Vaccinating Your Daughter Against HPV Can Be a Difficult but Life-Saving Decision
As published in the Northgate Journal
Kim is a single mom, raising an 11-year-old daughter. She is well educated and wants to make the best decision for her daughter but is confused about the HPV vaccine. Two HPV vaccines (Gardasil® and Cervarix®) have been approved for girls by the U.S. Food and Drug Administration (FDA) to prevent cancers caused by the human papillomavirus, known as HPV. “I know the virus is transmitted sexually, but my daughter is not having sex so I’m not sure why I should vaccinate her,” Kim says.
“What parents need to know is how important it is to vaccinate their daughters and sons before they are exposed to the virus,” says Terri Wolber, DNP, a nurse practitioner at Pacific Medical Center’s Northgate clinic in Seattle. “That’s the point. To be effective, the vaccine must be given to teens young enough for sufficient antibody development to occur before exposure. For this reason, girls ages 9 to 16 have been targeted as ideal candidates for immunization.”
“HPV is the most common sexually transmitted infection in adults,” continues Dr. Wolber. “For example, more than 80 percent of American women will have contracted at least one strain of HPV by age 50. Worldwide, cervical cancer is the third most common type of cancer in women. Unfortunately, we can’t predict which HPV-positive women will go on to have cervical cancer.” In addition, according to Dr. Wolber, HPV has been associated with oral, penile and anal cancers. The HPV vaccine is expected to protect against all three.
HPV causes an infection that resolves in most cases by activating the normal immune system. Most people with the virus never know they have it. There are many strains of HPV. Both the Gardasil® and Cervarix® vaccines specifically protect against HPV 16 and 18, two of the more high-risk HPV viruses. Together, types 16 and 18 are responsible for about 70 percent of all cervical cancers in the United States. About 12,000 new cervical cancers cases and 3,400 deaths are reported every year in this country. On September 9, 2009, an advisory panel recommended that the FDA also license Gardasil® in the United States for boys and men ages 9–26 for the prevention of genital warts.
Dr. Wolber notes that the vaccine is effective in 89 percent of girls within four months of their first shot. The vaccine involves a three-shot series, with a booster given two months and again six months after the initial shot. Dr. Wolber stresses that even though a girl may have been vaccinated with Gardasil®, PAP screenings will still be needed later in life because the HPV vaccine does not protect against all types of the virus that causes cervical cancer. It also does not protect against any other sexually transmitted disease.
“The vaccine has been proven safe as well as effective,” Dr. Wolber says. “Because there is no drug treatment that can eliminate the HPV infection and its prevalence across the world, the vaccine represents a significant breakthrough in the health of women and men. Think of it this way. Immunization is the most natural way to fight disease. What we’re really doing is triggering the body’s own immune system to fight the infection.”
Washington State has subsidized the vaccine with a $35 sliding-scale fee, and the vaccine is available at some public health clinics and at designated private medical clinics across the state. Girls and women with private insurance should check with their doctors to assess if they are candidates for immunization. Many health insurances cover the full cost of the vaccine.
Terri Wolber, DNP, ARNP is a nurse practitioner in the Family Medicine department at the Northgate clinic of Pacific Medical Centers. Terri received her doctorate in nursing practice at the University of Washington. Click here for more information about Terri Wolber, DNP, ARNP.