Mom was on board before I even finished talking. I had just done a physical on her 16-year-old son and was discussing the new recommendations for human papillomavirus vaccination for tween and teen boys. Since the mother recalled vaccinating her adolescent daughter against HPV several years earlier, providing her son with the same viral protection seemed like a sensible medical decision.
According to a 2012 policy statement issued by the American Academy of Pediatrics, HPVs are the most common sexually transmitted viruses in the U.S. With the virus passed through skin to skin contact during sexual activity, even condom use provides "imperfect" protection against HPV.
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While most individuals with HPV have no symptoms and can clear the virus within two years, the AAP notes that persistent infection with "high-risk" HPV strains accounts for most of the cervical and anal cancers seen in females, as well as many of the cases of oral, anal and penile cancers found in males.
The HPV4 (Gardasil) and HPV2 (Cervarix) vaccines are "anti-cancer" vaccines, since they both provide protection against the two HPV types (16 and 18), which are known to cause 70 percent of cervical, 87 percent of anal, 60 percent of oropharyngeal and 31 percent of penile cancers.
The HPV4 provides additional vaccine protection against the two HPV types (6 and 11), which cause 90 percent of genital warts. HPV4 is licensed for use in both males and females, while HPV2 is only approved for females.
The academy encourages early vaccination for 11- to 12-year-old girls and boys. One reason for targeting this age group is that the HPV vaccine is actually most effective before sexual activity has begun. Vaccination cannot treat or cure HPV infections, which have already been acquired.
In addition, the antibody response to the HPV vaccine has been found to be at least twice as high when the shot is administered to 9- through 15-year-olds compared to older adolescents and young adults aged 16 through 26.
HPV vaccination is recommended for routine use in boys and girls aged 11 to 12 years, though the vaccine can be administered to children as young as 9. The AAP recommends "catch-up" immunization for females aged 13 through 26 years and males aged 13 through 21 years who have not yet been vaccinated. Young men aged 22 through 26 years may also choose to receive the HPV vaccine.
The pediatric group finds that after five years of HPV vaccine use in American girls, with a total of more than 40 million doses administered, no vaccine-specific adverse effects have been recorded other than rare allergic reactions to components of the HPV vaccine.
The Centers for Disease Control and Prevention report that common mild side effects can occur after HPV injection including pain at the shot site, fever, headache and nausea. The HPV vaccine is not "live" and cannot cause infection.
Since teens are prone to passing out after any type of injection, and fainting has been reported after HPV administration, the AAP advises that patients remain horizontal or at least seated for 15 minutes following HPV injection.
An HPV vaccine is considered safe to administer on the same day that other recommended vaccines are given to a patient. A total of three HPV shots are recommended with vaccinations scheduled at zero, one to two, and six months after the first dose. To date, immunity after the full HPV vaccination series has been shown to last at least five years in boys and 10 years in girls.
AAP infectious disease experts caution that even after receiving the HPV vaccines, young people still need to be counseled on making healthy choices about sexual activity and the prevention of all sexually transmitted infections.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.