be safe drivers, to respect their passengers so as to not put them at risk. We instill in them the enormous responsibility of being a safe driver. We insist on seat belts. Importantly, we have a dialogue with our teenagers. Adolescents deserve the same level of education about their sexual health.

Most parents don’t expect their kids to be sexually active, but one day, our kids will become young adults. Most of us want loving and healthy relationships for our children. We want the best health for our children, so of course, we want to prevent them from getting cancer. Studies have found that sexual activity has not increased in girls and women who have been vaccinated.

But why recommend it for 11 year olds? Why not let our children decide for themselves when they’re 18?

For a vaccine to work, you need to have it long before you’re exposed to give it time to produce an adequate response. Since three doses over six months are most effective, it takes time to complete the course. We need to protect our kids early and give them enough time to develop immunity, long before they come into contact with the virus. If you wait until your child is likely to be exposed, it’s too late.

Many parents report that although their son or daughter is in eighth grade, their pediatrician did not recommend the HPV vaccine. Now is the chance for you to educate your provider. The perfect time is when your child is starting middle school, updating their required adult tetanus, diphtheria, and pertussis (Tdap) and meningococcal vaccines.

If there was a vaccine for lung cancer, would you give it to your kids? Or would you say “If I give my kid this vaccine, they’ll start smoking?”

It’s not about the sex. It’s about preventing cancer.


*Top Image: A young woman receives one of three shots of the HPV vaccine. Photo courtesy CDC public image gallery.

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7 thoughts on “Parents: HPV Vaccine Is Not About Sex, It’s About Preventing Cancer

  1. You may not have written the title—“HPV Vaccine Is Not About Sex, It’s About Preventing Cancer”—but your own writing shows that it’s impossible to make that claim. You devote several paragraphs to the role of sexual activity in contracting the problematic strains of HPV. So comparing this to other vaccines isn’t fair because my agency in deciding to contract influenza or measles, for example, is limited—I can get it just by living around other people.

    On a related note, it seems that the cancer-linked HPV strains can be avoided nearly entirely by our own decisions. So forcing it on our children like we do with other vaccines (and if it matters to whether you agree with my argument, know that I’m 100% pro-vaccination) is kind of different categorically. Therefore you shouldn’t expect the same deference and be astounded when people disagree with the argument that (1) X is safer than not X, therefore (2) X should be required.

    For example, you talk about safe driving and wearing seat belts: but recall the huge pushback when seatbelt laws became mandatory. Why the pushback? Because my decision to wear a seatbelt affects no one but me (it was just a lobbying effort by insurance companies lobbying to reduce PIP payouts). Taking it a step further, why don’t we wear helmets while in the car? That’d be safer, too, and all your arguments would support legally requiring it. Should we legally require our kids to wear helmets in the car or on school buses? Do you wear a helmet in the car?

    Because that’s the HPV vaccine. It’s wearing a helmet while driving a car. It might be safer, but it’s ultimately my own decision because it affects no one but me and any other people intentionally deciding to participate in the activity that carries the risk of transmitting cancer-linked HPVs. Those types of decisions are very bad bases for legally mandating the implementation of a chosen public policy.

    • You bring up some interesting points. Like’s take them one by one.

      1. The vaccine isn’t about sex, it’s about protecting you from cancer. More on that later.

      2. At this time, there’s no legal mandate for HPV vaccination. It’s recommended. This article does not suggest it should be required.

      3. Your point that your ability to protect yourself from measles is limited, but you can protect yourself from HPV is well taken. Indeed, 9 years ago when the state tried to mandate it, I balked, despite working in Public Health. I believed strongly in the vaccine, but believed as you do, that people can choose to protect themselves by other means. There were other, public health reasons why I didn’t think it should be mandated then. Despite the enormous drop in cervical cancer rates (and other HPV-related cancers) since the vaccine has been in use, Public Health officials are still not pushing for a mandate at this time.

      4. “HPV strains can be avoided nearly entirely by our own decisions.” One hopes that our children will make wise choices, based on the information we’ve given them. But at some point in my children’s lives, I hope they develop an intimate relationship with someone, because, that’s kind of a positive thing for most of us. And I can’t guarantee their partner will have made the same “wise” decisions their entire lives before meeting my adult child.

