To HPV or Not to HPV…that is not a question

It was not unusual for our head nurse to enter a room ten years ago with a vaccine for an 11 year old girl. Nurses in pediatric offices give vaccines all day, every day.

It was unusual for the nurse to weep as she administered this vaccine to that child on that day. The patient’s mom, in a wheelchair and on oxygen, was dying of cervical cancer. This vaccine was one of the first doses given in our office to prevent cervical cancer. To this mother, this child, this nurse, this vaccine was miraculous.

But to many others, the human papillomavirus (HPV) vaccine, given to prevent transmission of a virus that can cause genital warts, cervical cancer, or head and neck cancers, is mysterious and scary. Because of constant misinformation on social media, parents fail to focus on the 27,000 new cases of cervical cancer which are diagnosed annually. They do not process the fact that over 4,000 people die every single year in this country from cervical cancer, or that having genital warts removed via multiple painful treatments is a common and quite unpleasant experience for many young women. They are not aware of the lifesaving potential of this vaccine or that the vaccine is very safe, with over 200 million doses distributed in the last ten years.

Perhaps some parents focus on the way the virus is transmitted and think that they can promote morality in their children by refusing to vaccinate them for this common virus. They are not aware that by age 18, about 80% of people in the US are already infected with a strain of HPV.

They forget that part of growing up is learning to make good decisions, often after making bad ones. They don’t understand that pediatricians relish the opportunity this vaccine offers to educate a young teen about the risks of having sex in an uncommitted relationship: “I want you to understand,” your child’s doctor might say, “that this vaccine does nothing to prevent HIV, herpes, chlamydia, gonorrhea, syphilis, trichomonas, or pregnancy.” Hormones might prevent your child from making good decisions, but this vaccine will not. It WILL help to prevent cancers in both boys and girls.

They have not met the mother who pulls the doctor aside to tearfully explain that she just changed her mind about administering the vaccine because her pap smear just came back positive for abnormal cells due to HPV. The mother has been in a committed monogamous relationship for the past 20 years, but HPV can be latent for at least that long. “Please start the series today on my son,” she says. “I am bringing my daughter in next week. I don’t want her to go through what I am going through right now.”

They have not been contacted by the old friend on Facebook who expresses her appreciation for those posts about the importance of the HPV vaccine. She did not vaccinate her daughter when it was first recommended because she was understandably concerned about the possible side effects of a new vaccine. But now her daughter is undergoing treatment for lesions caused by HPV on her cervix, and it is terrifying for her, on her own in a new city at age 22.

They have not been contacted by another physician whose father is dying from throat cancer and wants to say thanks for speaking out about the importance of HPV vaccine.

They have heard about brain cancers and skin cancers, leukemias and lymphomas, but friends’ early cervical cancers in the form of genital warts are not usually discussed over glasses of wine or cups of coffee, and so they seem less common than they really are.

The AAP and CDC recommend this vaccine be given in just two doses for both girls and boys starting before age 15 (they will need three after age 15). Like any vaccine, it works best if given well before exposure, and, like any vaccine, it works best if most people are immunized. All three of my children, two girls and one boy, have had the HPV vaccine. As a pediatrician and a mother, I strongly recommend that your teen get it too and here’s why:

The only thing worse than a sick child is a sick child with a preventable illness.

And the only thing worse than getting cancer is having your child get a cancer that could have been easily prevented.

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9 thoughts on “To HPV or Not to HPV…that is not a question

  1. I don’t want my daughter to experience cryo surgery, multiple biopsies and the fear of developing cancer. I can give her a better chance than I had. Isn’t that my job?

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  2. My sons fully vaccinated against HPV. I know that it won’t affect him very much even if he becomes a carrier, but I don’t want him to transmit it to any other women or girls. It’s my way of looking out for the future women in his life.

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    1. Thank you for making that choice! In fact, it may affect him very much, but you may never know because you have markedly reduced his chances of getting head and neck cancer. A fellow physician recently described her father in law’s struggle with metastatic tonsillar cancer. It is horrific, and he is dying. The cause: HPV. Thanks for thinking of others AND for protecting your son.

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  3. Martha – Thank you for this. I was in your Sunday School class when we lived in Rock Hill and respect your opinion. When we moved to Clemson, our pediatrician basically bullied me into these shots in front of my 5th grade son, talking about things we hadn’t gotten around to with him yet. I just wanted a thoughtful explanation like the one you gave here. You have helped me understand why I need to do this for my 12-year-old daughter, despite the fact that she fainted after her last T-Dap, Optional shots are not something I jump on with her fearful little self.

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    1. Lillie–I’m glad this post help bring you a touch of inner peace and sorry you felt bullied by a fellow vaccine zealot (your pediatrician). “My people” have become quite defensive about vaccines, alarmed that they are under attack, sad that our advice is often trusted less than someone’s friend’s friend on Facebook, but that does not give us license to make our patients feel attacked or bullied. There are often good reasons that people are skeptical or concerned about a new vaccine, and we should listen and discuss (both sides). Thanks for this note! It is good to hear from you.

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