Every year in the United States, more than 10,000 women are diagnosed with cervical cancer, and about 4,000 die from it. To get cervical cancer, a woman has to have been infected with a virus — human papilloma virus (HPV). Although this viral infection is very common, with approximately three out of four women and men with any history of sexual activity being infected, the majority of infections occur between the ages of 15 and 24.
Not all women infected with the virus get cervical cancer, but all women with cervical cancer have been infected with the virus. On average, infection occurs 25 years before diagnosis of cervical cancer, but it can happen sooner, which is why women get Pap smears to detect early signs of cancer risk. Clearly, cervical cancer is a bad thing that would best be prevented entirely. Fortunately, a lifetime of abstinence is not the only means of prevention.
In 2006, the first vaccine to prevent HPV infection was introduced. Now there are two vaccines that prevent the two specific strains of the virus that cause 75 percent of cervical cancers when the recommended three doses are received. Additionally, one of the available vaccines prevents the strains that cause 90 percent of genital warts and anal cancer.
The vaccines are made by growing proteins from the viral DNA in yeast. The proteins in the vaccine can’t cause infection, just protection, because they’re not the actual virus. They’re just containers — sort of like the fake computers and TVs at the furniture store that look real but have no guts.
The Advisory Committee on Immunization Practices — a panel of 15 immunization experts who advise the Centers for Disease Control on the use and scheduling of vaccines in the United States — recommends giving the vaccines in a three-dose series over a period of six months. The recipients, both female and male, should be between the ages of 9 and 26. (The main side effect is soreness at the site of injection, with about half of recipients having some mild redness or swelling as well.)
In my practice, parents sometimes question why the vaccine is given so young. There are a couple of reasons. First, because routine well-care tends to become less routine as children proceed through adolescence, it’s important to start early. It’s often difficult to get 16- and 17-year-olds into the doctor’s office when they are too busy going out on dates.
Which brings us to the second reason: Time is of the essence. Reliable studies in the United States have found that the prevalence of sexual intercourse in girls is 4 percent by age 13, 25 percent by age 15, and 70 percent by age 18.
If we are trying to prevent an infection transmitted by sexual contact, those are the statistics we need to keep in mind. As parents, I know we might not like to consider the possibility that our children could be sexually active, but we need to put their safety first, making no assumptions.
For some parents, the hesitation to provide this vaccine for their adolescent seems to hinge on a moral issue — as though they are giving their child the green light to have sex. But think of it this way: When you insist that your children wear their seatbelts, you’re certainly not giving them the freedom to drive recklessly.
Matt Thompson is a pediatrician at the Kids Clinic in Spokane.