      5. Studies have shown that even teens who hold virginity as significantly important, engage in other acts that can transmit HPV. They don’t believe this to be “sex” though, because it’s not intercourse. Intercourse isn’t required for transmission. Skin to skin contact is, which is also why condoms are not sufficient protection. Again, we can choose to believe that our children will never do that before they’re married. Evidence indicates that, at some point in their lives, most do. (Not all, and your child may be the exception, but most do)

      6. Your choice to not wear a seatbelt affects more than you. If anyone is in the car with you when you have an accident, and your body flies around the car, you hit your passenger, putting them at substantial risk. Sometimes, people need to be forced to do something for their own good, for the benefit of all, like wear seatbelts. There is also a significant cost burden to society with every fatal traffic accident. Similarly, there is an enormous health cost burden with cancer cases. And I don’t mean public-pay patients. When someone with private insurance has cancer, those costs get transmitted across all payers. Reducing health care costs for one, especially through prevention, benefits all.

      7. We wear helmets on a motorcycle or bike, because our heads are exposed. In a car or a bus, our heads have some protection from the vehicle. Your analogy would suggest that you must wrap your teen in a reinforced steel cage to protect them from HPV, rather than give them a vaccine.

      8. Unfortunately, the decision not to vaccinate does affect others, unless you’ve chosen to remain celibate your entire life. That the rate of infection is well over 90% in women in their lifetime, suggests that most people don’t choose to remain celibate their entire lives.

      9. Back to #1. The vaccine prevents the disease – cancer. When you get a polio vaccine, do you talk about fecal films? Probably not. You talk about the disease. The HPV vaccine prevents a number of cancers. I’d argue that it’s a good opportunity to talk to your child about all “sexual contact” involves, but the primary aim of this vaccine is to prevent cancer.

      At this point, it’s still your choice. I’d argue the best choice is the one that protects the health of your child and the health of any partner they may have. Dying from cervical cancer at 30, when I could have prevented it, would be devastating.

      ps- my nine-year old just read this, and asked why someone would choose not to prevent cancer?

    • One more point about “choice.” You are making the assumption that every one gets to choose the when and the extent of their encounters. Unfortunately, it is all too common, much more than reported, for a person to be forced or coerced into sexual activity.

  2. You don’t have to explain to your child how a person gets HPV. You don’t even have to use the term HPV with your child. Just take them to a doctor’s office and ask the medical personnel to give the vaccination with you present and without an explanation. If they insist on giving an explanation of what its purpose is, ask them to restrict what they say only to the basics and without naming it–that it is a new vaccination to prevent several types of cancer just like you got shots to prevent measles, mumps, etc. , when you were younger. People seem to lose all sense of reason about something if sex is an aspect of it. Sex doesn’t even have to be discussed with the child in relation to this vaccination!!

    • Right. As a parent, I would say it’s a great segue to discuss sex with your kid. But many are not comfortable with that.

      There’s certainly no need for the provider to discuss it, and I’ve yet to meet a provider who insists on that discussion with an 11 yr old. Providers say just that – it’s a vaccine to protect against cancer. They’ll gladly answer your questions, but just like they don’t go into a discussion about how you contract polio, there’s no need to discuss the details of HPV transmission unless asked.

  3. This vaccine has never been proven to prevent a single case of cancer and it will be decades before we find out. Cases of cervical cancer in developed countries using Pap screening are 9/100,000. Deaths have come down from 8 to just 2/100,000 over the last 40 years with no vaccine and current uptake of screening of just 80%. Screening is still necessary even after vaccination. There are over 100 strains of HPV and some scientists expect other strains to replace those that are targeted by the vaccine.

    In the meantime thousands of girls are being seriously disabled and their lives ruined by the adverse reactions. In the UK 20,503 adverse reactions have been reported by Yellow Card, including 5 with fatal outcome (data obtained by FOIA request to MHRA). Even the manufacturers admit huge numbers of serious adverse reactions during the clinical trials.

  4. The European Medicines Agency stated ‘reviews of the reports did not show a consistent pattern regarding time-to-onset following vaccination, they appear to have totally ignored the evidence provided by the UK Association of HPV Injured Daughters (AHVID) which reported that a questionnaire completed by 94 member families indicated that:

    • 27 girls (31% ) had adverse reactions on the same day as the vaccination, many of them suffrering immediately, within minutes.

    • 12 girls (14%) had adverse reactions after just 1 dose

    • 19 girls (22%) had adverse reactions after just 2 doses (some of these had reactions also to the 1st dose

    • 14 girls had adverse reactions after the 3rd dose (and some of these had earlier reactions)

    • At least 4 girls (4%) had adverse reactions after each of 3 doses. Health professionals had indicated that the vaccine is safe and the adverse reactions suffered were not recognised as side effects of the vaccine. Initial symptoms were often ‘generally unwell, flu-like, tired, aches and pains’. With each dose the severity increased and day-by-day the severity increased. With some it was eventually several weeks before these symptoms developed into collapse with total fatigue and sleeping up to 23 hours each day.

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