Should teens get the HPV vaccine?
In a rare consensus statement, the nation’s leading cancer centers say yes to HPV vaccination — and I did, too.
A low rate of vaccination against HPV infection, which can lead to cancer, is nothing less than a public health threat. That is the consensus of the nation’s leading cancer centers, including the Vanderbilt-Ingram Cancer Center.
The 69 National Cancer Institute-designated centers issued a statement in January 2017, calling on the nation’s healthcare providers, parents and young adults to take advantage this opportunity to prevent many types of cancer.
The news reminded me of my family’s own experience with the HPV vaccine for my daughter. She was 14 when she began the three-dose series in 2006. This was shortly after the U.S. Food and Drug Administration had approved the first vaccine, marketed as Gardasil, as a way to prevent cervical cancer.
A decade later, as many as 40 strains of this virus have been implicated in cervical and other cancers, including those of the vagina, vulva, anus, and head and neck. Three vaccines are now approved that prevent infection by the most common of those — and thus prevent cancer. Vaccination is recommended for girls/women and boys/men between the ages of 13 and 26.
Still, whether to vaccinate remains a difficult question for a lot of parents. This has resulted in a low rate of vaccination across the country. Fewer than 40 percent of girls and just more than 21 percent of boys are fully vaccinated, the cancer centers noted. The vaccination rates are even lower in Tennessee, according to the state Department of Health.
“The HPV vaccine gives us a powerful tool to protect our children from several types of cancer,” said Paula Hull, Ph.D., a Vanderbilt-Ingram Cancer Center member who participated in a summit of leading cancer experts that led to the consensus statement. “The HPV vaccine is very safe, just as safe as all the other vaccines we give our children when they are little. Parents should ask their doctors about HPV vaccine, and doctors should talk to parents of pre-teens every chance they get.”
As a former medical journalist, I know that all healthcare decisions require careful consideration of the risks versus the benefits. I have always believed in doing my research about healthcare decisions for my family. This was no different. I reviewed the safety data, learned about potential benefits and risks, and talked to my daughter about her thoughts and reservations. I was also lucky enough to be able to hear directly from renowned vaccine experts at Vanderbilt, including some involved in the trials that led to the vaccine’s approval.
Here’s why I decided to vaccinate my daughter and why I would choose to do so again.
HPV is the most common sexually transmitted infection
The Centers for Disease Control and Prevention estimates that every sexually active adult will be infected by a strain of HPV at least once in his or her lifetime. More than 79 million Americans are believed to be infected and about 14 million new infections occur each year. Many people “clear” the infection on their own within a year or two, but in many cases, infection persists. This can cause changes in cells that ultimately lead to cancer.
We’re talking about potentially life-threatening diseases
HPV infections are responsible for 27,000 new cancer cases each year. To put that into context, fewer than 11,000 children are diagnosed with pediatric cancers each year; if a vaccine could prevent childhood leukemia or pediatric brain cancer, would I have given my child a vaccine to prevent it? Probably. And, yes, adoption of Pap smears to screen for cervical cancer has reduced the death rate significantly. It does so by detecting abnormal cells that can be treated before they become cancer; but this treatment is not without its own drawbacks including possibly complicating future pregnancies and deliveries.
The vaccines have been tested in thousands of people, and have continued to be closely monitored since FDA approval.
The longest safety track record is with Gardasil, the first vaccine to be approved. Of more than 80 million doses given as of September 2015, about 32,000 “adverse events” were reported — 0.04 percent. Of those, only 7 percent (0.0028 percent of the total 80 million doses) were found to be serious, and 14 percent had nothing to do with health. There were 51 verified deaths in people who had received Gardasil vaccination during this time. The CDC found no common diagnosis that would suggest the deaths were related to the vaccine, nor were there any patterns related to timing after vaccination or consistency in vaccine dose number or combination of doses. Context matters here too — if everyone had received all three doses of the vaccine, that would mean 80 million doses were given to 26.6 million individuals — so the deaths account for 0.0002 percent of the 26.6 million. When I compared that to deaths from cervical cancer — 12,000 cases and 4,000 deaths, or 33 percent — I concluded the benefits far outweigh the risks. Mild side effects are common and include pain where the shot was given, nausea, headache and fever. My daughter said it really hurt, all the way down her arm, and our nurse said many girls report the same thing. Some people experience fainting, and after that effect was reported, guidelines were changed to encourage doctors and nurses take steps to prevent falls or injury if fainting occurs.
I’m a believer in my own responsibility to help protect the community
Vaccination programs work in large part by creating what is known as “herd immunity.” As more people are protected against a virus like HPV, polio or measles, the virus has fewer “hosts” to invade and the sooner the disease it causes can be wiped out. By vaccinating my daughter, I am helping to protect not only her but others.
Many parents find this issue unsettling because HPV is spread sexually. I did, too, but I found it important to put my own squeamishness aside. If a shot were available to protect my daughter against breast cancer, wouldn’t I want her to have it? If she developed cervical cancer or her ability to carry a child were compromised because of a treatment we could have avoided with three simple shots, would I regret it?
This is just our story. Your family’s decision is your own.
Editor’s notes: See the press release about Vanderbilt’s support of the consensus statement on HPV vaccination by the 69 National Cancer Institute-designated cancer centers. You also can read a Q&A from an adolescent medicine specialist at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Cynthia Floyd Manley is content strategist at Vanderbilt University Medical Center and has more than 20 years’ experience writing about health, medicine and medical research. Her daughter is now 23.
The Prevent Cancer Foundation, with Vanderbilt-Ingram Cancer Center (VICC), is sponsoring “Think About the Link,” a seminar about the link between viruses and certain cancers, July 20 in Nashville. The event coincides with the Tennessee Cancer Consortium’s annual conference. “Think About the Link” is for cancer survivors, health professionals and members of community organizations and are open to the public. Information and registration.