Ask the Doc: Is the HPV Vaccine Effective in Fighting Cervical Cancer?
By Judy Schaechter, MD, MBA
When Ebola was making headlines worldwide, a number of people asked if there was a vaccine to fight it. No vaccine was available, but it seemed many among us were ready and willing to take a shot against Ebola, a disease which killed people in underdeveloped nations, but just two in the United States.
Ironically, vaccines are readily available for diseases which can be both devastating and, in some cases common. Yet we do not use them enough. We ignore what is available to us and could save lives.
One example is the vaccine to stop human papillomavirus, also known as HPV. HPV is the leading cause of cervical cancer, which kills more than 4,000 women a year in the U.S.
HPV is a scary disease because people don’t always know that they have it. Most often, there are no symptoms and people can “catch” the virus when they are young and healthy. Like other viruses, the body may fight it off – but not always. HPV can live unnoticed for years.
Cancers caused by HPV may start much later – in the mouth, throat, or the “private parts” of their bodies. For women, that’s usually the cervix, vagina or vulva. For men, HPV related cancers can grow in the penis, the anus and other areas. Because it is deeply internal, cervical cancer can be dangerously advanced before it is detected.
The virus is often spread among adolescents and young adults through genital or oral-genital contact (sex and “just fooling around). The cancers are diagnosed 10 or 15 years later, often when those once young people have become parents to their own children. Prevention can help both generations.
The HPV vaccine, available at most pediatric offices, is very effective – almost 90 percent – provided two doses are given to young adolescent boys and girls. The ideal time to start is the 11 and 12-year-old visit, with a follow up vaccine six months later. It is important to give the vaccine early for two reasons. First, we want to give the shot before a teenager has been exposed to the virus – when it is most effective. Second, if the vaccines are started early only two are needed. Waiting until after age 14 means that three shots will be needed (instead of two), and no one wants to be poked more than necessary.
Unfortunately, a lot of young people still aren’t getting the HPV vaccine – even though it prevents cancer, a deadly disease. It may be that some parents hesitate because they link HPV or the vaccine to sex. That makes some sense. However, kids – even good kids – grow up and eventually become adults. Most of them will at some point do what adults do. And the fact is, two-thirds of the population will be diagnosed with HPV at some point in their lives. If we want to protect them, the time to do that is early.
As a pediatrician, I ask parents all the time, ‘Don’t you want to eventually be a grandparent? Not now, of course, but someday?’ We all do! Well, when that happens, we want to know that the mother or father of our grandchildren does not have an HPV-related cancer! We don’t want our grandchildren to go through that! So let’s give the HPV vaccine well before our child is exposed to the virus. It protects against 70 percent of those cancers. What parent wouldn’t want to do that? What future grandparent?
The HPV vaccine is as safe as any other vaccine. That means there can be side effects, but most are pretty minimal, such as pain and redness at the site of the shot. A few people may experience a headache, dizziness or fainting. But the majority do not complain about any problems.
There are two types of vaccine – Gardasil and Cervarix. Both provide protection against some HPV strains. Gardasil covers more strains of HPV,-9 in total. Gardasil is approved for males and females.
When we fight against cancer, or any serious disease, it is best to weigh the risk against the benefit. In this case, reducing the risk of future cancer to our children is worth the risk of a needle poke. Along with the vaccine, families deserve a sensitive explanation from a doctor about the HPV vaccine and parent should discuss with their adolescents the responsible behaviors which are still expected of them to keep themselves safe and protected for a long time to come.
Judy Schaechter, MD, MBA, is the Chair of Pediatrics at the University of Miami Miller School of Medicine and the Chief of Service at Holtz Children’s Hospital, located the University of Miami/Jackson Memorial Medical Center. For more information about Holtz Children’s Hospital and its services, visit HoltzChildrensHospital.org or call 305-585-KIDS.
