Tag Archives: hpv vaccine

The HPV Vaccine: Part 3

Questions and Answers

In this segment, I address common arguments concerned parents make against getting their kids vaccinated.

1. The HPV vaccine will encourage sexual activity; therefore, we should not vaccinate

One of the cool things about being human is the ability to have a lot of complex, conflicting thoughts and feelings on one issue, but when our kids’ health is at stake, I think we need to be very honest with ourselves:  The anxiety that we are feeling probably isn’t about the HPV vaccine in and of itself; otherwise we would also feel this anxiety about the hepatitis B vaccine and the possibility of an AIDS vaccine.  I’ve yet to hear someone oppose hep B vaccinations on the grounds that it might encourage sexual activity, and everyone I’ve talked to hopes the AIDS vaccine gets here yesterday, so I’m not sensing that same anxiety with those vaccines.

I would like to humbly suggest that, since the feelings about the HPV vaccine are not consistent with feelings about hep B (which is given as a routine vaccination to very small children), this argument stems from fear that teens are going to have sex before they’re ready.  The HPV vaccine and its timing (when kids are eleven and are starting to develop into sexual beings) reminds us that sex is a not-too-distant possibility, so we feel fearful, and think the HPV vaccine is causing the fear when it actually isn’t.

These fears are totally valid, and I would not discount or minimize them for the world.  We live in a highly sexualized culture where teens and preteens are getting a lot of conflicting messages about sex and how it relates to them and their bodies and their self-worth.  Sex can be a risky activity; I completely understand that parents don’t want their kids engaging in sexual activity before they’re ready, and I certainly think teens and preteens need education so they know what consent is, what sex acts are, which sexual activities put them at which risks, and how to reduce those risks.

I also think these concerns need to be addressed with frequent, frank, factual communication between parents and kids.  Withholding a vaccine—trying to scare your kid out of sexual activity by threatening them with a horrible cancer—is not an honest, effective, or fair way to attempt to prevent sexual activity.  I think that if parents are refusing to vaccinate kids on these grounds, they are doing them a profound disservice, not just by putting the kids’ health at risk, but by not discussing their views and values with them.

I remember, very vividly, that as a teen not too long ago, what my parents said to me about sex was more important than what my peers, television, or the Internet said.  It sounds corny, but talk to your kids about sex.  They’ll listen.

Then maybe, after this discussion, you’ll feel less anxious.

But even if you don’t, they should still get vaccinated.

2. HPV vaccine will make teens think they are “immune” to STDs and reduce how often they engage in safe sex.  Therefore, we should not vaccinate.

I’m vaccinated against hepatitis A because I went on a medical mission trip to a third-world country.  No one discouraged me from getting the hepatitis A vaccine on the basis that it would encourage me to drink the local water, exposing me to other pathogens.  On the contrary, I was extremely encouraged to get it because it protected my liver from hep A, should I ingest the local water.

Furthermore, during my office visit to get the vaccine, the doctor, nurse, and even the secretary educated me on why I still should not drink the local water. The vaccine was a tool to help keep me safe, but not my only tool, and they made sure I had tools in addition to the hep A vaccine to stay safe.

In my ideal world, this is how the HPV vaccine would be viewed: Not an all-powerful panacea, but a useful tool among many in the toolbox of sexual health. Teens are smart, and if we educate them about sexual health, they will understand that being vaccinated against HPV means they are still vulnerable to gonorrhea, herpes, AIDS, and other diseases they’d really rather not get.  I see no reason to keep them from getting a valuable tool just because it is not an all-powerful tool.

3. The HPV vaccine only protects against certain strains of HPV, plus most infections with HPV are cleared anyway, so we should not vaccinate.

True, but, as my mother has said, “Being protected against only four strains is still one heck of a lot better than a sharp stick in the eye!” Strains 16 and 18 are the most common high-risk strains of HPV, and strains 6 and 11, while low-risk, are also very common and do carry a risk of cervical cancer.  There are other strains, but these are certainly among the most worrisome.

Yes, most HPV infections are cleared, but enough aren’t so that over 12,500 women were diagnosed with cervical cancer in 2013.  The vast majority of these cases were preventable with the HPV vaccine.

4. There are risks to any medical procedure!  My kid will not even lay eyes upon potential sexual partners until marriage and then they will be monogamous!  Why needlessly expose them to those risks?

