The Human Papillomavirus (HPV) vaccine has been recommended and approved by the United States Food and Drug Administration since 2006. According to the Centers for Disease Control, children between the ages of 11-12 should receive two doses of the shot. It is approved for ages nine through 26, but the tween years are ideal. Even so, a study from the CDC found that only 58.6 percent of adolescents between the ages of 13-17 were fully vaccinated in 2020.
While this is an uptick in vaccinations from previous years, there is still much stigma around this vaccine. IHA Ann Arbor pediatrician Dr. Omkar Karthikeyan has made sure to prioritize conversations around the HPV vaccine with his patients and their families. “I still do see a surprising amount of resistance to this vaccine, albeit far less than I did a few years ago,” Dr. Karthikeyan says. “This often occurs even among families who otherwise get all the other recommended vaccines. I think it boils down to people viewing HPV as an STD, and most hesitant parents are just uncomfortable thinking about their 11-year-old in that way.”
Dr. Mara Perch, a pediatrician with Nationwide Children’s Hospital – Toledo, adds that many parents think of the vaccine as a kind of “greenlight” for sexual activity, which is an unfortunate way to look at a preventative measure. “We want to get across to the parents that the best thing is to give their child the vaccine before they’re sexually active, because their body does a better job of building that immune response before they’ve come in contact with any of these viruses.”
HPV is classified by the CDC as “a group of more than 150 related viruses that infect men and women. These common viruses infect about 13 million people, including teens, every year.” Contracting HPV can lead to multiple types of cancers including throat, anal, cervical, vaginal, vulvar and penile cancers.
Dr. Perch explains that “the most common [HPV vaccine] is Gardasil, which targets four strains: 6,11,16 and 18. Those are the strains that essentially are causing 90 percent of anal cancers, oral cancers, and vaginal cancers.”
She says that most people will come into contact with some strain of HPV in their lifetime, as there are so many different strains. Often your body will rid itself of the infection on its own without you even noticing any symptoms. It’s the lingering, potentially dangerous strains that can cause cancer down the line, which is why being protected by the vaccine is vital.
“The thing about HPV is that it can lie dormant for years, or even decades, without causing any symptoms,” Dr. Karthikeyan says. “Over that time, one can spread it to others, or begin to develop cancerous changes which may not be evident until they are very far along.”
Most people receive vaccines at a younger age, including the HPV vaccine. “The key with the HPV vaccine is to get kids vaccinated before they’re exposed,” Dr. Karthikeyan said. “For a virus that is transmitted via direct, often intimate, contact, it’s best to give this vaccine long before that’s even on anyone’s mind.”
Taking the HPV vaccine later than what has been medically recommended (after a person’s 15th birthday) leads to less effectiveness and potentially a higher likelihood of contracting the virus when exposed.
“This was evidenced by the update to the dosing regimen about three to four years ago,” Dr. Karthikeyan explains. “Those starting the series prior to their 15th birthday, ideally at age 11, as recommended, only require a two-dose regimen, as opposed to those 15 and older, who require the three-dose regimen.”
Dr. Perch also notes that it is just as important for boys to receive the vaccine as it is for girls. “There’s been a lot of new information over the last ten years about its protection against oral and anal cancers, and those are the ones that we worry most about in the male population.”
For most patients, the side-effects from the vaccine are very mild. The CDC states that the most common side-effects include pain, redness, fever, dizziness/fatigue, nausea, headache and muscle/joint pain. Overall, parents and adolescents considering getting this vaccine should consult their primary care provider to further understand the benefits of the vaccine.
“Prior to the vaccine, about 60-80 percent of all people were carriers of the HPV virus. That’s a pretty enormous number,” says Dr. Karthikeyan.“The current HPV vaccine is estimated in some large studies to be about 97-100 percent effective in those populations who have not already been exposed. It is estimated that about 14 million cases of HPV are transmitted in the U.S. each year, and this translates to tens of thousands of preventable cancer diagnoses. There is no debate within the medical community on this one. We highly recommend it, without reservation.”