HPV Vaccine: A Guide for Parents

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According to the Centers for Disease Control (CDC), approximately 20 million people in the United States become infected with HPV with 6.2 million new cases each year. There are many different types of HPV (Human Papillomavirus). There are about 150 different types and more than 40 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers such as 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Some types cause genital warts (flesh colored growths that may appear around the vagina or anus), others cause pre-cancerous changes (cellular changes that can lead to cancer of the cervix later). In rare cases, the virus can cause other types of cancers to the vulva, vagina, and anus in girls, the anus and penis in males, and the oropharynx (back of throat, base of tongue and tonsils) in both.

Is my daughter at risk of getting HPV?

If your daughter is or plans to be sexually active in her lifetime, she is at risk for getting HPV. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. In fact, at least 1 in every 2 sexually active young women has had a genital HPV infection.

About 20 million Americans currently have an HPV infection and approximately 6 million new cases are diagnosed each year. About 12,000 women get cervical cancer in the U. S. and almost all of these cases are related to HPV. – Centers for Disease Control

Some people who have been infected with the HPV virus know they have it because they have had genital warts or an abnormal Pap test, or have tested positive for HPV. However, most people do not know they have HPV because they do not have symptoms.

How is HPV spread?

HPV and genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or oral sex with someone who is infected with HPV. Condoms and dental dams (used as a barrier during oral sex) can help protect against HPV, but they aren’t perfect because warts can be found on skin that isn’t covered by a condom. HPV can be in the skin and genital organs without any symptoms. In fact, the only way that is 100% effective in preventing exposure to HPV is avoiding any kind of sexual activity that involves contact with genital areas.

What are the HPV vaccines?

Gardasil® protects young women and men against four different types of HPV. The vaccine works to prevent two types of HPV—16 and 18, which cause 70% of cervical cancer, and two other types—6 and 11, which cause 90% of genital warts. It can also prevent some vulvar, vaginal, and anal cancers. Gardasil® has also been approved by the FDA for young men and is effective in protecting against genital warts.

Gardasil 9® protects young women and men against nine different types of HPV, including the four previously covered by Gardasil® (6, 11, 16, 18) and five additional types (31, 33, 45, 52, and 58). Overall, Gardasil 9® is expected to prevent 90% of genital warts and 90% of cervical cancers. It can also prevent some vulvar, vaginal and anal cancers.

Cervarix® protects young women (10-26 years old) against two types of HPV. This vaccine works to prevent HPV-16 and 18, which cause 70% of cervical cancer. It does not protect against HPV-6 and 11. Cervarix® is not approved for young men because it doesn’t prevent genital warts (6, 11).

The HPV vaccine works best for those who have not yet come in contact with these viruses. It is recommended for all 11 and 12 year olds as a routine vaccination and for everyone between 13-26 years of age who have not yet received the vaccine. It is also recommended for all young men 13-21 years of age who have not yet received the vaccine, but young men ages 22-26 years may also receive Gardasil®. Cervarix® is not approved for young men because it doesn’t prevent genital warts (6, 11).

In 2017, only 9vHPV (Gardasil 9®) will be available in the United States.

 

How does the HPV vaccine work?

The vaccine is a fluid that has very small particles in it that look like HPV. After the vaccine is given, the body quickly starts making antibodies against the certain types of HPV. Antibodies are necessary to fight HPV. Remember that the virus is not a live virus, which means your daughter can’t get HPV from the vaccine.

How does a vaccine get approved?

Before the Food and Drug Administration (FDA) approves any medicine or vaccine, scientists and doctors must study it. After researching the vaccine for a long time, the pharmaceutical company must show that the vaccine will improve the health of people who receive it. In June of 2006, the FDA found the Gardasil® vaccine to be an excellent way to lower the chances of getting HPV for girls and young women between the ages of 9-26. The Cervarix® vaccine was approved by the FDA in October of 2009 for girls and young women between the ages of 10-25. In December 2014, Gardasil 9® was approved by the FDA. Gardasil 9® protects against 9 different types of HPV (the first 4 strains 6, 11, 16, 18, and also 31, 33, 45, 52, and 58.

Is the HPV vaccine effective?

When tested in girls, Gardasil® was 100% effective in preventing pre-cancerous changes in the cervix caused by HPV types 16 and 18. Gardasil® was also shown to be nearly 100% effective in preventing vulvar and vaginal pre-cancers and genital warts caused by HPV types 6 and 11. When Cervarix® was tested in girls not yet exposed to HPV types 16 and 18, it was 93% effective in preventing pre-cancerous changes in the cervix caused by HPV types 16 and 18. Both vaccines are less effective in young women who have already come in contact with the HPV types in the vaccine. However, if a young woman has been exposed only to one of the types, the vaccine still gives protection against the remaining types. So, even young women who have had sexual contact should get immunized.

