Teen immunization against HPV

HPV is a very common virus. Nearly 80 million people—about one in four—are currently infected in the United States. About 14 million people, including teens, become infected with HPV each year. The infection occurs by sexual contact.

The HPV vaccine is recommended for preteen boys and girls at age 11 or 12 so they are protected before ever being exposed to the virus. HPV vaccine also produces a more robust immune response in younger persons. There is no protection afforded by immunizing older teens or adults once HPV infection occurs.

HPV vaccine recommended by the Centers for Disease Control (CDC) because it protects against cancers caused by human papillomavirus (HPV) infection. HPV infection can cause cervical, vaginal, and vulvar cancers in women; penile cancer in men; and anal cancer, cancer of the back of the throat (oropharynx) and genital warts in both men and women. This is the first vaccine to prevent cancer, and protection from HPV vaccine is expected to be permanent. But vaccinated women still need cervical cancer screening ("Pap smears") because the vaccine does not protect against all virus types that cause cervical cancer. HPV causes at least 70 percent of cervical cancer. Ten thousand women get cervical cancer and 3,700 die from it each year, according to the National Cancer Institute.

Now a recent medical study suggests that human papillomavirus infection increases risk of developing breast cancer later in life. The study found HPV type 18 & 16 was identified in breast cancer specimens. The HPV vaccine Gardasil prevents infection from several HPV types, including 18 and 16. The authors conclude:

Gardasil is very effective for those types, and while we don’t have enough evidence to say for sure, Gardasil should be effective at preventing breast cancers associated with those types as well as cervical cancers. Ensuring people receive the vaccine is the obvious and wise thing to do, and that applies to young males as well as they’re involved in the sexual transmission of HPV to women.

Acceptance of HPV vaccine has been suboptimal. The Centers for Disease Control and Prevention reports that as of 2008, 37.2% of teenage girls had initiated vaccination but only 17.9% had completed the full three-dose series. Even though vaccination rates have been low, a CDC report in 2013 showed over 60% reduction in HPV infection in girls since the vaccine was introduced in 2006.

Objections to vaccination can be general anti-vaccine or religious based. Some parents are concerned that HPV vaccination will contribute to sexual promiscuity. As a physician, I question how valid these arguments will seem as these parents watch their children suffer and die from a preventable cancer.

I also wonder how many anti-vaccine advocates favor returning to the era before modern vaccines were widely available: