With the start of autumn comes all of the usual preparations for back-to-school: gathering supplies, buying new clothes and …visits to the doctor. As a physician practicing in Waterbury and New Haven, I’ve spent the last several weeks seeing children for their yearly ‘well-child visits.’ After the routine topics have been covered, savvy kids know to ask: “Am I getting any shots today?”
Most of the vaccinations recommended by the Centers for Disease Control and required to enter public school in Connecticut are administered in early childhood and completed by age 4, and then begin again at age 11 (excepting the yearly influenza vaccine). But there is an additional and essential vaccine that was explicitly developed to prevent cancer: the vaccine against human papilloma virus (HPV). Our practice proudly offers it to boys and girls beginning at age 9.
Parents: I urge you to protect your child against cancer with this immunization against HPV.
The facts about the vaccine: More than half of American adults are exposed to human papillomavirus via skin-to-skin contact throughout the course of their lives. While the virus is usually benign, certain high-risk strains cause nearly all cervical cancer, many cancers of the head and neck, and cancers of the genitals. By decreasing transmission of high-risk types of HPV with this immunization, we prevent children from getting both HPV and cancer.
The anti-cancer vaccine became available over ten years ago and has been a crucial advance in public health. Universally recommended by major medical organizations (AAP, AAFP, CDC, ACOG) as both safe and effective, the vaccine is drastically underutilized in the United States. In our home state of Connecticut, in 2017, just over half of girls (63.5 percent) and only half of boys (52.7 percent) have completed the series. These numbers compare with the 95 percent of adolescents who have been protected against tetanus, diphtheria and pertussis (with Tdap).
One reason for this low rate is that the HPV vaccine has not yet made it to the list of immunizations mandatory for public school. Therefore, parents need to make sure their children receive it.
Here’s the scoop on the updated guidelines. First, both girls and boys should be vaccinated. While boys are not at risk for cervical cancer, contracting HPV puts them at risk for cancers of the mouth and throat, and certain genital cancers. Just recently, the web-based publication C-HIT highlighted both the concerning rise of mouth and throat cancers, and the gender disparities that persist in vaccinating boys. Second, it’s helpful to know that the CDC recently changed guidelines from a three-shot to a two-shot series, making it easier for your child to complete the series.
In the past, some parents might have viewed this anti-cancer vaccine as directly related to sexual activity in their children, but they should not to fall into this trap. So many vaccinations that we use routinely to protect our children are not preempted by explanations about how those diseases are contracted.
For example, polio is transmitted via the fecal-oral route, but we don’t discuss the potential ingestion of feces when we vaccinate children against this disease. We also routinely immunize newborns and infants against hepatitis B, which is spread by contact with blood or sexual contact, to protect them for most of life. We also know that kids who receive the HPV vaccine do not have sex more: a large 2012 study in Pediatrics showed that getting the vaccine did not increase teen pregnancy or sexually transmitted disease rates, or influence sexual behavior in school-age girls in the least.
Parents: just as we’ve eradicated polio in the United States, we can make cancer from HPV next.
Demand that your sons and daughters are protected from cancer at their next doctor’s visit!
Hannah Rosenblum, MD, practices internal medicine and pediatrics at Yale-New Haven Hospital.