It is important for your daughter to plan on returning to her health care provider for the second and third shots.

When is the best time for my daughter to get vaccinated?

The best time for your daughter to get vaccinated is before she comes in contact with the HPV virus. In fact, the government organization that decides when children and adolescents should be immunized recommends that all 11 and 12 year old girls receive it. Health care providers can also offer the vaccine to younger girls (9 and 10 year olds). Gardasil® is approved for young women and young men from 9 years of age up to 26 years, while Cervarix® is approved for only young women from 10 years of age up to 25 years.

Are there any side effects with the HPV vaccine?

Side effects are rare; however, some young women who get the vaccine may complain of pain, or have swelling, redness, or itchiness where they got the shot (arm or thigh). These discomforts are temporary, but may last a couple of days. In very few cases, side effects may include a fever, dizziness, and/or nausea. Some young women have fainted after receiving the vaccine, so your daughter may want to sit quietly for 10-15 minutes after receiving the vaccine.

It is very uncommon to have side-effects from vaccines. If you think your daughter might have had a side-effect from a vaccine, talk to her health care provider. You can also call 1-800-822-7967 or log on to vaers.hhs.gov.

Does my daughter have a choice about getting the HPV vaccine?

Yes. The HPV vaccine is not mandatory except in the state of Texas, however, at least 42 states (in the U.S.) have introduced legislation that would require the vaccine. With that being said, most health care providers will recommend the vaccine if your daughter is between the ages of 9-26 to reduce her risk of cervical cancer―the younger, the better. For more information about state legislation policies regarding the HPV vaccine, see the national conference of state legislatures site.

How do I know if my daughter should get the HPV vaccine?

Talk it over with your daughter’s health care provider. Now that the vaccine is available, it is a good idea to take advantage of it. Most young women will become sexually active at some point in their lives, and the vaccine is very effective in preventing the spread of HPV. The risk of getting HPV is far worse than getting a shot.

Is there any reason why my daughter shouldn’t get the HPV vaccine?

The vaccine is not recommended if a young women is allergic to any of the components of the HPV vaccine, if she is pregnant, has certain blood conditions, an immune disorder or certain other medical problems. Let her health care provider know if she has a latex allergy, as Cervarix® comes in two different preparations, and one contains latex. If you are thinking about having your daughter vaccinated, it’s a good idea to have a conversation with your daughter and her health care provider to see if there is any reason why she shouldn’t get the vaccine.

Should my daughter get the HPV vaccine if she is already sexually active?

Yes. Girls and young women should receive the vaccine even if they have already had sex. It is not necessary for your daughter to have an HPV test before getting the vaccine.

Is the HPV vaccine safe?

The vaccine is considered safe by FDA standards. It does not contain mercury or thimerosal.

If my daughter already has HPV, will the vaccine help?

It depends on what type of HPV your daughter has been exposed to. The vaccine won’t cure an HPV infection that she has already, such as genital warts, pre-cancers (changes that happen before a cancer starts to grow), or cervical cancer. However, many people who have HPV are not infected with all the types of HPV that the vaccine targets. Since there is no test available to tell for sure if a young woman has had just one or multiple types of the HPV virus, it is recommended to get the vaccine so she can have protection from the types she may not yet have come in contact with.

If my daughter gets the HPV vaccine will she be protected for the rest of her life?

The vaccine is effective for at least 8 years, but is likely effective even longer. It is currently unknown, but it’s possible that at some point in the future a booster will be recommended.

Does insurance cover the HPV vaccine?

The vaccine is covered by most insurance plans, but it is best to check directly with your family’s insurance carrier. The HPV vaccine is expensive if your insurance company doesn’t pay for it. Each dose is about $130, and 2-3 doses are needed.

Will there be a vaccine someday that prevents other types of HPV?

Yes. In 2014 Gardasil 9® was approved by the FDA. This vaccine protects those who get the vaccine from 5 more types of HPV than the original Gardasil® vaccine. It is likely that there will be a vaccine or booster that works to prevent more types of HPV in the future.

Having a vaccine that protects against certain types of HPV is significant as it can prevent serious health problems and may even save lives. It is important to keep in mind that the HPV vaccine will protect your daughter from up to 9 strains of the virus, but it won’t protect her from all of them. There are more than 150 different types of HPV and more than 40 are sexually transmitted. Help your daughter understand that (when the time comes) it is still very important to practice safe sex. She should also see her health care provider for regular check-ups and Pap tests.