Did you know that there is a vaccine that can be given to 11- and 12-year old boys and girls that can help protect them from certain types of cancer? And did you know that the full course of this vaccine has been given to less than 50 percent of the children in Vermont? Why would that be? you might ask. We could blame it on the misinformation disseminated by the anti-vaccine movement, but that would only be half the story. Also to blame is the obfuscation that has issued forth from the puritanical abstinence campaign.
It is unfortunate that concerned parents are misled by the anti-vaccinators and buy into the fantasy that if you don't teach teenagers about sex they won't engage in it, but the end result is those who don't vaccinate their children with the human papillomavirus vaccine are putting them at very serious risk of contracting cancer later in life.
Certain types of HPV infection can cause cervical cancer in women and penile cancer in men. HPV can also cause throat cancer, anal cancer and genital warts in both men and women. The HPV vaccine is recommended for both boys and girls at age 11 or 12 in order to protect them from the forms of the virus most likely to cause cancer. Three doses are given over the course of six months to protect against HPV infection.
The Vermont Department of Health and other state health departments are attempting to dispel much of the misinformation about the HPV vaccine that is floating in the cloud and has been downloaded to chatrooms, blogs and social media on a computer near you.
Despite an increase in awareness about the safety and effectiveness of the vaccine, Vermont's coverage rates among girls are declining. The Centers for Disease Control and Prevention recently published results from the 2013 National Immunization Survey for teens. Sixty percent of Vermont females age 13-17 have had one dose of HPV vaccine, but only 43 percent have completed the three-dose series. The numbers are even lower for boys in Vermont. Only 41 percent of boys have received one dose, and 21 percent have received all three doses. Nationally, the statistics are even more dismal. In 2013, among those ages 13 to 17, 37.6 percent of girls and fewer than 14 percent of boys have gotten all three doses of the vaccine.
"We're missing opportunities to prevent cancer among Vermonters," said Chris Finley, immunization program chief for the Vermont Department of Health.
According to the CDC, nearly all sexually active people will contract a form of HPV at some point in their lives. Nationally there are about 26,000 HPV related cancers each year, and most could be prevented with the HPV vaccine. Since the introduction of the HPV vaccine eight years ago, the HPV infection rate among teenage girls nationwide has dropped by 56 percent, but millions of people are still infected with HPV every year.
Christine Charbonneau, the chief executive officer for Planned Parenthood of the Great Northwest, writing for the Twin Falls Times-News, poses the very real question that many parents are asking: Why should their children be vaccinated for a sexually transmitted infection at the age of 11 or 12?
"Medical and scientific experts agree that the vaccine is most effective when it is administered early, in part because the full vaccine has to be administered prior to any possible exposure," wrote Charbonneau. "In other words, the HPV vaccine isn't intended for sexually active people -- it's for children, to prevent infection and possible cancer later in life."
Tom Frieden, the director of the CDC, is also urging pediatricians to reframe the discussion about the HPV vaccine.
"The issue of kids having sex is an uncomfortable one. But this isn't about sex. It's about preventing cancer."
Many of the people who shy away from the HPV vaccine refer to a "study" conducted by Lucija Tomljenovic and Christopher Shaw and published in The Annals of Internal Medicine.
"At present there are no significant data showing that either Gardasil or Cervarix (GlaxoSmithKline) can prevent any type of cervical cancer since the testing period employed was too short to evaluate long-term benefits of HPV vaccination," wrote Tomljenovic and Shaw.
But according to Helen Petousis Harris, writing for SciBlogs, Tomljenovic and Shaw's report depends on the misuse of raw data, which "must never be used to imply causality. To do so is either ignorant or devious and ignores all the caveats that the guardians of the data clearly state ... A 2011 follow up study in the US after the administration of over 600,000 doses using a scientific methodology that looks at vaccine exposure and pre-specified outcomes found no increased risk for any of the events noted in the Tomljenovic and Shaw paper ..."
According to a study conducted Georgia Regents University in Atlanta, "There are all indications that the vaccine is safe, and it looks like it's effective in preventing genital warts and other diseases caused by HPV."
"If you haven't had your child vaccinated, please get them vaccinated," said lead researcher Dr. Daron Ferris, director of the HPV epidemiology and prevention program at Georgia Regents. "It's more dangerous not to give the vaccine to your children. Thousands of people will continue to die each year if they are not vaccinated."
And according to the CDC, most adverse effects were minor and not greater than background rates connected with other vaccines. Since the vaccine was introduced, there have been about 70 cases of ill effects, or 0.02 events per 100,000 doses.
Of course, the most effective way to protect yourself from contracting HPV is to not have sex. However, a life of celibacy is not a very realistic approach for most of us. If you do plan on having sex, there are three ways to decrease the chance of HPV infection: Use a condom; limit your sexual partners; and, for women, starting at age 21, get a regular Pap test that can detect HPV. Another way is to get the HPV vaccine.
We realize that a small handful of children have been hurt or even killed by vaccines and the trauma inflicted on their parents by those events is very real, but getting all of the recommended vaccines is one of the most important things parents can do to protect their children's health. While there may be very real health reasons for not having a child vaccinated, in 99 percent of the cases to not do so is irresponsible and, in the case of the HPV vaccine, puts a child in very real danger of contracting cancer when he or she becomes an adult.