By Dr. Maureen L. Beurskens, MD
The Center for Disease Control (CDC) and the American Academy of Pediatrics recommend human papilloma virus (HPV) vaccination of females at age 11 or 12 and females between the ages of 13 and 26 who have not been vaccinated.
The human papilloma virus is actually a family of over one hundred different subtypes of related viruses. About 15 of the subtypes are now felt to be responsible for over 95% of all cancers and precancers of the cervix. Viral subtypes 16 and 18 are responsible for 70% of cervical cancers. Two other subtypes, types 6 and 11, cause genital warts and are linked to penile and anal cancers.
There are two Food and Drug Administration (FDA) licensed HPV vaccines. Cervarix made by GlaxoSmithKline protects against HPV subtypes 16 and 18. Gardisil is a quadrivalent vaccine made by Merck which protects against HPV subtypes 16, 18, 6, and 11.
Although some view HPV as sexually transmitted, approximately 20 million people in the U.S. harbor one or more subtypes of HPV. HPV is so common that most sexually active adults become exposed at some point in their lives. Since Oct. 2009, the CDC’s Advisory Committee on Immunization Practice’s guidance has been that the quadrivalent vaccine may be given to males 9-26 years of age to reduce the likelihood of acquiring genital warts.
Ideally patients should receive the vaccine before they become sexually active. Patients infected with one subtype of HPV will still get protection from the vaccine against the viral subtypes they have not yet been infected with.
The safety of both HPV vaccines was extensively studied prior to licensing. Vaccine trials for Gardisil ensuring safety included over 29,000 participants and the trials for Cervarix included over 30,000 vaccine recipients. The FDA and the CDC monitor the ongoing safety of all vaccines. The majority of adverse events following HPV vaccination have been minor. Reports have included pain at the vaccination site, headache, nausea and fever. There have been some reports of fainting after vaccination. Fainting is not an uncommon response to an injection in preteens and teens. Consequently, both the FDA and the CDC recommend lying or sitting down for 15 minutes after receiving the vaccination. The incidence of serious, major adverse reactions to either vaccine has been very low and is no higher compared to any other vaccine such as flu or tetanus vaccine.
Distrust among parents regarding vaccinations in general has been growing. It is not clear where this distrust stems from although distrust abounds these days towards government, banks and other institutions. Unfortunately, as parents delay or avoid vaccinating their children, there have been reports in some communities of deadly, preventable diseases that have not been seen in generations.
Vaccinations including the HPV vaccines provide an opportunity to protect children from acquiring what can be a life threatening disease. If parents want to keep their children healthy and safe, vaccinations, including the HPV vaccine, are just another part of what they can do to try to achieve this goal.