Good news: HPV vaccine is now more effective
Whether to vaccinate your kids (or yourself) against HPV is a no-brainer, according to Nisha David, MD, of Cape Obstetrics and Gynecology.
“It’s the only vaccine that prevents cancer – why wouldn’t you want to do it?,” said Dr. David, who sees patients at Falmouth Hospital’s Medical Office Building, Stoneman Outpatient Center in Sandwich and at the Bourne Health Center.
Some of the more than 150 strains of HPV, or human papillomavirus, cause cervical cancer, as well as cancers of the vagina, vulva, penis, throat, mouth and anus. It’s responsible for 30,700 cancers nationally every year, according to the U.S. Centers for Disease Control and Prevention. Some strains cause genital warts.
HPV is ubiquitous among sexually active men and women, with nearly all being infected by at least one strain during their lifetime. Fortunately, most infections resolve within two years.
While the vaccine ideally should be given before the patient becomes sexually active, Dr. David said young adults up to age 26 who are sexually active should get vaccinated, as they may not yet have been exposed to all the strains of the virus that cause cancer and genital warts.
Inoculating children before their teens provides two benefits, Dr. David said. First, vaccination occurs before they’re sexually active – HPV is spread by sexual contact. Second, the vaccine is more effective when given at an early age.
“It’s 93 percent effective for girls 10 to 13,” she said, contrasting that with women in their 20s, for which HPV vaccination was 20-50 percent effective.
The HPV vaccine has become much more effective since it was first introduced to the U.S. market in 2006. Of the three federally licensed for use, all protect against the two HPV strains (16 and 18) that cause most cases of cervical cancer. The early versions protected against these strains and two more (6 and 11) that cause genital warts. The newest version protects against nine strains, and is the only one now being distributed in the United States, according to the CDC.
A year-long evaluation by the CDC that ended in October found that two doses of vaccine given six to 12 months apart to children 11-12 years of age was just as effective as the previously recommended three doses. In light of this finding, the CDC in December reduced the recommendation to two doses for children 9-14 years old. Three doses remains the recommendation for people starting immunization between 15 and 26 years of age and for those with compromised immune systems, such as having HIV infection, an autoimmune disease or undergoing immunosuppressive therapy.
Reducing the number of doses should improve compliance with completing the full series of shots, Dr. David said.
“People have a hard time getting all three vaccinations,” she said. “They say only 33 percent get all three doses.”
Dr. David acknowledged some parents worry about the safety of vaccines.
“Really, the data’s just not there to support that (vaccines pose a substantial risk),” she said.
The HPV vaccines have been closely monitored. In the decade ending March 2016, 90 million doses of the three licensed vaccines were distributed. Since the newest vaccine, Gardasil 9, was introduced on March 31, 2016, 10 million doses have been distributed and 1,447 reports of adverse effects (mainly headache, nausea, fever and pain) have been recorded, of which 7 percent were deemed “serious,” according to the CDC.
Addressing parental concerns that vaccinating their child for HPV might be akin to granting permission for sex, Dr. David said it’s no different than vaccinating children against hepatitis C, which can also be spread via sex.
HPV vaccination rates fall behind that of some other vaccines given to children, but they are improving. Citing a 2015 national study, the CDC reports that 63 percent of teenage girls and 50 percent of teenage boys have been inoculated. The numbers are slightly better in Massachusetts, with more than 70 percent of teenage girls and more than 60 percent of teenage boys having been vaccinated.
While no medicine is without some risk, Dr. David said the good increased HPV vaccination could do is overwhelming, as it could cut healthcare costs and save patients from unnecessary worry, pain and death. She said much of her practice revolves around screening for, and treatment of, cervical cancer: annual pap tests, follow-ups for abnormal pap tests and surgical procedures.
Team Maureen, a non-profit community group building awareness of HPV, produced the featured video to encourage HPV vaccination. For more information, visit www.TeamMaureen.org.