HPV vaccine: To give or not to give

As an OB/GYN, I have seen and dealt with the consequences of HPV-related disease and have been very vocal about aggressively promoting vaccination. I have vaccinated my own children against HPV and make it a habit to educate my patients who are mothers of preteens/teens to consider the HPV vaccine for their children.

But we are still seeing too many patients in their 20’s coming to see us at advanced stages of a vaccine-preventable illness.

In the U.S., 12,000 women are diagnosed with cervical cancer and 4,000 die of it each year. Annually, 9,300 HPV-related cancers are diagnosed in men. For us to make a significant impact, young people need to be vaccinated before they become sexually active. The newest HPV vaccine series covers nine serotypes and is available in pediatric, family medicine and OB/GYN clinics.

The vaccine is recommended by the age of 11 to 13, and it is FDA approved for ages 9 to 26. Younger people create a better immune response to the vaccine with higher antibody levels. The vaccine is recommended regardless of sexual activity or exposure to HPV. Even if a patient is sexually active and possibly already HPV exposed, they may get coverage from the unexposed serotypes in the vaccine.

Parents should talk to their primary providers about getting this for their children. We need to talk to parents first and introduce this vaccine to them to explain why it’s so important to vaccinate their children. We need to explain how HPV is related to a wide variety of preventable cancers and disfiguring warts in both genders and that the best time to vaccinate is in their youth. I try to educate my patients who are mothers of preteens/teens at the time of their annual pap smear. This tends to remind them of the consequences of HPV disease. A recommended immunization schedule can be found on the Center for Disease Control’s website.

We are fortunate today as primary providers to be able to make a huge impact on human papillomavirus (HPV)-generated disease in our young population.

The HPV vaccine was introduced in 2006 and has already contributed to an impressive 56 percent reduction in vaccine-type HPV disease despite only one-third of women having completed the full 3-vaccine series. I encourage patients to complete the whole series to get the most benefits. In the series, the first two injections are given two months apart and the first and last are given six months apart. If any of these intervals are missed, it is still recommended that it be given at any time to catch up.

More than 60 million doses have already been given, and although many perceive the HPV vaccination as an “optional” vaccine, the risk of an adverse reaction is less than 0.0003 percent. The American College of OB/GYN (ACOG), The Center for Disease Control, the American Academy of Family Practitioners (AAFP) and the American Academy of Pediatrics (AAP) are all now on board with encouraging the vaccination against HPV.

Can you imagine how much more of a difference it would make if we encourage all our youth (girls and boys) to complete the series? According to the Centers for Disease Control (CDC), if providers increase the rate of vaccination to 80 percent, an additional 53,000 cases of cervical cancer could be prevented during the lifetime for those less than 12-years of age.

Facts about HPV

  • There are about 100 serotypes of HPV and 13 of these cause cancer.
  • A total of 79 million people are infected with HPV and 14 million new infections occur yearly.

About the author

P. Christine Montemayor, MD
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P Christine Montemayor, MD, FACOG is a board certified obstetrician/gynecologist on the medical staff at Baylor Scott and White Medical Center – Round Rock in Texas. Dr. Montemayor attended Texas A&M College of Medicine, completed an internship at the Yale Primary Care Medicine Program in CT and then her OB/GYN training at Boston Medical Center. She subsequently worked on the Navajo Nation for seven years and was on the American College of OB/GYN Advisory board for American Indian Affairs for two years. She went into private practice in Tucson, AZ, for nine years and was named to Tucson's Top OB/GYN list and served on the executive committee for Genesis, OB/GYN for three years. She has subsequently completed a two-year integrative health training fellowship through the University of Arizona with Andrew Weil. As the mother of four children between the ages of 5 to 17, she draws from a lifetime of personal experience to help counsel patients and providers through the complexities and nuances of their OB/GYN issues.

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HPV vaccine: To give or not to give