Monday, April 8, 2013

Parents Reluctant to Vaccinate Kids against HPV?

As one of the medical providers at Barnard College, I am asked every day by students to be tested for STD's.  When I ask them what tests in particular they have in mind, they often answer "all of them."

We, like most clinicians in this kind of clinic only screen for HIV, chlamydia and gonorrhea. And that is not "all" of the STDs. As a followup question I often inquire whether the student has had the three HPV, often called by its brand name, Gardisil, vaccine.  I have been shocked in the year I have been working there by how often students are not aware if they got the vaccine; do not know what HPV is or say that their parents "didn't want them" to get it. Then I launch into my little speech about how they can make their own decisions now and we have a tutorial on HPV.

Now a new study just released in the prestigious journal Pediatrics sheds some light on this situation.  It shows that over half of parents of teens are not vaccinating their teens against Human Papillomavirus or HPV. And the share of unvaccinated teens has increased even though they are making this decision against the medical advice from their own medical providers.

The three most common reasons for not vaccinating against HPV were:
  • my child is not sexually active
  • the vaccine is not needed or not necessary
  • safety concerns/side effects

These reasons linger and in fact increased over the study period from 2008 to 2010 in spite of scientific, medical and public health advice to the contrary.

So what is HPV vaccine and what do most clinicians who see teens and young adults say about it?
  • HPV is the most common sexually transmitted disease.
  • HPV is ubiquitous and easily transmitted even with non-intercourse sexual activities (read "oral sex")
  • By age 18 over 70% of sexually active adolescents have already acquired HPV
  • Their are over 100 sub types of HPV
  • Most healthy people will clear HPV from their system through natural immune mechanisms
  • BUT, four of the 100 subtypes do not clear spontaneously.
  • These four subtypes cause cervical cancer, head and neck cancers, and genital warts
  • Men and women, young men and women, and girls and boys are all equally susceptible to infection with HPV
  • The HPV vaccine was designed to protect agains the four nasty subtypes of the virus that cause most of the lasting and disfiguring diseases (warts and cancers)
  • The vaccine is recommended for boys and girls ages 12 and up
  • Finally, the vaccine is exceptionally safe and effective
  • PS: it requires a series of three shots and it hurts a bit more than the average immunization.
It is my belief that the marketers from Merck should have called this vaccine "the first shot we have to protect against cancer. " The mistake was in connecting the vaccine with sex, teens and heaven forbid, teen sexuality. This was the cue for Michelle Bachman to get on board with those who talk about the "ravages" of HPV vaccine.  

The denial mechanisms that parents need to stay sane as they dare to think about their teens becoming sexually active in a dangerous world have held them back from making smart decisions about this shot.    We don't' wait until our kids step on a rusty nail to get a tetanus shot.  We shouldn't wait until they are infected or have abnormal Pap smears to give them the HPV shot. Besides it would be too late by then.

Call for an appointment today if your children have not had the vaccine.  At least listen to what experts have to say.  And remember when the eighteen year old comes in to see me in college and is ready to make her own decision--having done some reading, research and chatting with friends, it is often too late for the vaccine to work.

image from


  1. ut still, you know they're there - and in some of you these genital warts in women can cause maddening itching - or even bleed and discharge during intercourse. warts genital

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