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Who Should Get the HPV Vaccine?

November 29, 2016 | Heather Robinson, NP-C

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hpv-vaccine-preteens.jpgFirst, a few facts: The cancer-causing human papillomavirus (HPV) is, by far, the most common sexually transmitted infection in the United States. But the HPV vaccine, best given at age 11 to 12 to both girls and boys, is currently the most underutilized immunization available for children.

Partially, that’s because the vaccine (approved in 2006) is fairly new. But it’s also because many parents don’t understand why they are advised to vaccinate their child at such a young age (more on that later.)

The reality is that 80 percent of the population has been exposed to the HPV virus, which means that most children eventually will be exposed to it as well. The key is, like all vaccines, it only works before exposure to the virus.

The HPV vaccine, marketed under the names Gardasil and Cervarix, protects against genital warts as well as many different types of cancer, including cervical, vaginal and vulvar cancers in women; penile cancer in men; and anal cancer and cancer of the back of the throat (oropharynx) in both men and women.

That’s a lot to take in and, frankly, not something most parents of young children like to spend much time thinking about. But the reasons for early vaccination are compelling.

First, and perhaps most importantly, preteens have a stronger immune response to the HPV vaccine. It’s also important to remember that not all sexual contact is consensual. And HPV can be spread by sexual contact beyond just intercourse, including oral sex and hand-to-genital contact.

What’s more, the vaccine is given in three doses spaced between two months and one year apart, meaning that a child might not be fully vaccinated against HPV until one year after beginning the process.

What about older teens—or even young adults—who have not yet received the vaccine?

The Centers for Disease Control and Prevention recommends that teen boys and girls who did not get the vaccine when they were younger should get it now. Even if they are already sexually active, they may not have been exposed to any or all of the HPV strains that are in the vaccine, so they are likely to get at least some protection from the vaccine.

The HPV vaccine is not approved for women over the age of 26 and men over the age of 21, based on the theory that, by then, most young adults are past the point of exposure at which the vaccine would benefit them.

Just because the vaccine would not help the majority of women over 26 and men over 21, however, does not mean that some individuals would not benefit. The vaccine can be given to adults at any age with a doctor’s permission, although it may not be covered by insurance. This story by The Atlantic does a nice job examining the situation.

All adult women over the age of 21—whether they have had the HPV vaccine or not—should have regular Pap tests, which can catch cervical cancer in the early stages when it’s treatable. (HPV vaccines do not protect against all types of cervical cancer, which is why screening is advised for all women 21 years and over.)

Possible side effects of the vaccine include mild fever, itching at the injection site, nausea, fainting, headache and arm pain.

Some more serious side effects—such as blood clots, seizures and even death—have been reported, but government, academic and other public health investigators could not identify the HPV vaccine as the cause of any severe adverse event. Investigators concluded that such events occur at a certain rate in any group of tens of millions of people. The vaccination before each adverse event seemed to be a simple coincidence.

Vaccinations can be confusing. But they can also save lives. Contact us today to make an appointment to discuss the best options for you and your family.

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