An immunization that could prevent cancer? It seemed like far fetched science fiction when I first heard the rumors as a medical student, but fast forward 15 years and now I give it to my patients almost every day.
HPV (Human papilloma virus) infects the skin of the genitals and the throat, potentially transforming normal cells into cancer. It is also the culprit for genital warts. There are 2 vaccines FDA approved to protect against HPV and thus prevent these types of cancer. Cervarix protects against HPV types 16 and 18, which are responsible for 90% of cervical cancers. Gardsil protects against the cancer causing types 16 and 18, but also prevents types 6 and 11 which cause genital warts.
The current recommendation is for girls and boys to get the vaccine at age 11. The virus is sexually transmitted, so the idea is to give it before the kids even start thinking about sex. If they don’t get it in adolescence, the vaccine can be given up to age 26.
I’m often asked by patients and friends if I plan to give it to my kids. The answer is absolutely yes and here is why:
It’s safe.
With nearly 57 million vaccines already given worldwide, Gardasil is a well studied, safe vaccine. The most common side effects are pain at injection site {duh} and fainting. After getting the vaccine, it is recommended to sit down for 15 minutes to prevent the fainting side effect. Other common side effects include headache and fever. Allergic reaction to vaccines are rare. The data does not show any severe or unexpected short or long term side effects with the HPV vaccine.
I don’t want them to get cancer.
The HPV virus causes 12,000 cases of cervical cancer; 3,000 cases of vulvar cancer; and 8,000 cases of throat cancer each year. The vaccine has been shown to be 100% effective in preventing HPV 16/18 related disease if given before kids become sexually active. Throat cancers occur most commonly in men, who get the HPV from performing oral sex on women who have the virus. Anal cancer can also be caused by HPV, but it is rare.
I’m not naïve.
We are raising our kids in church, praying for them, and teaching them not to have sexual relations before marriage. But honestly, this is a fallen world and I know a lot of “good kids” who have made stupid decisions along the way. HPV is spread by vaginal, oral, and anal sex. Actually, any genital to genital contact can spread HPV.
Statistically 80% of women will contract HPV in their lifetime. Even if my kid manages to make it to marriage without HPV, odds are his mate will not.
I don’t want them to get genital warts.
Genital warts are not deadly, but they are painful and embarrassing. I’ve gone through many tissues in my office as I’ve comforted sobbing woman after telling them that what they thought was a mole on their labia was actually a genital wart. Genital warts are also commonly seen in pregnancy, as the lowered immune state can lead to the dormant virus suddenly popping up as “cauliflower like” bumps all over their lady regions as they approach the delivery suite {the one time in their life where their lady parts will literally be in the spotlight}.
I don’t want them to get pre-cancer.
The pap smear has become increasingly effective in preventing actual cancer, but the real gem of HPV immunization is the prevention of cervical dyplasia or “pre-cancer.” There are over 1 million abnormal pap smears in the United States each year. Each one requires a colposcopy, where the doctor looks at the cervix under the microscope and takes biopsies. The biopsy shows pre-cancer up to 35% of the time. A cone or LEEP is then performed which cuts out a portion of the cervix about the size of a thimble. Then the woman needs repeat pap smears 2-3 times a year for several years. If the pre-cancer returns, then another LEEP or even hysterectomy is warranted. The LEEPs are painful and multiple LEEPs can lead to pregnancy complications like preterm delivery.
Abnormal pap smears would not be eliminated by universal vaccination, but would be reduced by 70%. That would save significant anxiety, pain, and money for a lot of women.
Perhaps it’s the misinformed apprehension that some parents currently have about vaccines in general, or maybe just the fact that HPV is associated with sex that throws them for a loop, but currently only 33% of adolescents have received the full vaccination series despite overwhelming safety and efficacy studies. I bet if you ask the 350,000 women a year who needed cone biopsies or even the many who have genital warts, if they wished they could have had the vaccine, the answer would be an overwhelming yes.
I’m a Christian, a doctor and a mom. I love my boys and yes they are getting the Gardasil/HPV vaccine. HPV is a nasty virus that causes a lot of harm and emotional grief. I don’t wish for them or their future wives to have any type of unnecessary cancer or disease.
Dr. Heather Rupe 