Archive for Tuesday, June 20, 2006

Realistic parents might consider discussing HPV vaccine with kids

June 20, 2006


Marissa: I had mixed feelings when I heard there was a vaccine that had been developed for HPV, or human papillomavirus. On the one hand, I thought that it was a wonderful scientific breakthrough; one the other hand, I questioned how much it was truly needed.

No one talks about HPV, or even what it is, but according to statistics, approximately 20 million Americans are currently infected with some strain of the virus. Among those ages 15-49, only one in four Americans has not had a genital HPV infection. The numbers are staggering, and it's obvious we all need to educate ourselves.

HPV is a general name for a group of viruses that includes more than 100 different strains. When I have read articles on the vaccine, the general theme I encounter is that we should all run out and get the shot before we contract HPV and instantly die a terrible death. However, when I began researching, I found that there are only about 10 to 30 strains that, in very rare cases, could lead to cervical cancer. And the vaccine does not protect against all of them.

"Low-risk" types cause abnormal Pap smears but do not cause cancer. "High-risk" types are the ones that cause abnormal tests and are known to cause cancer.

All that being said, my intention is not to underestimate how the vaccine can benefit many people, just to make sure that the decision is considered carefully. Many people now have had more than one sexual partner, so it seems to make sense to take this preventive step.

Dr. Wes: As a therapist who has sat literally hundreds of times across the room from a sobbing young woman after a diagnosis of HPV, I am very happy about this development. This vaccine has been in process for several years. It appears to have been so carefully researched that many medical professionals want to make it mandatory for entry into school.

The only opposition appears to be from groups who fear that it could increase careless sexuality, as vaccinated teens might have less anxiety about this disease. I'm not sure of the wisdom of requiring the vaccine, but I would encourage families to consider it very carefully in consultation with health care providers before casting it aside.

Based on the preponderance of statistics, families can assume their children will be sexually active by late adolescence. They also can assume that, by young adulthood, their children will have had more than one partner. Unfortunately, the stats on the breadth of HPV infection also make it necessary to assume that most young adults will contract one of its strains. The new vaccine will knock out 70 percent of the strains that are known to cause cervical cancer - a more common killer of American women than HIV/AIDS. Vaccination before a young person is exposed is a great gift of health.

There is little likelihood that teens will be encouraged toward sexual promiscuity by this vaccine. If that were so, then the reverse would be true: Teens would be less likely to engage in sexual activity if they feared the virus. That's clearly not the case. Teens make decisions about sexuality based on a great many factors, and, unfortunately, disease and pregnancy are rarely among them.

Moreover, by the time they reach adulthood and may be inclined to seek the vaccine on their own, most already will have contracted some form of HPV - maybe even one of the severe strains. Thus, it is up to parents to advise and direct their children on this issue early on. For those particularly concerned about sending the wrong message, I suggest getting the vaccine earlier rather than later. The FDA recommends it for girls ages 9 to 26. If families pursue the vaccine in the late stages of childhood as a matter of routine health care, the child is less likely to base any decisions about sex upon it. Thus, the family can maintain both a protective stance with the child and an expectation that sexuality be taken seriously, as we've discussed before.

The one downside to early vaccination will not be proven for several years to come. There is some concern that the HPV vaccine may wear off over time. If that is so, then teens who wait until they want to be sexually active to receive the vaccine are probably better off because they will have a greater window of protection before re-vaccination. Thus, for families in which communication about sexuality, birth control and disease is easy and open, one might consider this part of the process of responsible sexual activity.

Finally, I want to point out that the HPV vaccine does not protect anyone against anything other than some strains of HPV. Herpes continues to flourish, as does chlamydia and other STDs. However, for this troublesome, painful, cancer-causing infection that is impervious to condoms and "safe sex," we finally have a good weapon. Research it and use it wisely.

Next week

Summer vacations: The 900-word manual for teens and families.


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