Since 2005, teen immunizations have been recommended at the 11 year-old well child check-up but rates of teens who keep up to date on their shots lag. In an ideal community, 90% of us would be up to date on shots to prevent disease spread most effectively. Back in 2007, teen recommendations were expanded to include HPV vaccine for girls. In 2011, both boys and girls were recommended to get HPV shots. Although the majority of teens get the Tdap shot (tetanus and whooping cough booster) only around 1/3 of teen girls are up-to-date on their HPV shot when most recently surveyed.
Teen Shots Recommend at age 11:
- Tdap (tetanus, diphtheria, pertussis shot)
- MCV4 (meningitis shot)
- HPV (human papillomavirus shot, requires 3 doses over 6 months)
A Pediatrics Study on teen shots revealed that parents may not get their teen shots due to concerns about safety or not understanding the shot was recommended. Not all shots are required by schools; I think some families tend to experience that as an endorsement for the shot being less important. In the survey conducted between 2008-2010, researchers sought to understand trends and rationale for lagging shots:
- From 2008-’10, parents declined HPV shots more than others. In 2008, 4.5% of parents reported safety concerns, but by 2010 16.5% of parents reported safety concerns. During that time there were no significant warnings or increased knowledge of severe side effects. Yet, parents concerns about side effects tripled between 2008 and 2010.
- Intention to get HPV shot decreased over the years. In 2008, 39% parents, heading off to the check up with their teen, stated they didn’t intend to get the HPV shot. By 2010, 44% of parents said they didn’t plan on getting it. This was despite reports of increasing number of pediatricians recommended the vaccine at the visit.
- Overall, teen vaccine rates are increasing in the US. The CDC reports that most recently ongoing increases continue for Tdap, MCV4 and HPV yet the HPV increases are occurring at half the rate. The Pediatrics survey reported 2010 data that found 80% of 13-17 year-old teens had their Tdap, 63% had MCV4, and 32% of girls had completed their 3 series of HPV vaccines.
- Many parents reported that their teen didn’t get Tdap and/or MCV4 mainly because parents reported feeling the shots “weren’t recommended” or were “not necessary.”
My question is this, if you’ve hesitated more on teen shots that you did with your infant or toddler or school-age shots, why have you? What concerns do you have about HPV vaccine? Let’s hash this out.
Angie G says
I will be honest, the HPV shot scares me. Maybe it shouldn’t, but it does. My children (3 & 1) have received all of their vaccinations to date & I generally believe vaccinations to be a great thing. However, I have watched a few of my friends live through scary circumstances following the HPV vaccine & their experiences seem like too much of a coincidence to attribute to something other than the vaccine. Both girls were taken to the ER within a day of the vaccine with severe headaches, nausea, vomiting and dizziness. One girl’s symptoms resolved within a day or 2. The other girl now suffers severe headaches & dizziness that have been unexplained to date. This has included 3 different hospital admissions for her symptoms. So it is one thing when you hear stories on the news (remember the girl who can only talk if she is walking backward?) but it is another when you know individuals who seem to have suffered negative side effects.
Wendy Sue Swanson, MD, MBE says
Thanks so much for your comment! The thing about these terrible rumors is that they get all bumbled up. Even the hoax about the “girl who can only walk backwards” wasn’t a claim as an HPV side effect, rather a flu shot side effect.
I don’t have the heart to link to the Youtube about the hoax (it makes me too mad) but you can easily find the video if you Google it…
Those stories do sound scary. It’s just so hard to tease out coincidence from cause with anecdotes. That’s what we rely on large scientific studies to provide clarity. And vaccine side-effect reporting that happens routinely.
Some stats about HPV safety from CHOP vaccine education center:
“Because the HPV vaccine is made using only the surface protein from the virus, it can’t cause HPV and, therefore, can’t cause cervical cancer. The vaccine may cause redness and tenderness at the site of injection. The vaccine may also cause a slight fever.
Safety networks have continued to monitor reactions to the HPV vaccine since its licensure. Despite concerns raised by the media and some citizen groups, no cause-effect links have been found between HPV vaccine and adverse events, including blood clots, allergic reactions, strokes, seizures, Guillain-Barre Syndrome, birth defects, miscarriages, or infant/fetal deaths. While fainting episodes following HPV vaccination have been reported, the rates have not been higher than those following receipt of other vaccines for teens. Because of the possibility of fainting, teens are recommended to remain at the office for about 15 minutes after getting immunized.”
Kathleen Berchelmann says
Dear Dr. Swanson,
I get more parental questions about the HPV vaccine than any other topic. I find that “It’s not necessary” usually translates to “my child isn’t even close to becoming sexually active.” Mary parents are simply horrified that a pediatrician is recommending a vaccine against an STD for a child who is pre-pubertal or early in puberty. This reality was illustrated in Sept. 2011 when Representative Michele Bachmann stated, “To have innocent little 12-year-old girls be forced to have a government injection through an executive order is just flat out wrong. That should never be done. That’s a violation of a liberty interest.” I wrote a response to her statement here:
I am also hearing a growing number of parents concerned about the ethics and safty of fetal cell line vaccines. It is important to note that HPV is not a fetal cell line vaccine.
Thanks, Dr. Swanson, for all your work in this area!
Kathleen Berchelmann, MD
Washington University School of Medicine and St. Louis Children’s Hospital
I think it’s important for parents to understand: A.) HPV is highly contagious. The CDC states that MOST sexually active men and women will get HPV at some point in their lives, and most people don’t develop symptoms. There are 14 million new infections each year, and half of those are in teens and young adults. B.) You don’t have to have sex to get it. It can be passed by genital-to-genital contact. Cases have been reported of infection through “heavy petting,” or hand-to-genital contact as well. C.) The HPV vaccine only works if your child has been vaccinated BEFORE being exposed to the virus. Waiting for your teen to start dating might be too late. D.) ALL cervical cancers are caused by HPV. Other cancers of the head and neck are showing HPV as well. Aren’t our young people so fortunate to live during a time when a cancer vaccine is available? In my opinion, the HPV vaccine is a safe alternative to a devestating disease. For me, cancer is a much scarier possibility, and I will choose to protect my daughter however I can.