With spring starting up and summer just around the corner, it is almost time to start thinking about school physicals and starting up the vaccines for pre-teen and teen patients. Every year I get questions about the Human Papillomavirus (HPV) vaccine. A lot of people refer to this vaccine as the “cervical cancer” vaccine yet we offer it to boys starting at age nine. I thought I would take a little time this month to explain what HPV is and why the vaccine is important for both male and female patients.
What is HPV?
HPV is a very common virus that almost everyone has had at one time or another in their lives. This is the virus that causes those benign warts on our hands. Many of the HPV strains are nothing to worry about but some of them can be dangerous, causing genital warts and other concerns.
How is it transmitted?
Typically the virus is spread through sexual transmission. Unlike other sexually transmitted illness that require sexual fluid to transmit the disease (gonorrhea and chlamydia, for example), HPV can easily be spread through skin-to-skin contact. Though it can be transmitted through oral and genital contact, HPV can also be spread through kissing. The virus can be spread very easily and for that reason the vaccine is recommended for both boys and girls.
When should the vaccine be given?
The vaccine is rated to be given as early as nine years of age for both male and female patients but is most commonly offered at the 11 and 12 year well child appointments along with other vaccines. There are a couple of reasons the vaccine is offered and given during this time frame. With all vaccines, we want to give them before the child is exposed to the disease or illness. 11 and 12 is generally before the patient is sexually active and, therefore, we can get the child protected before exposed to HPV. Another reason is that it gives parents time to think about the vaccine and whether or not to protect their child from HPV before they become sexually active. Additionally, if the vaccine is started before the age of 15 there are only two injections in the series rather than three, which I will discuss shortly.
What does the HPV vaccine protect against?
At this point, you may be thinking “so what exactly does the HPV vaccine protect against and why is it important for boys?” The vaccine does protect female patients against cervical, vaginal, anal, and throat cancers. However, with more studying of the cancers that HPV can protect against, we have found that male patients are also susceptible to anal and throat cancers, as well as penile cancers. Symptoms are usually not present until warts or cancers start to develop. Specifically for boys and men we see the development of genital warts, anal and penile cancers, and head and neck concerns. They may see bleeding in the anal or penile area, swollen lymph nodes in the groin, or warts that develop. Sore throat and ear pain area common for the head and neck cancers and can eventually lead to airway issues and voice changes. These symptoms can be mistake for any other illness or conditions which can lead to delay in care and treatment. Protecting as many young pre-teen and teens against virus is one of the best ways to prevent spread of the illness.
HPV vaccine studies and side effects
Let’s take a minute to talk about the vaccine itself. As I mentioned above, we can start the vaccine as early as nine years of age for both boys and girls. Typically we wait until 11 or 12 to start the vaccine. The vaccine is also very safe. It is one of the most studied vaccines because of what it protects against. professionals giving the vaccine knew it would be under the microscope, and its use with male and female patients has been widely studied.
There are some side effects to think about, as with all medications and vaccines. Most patients who receive the vaccine have no side effects except some injection site discomfort which is one of the most common reported issues. Some patients have also reported low grade fevers, headaches, nausea, and some muscle or joint discomfort. Another side effect that has some parents concerned is the possibility of having some dizziness or even fainting in the first 24 hours after. This has been the most common side effect reported the vaccine adverse event reporting system.
Who should and should not get the vaccine?
Though this vaccine is not required, it is still a highly recommended vaccine because of what it protects against but not everyone should get the vaccine. If you have ever had a life-threatening reaction to any component of the HPV vaccine, you should not receive it. Anyone with severe allergies to yeast should talk to their provider before getting the vaccine. Pregnant woman are not recommended to get the vaccine but, if they do, there should be no cause for alarm. There have been no negative effects to the mother or baby noted when this occurs. It is also safe to get if you are a breastfeeding mother.
Lastly, anyone with fevers greater than 101, who has moderate cold symptoms, or a severe cough should hold off until they are feeling better. Those with mild illness symptoms are able to get the vaccine as long as they do not have a fever. As I mentioned above, if the vaccine is started before the age of 15 it can be done in a two dose series given at least six months apart. If the patient is 15 or older they receive three shots. One shot is two months after the first and the third and final shot is six months after the first injection. Something to keep in mind for those who have needle phobia.
As with any vaccine or medication, it is important to discuss this with your primary care provider. Never hesitate to ask questions and get as much information from your child’s pediatrician before getting the vaccine.
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