If you're anything like Dr. Jaime Friedman, you might be a little fed up with all the misinformation floating around about vaccines.
One vaccine in particular that has patients' parents skeptical is the human papillomavirus vaccine. There's a variety of objections, including safety concerns or a perceived "lack of necessity," citing their child's lack of sexual activity.
With all the misinformation out there, we're here to arm you with the most up-to-date HPV vaccine guidelines straight from our 9th Edition Pediatrics Core. If you are faced with a hesitant patient or parent, you'll have all the information you need to approach the situation. Here are some objections you might encounter—plus what to know—so you can educate your patients.
Objection 1: HPV Is Rare
HPV is the most common sexually transmitted infection in the U.S. More than 50% of sexually active men and women are infected with HPV at some time in their lives.
Objection 2: HPV Isn't A Big Deal
In the U.S., HPV Types 16 and 18 cause about 12,000 annual cases of cancer (i.e., cervical, vulvar, vaginal) in females and 7,000 cases of cancer (i.e., penile, anal) in males.
Each year, nearly 4,000 die from HPV-related disease. HPV also causes juvenile recurrent respiratory papillomatosis, characterized by recurring papillomas in the larynx and other areas of the upper respiratory tract.
Objection 3: My Child Isn't Sexually Active
Optimal vaccine efficacy is achieved when the vaccine is administered before onset of sexual activity. The vaccine has no effect against HPV types previously acquired.
Objection 4: It's Too Late For My Child To Get This
A history of previous HPV infection is not a contraindication to receiving the vaccine because it is highly unlikely that an individual was previously infected by all 9 HPV serotypes contained in the vaccine.
Males 22–26 years of age should be vaccinated if they are immunocompromised or have sex with men. In transgender people, the HPV vaccine should be administered through 26 years of age.
Objection 5: My Son Doesn't Need This Vaccine
Both females and males should receive the vaccine.
The 9vHPV vaccine is recommended in all females through 26 years of age and all males through 21 years of age who were not previously vaccinated. HPV vaccination is recommended in males 22-26 years of age who have sex with men or who are immunocompromised (including HIV infection).
Objection 6: My Child Is Too Young For This Vaccine
It is recommended to give the 9-valent vaccine (9vHPV) to all females 11–26 years of age and to all males 11–21 years of age to prevent genital warts and for cancer prevention.
Administer a 2-dose series of 9vHPV vaccine on a schedule of 0 and 6–12 months to all adolescents at 11–12 years of age. Administer 9vHPV vaccine to all adolescents through 18 years of age who were not previously vaccinated. If vaccination is initiated before 15 years of age, the recommended immunization schedule is 2 doses of HPV vaccine at 0 and 6–12 months. If vaccination is initiated at ≥ 15 years of age, 3 doses of HPV vaccine on a schedule of 0, 1–2, and 6 months is recommended.
For children with a history of sexual abuse or assault, the 9vHPV vaccination series should be initiated at 9 years of age.
Objection 7: There Are Dangerous Side Effects
Fainting (syncope) can occur after vaccination and has been observed among adolescents and young adults. It's recommended to have patients stick around for 15 minutes after they receive the vaccine to minimize risk of injury due to a syncopal event.
It's also good to note that HPV vaccines are not recommended during pregnancy. Health care providers should inquire about pregnancy in sexually active patients, but a pregnancy test is not required before beginning the immunization series. The HPV vaccines can be administered to lactating women.
"HPV vaccines are contraindicated for persons with a history of immediate hypersensitivity to any vaccine component. 4vHPV and 9vHPV are contraindicated for persons with a history of immediate hypersensitivity to yeast. 2vHPV should not be used in persons with anaphylactic latex allergy.
Adverse events occurring after administration of any vaccine should be reported to VAERS. Additional information about VAERS is available by telephone (1–800–822–7967) or online."
Finally, the CDC cites some other possible side effects including:
- Pain, redness, or swelling in the arm where the shot was given
- Dizziness or fainting (fainting after any vaccine, including the HPV vaccine, is more common among adolescents)
- Headache or feeling tired
- Muscle or joint pain
If these allergies or areas of concern are not present in the child in discussion, remind parents about what the HPV vaccine can prevent. Pediatricians have the power to educate parents and patients about why the HPV Vaccine is so important and correct the misinformation surrounding these topics.