In 2006, I entered pediatric practice. It was the same year that the Advisory Commission on Immunization Practice (ACIP) recommended to start giving 11 year-old girls the Human Papilloma Virus (HPV) vaccine. Therefore, I’ve really never practiced pediatrics (outside of my training) without the ability to offer up immunization and protection against HPV virus; I’ve been discussing this for about 6 years. We now give HPV shots to both boys and girls because it’s so common–about 50% of all adults who are sexually active will get one form of HPV in their lifetime.
HPV virus can come into our body and do no harm. But it also can come into our bodies and cause vaginal, penis, anal and oral/throat warts. Other strains of HPV also cause changes in the cervix that can lead to cervical cancer and can rarely lead to penile cancer and/or tongue/throat cancer. Teens and adults can get HPV from oral, vaginal, or anal sex. Condoms don’t provide 100% protection from getting it.
GREAT NEWS: Being protected (by the HPV shot) doesn’t trigger risky sexual behaviors in teens.
Nice to have an immunization to protect against the potential development of such disfiguring, embarrassing, and uncomfortable lesions. And what a windfall to have a vaccine that prevents cancer. I often say to my patients, “If my grandmother only knew that I’d see the day where we could prevent cancer.” I mean it—if she only could have seen the day (she died in the late 1980’s).
The reality is though, parents to teenage girls have consistently been hesitant in getting the HPV vaccine in my office. Over the 6 years hesitancy around getting HPV vaccine has lessened, but many of my patients’ parents have told me they don’t want their girls or boys to feel that getting the shots is a green light for sexual activity. And many have worried that having their girls immunized will make them more likely to engage in earlier sexual activity.
Parents often say, “But she’s only 11!” or “We know she isn’t going to have sex before marriage,” or “He’s just so young.” Reality is, the best way to protect girls and boys from HPV is to have them develop immunity (responding to the HPV 3-shot series takes 6 months) BEFORE ever having any sexual contact. Even if they are just starting to develop breasts or their penis is just starting to grow, age 11 can be a great time to start the HPV series so that a teen has completed and responded to all 3 shots by the time they are sexually active. There is no reason to wait to get HPV shots. The risks are no lower for a 15 year-old when compared to an 11 year-old.
Only 13% of 15 year-olds have had sex. But 70% of 19 year-olds have. We want all teens protected against HPV prior to any sexual contact.
An October 2012 study proves the concern for early sexual activity after HPV shot is not the reality. It’s not only fantastic news, it’s exceedingly reassuring for the concerns many parents have.
HPV Vaccination Does Not Change Sexual Behavior:
- At the 11 year-old visit we now offer 3 shots to girls and boys: HPV, Tdap, and MCV4. The HPV vaccine has 2 follow-up booster doses: one shot 2 months later and one shot 6 months after the first shot.
- Researchers studied nearly 500 eleven to twelve-year-old girls who had received HPV vaccine (at least one dose). They compared those girls to 900 other girls who only received Tdap and MCV4 at their 11 year-old well-child appointment. All 1400 girls were followed for 3 years.
- Researchers then compared testing, diagnosis and counseling outcomes when it came to sexual activity, STD, or pregnancy (visits to the doctor for any pregnancy or sexually transmitted infection testing or diagnosis or visits for birth control counseling).
- Girls who received HPV shots were no different than those girls who didn’t.
- Researchers concluded that HPV vaccine was not related to any “sexual-activity outcome” rates. Meaning: getting the HPV shot didn’t endorse sexual activity and thus didn’t lead to more STDs, unintended pregnancy, or coming into the office for birth control.
Tips For Teens Getting Their 11 Year-Old Shots:
- Bring a cellphone, smartphone, tablet, or enticing magazine along with you to the clinic.
- HPV vaccine really stings when it goes in. Most all teens report this back to me! This is in part because of the high-salt concentration in the solution. Although telling your teen, “This shot is really going to hurt” won’t help and will likely only increase anxiety, providing support and acknowledgement for the discomfort during and after the shot is very helpful. Also, help distract your teens during the shot (use a smartphone, tell a story or joke, ask them about prom or something!). And if your teen is anxious or nervous, have them wait for 10-15 minutes after getting the shot to prevent them from getting woozy or from fainting. Teens often feel woozy or even faint after any shot during the teen years.
- Many parents are concerned about shots for sexually-transmitted infections. Do your best to ask your teen’s doctor or nurse about fears or worries you have. You’re certainly not alone in being queasy about your teen potentially having sex some day!!
- Fear of Needles? If you teen has a fear of needles check out this blog post. Also, don’t hesitate to talk to your child’s clinician about the fear and get them on-board to help.
- Finish The Series: Make that first poke worth it! The best way to protect your teen (or yourself) from getting HPV is to finish all 3 shots in the series. Don’t forget to return to the nurse or medical assistant for the 2-month and 6-month booster! Many girls and boys start the series and don’t finish, thus leaving them exposed and vulnerable to HPV when they are sexually active. Teens have a bad track record for all their shots, but the worst record when it comes to finishing HPV shots. Here’s data from the CDC.
What else do you want to know?
Carol Da Costa MD says
I would love to post your blog to my office facebook page but can only “like” it and so it appears on the side bar of my personal fb page and cannot share it with my patients. Can anything be done about this? Thanks. Carol Da Costa, MD – Pediatrician
Lauren @ the VEC says
To see what other people have asked on the prevent-hpv.com website, take a look at the question and answer page: https://www.chop.edu/service/vaccine-education-center/prevent-hpv/hpv-questions-answers.html
What if your teen got the first shot, and then nothing else for over a year? Do you have to start over or can you just get the 2nd and 3rd shots?
Wendy Sue Swanson, MD, MBE says
No need to repeat. You can go in and get the 2nd shot without needing to repeat any doses. Then follow the schedule for the next shot interval (3rd dose has to be at least 24 weeks after the 1st dose).
This is true for nearly every vaccine series. Have to repeat shots only if given TOO EARLY, not when given later than minimum dosing interval.
Charlie Comstock says
Regarding vaccines…..Am I able to have the one who administers the shot sign a an agreement that they are liable to any damage caused by the vaccine….including government mandated vaccines?
Loretta Zanetti says
Have you found any creative ways to increase the compliance to the CDC recommendations of getting it at age 11-12 in your practice?
Wendy Sue Swanson, MD, MBE says
Creative? I don’t think so. Perhaps this blog helps?
I talk openly about risks, about lack of increased promiscuity, and opportunities to prevent both warts and cancer of cervix, throat, and penis.
Often those parents who decline HPV want to wait until their children are sexually active or state that they know their children will wait until marriage. But most data suggest the majority of teens are sexually active by the time they are 19 years…and waiting until they are older only increases risk that teens will get exposed to HPV before immunized.
But, creative? I don’t know…