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If adults had the opportunity to be vaccinated against a potentially deadly form of cancer, few would refuse. But when it comes to the human papilloma virus (HPV) vaccine, all sorts of feelings get in the way. That’s because the vaccine protects against two forms of cancer caused by a sexually transmitted virus – but is most effective when given before sexual activity begins.
At issue is a vaccine thought to be 100 percent protective against the four strains of HPV that are responsible for 70 percent of cervical cancer cases. When transmitted during sex, HPV can cause genital warts and has a 90 percent likelihood of evolving into cancer of the cervix or anus.
Additionally, about 25 percent of all squamous cell cancers of the head and neck (70 percent of those occurring in the back of the throat, base of the tongue and soft palate) are thought to be caused by the HPV virus.
The risks of these cancers is serious as many adolescents turn to oral and anal sex to avoid pregnancy or to be with same-sex partners.
A dose of reality
The HPV vaccine was approved by the FDA in 2008 for girls ages 9 to 26. But since HPV is sexually transmitted, that protected only half the population. So in 2010, the vaccine was also approved for boys age 11 to 26 – to slow the spread of the virus and to protect against anal cancer.
Yet the HPV vaccine has been slow to catch on. Fewer than half of teenage girls and only 1.4 percent of teenage boys have received the vaccine. This disturbs Jo Ann Jackson, MD, an adolescent medicine specialist in Cleveland Clinic’s Willoughby Hills Family Health Center.
“Many kids will get HPV from their first sexual contact, and a significant percentage of kids become sexually active by age 14," she says.
Worse, they may not know they have HPV for many years. Additional sexual encounters spread the virus to others, while the risk of cancer itself grows.
Better late than never
“Once a child has had sexual contact there is no way to tell if he or she has been exposed to the HPV virus, or whether the strain of HPV they contract is one of the four covered by the vaccine,” explains Raul Seballos, MD, Vice Chairman of Preventive Medicine at Cleveland Clinic.
“If a child is vaccinated after contracting one of the viruses, it will still offer protection against the three other strains of HPV. Yet it is still possible for the child to develop cervical, anal, or head and neck cancer from the strain they have.”
That’s why the Centers for Disease Control and Prevention advocate the vaccine for children before they reach the age at which sexual activity commonly begins.
Fear about the vaccine’s safety is a common reason for refusal to vaccinate. HPV has been purported to cause such serious disorders as Guillain-Barré and mental retardation. Nothing could be further from the truth, says Dr. Jackson.
She assures parents that the vaccine is safe: “No reported side effects have proven to be the result of the HVP vaccine. The rate of Guillain-Barré after vaccination is about the same as it is in the general population, and mental retardation is not even on the radar screen.”
The cost – $100 per shot for three shots – is covered by most insurance providers but can be a legitimate concern for some families.
Cancer concerns outweigh all else
Without a doubt, pediatricians are most frustrated by parents who refuse to give consent for the vaccine for fear that it will be construed as permission to have sex.
“It has nothing to do with when a child decides to first have sex. It is about protecting your child from cancer at some point down the line,” says Dr. Jackson.