With the school year in full swing, my patients have gotten the vaccines that are mandatory for school entry. However, there are a couple of shots that are not required but recommended by American Academy of Pediatrics. The one that generates the most controversy is the vaccine that prevents a sexually transmitted virus called HPV, or Human Papillomavirus.
This particular virus is the one that causes warts on our skin. There are about 100 strains, but 40 of them are associated with genital warts, and several of the 40 strains can lead to cervical, vulvar, vaginal, anal, penile and oropharyngeal (back of the throat) cancers.
The vaccine for HPV is intended to work against the strains most likely to cause the cancers and genital warts listed above. There are two HPV vaccines used today: Gardasil and Cervarix. Gardasil tends to be used more since it protects against more strains and can be used for both boys and girls. It's important to note that although these vaccines help prevent most of the serious problems caused by Human Papillomavirus, you can still get genital warts from other strains of the virus not included in the vaccine. The vaccines are given in a three-dose schedule over six months, and the protection is thought to last a very long time, if not lifetime.
For the rest of this article, I'll be referring to the Gardasil vaccine, since this is the one we use in our office. Gardasil is recommended for boys and girls from 9 to 25 years old. It works best when given to patients before they become sexually active. Both Virginia and the District of Columbia have laws on the books that mandate vaccination for all girls prior to sixth grade entry, but the Virginia law is not being enforced. Parents can opt out of both laws.
The most common side effects reported are:
Syncope (or fainting)—common after receiving shots, especially in pre-teens and teens
Local reactions at the site of immunization (pain and redness)
When I discuss this vaccine with parents, they are often concerned about its safety. Sometimes they have heard from a friend or read on the Internet that the vaccine is dangerous. In reality, the vaccine is as safe as any other vaccine we routinely give our patients. The Centers for Disease Control and Prevention (CDC) monitors all vaccines closely for unexpected adverse effects. Also, don’t forget that all vaccines and medicines have to pass intense scrutiny from the Food and Drug Administration (FDA) before they are allowed to be used for the general public.
In the past, parents have been anxious about other vaccines that were released, such as Hib for childhood meningitis, Prevnar for another strain of childhood meningitis; MMR for measles, mumps and rubella; and Varivax for chicken pox. They might have heard stories about kids who had negative experiences from taking the shots and therefore became hesitant to vaccinate their own kids. However, reputable studies have always been available demonstrating the safety of the vaccines, and once taking the vaccines became commonplace, many lives were saved.
Personally, what I think drives most of the apprehension for this vaccine is the notion that our precious "babies" could possibly be engaging in sexual activity. Does your child truly need a vaccine that is given for sexually transmitted problems? It is not pleasant to think about. Try looking at this objectively: What are the risks and benefits of receiving this vaccine? The risks are no different than other vaccines (24,000 reported adverse effects for 40 million doses given). The benefit is reduced risk of getting several types of cancers and genital warts.
The real question should be when do you have that discussion with your children about being responsible for their actions and getting the vaccine? My belief is that the vaccine is safe and effective, and I recommend it to all my patients. However, I leave it up to each parent to decide if and when the shot should be administered. When moral questions are involved, everyone will have a different viewpoint.
William “Dr. Bill” Incatasciato is a pediatrician at Capital Area Pediatrics in the Countryside Shopping Center in Sterling. For more information about Dr. Bill and/or his practice, visit www.CapitalAreaPediatrics.com.