There are two questions here: Are the risks worth it? And why should I vaccinate my kid if, because of their beliefs and lifestyle choices, they almost certainly will not need it?
Yes, there are risks to the HPV vaccine.  Among the reactions considered serious (and thus meticulously reported to and investigated by the CDC) are symptoms like headaches, nausea, allergic reactions to a vaccine component, local pain and swelling, dizziness, fatigue, and fainting.

These same risks apply to the tetanus vaccine, too, as well as just about every other vaccine your child has ever received, and I’d venture to guess many people do not cut themselves on rusty metal at any point in their lives.  I know I haven’t!

Still, I’m betting your kid is vaccinated against tetanus, and that’s probably because you’ve concluded that the risks of your kid contracting tetanus by freak accident are significantly worse than the risks of the vaccine.

Are the risks of cervical cancer really as trivial as the risks of the vaccine?  Is a headache as bad as even the most minor outpatient surgery?  Is having a sore arm as bad as needing your pelvis, legs, urinary system, and part of your colon removed?  Is feeling dizzy worse than worrying for days or weeks about the results of a biopsy?

As to why you should still vaccinate your kid, who you believe will not engage in sexual activity of any sort until marriage and will then remain monogamous, I have a couple of reasons:

Marriage is not a cure for STDs.  HPV infections acquired before marriage will remain after marriage, and there is a good chance an unvaccinated partner will pick up an HPV infection from an infected spouse.  Given that it is generally ideal for folks to have a fulfilling, loving sex life with their spouse, abstaining from sex isn’t a useful strategy to keep them from getting infected in this circumstance.  Vaccination is.

There’s also the unfortunate but very real fact that sometimes, even married folks will cheat.  True story: One of my dear friends is a wonderful, devout, churchgoing, Evangelical Christian woman who had no premarital sex and married a like-minded man from a similar family.  She just found out he has been cheating on her with multiple women for several years.  She didn’t get the HPV vaccine because she didn’t expect to need it—she was a virgin who married a virgin, and she doesn’t believe in divorce.

Now, on top of worrying about her marriage, she is worrying about her risk of getting cervical cancer.

It would be pretty awesome if she didn’t have to worry as much about the cervical cancer.

 5. Why vaccinate just girls?  Boys get HPV, too, and it leads to anal cancer and oropharyngeal cancer and all sorts of awful stuff!  If only girls get the vaccine, something is off, and I’m not vaccinating!

I have good news for you!  The CDC recommends the vaccine for all folks ages 9 to 26, including boys! The initial studies of vaccine effectiveness were only done on women and girls, so for a while the CDC only had data for women and girls, and thus they could only recommend its use in women and girls.  Western medicine, while not perfect by any means, does make a concerted effort to not recommend things for which there is no data.
Now, studies have been done on men and boys, providing data suggesting the vaccine was effective in men and boys, and the CDC was able to change their recommendation to include them.

So you’re the recipient of outdated information, and now you have current information!  Your son can be protected from oropharyngeal cancer and anal cancer, just like your daughter can be protected from cervical cancer! Aren’t you happy?  Aren’t you going to schedule that appointment right now?

No?

Much to my chagrin, folks who use this argument are rarely happy upon hearing that news, and none of them frolic joyously down to their family doctor to get their kids vaccinated.

I suspect this lack of frolicking is because they remembered that the HPV vaccine protects boys against anal cancer caused by the HPV virus.  And then they remember that boys get HPV in their anal canal by engaging in anal sex, usually by penetration from HPV-infected partners who have a penis.

Discomfort with homosexual sex and reluctance to discuss it can cause parents to hesitate in getting their sons vaccinated.

I’m not going to offer justifications about how boys are carriers of HPV so they need to be vaccinated for the sake of their female sex partners, because I think that argument is ridiculous.  There is no guarantee your son with have sex with women.  There is no guarantee your son will have sex with men.  There is no guarantee your son will have sex with anyone.  He shouldn’t be vaccinated for their sake, because we have no clue if “they” even exist.

Your son’s health, like your daughter’s, is worth protecting for its own sake.

 

Any other thoughts or questions?  Anything else you want me to argue? (Except against Anti-Vaxers.  Do I need to pull out my video again?  Because I will.)  Anything you’d like me to write about in future blog entries?  Leave it in the comments!
Until then, stay healthy, and get vaccinated!

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Fancci is a US osteopathic medical school student in her clinical years.  She hopes to one day open a rural family practice clinic, but first needs to survive the rest of med school and a residency.

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