How To Protect Your Kids Against HPV

As a gynecologist who takes care of a fair number of teenage patients, I sometimes find myself walking a fine line between patient privacy and parental information.  For example, I saw a young woman the other day who had recently become sexually active.  She had convinced her mother to bring her to me because she had painful cycles and wanted to control them with hormonal contraception.  The issue was twofold, of course.  She wanted the birth control pills because she wanted to protect against pregnancy as well.

We talked about the pill and about safe sex practices.  I gave her my speech about always using condoms.  I talked to her about Plan B, in case the condom broke or she forgot her pills or whatever else happens.  I talked to her about trying to talk to her parents about this (“Are you kidding?”  she tells me.  “They would die!”).  I reassured her that they wouldn’t.  I also talked to her about Gardasil, which is the HPV vaccine.  She was definitely interested in getting it, but knew that her mom was not in support of this.

Since Mom carried the insurance and needed to be in the know, I brought her into the room so we could discuss.  Mom was vehemently opposed, to say the least.  She informed me that the vaccine was not out long enough to be safe, and who knew what long term consequences it may have?  She did not want to impair her daughter’s ability to have children one day.  Plus, she told me, that vaccine is for girls who are having sex, and "my daughter isn’t doing any of that stuff".  She looks over at her daughter, who nods in agreement.  I just had to shake my head in disbelief.

Myth #1:  Gardasil is unsafe because it has not been out long enough, and has not been well studied.  (Myth debunked: Gardasil was released in 2006 after extensive study, and has since been shown through millions of doses administered that it is just as safe as any other vaccine out there.)

Myth #2:  Gardasil can make you infertile. (Myth debunked:  Immunity to HPV will never make you infertile.)

Myth #3:  Gardasil is for women who are already having sex. (Myth debunked: Gardasil is ideally for girls who haven’t become sexually active yet!  The whole goal is to give you immunity before you are exposed to it through sexual activity.)

Sadly, there are a lot of parents out there who are hesitant about this vaccine.  April’s issue of Pediatrics has some interesting numbers.  The percentage of parents who said they did not intend to vaccinate their daughters against HPV in the next 12 months went from 40% in 2008 to 41% in 2009 to 44% in 2010, even as parents said physicians were increasing their recommendations to get the shot.  Why wouldn’t parents vaccinate their daughters? 9% said it was not recommended; 17% said it was not needed/not necessary; 16% cited safety concerns/side effects; 11% said it was because their daughter was not sexually active.

HPV is a small virus that is sexually transmitted that causes cervical cancer in women and a variety of unpleasant things like genital warts in men and women.  It also plays a role in anal and oropharyngeal cancers.  85% of people in this country have had some exposure to it.  Given all of that, wouldn’t it be nice to have some immunity to it, especially before your first exposure?

I talked myself blue to try to get my patient’s mother to come around, and she finally did, although her rationale was a little skewed.  Her daughter was going to remain a virgin until marriage (Okay, fine- whatever).  The person she married, she conceded, may not be a virgin.  So it would be okay to protect her daughter against the HPV that her future husband may potentially give her one day.  Good grief.

The FDA has approved Gardasil for both boys and girls.  Pediatrician’s offices carry it, as do family medicine offices and ob/gyn offices.  Ask about it.  If you have the opportunity, vaccinate your kids.  They will thank you for it down the line, and we will be one step closer to decreasing the problems that HPV causes worldwide.

-Dr. Jahedi