If you have a child who is at least 9 years old, you may be weighing whether he or she should get vaccinated against human papillomavirus (HPV).
HPV is a common sexually transmitted infection that can cause genital warts and cervical cancer. Men and women can carry it. HPV sometimes plays a role in other cancers as well, including cancers of the vulva, vagina, penis, anus, and throat.
For decades we only had one type of flu vaccine, but these days we have a choice: the traditional flu shot or the newer nasal spray flu vaccine, FluMist. Either vaccine will help protect against the flu virus, but some people are better suited for the flu shot, while others will do better with the nasal spray. They offer about the same level of protection against the flu.
There are two HPV vaccines: Gardasil and Cervarix. Gardasil, which protects against four HPV types (6, 11, 16, and 18), is approved by the FDA for use by females aged 9-26 to help prevent cancer of the cervix, vagina, and vulva; genital warts, and anal cancer. It's also approved for males aged 9-26 to help prevent genital warts and anal cancer.
Cervarix targets HPV types 16 and 18. It's approved for females aged 10-25 to help prevent cervical cancer.
Both are relatively new vaccines -- the FDA approved Gardasil in 2006 and Cervarix in 2009. And that makes some parents uneasy. Should they be, or are their fears unfounded?
Resistance to the HPV Vaccine
Most pediatricians recommend routine vaccination against HPV for girls, and to a lesser extent, for boys (the CDC made a "permissive" recommendation regarding boys and the HPV vaccine. It can be given to them between 9 and 26 years old, but it need not be routine, partly because of the vaccine's high cost). However, the rate of full immunization among girls aged 13-17 in the U.S. in 2009 was about 27%. The same year, about 44% of the adolescent girls received at least one of the three shots in the series.
"Of course we would like coverage to be higher. However, it is not that different from rates for other new vaccines soon after licensure," says Lauri Markowitz, MD, a medical epidemiologist with the CDC. She led the team that reviewed safety trials for the CDC and recommended Gardasil in 2007.
Getting vaccinated against HPV is recommended before becoming sexually active. Markowitz says studies show that many parents wait until their daughters are older before getting the shot, which is recommended for girls 11 or 12.
Another reason for the low coverage, Markowitz says, is that getting vaccinated against HPV takes two additional appointments, ideally within 6 months, and adolescents typically don't make that many visits to their doctor or other health care provider.
Lingering Safety Concerns
Minnesota mom Lesley Doehr plans to have her 11-year-old daughter, Sally, vaccinated against HPV. Her pediatrician recommended it, and after reading up on it and talking to other parents, she believes the benefits far outweigh the risks.
"If there's any chance of reducing cancer, why wouldn't you try it? That is my bottom line," says Doehr, an assistant regional treasurer for Cargill, Inc. She says she'll probably wait until Sally is 13, "when boys are in the vocabulary.''