Pediatrician, professor of pediatrics, and author Paul A. Offit, M.D. doesn’t understand why parents aren’t lining up to prevent a potentially fatal sexually transmitted infection:
Why are adolescents and their parents embracing meningococcal and Tdap vaccines but not the HPV vaccine? One possible explanation is a clash between perception and reality, People just don’t understand how serious an infection HPV can be. In a typical year in the United States about 150 people die from meningococcus, four from tetanus, none from diphtheria, 20 from pertussis, and roughly 4,000 from cancers caused by HPV. People are more than 20 times more likely to die from HPV than from the other four diseases combined.
About 79 million people in the United States have been infected with HPV, and 14 million new infections occur every year. As a consequence, 18,000 women and 8,000 men suffer preventable cancers of the cervix, anus, penis and throat; it’s the most common, and except for H.I.V., the most fatal sexually transmitted disease.
As a pediatric infectious disease specialist and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, Dr. Offit sees firsthand the harm to children when parents refuse vaccines. He’s got the data that show, despite misperceptions, that the HPV vaccine is safe, and that the immunity derived from the vaccine is long-lasting. He tackles the nonsense claims from “high profile — and highly irresponsible” sources about the vaccine’s safety. He debunks the absurd notion that, somehow, immunizing 11- and 12-year-olds will make them sexually promiscuous. Maybe the problem lies with doctors who don’t like (or don’t want) to talk about sex with their patients and families:
The fact remains that millions of adolescents aren’t getting a vaccine to prevent a known cause of cancer. It takes about 20 years for an HPV infection to progress to cancer. That’s when the bill is due. Given current rates of immunization, somewhere around 2,000 adults every year whose parents had chosen not to give them the HPV vaccine will probably die from a preventable cancer. It’s unconscionable. And doctors will have only themselves to blame.
Meredith Wadman is happy she had her children immunized against HPV before their teenage years:
When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.
A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later of new, aggressive, radiation-induced cancers.
Wadman explains why giving the three-dose series of shots to boys and girls when they are preteens is so important:
Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.
It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.
We’ve made all of these same points many times on The PediaBlog. It’s time for parents to have “the talk” with their children before they start puberty. It’s time for pediatricians to get over their awkwardness and do the same, beginning at the 11 year checkup.